ATI Nursing Proctored Assessment — Questions and Answers

Question 1: A nurse receives a verbal order from a physician by phone. What is the appropriate action?

Have another nurse listen and co-sign the verbal order before acting
Refuse the verbal order and request written orders only
Repeat the order back to the physician to confirm accuracy, then document (Correct answer)
Carry out the order immediately and document later

Correct answer: Repeat the order back to the physician to confirm accuracy, then document

Read-back of verbal/telephone orders is the required safety practice to prevent transcription errors before carrying out the order.

Question 2: A client asks the nurse why they should choose whole grain bread over white bread. Which is the most accurate nutritional benefit of whole grains?

Lower in complex carbohydrates
Higher in fiber and B vitamins (Correct answer)
Higher in sodium content
Higher in saturated fat

Correct answer: Higher in fiber and B vitamins

Whole grains retain the bran and germ layers, which are rich in dietary fiber, B vitamins, and minerals that are lost during the refining process.

Question 3: A nurse manager notices that staff consistently skip the patient identification step before medication administration. The best management strategy is:

Terminate staff who do not comply
Conduct a root cause analysis and implement system-level safeguards (Correct answer)
Post warning signs at the medication cart
Send a memo reminding staff of the policy

Correct answer: Conduct a root cause analysis and implement system-level safeguards

Root cause analysis identifies systemic factors contributing to errors, enabling system-level improvements that are more effective than individual blame.

Question 4: A nurse is about to administer a medication. Which of the following is the MINIMUM number of patient identifiers that should be used?

Two (Correct answer)
Four
Three
One

Correct answer: Two

At least two patient identifiers (e.g., name and date of birth) must be verified before administering any medication per The Joint Commission standards.

Question 5: A nurse is concerned about a physician's order that seems unsafe. Using SBAR, what does the 'R' stand for?

Reason
Response
Recommendation (Correct answer)
Reassessment

Correct answer: Recommendation

In the SBAR communication tool, 'R' stands for Recommendation — what the nurse is requesting or suggesting the provider do.

Question 6: A nurse is planning care for five patients. Using the concept of prioritization, which patient has the highest priority?

A patient requesting a warm blanket
A patient awaiting a routine blood draw
A patient scheduled for discharge teaching
A patient with SpO2 of 88% on 2 L/min nasal cannula (Correct answer)

Correct answer: A patient with SpO2 of 88% on 2 L/min nasal cannula

An SpO2 of 88% represents dangerous hypoxemia requiring immediate intervention to maintain oxygenation.

Question 7: A nurse is assigned to care for four patients. Which patient should the nurse assess first?

A new admission awaiting a room assignment
A patient with stable COPD requesting a breathing treatment
A postoperative patient reporting increasing pain rated 7/10
A patient who had a seizure 30 minutes ago and is now postictal (Correct answer)

Correct answer: A patient who had a seizure 30 minutes ago and is now postictal

A postictal patient after a seizure requires immediate assessment for airway patency, injury, and neurological status — safety takes priority.

Question 8: A patient is prescribed clozapine for treatment-resistant schizophrenia. Which lab value must be monitored regularly due to the risk of a life-threatening adverse effect?

White blood cell count (WBC) (Correct answer)
Serum lithium level
Serum creatinine
Liver function tests only

Correct answer: White blood cell count (WBC)

Clozapine carries a black box warning for agranulocytosis; regular WBC monitoring is mandatory through the REMS program.

Question 9: A patient is 36 weeks pregnant and has a blood pressure of 158/104 mmHg with 3+ proteinuria. The nurse should prepare for management of:

HELLP syndrome
Severe preeclampsia (Correct answer)
Chronic hypertension
Gestational hypertension

Correct answer: Severe preeclampsia

BP ≥160/110 with significant proteinuria at or after 20 weeks gestation meets criteria for severe preeclampsia.

Question 10: Which assessment finding in a patient with acute appendicitis indicates perforation has occurred?

Right lower quadrant pain on palpation
Sudden relief of pain followed by diffuse abdominal rigidity (Correct answer)
Low-grade fever and nausea
Rebound tenderness at McBurney's point

Correct answer: Sudden relief of pain followed by diffuse abdominal rigidity

A sudden brief relief of pain followed by diffuse, board-like rigidity suggests the appendix has ruptured and peritonitis is developing.

Question 11: Which type of isolation precaution is required for a patient with active pulmonary tuberculosis?

Contact precautions
Airborne precautions (Correct answer)
Protective environment
Droplet precautions

Correct answer: Airborne precautions

Pulmonary TB is transmitted via airborne particles (droplet nuclei <5 microns), requiring airborne precautions and a negative-pressure room.

Question 12: What is the exact problem with relativistic thinking?

There is no problem at all.
Relativistic thinking promotes a view that something is the truth because it is the truth in my point of view. (Correct answer)
Relativistic thinking always promotes group opinions.
Relativistic thinking promotes absolute truth.

Correct answer: Relativistic thinking promotes a view that something is the truth because it is the truth in my point of view.

Relativistic thinking promotes a view that something is the truth because it is the truth in my point of view. This is problematic because it disregards objective truth and allows for subjective beliefs to be considered as valid and equal to factual evidence. It undermines the importance of evidence-based reasoning and critical thinking, leading to a lack of accountability and the potential for misinformation to be accepted as truth.

Question 13: Which action should a nurse take when a patient's peripheral IV site shows redness, warmth, and swelling?

Document and continue to monitor
Slow the infusion rate
Apply a warm compress and continue infusion
Discontinue the IV and start a new site (Correct answer)

Correct answer: Discontinue the IV and start a new site

Signs of phlebitis (redness, warmth, swelling) require immediate discontinuation of the IV and insertion at a new site.

Question 14: Which nursing action best demonstrates the principle of beneficence?

Allowing a client to refuse treatment
Distributing resources fairly among patients
Administering analgesics to relieve a client's pain (Correct answer)
Maintaining a client's confidentiality

Correct answer: Administering analgesics to relieve a client's pain

Beneficence means acting in the best interest of the patient, such as providing pain relief.

Question 15: What describes the action of a drug on the body?

Physiology
Microbiology
Pharmacodynamics (Correct answer)
Pharmacokinetics

Correct answer: Pharmacodynamics

Pharmacodynamics refers to the study of how a drug interacts with the body and produces its effects. It involves understanding the mechanisms of action, the biochemical and physiological effects, and the relationship between drug concentration and its effect on the body. This includes studying the drug-receptor interactions, signal transduction pathways, and the overall impact on the body's functions. Therefore, pharmacodynamics accurately describes the action of a drug on the body.

Question 16: Which assessment finding in a newborn is associated with respiratory distress syndrome (RDS)?

Nasal flaring and grunting on expiration (Correct answer)
Pink color with acrocyanosis only
Respiratory rate of 38 breaths/min
Oxygen saturation of 96% on room air

Correct answer: Nasal flaring and grunting on expiration

Nasal flaring and expiratory grunting are classic signs of RDS, indicating the infant is working hard to keep alveoli open.

Question 17: A nurse is administering a medication to a 4-year-old child. Which approach is most developmentally appropriate?

Explain the drug mechanism and its importance
Give the child a choice between two acceptable options (e.g., cup or spoon) (Correct answer)
Tell the child they will get a shot if they refuse
Tell the child the medicine will not hurt at all

Correct answer: Give the child a choice between two acceptable options (e.g., cup or spoon)

Offering limited choices gives preschoolers a sense of control, improving cooperation without dishonesty or threats.

Question 18: A nurse is caring for a child with nephrotic syndrome. Which finding is most characteristic?

Elevated BUN and creatinine with oliguria
Hematuria and hypertension
Flank pain and dysuria
Massive proteinuria and generalized edema (Correct answer)

Correct answer: Massive proteinuria and generalized edema

Nephrotic syndrome is defined by massive proteinuria, hypoalbuminemia, and generalized edema (including periorbital).

Question 19: A nurse is preparing to transfer a patient from bed to wheelchair. Which action is the priority?

Lock the wheelchair wheels (Correct answer)
Instruct the patient on the transfer technique
Ask a colleague to assist
Place the wheelchair parallel to the bed

Correct answer: Lock the wheelchair wheels

Locking the wheelchair wheels is the priority safety action to prevent it from rolling during transfer.

Question 20: A newborn's blood glucose is 38 mg/dL at 2 hours of age. What is the priority nursing action?

Initiate IV dextrose infusion
Offer early breastfeeding or formula feeding (Correct answer)
Recheck in 1 hour and document
Administer glucagon intramuscularly

Correct answer: Offer early breastfeeding or formula feeding

For asymptomatic neonatal hypoglycemia, the first intervention is early feeding (breast or formula) to raise blood glucose.

Question 21: A patient with type 1 diabetes is found unconscious with a blood glucose of 38 mg/dL. What is the priority intervention?

Administer subcutaneous insulin
Give 15 g of oral carbohydrate
Notify the physician and wait for orders
Administer IV dextrose 50% (D50W) (Correct answer)

Correct answer: Administer IV dextrose 50% (D50W)

An unconscious patient with severe hypoglycemia cannot take oral glucose — IV dextrose (D50W) must be administered immediately.

Question 22: A nurse is assessing a newborn at 1 minute after birth. The infant has a heart rate of 90 bpm, weak cry, some flexion, grimace to stimulation, and blue hands and feet. What is the APGAR score?

7
8
6 (Correct answer)
5

Correct answer: 6

HR <100 (1) + weak cry (1) + some flexion (1) + grimace (1) + acrocyanosis (1) = APGAR score of 6.

Question 23: A nurse is changing a wound dressing. Which action maintains sterile technique?

Keeping the sterile field in view at all times (Correct answer)
Wearing clean (non-sterile) gloves throughout
Reaching across the sterile field to retrieve supplies
Placing sterile items 1 inch from the edge of the sterile drape

Correct answer: Keeping the sterile field in view at all times

The sterile field must remain in constant view to ensure it is not contaminated.

Question 24: Which patient position is most appropriate for a client receiving a nasogastric tube feeding?

Supine with head flat
Left lateral Sims' position
Semi-Fowler's at 30–45 degrees (Correct answer)
Trendelenburg position

Correct answer: Semi-Fowler's at 30–45 degrees

Semi-Fowler's position at 30–45 degrees reduces aspiration risk during enteral feedings.

Question 25: What is the correct needle angle for an intramuscular (IM) injection?

10–15 degrees
90 degrees (Correct answer)
60 degrees
45 degrees

Correct answer: 90 degrees

IM injections are administered at a 90-degree angle to ensure the medication reaches the muscle tissue.

Question 26: What is the worst thing for a critical thinker?

Reaching to conclusion too soon. (Correct answer)
None of the above
An emotional mind
A logical mind

Correct answer: Reaching to conclusion too soon.

A critical thinker values evidence, reasoning, and careful analysis before reaching a conclusion. Reaching a conclusion too soon can hinder the critical thinking process as it may overlook important information or alternative perspectives. It is important for a critical thinker to consider all available evidence and evaluate different possibilities before coming to a final decision.

Question 27: A nurse is caring for a patient in active labor receiving magnesium sulfate. Which finding signals toxicity?

Respiratory rate of 14 breaths/min
Urinary output of 35 mL/hr
Loss of deep tendon reflexes (Correct answer)
Mild flushing and warmth

Correct answer: Loss of deep tendon reflexes

Loss of deep tendon reflexes (DTR) is an early sign of magnesium sulfate toxicity and must prompt immediate action.

Question 28: A newborn has not passed meconium within 48 hours of birth. The nurse should assess for:

Dehydration
Neonatal abstinence syndrome
Hyperbilirubinemia
Hirschsprung's disease or imperforate anus (Correct answer)

Correct answer: Hirschsprung's disease or imperforate anus

Failure to pass meconium within 24–48 hours suggests intestinal obstruction such as Hirschsprung's disease or imperforate anus.

Question 29: A hospital is implementing a new electronic health record (EHR) system. Which change management strategy is most effective?

Announce the change only after the system is live
Implement changes in secret to reduce resistance
Involve frontline nurses in the design and rollout process (Correct answer)
Mandate immediate system adoption with no training period

Correct answer: Involve frontline nurses in the design and rollout process

Involving end-users in design and implementation increases buy-in, identifies workflow issues early, and improves adoption success.

Question 30: Which type of dietary fiber helps lower LDL cholesterol levels by binding bile acids in the intestine?

Cellulose
Insoluble fiber
Lignin
Soluble fiber (Correct answer)

Correct answer: Soluble fiber

Soluble fiber forms a gel in the GI tract that binds bile acids, reducing their reabsorption and lowering LDL cholesterol.

Question 31: A patient with a fractured hip is in Buck's traction. Which nursing action is most important?

Place a pillow under the knee of the affected leg
Maintain continuous traction as ordered (Correct answer)
Remove weights when repositioning
Elevate the affected leg 90 degrees

Correct answer: Maintain continuous traction as ordered

Buck's traction must remain continuous to maintain alignment and reduce muscle spasm — weights must never be removed without an order.

ATI Nursing Proctored Assessment

ATI (Assessment Technologies Institute) nursing proctored assessments evaluate nursing students' knowledge across core clinical subjects including fundamentals, medical-surgical, maternal-newborn, and leadership and management, in preparation for NCLEX-RN licensure.

Questions

35 min

Time Limit

65%

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