ATI PN Fundamentals 2023

Question 1

A nurse is planning to assist a client who has dysphagia with several oral medications. Which of the following actions should the nurse plan to take? (Select all that apply.)

• Check the client’s gag reflex prior to administering medications.
• Position the client at a 90° angle.
• Encourage the client to self-administer the medications.
• Administer the medications with a straw.
• Place the medication on the back of the client’s tongue.

Question 2

A nurse is reviewing the medical record of a client. Which of the following findings should the nurse identify as a risk factor for a potential complication? (Drag and drop the risk factor and the potential complication to the appropriate boxes).

• Risk Factor: Opioid use
• Potential Complication: Constipation

Question 3

A nurse is assessing a client who is receiving a new antibiotic. Which of the following findings should the nurse identify as requiring immediate follow-up? (Select the 4 findings that require immediate follow-up).

• Heart rate 104/min
• Swollen tongue
• Breath sounds (wheezing)
• Urticaria

Question 4

A nurse is inspecting a client’s abdomen. Which of the following images indicates the next step the nurse should take?

• The image showing auscultation of the abdomen with a stethoscope.

Question 5

A nurse is reviewing the medical record of a client who has a urinary tract infection. Which of the following findings should the nurse report to the provider? (Select all that apply).

• Temperature 39.3°C (102.8°F)
• Heart rate 113/min
• Urinary frequency and burning on urination
• Leukocyte esterase: positive
• Nitrites: present

Question 6

A nurse is collecting data from a client. Which of the following findings should the nurse identify as a lifestyle risk factor for injury? ATI PN Fundamentals 2023

• Texting while driving

Question 7

A nurse is assisting with the admission of a client who has streptococcal pharyngitis. Which of the following precautions should the nurse take?

• Wear a surgical mask when giving the client direct care.

Question 8

A nurse is documenting a client’s bowel sounds and hears loud, growling sounds. Which of the following terms should the nurse use for documentation?

• Borborigymi

Question 9

A nurse is caring for a client who has a new prescription for “do not resuscitate” (DNR) status. The client’s partner asks the nurse what this means. Which of the following responses should the nurse make?

• “If your partner’s heart stops, the provider will not try to restart it.”

Question 10

A nurse is preparing to deliver a 90% oxygen concentration to a client. Which of the following images indicates the type of face mask the nurse should use?

• The image showing a non-rebreather mask (with an oxygen reservoir bag).

Question 11

A nurse is preparing to administer amoxicillin 50 mg/kg/day to be given in 4 divided doses to a child who weighs 55 lb. The available concentration is 125 mg/5 mL. How many mL should the nurse administer with each dose?

• 12.5 mL

Question 12

A nurse is teaching a client who has a new colostomy about how to change the ostomy appliance. Which of the following statements by the client indicates an understanding of the teaching?

• “I will press on the skin barrier for 30 seconds to ensure that it adheres.”

Question 13

A nurse is planning care for a group of clients. Which of the following tasks should the nurse assign to an assistive personnel (AP)?

• Measure the intake and output of a client who has received furosemide.

Question 14

A nurse is assisting with the bath of a client who has moderate-stage dementia. Which of the following actions should the nurse take?

• Stop the bath if the client becomes agitated.

Question 15

A nurse is caring for an older adult client who has dementia and is having difficulty with oral intake at mealtime. Which of the following actions should the nurse take?

• Offer the client finger foods at mealtime.

Question 16

A nurse is providing teaching to a client about fecal occult blood testing. Which of the following instructions should the nurse include?

• “Discontinue supplements containing vitamin C 24 hours before the test.”

Question 17

A nurse is assessing a client for fall risk. Which of the following findings place the client at risk for a fall? (Select the 4 findings that apply).

• Vision (Macular degeneration)
• Fear of falling
• Balance (reports dizziness)
• Environmental hazards (throw rugs)

Question 18

A nurse is caring for a client who has been experiencing vomiting and diarrhea for the past 24 hours. Which of the following laboratory findings should the nurse expect?

• Hyponatremia

Question 19

A nurse is teaching a newly licensed nurse about safe lifting techniques. Which of the following instructions should the nurse include?

• “Align the back with the neck and feet.”

Question 20

A nurse is caring for a client who has a temperature of 35°C (95°F) following a fall into a cold lake. Which of the following actions should the nurse take first?

• Provide the client with dry clothing.

Question 21

A nurse is screening a group of school-age children for scoliosis. Which of the following findings should the nurse recognize as an indication of this condition?

• Unequal height of the shoulders.

Question 22

A nurse discovers a frayed electrical cord on a piece of medical equipment. Which of the following actions should the nurse take first?

• Remove the device from the room.

Question 23

A nurse is providing teaching about sleep hygiene to a client who has insomnia. Which of the following statements by the client indicates an understanding of the teaching?

• “I should stop drinking caffeine two hours before bedtime.”

Question 24

A nurse is providing teaching about guided imagery to a client who has chronic pain. Which of the following statements by the client indicates an understanding of this technique?

• “I’ll think about my grandfather’s farm to reduce pain.”

Question 25

A nurse is preparing to transfer a client who has left-sided weakness from a bed to a wheelchair. Which of the following actions should the nurse take?

• Assist the client in sitting on the side of the bed.

Question 26

A charge nurse is talking with an assistive personnel (AP) who appears upset. Which of the following responses should the charge nurse make? ATI PN Fundamentals 2023

• “So, you are upset about all of the recent changes on the unit?”

Question 27

A nurse is documenting care in a client’s medical record. Which of the following entries is an example of correct documentation?

• “The client is diaphoretic.”

Question 28

A nurse is providing teaching to a client about perimenopause. Which of the following statements by the client indicates an understanding of the teaching?

• “I might have headaches due to a decline in my estrogen levels.”

Question 29

A nurse is collecting data from a client who is being admitted. Which of the following findings should the nurse identify as a potential stressor?

• Client reports inability to conceive.

Question 30

A nurse is planning to perform passive range-of-motion (ROM) exercises for a client. Which of the following actions should the nurse plan to take?

• Support each extremity above and below the joint.

Question 31

A nurse is preparing to collect a capillary blood specimen for glucose testing. Which of the following actions should the nurse take? (Select all that apply).

• Apply clean gloves.
• Prick the side of the client’s finger.

Question 32

A nurse is preparing to discharge a client who expresses concern about the cost of their new medications. Which of the following actions should the nurse take?

• Contact a social worker to request assistance for the client.

Question 33

A nurse is administering a new IV antibiotic to a client. Which of the following findings should the nurse report immediately?

• Severe wheezing.

Question 34

A nurse is calculating a client’s body mass index (BMI). The client weighs 95 kg (209.4 lb) and is 172 cm (5 ft 8 in) tall. The nurse should classify the client as:

• Obesity class I (BMI 32.1)

Question 35

A nurse is assessing a client’s balance. Which of the following actions should the nurse take? (Select all that apply).

• Perform the Romberg test.
• Have the client perform heel-to-toe walking.

Question 36

A nurse is talking with a client about advance directives. Which of the following statements by the nurse is appropriate?

• “Your advance directives will determine your care if you are unable to make decisions.”

Question 37

A nurse is providing teaching to a client who appears distracted. Which of the following responses should the nurse make?

• “Let’s talk about what you’re thinking.”

Question 38

A nurse is talking with the parent of a preschooler who is refusing to eat. Which of the following responses should the nurse make?

• “Tell me more about what happens at mealtime.”

Question 39

A nurse is preparing to suction a client who has a tracheostomy. Which of the following actions should the nurse take?

• Preoxygenate the client prior to suctioning.

Question 40

A nurse is communicating with a client who has significant hearing loss. Which of the following actions should the nurse take to promote communication?

• Decrease background noise.

Question 41

A nurse is preparing to instill otic medication for an adult client. Which of the following actions should the nurse take? ATI PN Fundamentals 2023

• Hold the ear dropper 1 cm (0.5 in) from the client’s ear.

Question 42

A nurse is teaching a newly licensed nurse about using a mechanical lift. Which of the following statements indicates an understanding?

• “This type of device is useful for a client who cannot assist.”

Question 43

A nurse is preparing to perform a sterile procedure. How should the nurse position their gloved hands?

• Interlock their fingers and hold their hands away from their body above their waist.

Question 44

For which of the following situations should the nurse complete an incident report? (Select all that apply).

• A client becomes disoriented and falls out of bed.
• A client’s visitor becomes dizzy and faints in the client’s room.
• A client receives burns from a heating pad.

Question 45

A nurse is caring for a client who is refusing a scheduled surgery. Which of the following responses should the nurse make?

• “I will inform your provider of your decision.”

Question 46

A nurse is planning to reduce environmental stressors for a client. Which of the following actions should the nurse include?

• Restrict the number of visitors for clients.

Question 47

A nurse is providing teaching to a client who has chronic constipation. Which of the following actions should the nurse recommend?

• Consume probiotic sources.

Question 48

A client with a terminal illness asks about end-of-life care. Which of the following statements should the nurse make first?

• “Tell me your expectations about activities related to the end-of-life.”

Question 49

A nurse is observing an AP performing postmortem care. Which of the following actions requires intervention?

• Removing the client’s dentures from their mouth.

Question 50

A newly licensed nurse is placing an indwelling urinary catheter for a female client. Which of the following statements indicates understanding?

• “I should advance the catheter 4 inches after urine appears.”

Question 51

A nurse is caring for a client who is unable to name common items. The nurse should recognize this as:

• Expressive aphasia.

Question 52

A nurse receives a phone call asking for an update on a client. Which of the following actions should the nurse take? ATI PN Fundamentals 2023

• Transfer the caller to the charge nurse.

Question 53

Identify the sequence of steps to set up a sterile field:

1. Prepare a dry work surface above the waist level.
2. Open the outside cover and remove the dust cover.
3. Grasp the outermost flap and open away from the body.
4. Open each side flap individually while pulling to the side.
5. Open the innermost lower flap standing away from the field.

Question 54

Which action by the AP indicates proper transfer technique?

• Positions the wheelchair parallel to the client’s bed.

Question 55

Which home safety finding places the client at additional risk?

• Throw rugs cover electrical cords on the floor.

Question 56

Which interventions should the nurse recommend for a client with a fever? (Select all that apply).

• Limit physical activity.
• Administer an antipyretic.
• Encourage intake of oral fluids.

Question 57

Which instruction should the nurse include for a three-point crutch gait?

• Bear weight on the unaffected leg.

Question 58

Which statement indicates understanding of using a standard walker?

• “I’ll keep my elbows slightly bent when I grasp the walker.”

Question 59

Which action should the nurse take for a bolus enteral feeding?

• Ensure that the formula is at room temperature.

Question 60

Which action by the AP for a belt restraint requires intervention?

• Placing the restraint across the client’s chest.

Question 61

Which client should the nurse expect to have a positive fecal occult blood test?

• A client who has ulcerative colitis.

Question 62

A client says, “I just don’t know what to expect.” Which response should the nurse make?

• “This must be a very difficult time for you.”

Question 63

Weight gain with age results from which of the following?

• Decrease in muscle mass.

Question 64

Which is a risk factor for a potential accident or injury?

• History of dementia.

Question 65

Which action should the nurse take regarding informed consent?

• Witness the client’s signature on the form.

Question 66

What action should the nurse take if a pulse oximeter reads 88%?

• Reposition the sensor probe.

Question 67

Which findings indicate an improvement in a dehydrated client? (Select all that apply).

• Stool output (semi formed)
• Oral mucosa (moist)
• Laboratory results (Na 138, K 3.6)
• Integumentary findings (elastic turgor)
• Urine output (150 mL, light yellow)

Question 68

Which findings indicate the client understands crutch teaching? (Select the 3 that apply).

• Three-point crutch gait observed.
• Client bears weight on the unaffected leg.
• During swing through, the client bears weight on hand grips.

Question 69

A nurse is reviewing a client with a UTI and a penicillin allergy. Which actions should the nurse take? (Select all that apply). ATI PN Fundamentals 2023

• Request a prescription for an antiemetic.
• Place the client on contact precautions.
• Clarify the prescription for amoxicillin with the provider.