ATI Nursing Proctored Assessment — Questions and Answers

Question 1: A patient with a spinal cord injury at T4 develops sudden hypertension, pounding headache, and diaphoresis above the level of injury. The nurse recognizes this as:

Orthostatic hypotension
Autonomic dysreflexia (Correct answer)
Hypertensive urgency from anxiety
Neurogenic shock

Correct answer: Autonomic dysreflexia

Autonomic dysreflexia is a hypertensive emergency in spinal cord injury above T6, triggered by a noxious stimulus below the injury level.

Question 2: A nurse is assigned to care for four patients. Which patient should the nurse assess first?

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

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 3: A child with epiglottitis is brought to the emergency department. Which nursing action is the priority?

Keep the child calm and do not examine the throat (Correct answer)
Place the child supine and prepare for intubation
Obtain a throat culture using a tongue depressor
Administer antipyretics and obtain an IV access

Correct answer: Keep the child calm and do not examine the throat

Examining the throat in epiglottitis can trigger complete airway obstruction; the child must remain calm, preferably in a parent's lap, while airway management is prepared.

Question 4: A client is placed in contact precautions. Which personal protective equipment (PPE) must the nurse don before entering the room?

Mask and eye shield only
N95 respirator and gloves
Gloves only
Gloves and gown (Correct answer)

Correct answer: Gloves and gown

Contact precautions require gloves and a gown to prevent transmission of pathogens via direct or indirect contact.

Question 5: A nurse is preparing to transfer a patient from bed to wheelchair. Which action is the priority?

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

Correct answer: Lock the wheelchair wheels

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

Question 6: What describes the action of a drug on the body?

Pharmacodynamics (Correct answer)
Pharmacokinetics
Physiology
Microbiology

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 7: A nurse is caring for a patient in acute pancreatitis. Which position provides the most comfort?

Supine with legs flat
Left lateral with head elevated 30 degrees
Semi-Fowler's with knees flexed toward chest (Correct answer)
Prone position

Correct answer: Semi-Fowler's with knees flexed toward chest

The fetal or knee-chest position reduces tension on the inflamed pancreas and relieves abdominal pain.

Question 8: A nurse is preparing a school-age child (age 8) for surgery. Which explanation is most appropriate?

'The doctors will put you to sleep and fix things while you sleep.'
'Don't worry — you'll be fine and it won't hurt.'
'We need to do this to keep you alive.'
'You will receive anesthesia that stops you from feeling pain during the procedure, and you'll wake up in recovery.' (Correct answer)

Correct answer: 'You will receive anesthesia that stops you from feeling pain during the procedure, and you'll wake up in recovery.'

School-age children benefit from simple, honest, concrete explanations because they think logically and fear the unknown.

Question 9: When performing a bed bath, the nurse should wash the patient in which order?

Face → neck → arms → chest → abdomen → legs → perineum → back (Correct answer)
Back → perineum → chest → face
Perineum → face → extremities → back
Legs → abdomen → chest → face → back → perineum

Correct answer: Face → neck → arms → chest → abdomen → legs → perineum → back

The correct sequence moves from cleanest areas (face) to dirtiest (perineum, back) to prevent contamination.

Question 10: Which maternal condition places the newborn at highest risk for hypoglycemia immediately after birth?

Group B Streptococcus colonization
Thyroid disease on levothyroxine
Poorly controlled gestational diabetes (Correct answer)
Gestational hypertension

Correct answer: Poorly controlled gestational diabetes

Infants of diabetic mothers have high insulin levels at birth due to chronic maternal hyperglycemia, leading to hypoglycemia when the glucose source is cut off.

Question 11: A newborn has not passed meconium within 48 hours of birth. The nurse should assess for:

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

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 12: A nurse discovers a patient fell while under the care of another nurse. Which document should never be referenced in the medical record?

Vital signs obtained after the fall
Physician progress notes
Nursing notes about the fall
Incident/variance report (Correct answer)

Correct answer: Incident/variance report

Incident reports are internal quality documents; referencing them in the medical record makes them discoverable in litigation, violating their protected status.

Question 13: A nurse is caring for a patient in active labor receiving magnesium sulfate. Which finding signals toxicity?

Urinary output of 35 mL/hr
Loss of deep tendon reflexes (Correct answer)
Respiratory rate of 14 breaths/min
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 14: Which dietary instruction is most important for a patient with gout?

Increase vitamin C supplements only
Avoid high-purine foods like red meat and organ meats (Correct answer)
Increase dairy product consumption
Limit fluid intake to 1 L per day

Correct answer: Avoid high-purine foods like red meat and organ meats

Purine-rich foods increase uric acid production, which precipitates gout attacks, so they must be limited.

Question 15: Which is not the characteristic of a critical thinker among the following?

He upholds the standards of critical thinking.
They use logical skills in reasoning.
They refuse to recognize the limitations of his mind and consistently pursue excellence. (Correct answer)
They think independently and do not always succumb to peer pressure.

Correct answer: They refuse to recognize the limitations of his mind and consistently pursue excellence.

A critical thinker is someone who uses logical skills in reasoning, thinks independently, and upholds the standards of critical thinking. However, refusing to recognize the limitations of one's mind and consistently pursuing excellence is not a characteristic of a critical thinker. Critical thinkers understand that everyone has limitations and are open to recognizing and addressing them. They focus on improving their thinking skills and seeking truth rather than just pursuing excellence.

Question 16: A nurse is measuring a client's blood pressure and notices the cuff is too small. What effect will this have on the reading?

Irregular pulse waveform only
Falsely high reading (Correct answer)
No effect on the reading
Falsely low reading

Correct answer: Falsely high reading

A cuff that is too small will produce a falsely elevated blood pressure reading.

Question 17: A patient who has been taking lithium for bipolar disorder presents with coarse hand tremors, polyuria, and confusion. The nurse suspects:

Lithium withdrawal syndrome
Normal side effects at steady state
Lithium toxicity (Correct answer)
Subtherapeutic lithium levels

Correct answer: Lithium toxicity

Coarse tremors (not fine), polyuria, and confusion indicate lithium toxicity, which requires immediate intervention.

Question 18: A nurse is planning care for five patients. Using the concept of prioritization, which patient has the highest priority?

A patient scheduled for discharge teaching
A patient awaiting a routine blood draw
A patient requesting a warm blanket
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 19: A nurse is preparing to insert a urinary catheter. Which step should be performed first?

Explain the procedure to the patient (Correct answer)
Open the sterile catheter kit
Apply sterile gloves
Cleanse the urinary meatus

Correct answer: Explain the procedure to the patient

Patient education and consent must occur before initiating any invasive procedure.

Question 20: Which strategy is most effective for improving HCAHPS (patient satisfaction) scores related to nurse communication?

Provide patients with printed satisfaction surveys at admission
Limit patient call light use to reduce unnecessary interactions
Increase the number of staff on each shift
Use hourly rounding to proactively address patient needs (Correct answer)

Correct answer: Use hourly rounding to proactively address patient needs

Hourly rounding proactively addresses patient needs, reduces call lights, and improves communication scores on HCAHPS surveys.

Question 21: Which of the following are well-perfused tissues?

Bone
Skeletal
None of the above
Brain (Correct answer)
Adipose

Correct answer: Brain

The brain is a well-perfused tissue because it has a rich blood supply. This is necessary for the brain to receive a constant supply of oxygen and nutrients, as well as to remove waste products. The brain requires a high amount of energy and oxygen to function properly, and its blood vessels ensure that these requirements are met.

Question 22: A newborn's blood glucose is 38 mg/dL at 2 hours of age. What is the priority nursing action?

Initiate IV dextrose infusion
Recheck in 1 hour and document
Offer early breastfeeding or formula feeding (Correct answer)
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 23: A nurse is changing a wound dressing. Which action maintains sterile technique?

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

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: A newly licensed nurse is overwhelmed during a busy shift. What is the most appropriate action for the charge nurse to take?

Assess the new nurse's workload and offer to help reprioritize tasks (Correct answer)
Reassign all of the new nurse's patients to experienced staff
Document the new nurse's inability to manage the assignment
Inform the nurse to manage their time better

Correct answer: Assess the new nurse's workload and offer to help reprioritize tasks

Supportive leadership involves assessing the situation and helping the new nurse prioritize effectively, promoting learning and ensuring patient safety.

Question 25: A nurse is teaching a client about omega-3 fatty acids. Which dietary source provides the highest concentration of EPA and DHA?

Walnuts
Canola oil
Fatty fish (salmon) (Correct answer)
Flaxseeds

Correct answer: Fatty fish (salmon)

Fatty fish like salmon are the richest sources of the long-chain omega-3 fatty acids EPA and DHA, which are most bioavailable from marine sources.

Question 26: Which assessment finding in a newborn is associated with respiratory distress syndrome (RDS)?

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

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 27: A nurse is preparing to delegate a task to an LPN. Which task is appropriate for delegation to an LPN?

Performing an initial head-to-toe assessment on a new admission
Educating a patient on a new diabetes diagnosis
Developing a patient's plan of care
Administering a routine oral medication to a stable patient (Correct answer)

Correct answer: Administering a routine oral medication to a stable patient

LPNs can administer routine medications to stable patients; initial assessments, care planning, and complex teaching require RN-level skill.

Question 28: At what gestational age is a fetus considered to be at full term by current ACOG definitions?

40 0/7 weeks
39 0/7 weeks (Correct answer)
37 0/7 weeks
38 0/7 weeks

Correct answer: 39 0/7 weeks

ACOG defines full term as 39 0/7 to 40 6/7 weeks; 37–38 weeks is now classified as early term.

Question 29: A gravida 3 para 2 patient is at 30 weeks and reports painless bright red vaginal bleeding. The nurse suspects:

Cervical polyp bleeding
Bloody show in early labor
Placental abruption
Placenta previa (Correct answer)

Correct answer: Placenta previa

Painless bright red bleeding in the second or third trimester is the classic presentation of placenta previa.

Question 30: A nurse is preparing to perform hand hygiene before a procedure. Which action is correct when using alcohol-based hand rub?

Apply to dry hands and rub for at least 15 seconds until dry (Correct answer)
Apply a small dime-sized amount and wipe off with a towel
Use only when hands are visibly soiled
Rinse hands with water after applying the rub

Correct answer: Apply to dry hands and rub for at least 15 seconds until dry

Alcohol-based hand rub should be applied to dry hands and rubbed together for at least 15 seconds until completely dry.

Question 31: Select the element which is not part of the critical thinking standards.

Completeness
Relevance
Clarity
Relativistic thinking (Correct answer)

Correct answer: Relativistic thinking

Relativistic thinking is not part of the critical thinking standards because critical thinking focuses on objective analysis and evaluation of information, while relativistic thinking is subjective and based on personal opinions and perspectives. The other three options - clarity, relevance, and completeness - are all important standards in critical thinking that involve clear communication, logical connections, and comprehensive understanding of the subject matter.

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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