ATI Fundamentals

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Sample questions from ATI Fundamentals

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 74-year-old client on a medical-surgical unit is 8 hours postoperative after abdominal surgery. The client received IV morphine 20 minutes ago and is difficult to arouse. Respirations are 7/min, oxygen saturation is 84%, pulse is 58/min, and blood pressure is 92/54 mm Hg. Which action should the nurse take first?

   • A.Position the client upright and reassess in 5 minutes.
   • B.Activate emergency assistance and support ventilation with a bag-mask device and oxygen.
   • C.Administer the prescribed naloxone before providing respiratory support.
   • D.Obtain an arterial blood gas specimen to determine the degree of respiratory acidosis.

   Rationale: Severe hypoventilation with hypoxemia requires immediate assistance and support of ventilation. Naloxone is indicated for suspected opioid toxicity, but obtaining or administering it must not delay ventilation. Upright positioning alone is inadequate, and obtaining an arterial blood gas would delay lifesaving care. The priority is to support airway and breathing while preparing definitive treatment.

2. 2.An 82-year-old client admitted to a rehabilitation unit after a stroke coughs during breakfast and develops a wet-sounding voice. The client is alert, with respirations of 20/min and oxygen saturation of 95%. Which action should the nurse take next?

   • A.Offer water to clear food from the throat.
   • B.Resume feeding with smaller spoonfuls.
   • C.Stop oral intake and arrange a swallowing assessment.
   • D.Recline the client slightly to reduce fatigue during meals.

   Rationale: Coughing and a wet voice during eating suggest dysphagia and possible aspiration, so oral intake should stop pending assessment. Water can also be aspirated, and smaller spoonfuls do not establish that swallowing is safe. Reclining increases aspiration risk rather than addressing its cause. The exam takeaway is to recognize aspiration cues before continuing feeding.

3. 3.A 68-year-old client on an orthopedic unit is recovering from hip replacement. The registered nurse is assigning care to an experienced unlicensed assistive personnel (UAP). Which task is appropriate to delegate?

   • A.Assist the stable client with a walker using the established mobility plan.
   • B.Determine whether the client's new dizziness permits ambulation.
   • C.Teach the client how to maintain hip precautions.
   • D.Evaluate whether prescribed analgesia improved walking tolerance.

   Rationale: Assisting a stable client with an established mobility plan is a routine task that can be delegated to trained UAP. Assessing new dizziness and evaluating an analgesic response require licensed nursing judgment. Initial teaching about hip precautions also remains with the licensed nurse. Delegation depends on client stability, task predictability, and verified worker competence.

4. 4.A 59-year-old client with pneumonia is receiving care on a medical unit. The registered nurse is assigning clients to a licensed practical/vocational nurse (LPN/VN), consistent with local scope and facility policy. Which assignment is most appropriate?

   • A.A newly admitted client requiring an initial comprehensive assessment.
   • B.A client with new stridor after the first antibiotic dose.
   • C.A client requiring development of an initial discharge teaching plan.
   • D.A stable client requiring a routine dressing change and scheduled oral medications.

   Answer and rationale are in the full material.

5. 5.A 77-year-old client in long-term care has dementia and repeatedly attempts to climb out of bed to find the bathroom. The client has an unsteady gait and takes a diuretic each morning. Which intervention should the nurse implement first?

   • A.Request a prescription for a vest restraint.
   • B.Provide scheduled toileting and supervised mobility.
   • C.Keep all four side rails raised whenever the client is in bed.
   • D.Ask the provider to prescribe a sedative at bedtime.

   Answer and rationale are in the full material.