ATI Fundamentals Practice Test Questions and Answers

The ATI Fundamentals Practice Questions set is your all-in-one companion to mastering the foundational nursing principles tested on the ATI Fundamentals Exam—also known as the ATI Foundations Practice Exam. Designed for nursing students preparing for proctored or practice assessments, this guide replicates the exact style, difficulty, and reasoning you’ll encounter in ATI testing. Each question reflects real-world clinical scenarios aligned with current 2026 NCLEX-RN and ATI blueprints, focusing on patient safety, infection control, medication administration, ethical decision-making, and communication skills. With detailed explanations, rationales, and test-ready reasoning strategies, it helps you understand not just what the right answer is—but why. Whether you’re a first-semester nursing student or revisiting fundamentals for review, this resource turns confusion into clarity and builds confidence for your next proctored ATI or clinical application exam.

What’s Inside: Complete Topic Coverage in this ATI fundamentals Test Bank

This ATI Foundations Practice Exam covers every essential area outlined in the 2026 ATI Fundamentals blueprint:

• Safety & Infection Control: Master procedures to prevent hospital-acquired infections, proper PPE sequence, sterile field setup, and safe patient transfers. Learn about fall prevention, seizure precautions, fire safety (RACE & PASS), and radiation exposure limits.
• Basic Care & Comfort: Review repositioning, body mechanics, pressure injury prevention, hygiene care, and thermal therapy (hot/cold application).
• Physiological Adaptation: Includes oxygen therapy, respiratory care, suctioning, pulse deficit assessment, orthostatic hypotension management, and post-operative care.
• Health Promotion & Maintenance: Understand nutrition principles, iron-rich diets, renal diet restrictions, and postoperative wound healing through protein and vitamin intake.
• Pharmacological & Parenteral Therapies: Get clear on medication administration safety—insulin, IV therapy, central line maintenance, high-alert drugs, and TPN management.
• Psychosocial Integrity: Covers anxiety reduction, communication techniques, defense mechanisms (projection, regression, denial), and therapeutic responses.
• Management of Care: Delegation rules (RN vs LPN vs UAP), prioritization, patient education, informed consent, and documentation standards are explained with clarity.

Each question mirrors clinical reality—equipping you to think critically, manage priorities, and apply nursing judgment in fast-paced hospital settings.

Who Can Take This ATI Fundamentals Practice Test

This ATI Fundamentals Practice Questions set is perfect for:

• Pre-licensure nursing students enrolled in ADN, BSN, or LPN-RN bridge programs.
• First-semester students completing the Fundamentals course before clinical rotations.
• Repeat test takers who need to strengthen weak areas before a re-attempt at the ATI proctored fundamentals exam.
• Internationally educated nurses transitioning into U.S. programs or preparing for NCLEX and ATI-based entrance assessments.
• Educators or tutors who want to supplement class materials with exam-style, rationale-rich questions for realistic student practice.

If your goal is to pass your first ATI proctored exam with confidence, this product provides all the structure, content, and strategy you need.

Why Our ATI Foundations for success Quiz is useful?

The ATI Fundamentals Practice Exam simulates real testing conditions with:

• Updated 2026 question styles—alternate formats, priority questions, and case-based scenarios.
• Explained rationales making every question a mini-lesson.
• Evidence-based alignment with QSEN competencies, NCLEX-RN test plan, and current ATI curriculum.
• Comprehensive scope—spanning safety, pharmacology, fluids, ethics, communication, and clinical judgment.

It’s more than a question bank—it’s a guided review system that teaches reasoning, reinforces memory, and trains you to recognize tricky wording and “except” statements common on ATI tests. Students who practice with these questions often report higher confidence and measurable score increases on the actual exam.

Study Tips for ATI Fundamentals Success

1. Simulate real exam timing. Complete one 60-question session without interruptions to mirror ATI test conditions and improve pacing.
2. Use rationales as tutorials. Don’t rush. Read every explanation—even for correct answers—to deepen concept understanding.
3. Organize by domain. Group topics like “infection control,” “nutrition,” or “ethics” to track performance patterns.
4. Review high-yield formulas & values. Memorize vital sign ranges, IV flow calculations, and lab norms (Na⁺, K⁺, Ca²⁺, Hgb).
5. Practice critical thinking. Rephrase each question: What’s the core issue? What would I do first?—a proven ATI test-taking strategy.
6. Mix recall with application. Pair flashcards for definitions with scenario questions to connect knowledge to nursing judgment.
7. Use process of elimination. Two options are often partially correct—learn to identify the most safe, most correct, or most immediate nursing response.

Consistent, active review using this guide trains both clinical reasoning and confidence—essential for the ATI Fundamentals exam.

How to Pass the ATI Fundamentals Exam

Passing the ATI Fundamentals Exam requires more than memorization—it demands understanding of nursing logic.

• Master foundational concepts: Focus on ABCs (airway, breathing, circulation), Maslow’s hierarchy, and safety principles.
• Think like a nurse: Ask, “Which action protects the patient first?” ATI tests application, not recall.
• Use nursing process steps (ADPIE): Assess → Diagnose → Plan → Implement → Evaluate.
• Apply evidence-based practice: Rationales in this guide use current 2026 standards (infection control, medication safety, patient rights).
• Stay calm under time pressure: Practice in test mode to build endurance; the ATI system often includes adaptive question sequences.
• Read carefully: Avoid “absolute” options like always or never—they’re rarely correct in patient care scenarios.
• Prioritize ethical and communication items: Expect questions on veracity, autonomy, beneficence, and patient advocacy.

With these skills, you can confidently interpret scenario-based questions and select the safest, most professional nursing action every time.

ATI Fundamentals Exam-Aligned Topics You’ll Master

From the 700 practice items, the following themes frequently appear in the ATI Foundations Practice Exam:

Each section blends clinical accuracy with practical reasoning, helping you recall facts and apply them to real nursing decisions.

Why Students Love This ATI Fundamentals Practice Questions

• Explanations: Every rationale sounds like your favorite instructor explaining why one choice is right.
• Up-to-date references: Reflects current nursing practice standards and 2026 clinical guidelines.
• Instant confidence boost: You’ll learn how ATI questions are structured—and stop overthinking distractor options.
• Perfect for quick review or deep study: Use a few questions between shifts or full-length tests for exam simulation.
• Compatible with any study style: Downloadable in PDF, Excel, or Word format for flexibility on mobile, tablet, or desktop.

Students report feeling calmer and more in control during the actual exam because they’ve already practiced similar items with realistic difficulty.

If you’re preparing for your first ATI Fundamentals proctored test—or just want to strengthen your foundation before clinical rotations—this ATI Fundamentals Practice Questions collection is a must-have. It’s comprehensive, realistic, and thoughtfully designed to teach critical thinking, not rote recall. Whether you’re reviewing ATI practice questions fundamentals or aiming to refine your clinical reasoning skills, this course-aligned review ensures mastery of key nursing concepts. By the end, you’ll not only pass your ATI Foundations Practice Exam but also enter the clinical setting with the confidence to deliver safe, evidence-based patient care.

ATI Nursing Practice Questions: Sample Questions and Answers

Q1. Vital signs—adult baseline
A nurse assesses an adult client: BP 118/72 mmHg, HR 86/min, RR 18/min, Temp 37.1°C (98.8°F), SpO₂ 96% on room air. Which action is most appropriate?
A. Recheck BP in 15 minutes
B. Notify the provider of hypoxia
C. Document findings as within expected limits
D. Administer antipyretic

Correct answer: C
Explanation: These vital signs fall within normal adult ranges: BP ~90–120/60–80, HR 60–100, RR 12–20, oral temp ~36.4–37.6°C, SpO₂ ≥95% on room air (individual baselines matter). No symptom suggests acute instability. Antipyretics are unnecessary for 37.1°C. Rechecking a normal BP without indication is not needed. Provider notification is reserved for abnormal or trending-down SpO₂ (<92–94% depending on baseline). Document and continue routine monitoring, watching for trends and clinical context.

Q2. Infection control—PPE sequence (contact precautions)
Before entering a room for a client with C. difficile, which donning order is correct?
A. Gown → Gloves → Mask → Goggles
B. Hand hygiene → Gown → Gloves
C. Mask → Goggles → Gown → Gloves
D. Hand hygiene → Gloves → Gown

Correct answer: B
Explanation: For contact precautions (e.g., C. difficile), focus on preventing environmental/hand contamination: perform hand hygiene, then don a clean, fully tied gown, then gloves over gown cuffs. Masks/goggles aren’t routinely required unless splash risk. On exit, remove gloves first, then gown, and perform hand hygiene with soap and water (spores require soap and water rather than alcohol rubs). Proper sequence limits self-contamination and cross-transmission to other patients and surfaces.

Q3. Sterile field—principles
Which action contaminates a sterile field?
A. Keeping sterile items 2.5 cm (1 in) from the edge
B. Holding a sterile solution bottle with label in palm
C. Reaching over the sterile field to grab tape
D. Pouring sterile solution 2–6 inches above the basin

Correct answer: C
Explanation: Reaching over a sterile field introduces microorganisms via sleeves and gravity-borne particles, contaminating the area. The outer 1-inch margin is considered contaminated; keep sterile items inside that boundary. When pouring, hold the bottle with label in the palm to prevent solution running over label and to maintain a controlled pour from a few inches above to reduce splash. Avoid turning your back on the field, keep it at waist level, and replace any item if sterility is in doubt.

Q4. Oxygen therapy—nasal cannula
A client on nasal cannula at 2 L/min asks what it provides.
A. ~24–28% FiO₂
B. ~35–50% FiO₂
C. Exact 21% FiO₂
D. 100% FiO₂

Correct answer: A
Explanation: A nasal cannula delivers low-flow oxygen; each additional liter per minute increases FiO₂ roughly 3–4%, starting near 24% at 1 L/min. Thus, 2 L/min provides about 28% (24–28% range cited). Masks (simple, Venturi, non-rebreather) deliver higher, more predictable concentrations. Emphasize humidification above 4 L/min, skin assessment under tubing, and safety (no smoking, secure tanks). Also encourage diaphragmatic breathing and assess for increased work of breathing or decreased SpO₂.

Q5. Pain management—reassessment
An opioid-naïve postoperative client receives IV morphine for 8/10 pain at 1400. When should the nurse reassess pain first?
A. 1500
B. 1415
C. 1600
D. 1700

Correct answer: B
Explanation: For IV opioids, onset is rapid (within minutes) with peak around 15–30 minutes. Safety and effectiveness require early reassessment near the peak—about 15 minutes post-dose. For oral analgesics, reassess ~30–60 minutes; for IM, ~30 minutes. Reassess both intensity and functional outcomes (e.g., ability to deep breathe/cough) and monitor adverse effects like sedation and respiratory depression. Use multimodal strategies (ice, positioning, splinting, non-opioids) to minimize opioid needs.

Q6. Documentation—legal best practice
Which charting entry is most appropriate?
A. “Client uncooperative; probably drug-seeking.”
B. “Gave pain med; client fine now.”
C. “1415: Client reports pain 8/10; morphine 2 mg IV given; 1425: pain 3/10; RR 16, sedation scale 1, tolerating deep breathing.”
D. “Client appears comfortable.”

Correct answer: C
Explanation: Accurate, objective, time-stamped, assessment-intervention-response documentation is best practice and legally protective. Avoid judgments (“drug-seeking”) or vague phrases (“fine,” “appears comfortable”). Include measurable data (pain scale, vitals, sedation level), the medication/dose/route/time, and the client’s response including function and side effects. Timely, legible, and factual notes support care continuity, billing accuracy, and risk management.

Q7. Delegation—RN to UAP
Which task is appropriate to delegate to an experienced UAP?
A. Educate a new diabetic on insulin administration
B. Assess pain after analgesic administration
C. Obtain a routine post-void residual with a bladder scanner
D. Titrate oxygen from 2 to 4 L/min

Correct answer: C
Explanation: UAPs can perform noninvasive, routine, predictable tasks with known outcomes, such as obtaining vitals, assisting with ADLs, applying standard precautions, and using bladder scanners per policy. RNs retain assessment, teaching, clinical judgment, and evaluation. Pain reassessment and oxygen titration require RN judgment. Initial diabetic education belongs to the RN. For any delegated task, the RN must provide clear instructions and follow-up based on results.

Q8. Prioritization—ABCs
Which client should the nurse see first?
A. COPD client with SpO₂ 91% and chronic cough
B. Post-op client requesting pain meds (7/10)
C. Client with new inspiratory stridor after thyroid surgery
D. Client awaiting discharge teaching

Correct answer: C
Explanation: Airway takes priority; post-thyroidectomy stridor may indicate airway edema or hemorrhage compromising the airway—an emergency. Intervene immediately: call rapid response, prepare for airway management, assess neck swelling, and maintain oxygen. COPD with 91% may be baseline; still important, but not emergent. Severe pain is urgent but follows airway/breathing. Discharge teaching is scheduled after stabilization of higher priorities. Use ABCs, then Maslow and acute vs chronic cues.

Q9. Fall prevention—safety
Which order is best to reduce fall risk in a confused, high-risk older adult?
A. Four side rails up
B. Frequent rounding with scheduled toileting
C. PRN restraints
D. Bed in high position for easier transfers

Correct answer: B
Explanation: Scheduled rounding (pain, potty, position, possessions) reduces unsupervised ambulation, a major fall driver. Keep bed low, brakes locked, call bell within reach, non-skid footwear, adequate lighting, and clear pathways. Four bed rails constitute a restraint and increase injury risk. Restraints are last resort after alternatives fail and require orders and monitoring. Individualize care with alarms or a sitter if needed, and reassess risk daily and after medication changes.

Q10. Mobility—canes
Which instruction is correct for cane use on the right side with a weak left leg?
A. Hold cane in left hand and move with left leg
B. Hold cane in right hand; move cane and left leg together
C. Hold cane in right hand; step first with right leg
D. Hold cane in either hand; step with stronger leg first

Correct answer: B
Explanation: The cane is held on the stronger side (right) to widen the base of support and offload the weaker limb. The proper sequence: move cane and the weak leg forward together, then advance the strong leg past the cane. Stairs: “up with the good, down with the bad”—on ascent lead with the stronger leg; on descent lead with the weaker leg and cane. Ensure cane height aligns with wrist crease and elbow flexion ~15–30° for safe mechanics.

Q11. Enteral feeding—aspiration prevention
For a tube-fed client with aspiration risk, the highest-priority intervention is to:
A. Check gastric residuals every 8 hours
B. Maintain HOB at 30–45° during and after feeds
C. Use sterile technique for formula
D. Flush tube with 60 mL water q8h

Correct answer: B
Explanation: Elevating the head of bed 30–45° during feedings and for at least 30–60 minutes afterward is the most effective, immediate measure to reduce reflux and aspiration. Residual checks may guide tolerance but are not as protective. Clean technique is adequate for most home-use formulas; sterile technique is not usually required. Flushing maintains patency and hydration but does not directly prevent aspiration. Also verify tube placement, consider continuous feeds, and monitor cough/SpO₂.

Q12. Medication rights
Which option lists the “Five Rights” of medication administration?
A. Right drug, dose, route, time, patient
B. Right drug, dose, route, time, diagnosis
C. Right drug, dose, route, time, provider
D. Right patient, provider, pharmacy, time, route

Correct answer: A
Explanation: The foundational rights are right patient, right drug, dose, route, and time—often expanded to include right documentation, reason, response, education, and to refuse. Use two identifiers (e.g., name and DOB), compare MAR to medication label three times, clarify look-alike/sound-alike drugs, and assess for allergies and contraindications. Document immediately after administration and evaluate therapeutic/ adverse responses, especially for high-alert medications.

Q13. Insulin—mixing
Which is correct when mixing NPH and regular insulin in one syringe?
A. Draw NPH first, then regular
B. Draw regular first, then NPH
C. Do not mix; always separate
D. Air into regular first, then NPH

Correct answer: B
Explanation: The rule is “clear to cloudy”: inject air into NPH (cloudy) vial first, then air into regular (clear), withdraw regular insulin first to avoid contaminating the clear vial, then withdraw NPH to the total dose. Roll (don’t shake) NPH to resuspend. Verify dose with another nurse per policy. Assess glucose trends and teach site rotation, onset/peak/duration differences, and hypoglycemia management. Not all insulins are mixable; follow manufacturer guidance.

Q14. Wound care—moist healing
A partial-thickness pressure injury on the sacrum is shallow with pink granulation. Best dressing?
A. Dry gauze daily
B. Hydrocolloid or foam to maintain moisture
C. Betadine-soaked packing
D. Leave open to air

Correct answer: B
Explanation: Moist wound healing supports cell migration, granulation, and autolytic debridement while protecting from contamination and shear. Hydrocolloids or foams maintain a balanced environment and minimize dressing changes. Dry gauze and open-air approaches desiccate tissue and delay healing. Cytotoxic solutions like povidone-iodine damage viable cells and are avoided in clean granulating tissue. Also offload pressure, optimize nutrition/protein, and manage moisture (incontinence) and friction.

Q15. Pressure injury—staging
A heel ulcer with full-thickness skin loss exposing subcutaneous fat but no bone/tendon is:
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4

Correct answer: C
Explanation: Stage 3 indicates full-thickness skin loss with visible adipose; slough/eschar may be present but does not obscure depth. No fascia, muscle, tendon, ligament, cartilage, or bone exposure (that’s Stage 4). Stage 2 is partial-thickness skin loss with a viable pink/red wound bed or serum-filled blister; Stage 1 is non-blanchable erythema over intact skin. Unstageable involves slough/eschar fully covering the base. Accurate staging guides dressing, offloading, and nutrition plans.

Q16. Urinary catheter care
Which action reduces CAUTI risk?
A. Routine daily irrigation with sterile saline
B. Keep drainage bag below bladder level
C. Disconnect tubing to obtain urine specimens
D. Cleanse meatus with povidone-iodine twice daily

Correct answer: B
Explanation: Keeping the closed drainage system intact and below bladder level prevents backflow and infection. Use the sampling port with aseptic technique for specimens—never disconnect. Routine irrigation and antiseptic meatal cleansing are not recommended; perform daily perineal hygiene with mild soap and water. Secure the catheter to prevent urethral trauma, ensure unobstructed flow without kinks, and remove catheters as soon as no longer indicated.

Q17. Specimens—24-hour urine
Key teaching for a 24-hour urine collection is to:
A. Save the first void to start the test
B. Discard any urine produced during bowel movements
C. Keep the collection on ice or refrigerated
D. Skip missed voids and continue

Correct answer: C
Explanation: Many timed urine studies require refrigeration/ice to preserve analytes; follow lab policy. To begin, discard the first void (note the start time) and then collect every subsequent void for 24 hours, including urine during bowel movements (use a hat/urinal to avoid loss). If any void is missed, the entire collection is invalid and must be restarted. Clear instructions, labels, and reminders help adherence and accuracy of results such as creatinine clearance.

Q18. Blood transfusion—ID checks
Before starting PRBCs, the most critical safety step is to:
A. Warm the blood
B. Verify client identity and blood product with another licensed nurse
C. Prime tubing with dextrose 5%
D. Start infusion at 250 mL/hr for the first 15 minutes

Correct answer: B
Explanation: Dual verification of the client’s identity, blood type, Rh, unit number, expiration, and compatibility prevents fatal hemolytic reactions. Use normal saline to prime and infuse; dextrose/solutions with calcium cause hemolysis/clotting. Begin slowly (e.g., 75–120 mL/hr) for the first 15 minutes while closely monitoring for reactions (fever, chills, back pain, dyspnea). If reaction suspected, stop infusion, keep IV open with NS, notify provider/blood bank, and follow protocol.

Q19. Perioperative—informed consent
Which statement reflects informed consent requirements?
A. The nurse explains risks/benefits and obtains consent
B. The provider explains procedure; nurse witnesses signature
C. Family may sign if client is oriented but anxious
D. Consent is implied once NPO

Correct answer: B
Explanation: The provider performing the procedure is responsible for explaining diagnosis, nature/purpose, risks, benefits, alternatives, and likely outcomes. The nurse assesses understanding, ensures the client is voluntary, competent, and not sedated, and witnesses the signature. If questions remain, hold signing and notify the provider. A competent client signs for themselves; a surrogate signs only if the client lacks capacity or per legal documentation. NPO status does not imply consent.

Q20. Cultural competence—diet
A hospitalized client observing Ramadan asks about fasting. Best response?
A. “Hospitalized patients are exempt; you must eat.”
B. “We can’t change meals; ask your family.”
C. “Let’s coordinate meal delivery at sunset and sunrise to respect your fast, ensuring your treatment plan remains safe.”
D. “We’ll provide only liquids during the day.”

Correct answer: C
Explanation: Culturally responsive care involves collaborating to honor beliefs while maintaining safety. For fasting observances, coordinate meal timing, consult nutrition and the provider about medication timing and clinical risks (e.g., diabetes, dehydration), and document preferences. Avoid dismissing beliefs or imposing practices. Assess for exceptions per religious guidance in illness, but the client’s autonomy and shared decision-making are central. Offer privacy for prayer and facilitate family support as appropriate.

Q21. Older adult—physiologic changes
Which age-related change is expected in older adults?
A. Increased total body water
B. Decreased skin elasticity and subcutaneous fat
C. Increased gag reflex
D. Faster hepatic drug metabolism

Correct answer: B
Explanation: Aging commonly brings thinner, drier skin with reduced elasticity and subcutaneous fat, raising risks for tears, pressure injuries, and hypothermia. Total body water decreases, increasing dehydration risk. Gag/cough reflexes may be diminished, elevating aspiration risk. Hepatic and renal clearance often decline, necessitating careful dosing (start low, go slow). Tailor interventions: moisturize skin, use gentle adhesives, reposition frequently, maintain hydration, and monitor polypharmacy effects.

Q22. Fluids & electrolytes—hypokalemia
Which finding is most consistent with hypokalemia?
A. Tall peaked T waves
B. Hypoactive bowel sounds and muscle weakness
C. Hyperreflexia and diarrhea
D. Moist mucous membranes and bradycardia

Correct answer: B
Explanation: Low potassium often presents with generalized weakness, cramps, hypoactive bowel sounds/constipation, and ECG changes like flattened T waves, U waves, and possible dysrhythmias. Tall peaked T waves suggest hyperkalemia. Hyperreflexia/diarrhea more often align with hyperkalemia or hyperthyroid states. Assess contributing factors (diuretics, GI losses), replace potassium per protocol (oral preferred if mild), monitor ECG and magnesium, and never give IV potassium as a rapid bolus.

Q23. IV therapy—complications
An IV site is cool, pale, and edematous with slowed infusion. This indicates:
A. Phlebitis
B. Infiltration
C. Infection
D. Thrombosis

Correct answer: B
Explanation: Infiltration occurs when non-vesicant fluid leaks into surrounding tissue, causing coolness, pallor, swelling, and damp dressing with decreased flow. Stop the infusion, remove the catheter, elevate the limb, and apply a warm or cool compress per solution and policy. Phlebitis features warmth, erythema, pain along the vein, and a palpable cord. Local infection may present with purulence and fever. Restart IV in another extremity and assess for vesicant extravasation protocols if applicable.

Q24. Isolation precautions—airborne
Which disease requires airborne precautions?
A. Influenza
B. MRSA wound infection
C. Tuberculosis
D. C. difficile colitis

Correct answer: C
Explanation: TB requires airborne precautions: negative-pressure room and fit-tested N95/respirator. Influenza generally requires droplet plus standard precautions; MRSA wound infections need contact (and possible droplet if respiratory). C. difficile needs contact with soap-and-water hand hygiene on exit. Educate on door signage, visitor PPE, and transport policies (patient masked for TB if leaving room). Ensure timely screening and early isolation to prevent nosocomial spread.

Q25. NG tube—placement verification
Best initial method to verify NG tube placement before first feeding?
A. Auscultate “whoosh” of air over stomach
B. Check pH of aspirate and confirm with x-ray per policy
C. Observe for absence of coughing
D. Assume placement if tape is intact

Correct answer: B
Explanation: The gold standard before first use is radiographic confirmation. Bedside pH testing (≤5 generally suggests gastric placement in fasting adults) supports ongoing checks, but whoosh auscultation is unreliable and unsafe. Lack of coughing is not a valid marker. After x-ray confirmation, mark the exit site and assess length before each use, observe for respiratory distress, and hold feeds if doubts arise. Document verification method and client tolerance of aspirate checks.

Q26. BLS—adult one-rescuer
For an unresponsive adult with no normal breathing and no pulse, the correct compression-to-ventilation ratio for a single rescuer is:
A. 15:2
B. 30:2
C. 5:1
D. Continuous compressions with 8–10 breaths/min

Correct answer: B
Explanation: Single-rescuer adult CPR uses a 30:2 ratio with compressions at 100–120/min, depth ~5 cm (2 in), full recoil, minimal interruptions, and early AED use. Two-rescuer for adults still uses 30:2, whereas advanced airway in place allows continuous compressions with 1 breath every 6 seconds. High-quality compressions and rapid defibrillation are the priorities. Ensure firm surface, switch compressors every 2 minutes if help arrives, and avoid over-ventilation which reduces venous return.

Q27. Fire safety—RACE
A small trash fire starts in a client’s room. First action?
A. Extinguish the fire
B. Rescue client to safety
C. Contain by closing doors
D. Pull the fire alarm after containment

Correct answer: B
Explanation: Follow RACE: Rescue anyone in immediate danger, Alarm (activate system), Contain (close doors/oxygen where appropriate and safe), then Extinguish/Evacuate if trained and the fire is small/confined. Life safety precedes property. PASS is used to operate an extinguisher (Pull, Aim, Squeeze, Sweep) only if evacuation is progressing and it’s safe to do so. Document the event and participate in post-incident debriefing to improve response protocols.

Q28. Ethics—advance directives
A competent client states, “I don’t want CPR if my heart stops,” but there’s no DNR order. The nurse should:
A. Ignore the statement until an order exists
B. Tell the client CPR is mandatory in hospitals
C. Notify the provider to discuss and write orders reflecting the client’s wishes
D. Ask the family to sign a DNR

Correct answer: C
Explanation: Respect for autonomy requires ensuring the client’s informed preferences are honored. The nurse should promptly notify the provider so wishes can be documented through appropriate medical orders (DNR/DNI) and, when applicable, advance directive forms. Without an order, default is full code during emergencies. Family cannot override a competent client’s wishes. Provide education, assess understanding, and confirm that the client’s preferences are recorded in the chart and communicated to the team.

Q29. Health promotion—immunizations
Which adult requires immediate influenza vaccination unless contraindicated?
A. 25-year-old teacher mid-season with mild cold
B. 30-year-old healthy athlete right after recovering from flu
C. 50-year-old with egg allergy anaphylaxis history
D. 40-year-old starting chemotherapy next month

Correct answer: D
Explanation: Adults, especially those with anticipated immunosuppression (e.g., starting chemotherapy), benefit from timely inactivated influenza vaccination to reduce complications. Mild upper-respiratory symptoms aren’t a contraindication. Prior true anaphylaxis to egg is no longer an absolute barrier—egg-free or standard inactivated vaccines with appropriate precautions are options per current guidance; evaluate setting and allergist input. Post-infection vaccination is still recommended because strains vary and immunity wanes.

Q30. Therapeutic communication
A client newly diagnosed with heart failure says, “I’m scared about going home.” Best response?
A. “Don’t worry; you’ll be fine.”
B. “Why are you scared?”
C. “Tell me more about what feels most overwhelming right now.”
D. “You should read the discharge packet.”

Correct answer: C
Explanation: Open-ended, empathetic statements invite exploration of feelings and concerns, allowing the nurse to assess coping, knowledge gaps, support systems, and practical barriers (medication costs, diet, follow-up). Avoid false reassurance (“you’ll be fine”), closed “why” questions that can feel accusatory, or deflecting to handouts before exploring emotions. After listening, provide tailored education (weight monitoring, sodium limits, symptoms to report), involve caregivers, and coordinate resources like case management.