ATI RN Fundamentals Proctored Exam 2026: OFFICIAL STUDY RESOURCE: FULL TEST BANK WITH RATIONALES 2026 COMPLETE EXAM SOLUTION - MULTIPLE VERSIONS INCLUDED

A client who had abdominal surgery 24 hours ago reports a pulling sensation and pain in his surgical incision. The nurse checks the client’s surgical wound and finds it separated with viscera protruding. Which of the following interventions should the nurse perform? (Select all that apply.) A. Cover the area with saline-soaked sterile dressings B. Apply an abdominal binder snugly around the abdomen C. Use sterile gloves to apply gentle pressure to the exposed tissues D. Position the client supine with his hips and knees bent E. Offer the client a warm beverage, such as herbal tea • Correct Answers: A, D • Rationale: * A is correct: Moist, saline-soaked sterile dressings prevent the exposed organs from drying out and reduce the risk of environmental infection. o D is correct: Flexing the hips and knees reduces abdominal muscle tension, lowering the internal pressure on the open wound. o B & C are incorrect: Applying an abdominal binder or putting manual pressure on exposed tissues can cause tissue trauma or ischemia to the protruding organs. o E is incorrect: Offering anything by mouth is contraindicated; the client will need immediate emergency surgery. Question 2: Delegation (RN to LPN) – PCA Pump An RN is assigning care tasks to a Licensed Practical Nurse (LPN). Which of the following tasks should the LPN question? A. Assisting a client who is 24 hours post-op to use an incentive spirometer B. Collecting a clean-catch urine specimen C. Providing nasopharyngeal suctioning for a client with pneumonia D. Replacing the cartridge and tubing on a patient-controlled analgesia (PCA) pump • Correct Answer: D • Rationale: Replacing PCA cartridges and managing continuous IV narcotic infusions are high-risk interventions that require advanced RN-level clinical judgment, programming verification, and monitoring. Tasks A, B, and C fall safely within the standard scope of practice for an LPN. Question 3: Delegation to Assistive Personnel – Condom Catheter A nurse receives a shift report and is determining which tasks to assign to assistive personnel (AP). Which task is appropriate to delegate? A. Feeding a client admitted 24 hours ago with aspiration pneumonia B. Reinforcing cane-walking technique with a client using a quad cane C. Reapplying a condom catheter for a client with urinary incontinence D. Applying a sterile dressing to a pressure ulcer • Correct Answer: C • Rationale: The application of a condom catheter is noninvasive, routine, and carries low risk, making it appropriate for AP. Options A, B, and D involve clinical assessment, patient education/reinforcement, or sterile technique, all of which require licensed nursing judgment. Question 4: Delegation – Ambulating a Post-Op Client A nurse is delegating the ambulation of a client who had a knee arthroplasty 5 days ago. What information should be explicitly shared with the assistive personnel (AP)? (Select all that apply.) A. The roommate is up independently B. The client ambulates with slippers over antiembolic stockings C. The client uses a front-wheeled walker D. The client received pain medication 30 minutes ago E. The client is allergic to codeine F. The client ate 50% of his breakfast • Correct Answers: B, C, D • Rationale: * B, C, & D are correct: Safety parameters—such as proper footwear, the correct assistive mobility device, and the timing of recent analgesics (which affects both pain control and dizziness/fall risk)—must be communicated to the AP ensuring safe transit. o A, E, & F are incorrect: The roommate's status, medication allergies, and breakfast intake do not directly alter the immediate physical safety mechanics of ambulating this specific client. Question 5: Delegation – Tracheostomy Care by LPN Can an RN delegate routine tracheostomy care to an LPN for a client with pneumonia? A. Yes B. No • Correct Answer: A • Rationale: Tracheostomy care is within the standard LPN scope of practice, particularly for clients with established, stable airways. However, initial respiratory assessments or managing an acutely unstable airway must remain the direct responsibility of the RN. Question 6: The 5 Rights of Delegation A nurse is preparing an in-service educational program about professional delegation. Which of the following elements should she include as part of the "5 Rights of Delegation"? (Select all that apply.) A. Right client B. Right supervision/evaluation C. Right direction/communication D. Right time E. Right circumstances • Correct Answers: B, C, E • Rationale: The established 5 Rights of Delegation are: (1) Right task, (2) Right circumstance, (3) Right person, (4) Right direction/communication, and (5) Right supervision/evaluation. "Right client" and "Right time" are components of the 10 Rights of Medication Administration, not delegation. Question 7: Prioritization – Risk of Hypoxia A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse assess first? A. A client with pneumonia who has an oxygen saturation of 90% on room air B. A client with heart failure who is reporting 2+ pitting edema in the legs C. A client post-op day 1 with a hemoglobin level of 10 g/dL D. A client who is 2 days post-op and reports mild incisional pain rated 3/10 • Correct Answer: A • Rationale: Utilizing the ABCs (Airway, Breathing, Circulation) framework, an oxygen saturation of 90% indicates mild-to-moderate hypoxemia and demands immediate assessment. The remaining clients exhibit expected, stable clinical findings for their respective diagnoses and timelines. Question 8: Scope of Practice – LPN Role Which of the following clinical tasks is appropriate for an RN to delegate to an LPN? A. Initiating a blood product transfusion B. Titrating continuous IV insulin drips C. Monitoring a client receiving ongoing enteral tube feedings D. Performing an initial admission assessment on a newly admitted client • Correct Answer: C • Rationale: LPNs are qualified to monitor, maintain, and care for clients receiving ongoing, stable therapies like enteral tube feedings. Initiating blood components, managing complex titrated IV medications, and conducting baseline/initial assessments require advanced RN assessment skills. Question 9: Delegation – Assistive Personnel Scope Which of the following tasks is appropriate to delegate to unlicensed assistive personnel (UAP)? A. Assisting a post-stroke client to swallow oral medications B. Monitoring fluid intake and output (I&O) on an unstable client with fluid volume deficit C. Performing passive range-of-motion (PROM) exercises for a paralyzed client D. Teaching a diabetic client how to self-administer subcutaneous insulin • Correct Answer: C • Rationale: Performing passive range-of-motion exercises is a routine, non-complex physical task suitable for a UAP. A, B, and D require ongoing evaluation, risk management, data analysis, or formal patient education, which cannot be delegated. Question 10: Ethical/Legal – Informed Consent A nurse is witnessing an informed consent signature for a client scheduled for major surgery. Which of the following actions reflects the nurse’s correct legal role? A. Explain the surgical procedure and potential clinical complications B. Evaluate the client’s deep medical understanding of the procedure C. Confirm that the provider obtained the client’s consent and that the signature is authentic D. Describe the alternative treatments and the risks of not undergoing the surgery • Correct Answer: C • Rationale: The legal role of the nurse witnessing consent is strictly to verify that the signature on the form is authentic, that the client appears competent, and that the consent is voluntary. Explaining procedures, risks, and alternatives is entirely the provider's responsibility. Question 11: Medication Administration – Digoxin Toxicity A client receiving digoxin reports sudden nausea and blurred, yellowish vision. Which of the following actions should the nurse take first? A. Check the client’s apical pulse B. Notify the healthcare provider C. Review the client’s most recent serum digoxin level D. Administer a prescribed PRN antiemetic • Correct Answer: A • Rationale: Nausea and visual disturbances (halos or blurred vision) are classic, early indicators of digoxin toxicity. The nurse must immediately assess the client's apical pulse for a full minute to screen for bradycardia or arrhythmias before holding the drug or contacting the provider. Question 12: Safety – Medication Error Prevention A nurse prepares to administer an ordered medication but notes that the dosage listed in the electronic medical record is significantly higher than the standard therapeutic range. What should the nurse do? A. Administer the dose as written by the provider B. Call the pharmacy to see if they can clarify and dispense it C. Notify the prescribing provider to clarify the order before administering D. Ask another staff nurse if they think the dose is acceptable • Correct Answer: C • Rationale: If a medication order falls outside safe parameters, the nurse holds a legal duty to protect the patient. The nurse must clarify the order directly with the prescribing provider before administration. Question 13: Assignment – Post-Operative Transfer A nurse manager of a medical-surgical unit is assigning care responsibilities for the oncoming shift. A client is awaiting transfer back to the unit from the Post-Anesthesia Care Unit (PACU) following thoracic surgery. To which staff member should the nurse assign this client? A. Charge nurse B. Registered Nurse (RN) C. Licensed Practical Nurse (LPN) D. Assistive Personnel (AP) • Correct Answer: B • Rationale: A client returning directly from major surgery (thoracic surgery) is potentially unstable and requires comprehensive physical assessment, stabilization, and the establishment of a nursing care plan. This complex level of care must be assigned to an RN. Question 14: Legal Torts – Threat of Restraint A nurse observes assistive personnel (AP) reprimanding a client for not using the urinal properly. The AP tells the client that she will force him into a diaper if he does not use the urinal more carefully next time. Which of the following intentional torts has the AP committed? A. Assault B. Battery C. False imprisonment D. Invasion of privacy • Correct Answer: A • Rationale: Assault is an intentional action that places a person in fear or apprehension of immediate, harmful, or offensive contact. The AP's verbal threat to apply an unwanted garment/restraint constitutes assault. Battery requires actual physical contact. Question 15: Legal Torts – Chemical Restraint An adult client who is alert and competent tells the nurse that he is leaving the hospital against medical advice (AMA). The nurse believes this is a dangerous choice, so she administers an unrequested PRN sedative medication alongside his usual scheduled medications to keep him calm and in bed. Which of the following intentional torts has the nurse committed? A. Assault B. False imprisonment C. Negligence D. Breach of confidentiality • Correct Answer: B • Rationale: Administering an unauthorized medication to physically or chemically restrict a competent individual’s freedom of movement or to prevent them from leaving a facility constitutes false imprisonment. Because the patient did not request or consent to the sedative for this purpose, it serves as an illegal chemical restraint.