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ATI Fundamentals Proctored Exam 2026: Complete Exam Preparation Guide with Test Bank, Practice Quizzes, and Rationales

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hen ambulating with a cane, which instruction promotes safe mobility? A. Keep only one point of contact with the floor B. Advance the stronger leg first C. Keep two points of support on the floor and move the weaker leg forward after advancing the cane D. Hold the cane on the weaker side Rationale: Maintaining two points of support improves balance and stability. Advancing the weaker leg after the cane reduces stress on the injured extremity. Using only one point of support or holding the cane on the weaker side increases fall risk. Which findings are effects of immobility on the cardiovascular system? A. Increased cardiac output and improved circulation B. Increased blood volume and decreased workload C. Orthostatic hypotension, venous stasis, increased thrombus risk, decreased cardiac output D. Increased autonomic response Rationale: Immobility leads to venous pooling, reduced circulating volume, and decreased cardiac efficiency. The other options describe effects opposite of immobility. What are effects of immobility on the respiratory system? A. Increased lung expansion B. Improved oxygen exchange C. Decreased respiratory movement, secretion stasis, atelectasis, hypostatic pneumonia D. Strengthened respiratory muscles Rationale: Immobility limits chest expansion and weakens respiratory muscles, promoting secretion buildup and impaired gas exchange. Which strategies should the nurse use during a physical examination? A. Ask only closed-ended questions B. Increase environmental stimulation C. Use open- and closed-ended questions and reduce environmental noise D. Perform invasive procedures first Rationale: Clear communication and a calm environment improve data accuracy and client comfort. What should be included in the general survey of a client? A. Reflexes and lung sounds B. Blood pressure and pulse C. Posture, skin lesions, and speech D. Abdominal contour Rationale: The general survey provides an overall impression of the client’s physical and behavioral status. After inspecting the abdomen, what is the next step in the assessment sequence? A. Palpation B. Percussion C. Auscultation D. Deep palpation Rationale: Auscultation is performed before palpation and percussion to avoid altering bowel sounds. Which interventions are appropriate when examining an older adult? A. Rush the examination B. Remove assistive devices C. Allow time for position changes, ensure sensory aids are in place, and allow bathroom use D. Limit explanations Rationale: Older adults require accommodations to promote comfort, safety, and accurate assessment. An 82-year-old client presents with fever, tachycardia, tachypnea, restlessness, and warm skin. What actions are appropriate? A. Start antibiotics immediately B. Restrict fluids C. Obtain cultures before antimicrobials, encourage rest, assist with oral hygiene, increase fluids D. Delay treatment Rationale: Cultures must be obtained prior to antibiotics to identify pathogens accurately. Supportive care helps prevent complications. A client receiving chemotherapy has a low platelet count. What is the priority consideration when measuring vital signs? A. Avoid oral temperature B. Use a tympanic thermometer C. Do not measure temperature rectally D. Measure temperature hourly Rationale: Rectal temperatures can cause mucosal trauma and bleeding in thrombocytopenic clients. Which guidelines should be followed when measuring respiratory rate? A. Count respirations for 15 seconds B. Ask the client to breathe deeply C. Place the client in semi-Fowler’s, rest an arm over the abdomen, observe a full cycle before counting D. Measure after activity Rationale: Proper positioning and observation ensure accurate respiratory assessment. A client with a fractured femur has a blood pressure of 140/94. What is the nurse’s priority action? A. Administer antihypertensive medication B. Notify the provider immediately C. Ask if the client is experiencing pain D. Restrict fluids Rationale: Pain commonly elevates blood pressure and should be assessed before initiating interventions. Which directions should the nurse give when testing cranial nerve V? A. Smile and frown B. Stick out your tongue C. Clench your teeth and report when you feel touch D. Follow my finger Rationale: Cranial nerve V controls facial sensation and the muscles of mastication. Which findings are expected when assessing the thyroid gland? A. Thyroid is not palpable B. Trachea deviates to one side C. Thyroid ascends with swallowing and trachea is midline D. Thyroid remains fixed Rationale: Normal thyroid movement and symmetry indicate normal anatomy. When examining an adult ear canal with an otoscope, which actions are appropriate? A. Insert upward and backward B. Touch the ear canal C. Insert the speculum slightly down and forward and visualize the tympanic membrane D. Apply pressure Rationale: Correct technique prevents injury and allows proper visualization of the tympanic membrane. What age-related findings are expected in the head and neck of an older adult? A. Increased hearing acuity B. Improved vision C. Tooth loss, glare intolerance, thickened eardrums D. Thinner tympanic membranes Rationale: Structural and sensory changes commonly occur with aging. Which breast findings are expected in an older adult client? A. Firm tissue and erect nipples B. Smaller nipples, pendulous breasts, nipple inversion C. Enlarged areola D. Increased glandular tissue Rationale: Aging causes decreased glandular tissue, loss of elasticity, and nipple changes. Which findings are expected when auscultating and percussing the thorax? A. Dullness B. Tympany C. Resonance, tactile fremitus, bronchovesicular sounds D. Absence of breath sounds Rationale: These findings indicate normal lung aeration and airflow. An abdominal assessment reveals distension, midline protrusion, taut skin, and no flank involvement. What is the cause of distension? A. Ascites B. Obesity C. Flatus D. Tumor Rationale: Gas causes symmetrical abdominal distension without flank involvement. Which heart sounds are heard at the left midclavicular line? A. Aortic valve closure B. Pulmonic valve closure C. Mitral and tricuspid valve closure D. Carotid bruit Rationale: The mitral valve is best heard at the left midclavicular line. What findings are expected when auscultating and percussing the abdomen? A. Dullness and silence B. Hyperresonance C. Tympany and borborygmi D. Friction rub Rationale: Tympany and audible bowel sounds indicate normal gastrointestinal function. Which skin findings are expected in a healthy client? A. Capillary refill greater than 4 seconds B. Thin soles of feet C. Capillary refill within 2 seconds and thick skin on soles D. Cyanosis Rationale: Normal circulation and protective skin thickening are expected findings. An older adult has tenting of the skin on the forearm. What explains this finding? A. Acute infection B. Loss of adipose tissue, dehydration, diminished skin elasticity C. Improved hydration D. Increased collagen Rationale: Aging and dehydration reduce skin turgor and elasticity. What should the nurse assess to evaluate peripheral vascular status in a postoperative knee surgery client? A. Reflexes B. Pulse oximetry C. Skin color, edema, and skin temperature D. Lung sounds Rationale: These findings assess circulation and detect complications such as impaired perfusion. Which conditions are characterized by vesicular skin lesions? A. Psoriasis B. Herpes simplex and varicella C. Acne D. Eczema Rationale: Vesicles are small fluid-filled lesions commonly seen in viral infections. Which skin finding requires immediate nursing intervention? A. Freckles B. Dry skin C. Cyanosis D. Skin tags Rationale: Cyanosis indicates inadequate oxygenation and requires urgent evaluation. Which findings are expected in a healthy young adult male’s musculoskeletal system? A. Kyphosis B. Lordosis C. Normal spinal curves and slightly larger muscles on the dominant side D. Muscle atrophy Rationale: Mild asymmetry due to dominance and normal spinal alignment are expected findings. To evaluate stereognosis, what should the nurse ask the client to do? A. Identify temperature differences B. Detect vibration C. Close eyes and identify a familiar object placed in the hand D. Follow a moving object Rationale: Stereognosis assesses cortical sensory function and the ability to recognize objects by touch alone.

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2026



ATI Fundamentals Proctored Exam
Study Guide 2026: Core Nursing
Concepts, Practice Exams, and Review
Questions
A nurse is assessing a client with a history of herpes zoster. Which finding suggests the client is
experiencing postherpetic neuralgia?
a. Vesicular lesions along a dermatome
b. Fever and malaise
c. Report of continued pain after the rash has resolved
d. Pruritus at the healed site

Rationale: Postherpetic neuralgia is characterized by persistent neuropathic pain after the
shingles rash has healed. Vesicles and fever occur during active infection, and itching alone does
not indicate neuralgia.



A nurse is providing care for a client receiving therapy for MRSA. Which action is most
important during treatment?
a. Monitor white blood cell count daily
b. Administer probiotics with antibiotics
c. Place the client on droplet precautions
d. Monitor the client’s serum antimicrobial levels

Rationale: Monitoring serum antimicrobial levels ensures therapeutic dosing and prevents
toxicity. WBC counts are supportive data, MRSA requires contact precautions (not droplet), and
probiotics are not a priority safety intervention.



Which finding is an atypical indication of infection in an older adult?
a. Fever
b. Elevated white blood cell count
c. Dysuria
d. Urinary incontinence

Rationale: Older adults may present with atypical signs such as new-onset urinary incontinence.
Fever, leukocytosis, and dysuria are typical infection indicators.

,2026




Which findings are manifestations of hypovolemia?
a. Bradycardia and hypertension
b. Bounding pulses and edema
c. Tachycardia, syncope, and decreased skin turgor
d. Jugular vein distention and crackles

Rationale: Hypovolemia leads to compensatory tachycardia, dizziness or syncope, and poor skin
turgor. The other options reflect fluid overload.



Which laboratory results indicate a client is developing dehydration?
a. Sodium 135 mEq/L
b. Urine specific gravity 1.010
c. Hematocrit 55%
d. Serum osmolality 275 mOsm/kg

Rationale: An elevated hematocrit reflects hemoconcentration from fluid loss. Normal sodium,
dilute urine, and low osmolality do not indicate dehydration.



Which client is most at risk for developing hypovolemia?
a. Client with chronic kidney disease
b. Client receiving corticosteroids
c. Client with SIADH
d. Client who has heart failure

Rationale: Clients with heart failure are often treated with diuretics, increasing the risk for
hypovolemia. The other conditions are more commonly associated with fluid retention.



A nurse is developing a plan of care for a client with hypernatremia. Which intervention is
appropriate?
a. Restrict oral fluids
b. Administer hypertonic saline
c. Increase sodium intake
d. Infuse hypotonic IV fluids

Rationale: Hypotonic fluids help dilute elevated sodium levels. Fluid restriction and hypertonic
saline worsen hypernatremia, and increasing sodium is contraindicated.

,2026


Which manifestation is associated with hypocalcemia?
a. Decreased deep tendon reflexes
b. Flaccid muscle tone
c. Hand and finger spasms during blood pressure cuff inflation
d. Polyuria

Rationale: Trousseau’s sign (carpal spasm with BP cuff inflation) indicates hypocalcemia.
Decreased reflexes and flaccidity occur with hypercalcemia.



A nurse reviews laboratory values. Which sodium level is within the expected reference range?
a. 128 mEq/L
b. 132 mEq/L
c. 140 mEq/L
d. 150 mEq/L

Rationale: Normal sodium levels range from 135–145 mEq/L. The other values indicate hypo- or
hypernatremia.



Which example best illustrates tertiary prevention?
a. Administering childhood vaccines
b. Screening adults for hypertension
c. Teaching smoking cessation
d. Improving quality of life and reducing symptoms in a client with HIV

Rationale: Tertiary prevention focuses on reducing complications and improving quality of life
in chronic illness. The other options reflect primary or secondary prevention.



A nurse suspects a colleague is impaired while on duty. What is the priority action?
a. Document observations in the medical record
b. Confront the nurse directly
c. Ignore the behavior unless a client is harmed
d. Notify the nurse manager immediately

Rationale: Protecting client safety is the priority, and reporting concerns to the nurse manager
follows proper chain of command. Direct confrontation or inaction is inappropriate.



A nurse is preparing to administer packed red blood cells. Which action is required before
initiating the transfusion?

, 2026


a. Prime tubing with lactated Ringer’s solution
b. Use a 22-gauge IV catheter
c. Have two nurses verify the blood product and client identification
d. Infuse the blood within 6 hours

Rationale: Two-nurse verification prevents transfusion errors. Only 0.9% NS is used for priming,
an 18–20 gauge catheter is required, and transfusion must be completed within 4 hours.

A nurse is reviewing laboratory results for a client. Which potassium level requires immediate
intervention?
a. 3.8 mEq/L
b. 4.5 mEq/L
c. 5.0 mEq/L
d. 6.2 mEq/L

Rationale: A potassium level above 5.0 mEq/L indicates hyperkalemia, which can cause life-
threatening cardiac dysrhythmias. The other values are within normal limits.



A nurse is caring for a client with suspected dehydration. Which additional laboratory finding
supports this diagnosis?
a. Serum sodium 136 mEq/L
b. Urine specific gravity 1.005
c. Serum osmolality 310 mOsm/kg
d. Hemoglobin 13 g/dL

Rationale: Elevated serum osmolality indicates concentrated blood due to fluid loss. Low urine
specific gravity and normal sodium or hemoglobin do not support dehydration.



A nurse is assessing a client with hypovolemia. Which assessment finding should the nurse
expect?
a. Bounding peripheral pulses
b. Hypertension
c. Crackles in lung bases
d. Orthostatic hypotension

Rationale: Hypovolemia causes decreased circulating volume, leading to orthostatic hypotension.
Bounding pulses and crackles suggest fluid overload.



A nurse is monitoring a client receiving IV vancomycin. Which adverse effect should the nurse
report immediately?

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