NEW 2026 ATI RN Fundamentals Exam Prep | 180
Q&A | Detailed Explanations | Covers Safety,
Health Assessment, & Nursing Process | RN
Fundamentals 2026-2028
Achieve a Level 3 on your 2026 ATI RN Fundamentals Proctored Exam with this ultimate 180-
question practice bank.
This study resource is meticulously organized into three comprehensive sections, each containing 60
high-yield, long-form scenario questions. Unlike basic test banks, this guide provides detailed grey-box
explanations for every answer, ensuring you understand the clinical judgment behind the "best" nursing
action.
What’s Included:
Section 1: Basic Nursing Care, Safety & Infection Control (Hygiene, mobility, PPE, and fall prevention).
Section 2: Health Assessment & Physical Care (Vital signs, physical exam techniques, wound staging,
and lab values).
Section 3: Nursing Process & Professionalism (Ethics, legal standards, delegation, SBAR, and
prioritization).
Section 1: Basic Nursing Care, Safety & Infection Control
1. A nurse is preparing to administer a soap-suds enema to a client who has constipation.
After inserting the rectal tube, the client reports sudden, severe abdominal cramping.
Which of the following actions should the nurse take?
A. Increase the height of the enema container to complete the procedure quickly.
,B. Stop the procedure immediately and notify the healthcare provider.
C. Lower the enema container to slow the rate of the fluid infusion.
D. Encourage the client to take short, panting breaths through the mouth.
Answer: C. Lower the enema container to slow the rate of the fluid infusion.
Explanation: Sudden cramping during an enema is usually caused by the pressure of
the fluid. Lowering the container decreases the pressure and slows the flow, which
typically relieves the cramping. The nurse can also briefly clamp the tube until the
cramp passes.
2. A nurse is caring for a client who is unconscious and requires oral hygiene.
Which of the following actions is the priority for the nurse to take?
A. Use two fingers to keep the client's mouth open during the procedure.
B. Place the client in a side-lying position with the head turned toward the nurse.
C. Swab the client's mouth with lemon-glycerin swabs every 4 hours.
D. Apply a thin layer of petroleum jelly to the client's lips.
Answer: B. Place the client in a side-lying position with the head turned toward
the nurse.
Explanation: The side-lying (lateral) position is the priority because it allows secretions
to drain out of the mouth by gravity, significantly reducing the risk of aspiration. Fingers
should never be placed in the mouth of an unconscious client due to the risk of a bite
reflex.
3. A nurse is preparing to lift a heavy object from the floor to a table. Which of the
following actions demonstrates the correct use of body mechanics?
A. Bend at the waist to reach the object while keeping the legs straight.
B. Spread the feet apart to create a wide base of support.
C. Hold the object as far away from the body as possible while lifting.
D. Twist the torso to place the object on the table once it is lifted.
Answer: B. Spread the feet apart to create a wide base of support.
Explanation: A wide base of support increases stability. The nurse should also bend at
the knees (not the waist), hold the object close to the body’s center of gravity, and pivot
the feet rather than twisting the spine.
4. A nurse is planning care for a client who has been placed on "Contact
Precautions" for a Vancomycin-resistant enterococcus (VRE) infection. Which of the
following actions should the nurse include in the plan?
,A. Wear an N95 respirator mask when entering the client's room.
B. Use a dedicated stethoscope and blood pressure cuff for the client.
C. Ensure the client's room has negative-pressure airflow.
D. Wear a surgical mask when working within 3 feet of the client.
Answer: B. Use a dedicated stethoscope and blood pressure cuff for the client.
Explanation: Contact precautions require the use of dedicated equipment or thorough
disinfection between patients to prevent indirect transmission. Gowns and gloves are
required, but N95 masks and negative pressure are reserved for airborne precautions.
5. A nurse is assessing a client for orthostatic hypotension. Which of the following
findings indicates a positive result?
A. A decrease in systolic blood pressure of 10 mmHg when standing.
B. An increase in heart rate of 5 beats per minute when sitting up.
C. A decrease in systolic blood pressure of 20 mmHg when moving from supine to
standing.
D. A decrease in diastolic blood pressure of 5 mmHg when moving from supine to
sitting.
Answer: C. A decrease in systolic blood pressure of 20 mmHg when moving from
supine to standing.
Explanation: Orthostatic hypotension is defined as a drop in systolic BP of at least 20
mmHg or a drop in diastolic BP of at least 10 mmHg within three minutes of changing
positions.
6. A nurse is preparing to perform a sterile dressing change for a client. Which of
the following actions will result in the contamination of the sterile field?
A. Opening the first flap of the sterile package away from the nurse's body.
B. Reaching over the sterile field to pick up a sterile gauze pad.
C. Dropping a sterile instrument onto the center of the sterile drape.
D. Keeping the sterile tray at or above the level of the nurse's waist.
Answer: B. Reaching over the sterile field to pick up a sterile gauze pad.
Explanation: Reaching over a sterile field is a violation of surgical asepsis because
microorganisms from the nurse's non-sterile sleeves or skin can fall onto the field.
Sterile items must only be approached from the sides or front.
7. A nurse is performing a skin assessment on a client who is bedbound. Which of
the following bony prominences is at the highest risk for the development of a pressure
, injury?
A. Patella
B. Sacrum
C. Scapula
D. Olecranon
Answer: B. Sacrum.
Explanation: The sacrum is the most common site for pressure injuries because it
bears the most weight when a client is in the supine or semi-Fowler's position.
8. A nurse is providing discharge teaching to a client who will be using a walker at
home. Which of the following instructions should the nurse include?
A. "Advance the walker about 18 inches forward with each step."
B. "Move your stronger leg forward into the walker first."
C. "Ensure the height of the walker allows for a 45-degree bend at the elbows."
D. "Pick up the walker and move it forward, then step into it with the affected leg."
Answer: D. "Pick up the walker and move it forward, then step into it with the
affected leg."
Explanation: The correct sequence for using a walker is to move the walker forward
about 6 to 10 inches, then step forward with the affected or weaker leg, followed by the
stronger leg. The elbow bend should be about 15 to 30 degrees.
9. A nurse is documenting an incident report after a client fell while ambulating.
Which of the following information should the nurse include in the medical record?
A. "An incident report has been filed and sent to the risk management department."
B. "The client fell because the floor was slippery from a recent cleaning."
C. "Client found lying on the floor; stated 'I slipped and fell.' Provider notified."
D. "Client fell due to nurse's failure to provide a gait belt during ambulation."
Answer: C. "Client found lying on the floor; stated 'I slipped and fell.' Provider
notified."
Explanation: The medical record should contain only objective, factual data about the
event. The nurse should never document that an incident report was completed in the
patient's chart, as the report is an internal tool for the facility.
10. A nurse is preparing to provide tracheostomy care for a client. Which of the
following actions should the nurse take first?
A. Remove the old tracheostomy ties and replace them with new ones.
Q&A | Detailed Explanations | Covers Safety,
Health Assessment, & Nursing Process | RN
Fundamentals 2026-2028
Achieve a Level 3 on your 2026 ATI RN Fundamentals Proctored Exam with this ultimate 180-
question practice bank.
This study resource is meticulously organized into three comprehensive sections, each containing 60
high-yield, long-form scenario questions. Unlike basic test banks, this guide provides detailed grey-box
explanations for every answer, ensuring you understand the clinical judgment behind the "best" nursing
action.
What’s Included:
Section 1: Basic Nursing Care, Safety & Infection Control (Hygiene, mobility, PPE, and fall prevention).
Section 2: Health Assessment & Physical Care (Vital signs, physical exam techniques, wound staging,
and lab values).
Section 3: Nursing Process & Professionalism (Ethics, legal standards, delegation, SBAR, and
prioritization).
Section 1: Basic Nursing Care, Safety & Infection Control
1. A nurse is preparing to administer a soap-suds enema to a client who has constipation.
After inserting the rectal tube, the client reports sudden, severe abdominal cramping.
Which of the following actions should the nurse take?
A. Increase the height of the enema container to complete the procedure quickly.
,B. Stop the procedure immediately and notify the healthcare provider.
C. Lower the enema container to slow the rate of the fluid infusion.
D. Encourage the client to take short, panting breaths through the mouth.
Answer: C. Lower the enema container to slow the rate of the fluid infusion.
Explanation: Sudden cramping during an enema is usually caused by the pressure of
the fluid. Lowering the container decreases the pressure and slows the flow, which
typically relieves the cramping. The nurse can also briefly clamp the tube until the
cramp passes.
2. A nurse is caring for a client who is unconscious and requires oral hygiene.
Which of the following actions is the priority for the nurse to take?
A. Use two fingers to keep the client's mouth open during the procedure.
B. Place the client in a side-lying position with the head turned toward the nurse.
C. Swab the client's mouth with lemon-glycerin swabs every 4 hours.
D. Apply a thin layer of petroleum jelly to the client's lips.
Answer: B. Place the client in a side-lying position with the head turned toward
the nurse.
Explanation: The side-lying (lateral) position is the priority because it allows secretions
to drain out of the mouth by gravity, significantly reducing the risk of aspiration. Fingers
should never be placed in the mouth of an unconscious client due to the risk of a bite
reflex.
3. A nurse is preparing to lift a heavy object from the floor to a table. Which of the
following actions demonstrates the correct use of body mechanics?
A. Bend at the waist to reach the object while keeping the legs straight.
B. Spread the feet apart to create a wide base of support.
C. Hold the object as far away from the body as possible while lifting.
D. Twist the torso to place the object on the table once it is lifted.
Answer: B. Spread the feet apart to create a wide base of support.
Explanation: A wide base of support increases stability. The nurse should also bend at
the knees (not the waist), hold the object close to the body’s center of gravity, and pivot
the feet rather than twisting the spine.
4. A nurse is planning care for a client who has been placed on "Contact
Precautions" for a Vancomycin-resistant enterococcus (VRE) infection. Which of the
following actions should the nurse include in the plan?
,A. Wear an N95 respirator mask when entering the client's room.
B. Use a dedicated stethoscope and blood pressure cuff for the client.
C. Ensure the client's room has negative-pressure airflow.
D. Wear a surgical mask when working within 3 feet of the client.
Answer: B. Use a dedicated stethoscope and blood pressure cuff for the client.
Explanation: Contact precautions require the use of dedicated equipment or thorough
disinfection between patients to prevent indirect transmission. Gowns and gloves are
required, but N95 masks and negative pressure are reserved for airborne precautions.
5. A nurse is assessing a client for orthostatic hypotension. Which of the following
findings indicates a positive result?
A. A decrease in systolic blood pressure of 10 mmHg when standing.
B. An increase in heart rate of 5 beats per minute when sitting up.
C. A decrease in systolic blood pressure of 20 mmHg when moving from supine to
standing.
D. A decrease in diastolic blood pressure of 5 mmHg when moving from supine to
sitting.
Answer: C. A decrease in systolic blood pressure of 20 mmHg when moving from
supine to standing.
Explanation: Orthostatic hypotension is defined as a drop in systolic BP of at least 20
mmHg or a drop in diastolic BP of at least 10 mmHg within three minutes of changing
positions.
6. A nurse is preparing to perform a sterile dressing change for a client. Which of
the following actions will result in the contamination of the sterile field?
A. Opening the first flap of the sterile package away from the nurse's body.
B. Reaching over the sterile field to pick up a sterile gauze pad.
C. Dropping a sterile instrument onto the center of the sterile drape.
D. Keeping the sterile tray at or above the level of the nurse's waist.
Answer: B. Reaching over the sterile field to pick up a sterile gauze pad.
Explanation: Reaching over a sterile field is a violation of surgical asepsis because
microorganisms from the nurse's non-sterile sleeves or skin can fall onto the field.
Sterile items must only be approached from the sides or front.
7. A nurse is performing a skin assessment on a client who is bedbound. Which of
the following bony prominences is at the highest risk for the development of a pressure
, injury?
A. Patella
B. Sacrum
C. Scapula
D. Olecranon
Answer: B. Sacrum.
Explanation: The sacrum is the most common site for pressure injuries because it
bears the most weight when a client is in the supine or semi-Fowler's position.
8. A nurse is providing discharge teaching to a client who will be using a walker at
home. Which of the following instructions should the nurse include?
A. "Advance the walker about 18 inches forward with each step."
B. "Move your stronger leg forward into the walker first."
C. "Ensure the height of the walker allows for a 45-degree bend at the elbows."
D. "Pick up the walker and move it forward, then step into it with the affected leg."
Answer: D. "Pick up the walker and move it forward, then step into it with the
affected leg."
Explanation: The correct sequence for using a walker is to move the walker forward
about 6 to 10 inches, then step forward with the affected or weaker leg, followed by the
stronger leg. The elbow bend should be about 15 to 30 degrees.
9. A nurse is documenting an incident report after a client fell while ambulating.
Which of the following information should the nurse include in the medical record?
A. "An incident report has been filed and sent to the risk management department."
B. "The client fell because the floor was slippery from a recent cleaning."
C. "Client found lying on the floor; stated 'I slipped and fell.' Provider notified."
D. "Client fell due to nurse's failure to provide a gait belt during ambulation."
Answer: C. "Client found lying on the floor; stated 'I slipped and fell.' Provider
notified."
Explanation: The medical record should contain only objective, factual data about the
event. The nurse should never document that an incident report was completed in the
patient's chart, as the report is an internal tool for the facility.
10. A nurse is preparing to provide tracheostomy care for a client. Which of the
following actions should the nurse take first?
A. Remove the old tracheostomy ties and replace them with new ones.
