1
ATI PN Fundamentals Review 2025–2026 | 160 Exam
Questions & Answers with Detailed Rationales
1)
A practical nurse (PN) enters the room of a 76-year-old client admitted with
pneumonia who has become increasingly restless and is now reporting shortness of
breath and difficulty speaking in complete sentences. The client’s respiratory rate is
28 breaths per minute, and the oxygen saturation has dropped to 86% on room air.
Which action should the PN take first?
A. Notify the registered nurse (RN) or provider of the client’s worsening
symptoms.
B. Apply oxygen via nasal cannula as prescribed and reassess oxygen saturation.
C. Obtain a complete set of vital signs and document findings in the chart.
D. Raise the head of the bed to a high-Fowler’s position.
Correct Answer: D
Rationale: Elevating the head of the bed immediately promotes lung expansion
and eases breathing. Although oxygen application and notifying the provider are
also essential, positioning is a rapid, non-invasive first step. Documentation should
occur after interventions.
2)
While performing a routine medication pass, a PN realizes that the medication in
hand is for a different client with a similar last name. The error is noticed before
administration. The client is waiting expectantly for the medication. What is the
PN’s priority action?
A. Administer the medication since it is already in hand and the client is ready.
B. Return the medication to the medication dispensing system and verify the
correct prescription for the correct client.
, 2
C. Inform the client that they cannot receive any medication at this time.
D. Ask another nurse to double-check the medication before giving it.
Correct Answer: B
Rationale: The PN must follow the “rights” of medication administration and
verify client identity with MAR before proceeding. Giving the wrong medication is
unsafe. Asking another nurse is not a substitute for verification. Delaying without
explanation is not appropriate; proper verification comes first.
3)
A PN is caring for a 52-year-old client with chronic obstructive pulmonary disease
(COPD) who is on home oxygen therapy. The client states, “Sometimes I use
Vaseline inside my nose because it feels dry.” What should the PN respond?
A. “That’s fine, as long as you use a small amount.”
B. “Petroleum products are flammable and should not be used with oxygen.”
C. “You can switch to using olive oil instead, it’s safer.”
D. “Use the petroleum jelly only at night before sleeping.”
Correct Answer: B
Rationale: Petroleum-based products can ignite easily in an oxygen-rich
environment. Water-based lubricants are recommended. Even small amounts of
petroleum are unsafe. Olive oil is also a flammable lipid.
4)
During a morning assessment, a PN notices a red area on the sacrum of a bedbound
client who has limited mobility following a stroke. The skin is intact, but the
redness does not blanch when pressed. What is the most appropriate immediate
nursing action?
A. Document the finding and reassess the area in 4 hours.
B. Apply a transparent dressing over the area.
C. Reposition the client to relieve pressure from the sacrum.
D. Massage the reddened area to improve blood flow.
Correct Answer: C
Rationale: Non-blanchable redness indicates stage 1 pressure injury. The priority
, 3
is relieving pressure immediately to prevent progression. Massage can damage
fragile tissue. Documentation is important but not the first priority.
5)
A PN working in a long-term care facility hears the fire alarm. Upon reaching the
hallway, the PN sees smoke coming from a resident’s room. Inside, the resident is
in bed reading a magazine and is unaware of the danger. What is the PN’s next
action?
A. Run to get the fire extinguisher before helping the resident.
B. Rescue the resident by moving them to a safe location.
C. Activate the fire alarm system at the nurses’ station.
D. Close the door to contain the smoke and continue rounds.
Correct Answer: B
Rationale: According to RACE (Rescue, Alarm, Contain, Extinguish/Evacuate),
the first priority is rescuing individuals in immediate danger before activating
alarms or containing fire.
6)
A PN is assisting a client with hand hygiene before meals. The client’s hands are
visibly soiled with dried food and dust from gardening earlier in the day. Which
method is most appropriate?
A. Apply alcohol-based hand sanitizer for 20 seconds.
B. Wash with soap and water for at least 20 seconds.
C. Wipe hands with a pre-moistened antiseptic towelette.
D. Rinse under warm running water without soap.
Correct Answer: B
Rationale: Soap and water are necessary when hands are visibly soiled; alcohol
sanitizers are ineffective on organic debris. Antiseptic wipes and rinsing alone are
inadequate.
7)
A PN is caring for a client on contact precautions for Clostridioides difficile
, 4
infection. After completing morning care, the PN prepares to leave the room. What
is the most appropriate hand hygiene method?
A. Use alcohol-based sanitizer before removing gloves.
B. Remove gloves and wash hands with soap and water.
C. Wash gloves under running water before removing them.
D. Remove gloves and wipe hands with antiseptic wipes.
Correct Answer: B
Rationale: Alcohol-based sanitizer is not effective against C. diff spores. Washing
with soap and water physically removes spores. Gloves should never be washed
while on the hands.
8)
The PN is caring for a confused elderly client who attempts to get out of bed
without assistance. The client has fallen twice in the past week. Which intervention
is most appropriate to reduce fall risk?
A. Apply a vest restraint to prevent the client from getting out of bed.
B. Keep the bed in the lowest position with wheels locked and call light in reach.
C. Raise all four side rails to prevent the client from climbing out.
D. Turn off the overhead light to encourage rest during the day.
Correct Answer: B
Rationale: The lowest bed position, locked wheels, and accessible call light are
effective and non-restrictive fall prevention methods. Restraints and four raised
rails increase risk of injury.
9)
A PN is preparing to administer a subcutaneous injection to a client. After
cleansing the site with an alcohol swab, the PN realizes they forgot to verify the
medication with the MAR. The medication is still in the syringe. What is the safest
next step?
A. Proceed with administration since the medication is already prepared.
B. Discard the syringe in a sharps container and restart the preparation process.
C. Ask a colleague to verify the medication and client at the bedside.
D. Place the syringe in a labeled cup until the MAR can be checked.
ATI PN Fundamentals Review 2025–2026 | 160 Exam
Questions & Answers with Detailed Rationales
1)
A practical nurse (PN) enters the room of a 76-year-old client admitted with
pneumonia who has become increasingly restless and is now reporting shortness of
breath and difficulty speaking in complete sentences. The client’s respiratory rate is
28 breaths per minute, and the oxygen saturation has dropped to 86% on room air.
Which action should the PN take first?
A. Notify the registered nurse (RN) or provider of the client’s worsening
symptoms.
B. Apply oxygen via nasal cannula as prescribed and reassess oxygen saturation.
C. Obtain a complete set of vital signs and document findings in the chart.
D. Raise the head of the bed to a high-Fowler’s position.
Correct Answer: D
Rationale: Elevating the head of the bed immediately promotes lung expansion
and eases breathing. Although oxygen application and notifying the provider are
also essential, positioning is a rapid, non-invasive first step. Documentation should
occur after interventions.
2)
While performing a routine medication pass, a PN realizes that the medication in
hand is for a different client with a similar last name. The error is noticed before
administration. The client is waiting expectantly for the medication. What is the
PN’s priority action?
A. Administer the medication since it is already in hand and the client is ready.
B. Return the medication to the medication dispensing system and verify the
correct prescription for the correct client.
, 2
C. Inform the client that they cannot receive any medication at this time.
D. Ask another nurse to double-check the medication before giving it.
Correct Answer: B
Rationale: The PN must follow the “rights” of medication administration and
verify client identity with MAR before proceeding. Giving the wrong medication is
unsafe. Asking another nurse is not a substitute for verification. Delaying without
explanation is not appropriate; proper verification comes first.
3)
A PN is caring for a 52-year-old client with chronic obstructive pulmonary disease
(COPD) who is on home oxygen therapy. The client states, “Sometimes I use
Vaseline inside my nose because it feels dry.” What should the PN respond?
A. “That’s fine, as long as you use a small amount.”
B. “Petroleum products are flammable and should not be used with oxygen.”
C. “You can switch to using olive oil instead, it’s safer.”
D. “Use the petroleum jelly only at night before sleeping.”
Correct Answer: B
Rationale: Petroleum-based products can ignite easily in an oxygen-rich
environment. Water-based lubricants are recommended. Even small amounts of
petroleum are unsafe. Olive oil is also a flammable lipid.
4)
During a morning assessment, a PN notices a red area on the sacrum of a bedbound
client who has limited mobility following a stroke. The skin is intact, but the
redness does not blanch when pressed. What is the most appropriate immediate
nursing action?
A. Document the finding and reassess the area in 4 hours.
B. Apply a transparent dressing over the area.
C. Reposition the client to relieve pressure from the sacrum.
D. Massage the reddened area to improve blood flow.
Correct Answer: C
Rationale: Non-blanchable redness indicates stage 1 pressure injury. The priority
, 3
is relieving pressure immediately to prevent progression. Massage can damage
fragile tissue. Documentation is important but not the first priority.
5)
A PN working in a long-term care facility hears the fire alarm. Upon reaching the
hallway, the PN sees smoke coming from a resident’s room. Inside, the resident is
in bed reading a magazine and is unaware of the danger. What is the PN’s next
action?
A. Run to get the fire extinguisher before helping the resident.
B. Rescue the resident by moving them to a safe location.
C. Activate the fire alarm system at the nurses’ station.
D. Close the door to contain the smoke and continue rounds.
Correct Answer: B
Rationale: According to RACE (Rescue, Alarm, Contain, Extinguish/Evacuate),
the first priority is rescuing individuals in immediate danger before activating
alarms or containing fire.
6)
A PN is assisting a client with hand hygiene before meals. The client’s hands are
visibly soiled with dried food and dust from gardening earlier in the day. Which
method is most appropriate?
A. Apply alcohol-based hand sanitizer for 20 seconds.
B. Wash with soap and water for at least 20 seconds.
C. Wipe hands with a pre-moistened antiseptic towelette.
D. Rinse under warm running water without soap.
Correct Answer: B
Rationale: Soap and water are necessary when hands are visibly soiled; alcohol
sanitizers are ineffective on organic debris. Antiseptic wipes and rinsing alone are
inadequate.
7)
A PN is caring for a client on contact precautions for Clostridioides difficile
, 4
infection. After completing morning care, the PN prepares to leave the room. What
is the most appropriate hand hygiene method?
A. Use alcohol-based sanitizer before removing gloves.
B. Remove gloves and wash hands with soap and water.
C. Wash gloves under running water before removing them.
D. Remove gloves and wipe hands with antiseptic wipes.
Correct Answer: B
Rationale: Alcohol-based sanitizer is not effective against C. diff spores. Washing
with soap and water physically removes spores. Gloves should never be washed
while on the hands.
8)
The PN is caring for a confused elderly client who attempts to get out of bed
without assistance. The client has fallen twice in the past week. Which intervention
is most appropriate to reduce fall risk?
A. Apply a vest restraint to prevent the client from getting out of bed.
B. Keep the bed in the lowest position with wheels locked and call light in reach.
C. Raise all four side rails to prevent the client from climbing out.
D. Turn off the overhead light to encourage rest during the day.
Correct Answer: B
Rationale: The lowest bed position, locked wheels, and accessible call light are
effective and non-restrictive fall prevention methods. Restraints and four raised
rails increase risk of injury.
9)
A PN is preparing to administer a subcutaneous injection to a client. After
cleansing the site with an alcohol swab, the PN realizes they forgot to verify the
medication with the MAR. The medication is still in the syringe. What is the safest
next step?
A. Proceed with administration since the medication is already prepared.
B. Discard the syringe in a sharps container and restart the preparation process.
C. Ask a colleague to verify the medication and client at the bedside.
D. Place the syringe in a labeled cup until the MAR can be checked.
