ATI PN Fundamentals Proctored Exam
2026 (NGN-Style Questions & Case
Scenarios) – Actual Qs & Ans with
Rationales"
Questions 1–10: Safety & Infection Control
1. A nurse is preparing to change the linens on a bed occupied by a client who
has a diagnosed Clostridioides difficile (C. diff) infection. Which of the following
personal protective equipment (PPE) combinations is required?
A) Mask and gloves
B) Gown and gloves
C) N95 respirator and gown
D) Goggles and mask
Correct Answer: B) Gown and gloves
Rationale: Clostridioides difficile is transmitted via contact with surfaces
contaminated by fecal matter or bacterial spores. Contact precautions mandate
wearing a clean gown and gloves before entering the client's room to prevent
transferring spores onto your skin or uniform.
2. A nurse is performing hand hygiene after caring for a client with Clostridioides
difficile. Which of the following cleaning agents must the nurse use?
A) Alcohol-based hand sanitizer
B) Chlorhexidine gluconate wipes
C) Antimicrobial soap and running water
D) Isopropyl alcohol liquid rub
Correct Answer: C) Antimicrobial soap and running water
Rationale: C. diff bacterial spores are physically resistant to alcohol-based hand
sanitizers and rubs. The mechanical friction of rubbing hands under running
water with soap is the only effective way to physically rinse the spores off your
skin.
,3. A nurse enters a client's room and notices flames shooting out from an
electronic IV infusion pump. According to the RACE fire safety acronym, which
action must the nurse take first?
A) Pull the fire alarm box in the hallway.
B) Close the door to the client's room.
C) Evacuate the client from the room to safety.
D) Aim a fire extinguisher at the base of the flames. [1, 2]
Correct Answer: C) Evacuate the client from the room to safety.
Rationale: The RACE acronym outlines fire safety priorities in order: R =
Rescue/Remove anyone in immediate danger; A = Activate the alarm; C =
Confine/Contain the fire by closing doors; E = Extinguish the fire. Client rescue
always takes immediate precedence. [1, 2]
4. A nurse is evaluating a new assistive personnel (AP) who is applying soft wrist
restraints on a confused client. Which action by the AP requires immediate
intervention by the nurse?
A) Tying the restraint strap to the moving bed frame.
B) Securing the restraint using a quick-release knot.
C) Tying the restraint strap to the elevated side rail.
D) Allowing two fingers of space between the restraint and wrist. [1, 2, 3]
Correct Answer: C) Tying the restraint strap to the elevated side rail.
Rationale: Restraints must never be tied to a side rail. If the side rail is lowered or
moved, it can pull tightly against the client's limb and cause severe
neurovascular injury or fracture. Restraints must always be secured to the
stationary bed frame.
5. A nurse is preparing a sterile field to perform a wound dressing change. Which
of the following actions will cause a contamination of the sterile area?
A) Opening the first flap of the sterile package away from the body.
B) Keeping the sterile gloved hands above waist level.
C) Placing an item within the 1-inch (2.5 cm) outer edge of the sterile drape.
D) Dropping sterile gauze onto the middle of the sterile field.
Correct Answer: C) Placing an item within the 1-inch (2.5 cm) outer edge of the
sterile drape.
Rationale: The outer 1-inch (2.5 cm) border of a sterile field or drape is
considered unsterile and contaminated. Any sterile item placed within this border
is no longer sterile and must be discarded. [1]
,6. A nurse is teaching an older adult client how to use a standard cane for
stability following a stroke. Which instruction should the nurse include?
A) "Hold the cane in the hand opposite your weak leg."
B) "Hold the cane in the hand on your weak side."
C) "Move your strong leg forward first, then advance the cane."
D) "Keep the cane 12 inches out to the side of your foot."
Correct Answer: A) "Hold the cane in the hand opposite your weak leg."
Rationale: A cane must always be held on the client's stronger, unaffected side.
This provides a wider base of support and mimics the natural, opposing
movement of the arms and legs during normal ambulation. [1]
7. A nurse is admitting a client who is suspected of having pulmonary
tuberculosis. Which of the following isolation precautions should the nurse
implement?
A) Droplet precautions
B) Airborne precautions
C) Contact precautions
D) Protective isolation
Correct Answer: B) Airborne precautions
Rationale: Tuberculosis is caused by microscopic droplet nuclei that remain
suspended in the air for long periods. Airborne precautions require placing the
client in a negative-airflow private room and wearing a fitted N95 respirator. [1, 2]
8. A nurse is reviewing a prescription for physical restraints for a combative
client. Which of the following details must be included for the restraint order to be
legally valid?
A) A PRN (as-needed) directive for renewal.
B) The specific type of restraint and a clear time limit.
C) A authorization allowing the order to last for 48 hours.
D) A list of sedatives that can replace the physical restraint.
Correct Answer: B) The specific type of restraint and a clear time limit.
Rationale: Legally, a restraint order can never be written as a PRN order. It must
specify the exact clinical reason, type of restraint (e.g., wrist vs. vest), and
duration. Orders for adults must be renewed every 4 hours up to a maximum of
24 hours.
, 9. A nurse is preparing to insert a peripheral IV line for an adult client. Which of
the following solutions should the nurse use to cleanse the insertion site?
A) 70% isopropyl alcohol only
B) Hydrogen peroxide solution
C) Chlorhexidine gluconate solution
D) Sterile normal saline
Correct Answer: C) Chlorhexidine gluconate solution
Rationale: Evidence-based guidelines recommend chlorhexidine gluconate as the
primary antiseptic agent for skin preparation before invasive peripheral or central
venous line placement because it significantly reduces skin-surface bacterial
counts.
10. A nurse is caring for an older adult client who is at high risk for falls. Which of
the following proactive safety interventions should the nurse perform?
A) Keep all four side rails raised at all times.
B) Place the client's bed in its highest position.
C) Keep the call light within the client's reach.
D) Lock the wheels of the bed only during transfers. [1, 2]
Correct Answer: C) Keep the call light within the client's reach.
Rationale: Keeping the call bell accessible ensures the client can request
assistance easily before attempting to get out of bed alone. Bed wheels must
remain locked at all times, the bed must stay in its lowest position, and raising
four rails is considered an illegal restraint. [1, 2]
Questions 11–20: Basic Care, Prioritization & Ethics
11. A nurse on a medical-surgical floor is prioritizing care for four clients at the
start of the shift. Which client should the nurse assess first?
A) A client who is 2 days postoperative and reports a pain level of 6 out of 10.
B) A client with a history of asthma who is experiencing new-onset expiratory wheezing.
C) A client with diabetes whose fasting blood glucose level is 110 mg/dL.
D) A client scheduled for a physical therapy session in 30 minutes.
Correct Answer: B) A client with a history of asthma who is experiencing new-
onset expiratory wheezing.
2026 (NGN-Style Questions & Case
Scenarios) – Actual Qs & Ans with
Rationales"
Questions 1–10: Safety & Infection Control
1. A nurse is preparing to change the linens on a bed occupied by a client who
has a diagnosed Clostridioides difficile (C. diff) infection. Which of the following
personal protective equipment (PPE) combinations is required?
A) Mask and gloves
B) Gown and gloves
C) N95 respirator and gown
D) Goggles and mask
Correct Answer: B) Gown and gloves
Rationale: Clostridioides difficile is transmitted via contact with surfaces
contaminated by fecal matter or bacterial spores. Contact precautions mandate
wearing a clean gown and gloves before entering the client's room to prevent
transferring spores onto your skin or uniform.
2. A nurse is performing hand hygiene after caring for a client with Clostridioides
difficile. Which of the following cleaning agents must the nurse use?
A) Alcohol-based hand sanitizer
B) Chlorhexidine gluconate wipes
C) Antimicrobial soap and running water
D) Isopropyl alcohol liquid rub
Correct Answer: C) Antimicrobial soap and running water
Rationale: C. diff bacterial spores are physically resistant to alcohol-based hand
sanitizers and rubs. The mechanical friction of rubbing hands under running
water with soap is the only effective way to physically rinse the spores off your
skin.
,3. A nurse enters a client's room and notices flames shooting out from an
electronic IV infusion pump. According to the RACE fire safety acronym, which
action must the nurse take first?
A) Pull the fire alarm box in the hallway.
B) Close the door to the client's room.
C) Evacuate the client from the room to safety.
D) Aim a fire extinguisher at the base of the flames. [1, 2]
Correct Answer: C) Evacuate the client from the room to safety.
Rationale: The RACE acronym outlines fire safety priorities in order: R =
Rescue/Remove anyone in immediate danger; A = Activate the alarm; C =
Confine/Contain the fire by closing doors; E = Extinguish the fire. Client rescue
always takes immediate precedence. [1, 2]
4. A nurse is evaluating a new assistive personnel (AP) who is applying soft wrist
restraints on a confused client. Which action by the AP requires immediate
intervention by the nurse?
A) Tying the restraint strap to the moving bed frame.
B) Securing the restraint using a quick-release knot.
C) Tying the restraint strap to the elevated side rail.
D) Allowing two fingers of space between the restraint and wrist. [1, 2, 3]
Correct Answer: C) Tying the restraint strap to the elevated side rail.
Rationale: Restraints must never be tied to a side rail. If the side rail is lowered or
moved, it can pull tightly against the client's limb and cause severe
neurovascular injury or fracture. Restraints must always be secured to the
stationary bed frame.
5. A nurse is preparing a sterile field to perform a wound dressing change. Which
of the following actions will cause a contamination of the sterile area?
A) Opening the first flap of the sterile package away from the body.
B) Keeping the sterile gloved hands above waist level.
C) Placing an item within the 1-inch (2.5 cm) outer edge of the sterile drape.
D) Dropping sterile gauze onto the middle of the sterile field.
Correct Answer: C) Placing an item within the 1-inch (2.5 cm) outer edge of the
sterile drape.
Rationale: The outer 1-inch (2.5 cm) border of a sterile field or drape is
considered unsterile and contaminated. Any sterile item placed within this border
is no longer sterile and must be discarded. [1]
,6. A nurse is teaching an older adult client how to use a standard cane for
stability following a stroke. Which instruction should the nurse include?
A) "Hold the cane in the hand opposite your weak leg."
B) "Hold the cane in the hand on your weak side."
C) "Move your strong leg forward first, then advance the cane."
D) "Keep the cane 12 inches out to the side of your foot."
Correct Answer: A) "Hold the cane in the hand opposite your weak leg."
Rationale: A cane must always be held on the client's stronger, unaffected side.
This provides a wider base of support and mimics the natural, opposing
movement of the arms and legs during normal ambulation. [1]
7. A nurse is admitting a client who is suspected of having pulmonary
tuberculosis. Which of the following isolation precautions should the nurse
implement?
A) Droplet precautions
B) Airborne precautions
C) Contact precautions
D) Protective isolation
Correct Answer: B) Airborne precautions
Rationale: Tuberculosis is caused by microscopic droplet nuclei that remain
suspended in the air for long periods. Airborne precautions require placing the
client in a negative-airflow private room and wearing a fitted N95 respirator. [1, 2]
8. A nurse is reviewing a prescription for physical restraints for a combative
client. Which of the following details must be included for the restraint order to be
legally valid?
A) A PRN (as-needed) directive for renewal.
B) The specific type of restraint and a clear time limit.
C) A authorization allowing the order to last for 48 hours.
D) A list of sedatives that can replace the physical restraint.
Correct Answer: B) The specific type of restraint and a clear time limit.
Rationale: Legally, a restraint order can never be written as a PRN order. It must
specify the exact clinical reason, type of restraint (e.g., wrist vs. vest), and
duration. Orders for adults must be renewed every 4 hours up to a maximum of
24 hours.
, 9. A nurse is preparing to insert a peripheral IV line for an adult client. Which of
the following solutions should the nurse use to cleanse the insertion site?
A) 70% isopropyl alcohol only
B) Hydrogen peroxide solution
C) Chlorhexidine gluconate solution
D) Sterile normal saline
Correct Answer: C) Chlorhexidine gluconate solution
Rationale: Evidence-based guidelines recommend chlorhexidine gluconate as the
primary antiseptic agent for skin preparation before invasive peripheral or central
venous line placement because it significantly reduces skin-surface bacterial
counts.
10. A nurse is caring for an older adult client who is at high risk for falls. Which of
the following proactive safety interventions should the nurse perform?
A) Keep all four side rails raised at all times.
B) Place the client's bed in its highest position.
C) Keep the call light within the client's reach.
D) Lock the wheels of the bed only during transfers. [1, 2]
Correct Answer: C) Keep the call light within the client's reach.
Rationale: Keeping the call bell accessible ensures the client can request
assistance easily before attempting to get out of bed alone. Bed wheels must
remain locked at all times, the bed must stay in its lowest position, and raising
four rails is considered an illegal restraint. [1, 2]
Questions 11–20: Basic Care, Prioritization & Ethics
11. A nurse on a medical-surgical floor is prioritizing care for four clients at the
start of the shift. Which client should the nurse assess first?
A) A client who is 2 days postoperative and reports a pain level of 6 out of 10.
B) A client with a history of asthma who is experiencing new-onset expiratory wheezing.
C) A client with diabetes whose fasting blood glucose level is 110 mg/dL.
D) A client scheduled for a physical therapy session in 30 minutes.
Correct Answer: B) A client with a history of asthma who is experiencing new-
onset expiratory wheezing.
