ATI Fundamentals Proctored Exam Study Guide | 2026/2027
ATI Fundamentals Proctored Exam Study Guide
Latest 2026/2027 Edition
200 Comprehensive Questions with Rationales
Aligned with NCLEX-Style Competency Standards
Section 1: Safe, Effective Care Environment
(Management of Care | Safety and Infection Control)
Q1: A nurse is caring for a client who asks about the purpose of a living will. Which of the following responses by
the nurse is appropriate?
A. A. "It authorizes someone to make financial decisions for you."
B. B. "It documents your wishes regarding medical treatment if you become unable to communicate."
[CORRECT]
C. C. "It is required for all hospital admissions."
D. D. "It allows your provider to override your family's wishes."
Correct Answer: B
Rationale: A living will is a legal advance directive that documents a client's wishes regarding medical treatment in the event
they lose decision-making capacity. It does not address financial decisions (power of attorney does that), is not mandatory for
admission, and does not authorize providers to override family wishes. The nurse's role includes providing information and
ensuring the client understands the document.
Q2: A nurse is witnessing a client sign an informed consent form for a surgical procedure. Which of the following
actions should the nurse take?
A. A. Explain the risks and benefits of the procedure to the client.
B. B. Ensure the client understands the procedure, risks, benefits, and alternatives before signing.
[CORRECT]
C. C. Sign the consent form as the primary witness on behalf of the facility.
D. D. Contact the family to obtain verbal consent before the client signs.
Correct Answer: B
Rationale: The nurse witnessing informed consent must verify that the client understands the procedure, its risks, benefits, and
alternatives, and that consent is voluntary. The provider is responsible for explaining the procedure. The nurse serves as a
witness to the signature, not as the primary explainer. Family consent does not replace the competent client's own consent.
, ATI Fundamentals Proctored Exam Study Guide | 2026/2027
Q3: A nurse is caring for a client who states, "I do not want the blood transfusion." Which of the following responses
by the nurse is best?
A. A. "You must have the transfusion; it is an order from your provider."
B. B. "I will document your refusal and notify your provider of your decision." [CORRECT]
C. C. "Let me call your family so they can convince you to accept it."
D. D. "If you refuse, you could die from blood loss."
Correct Answer: B
Rationale: Clients have the right to refuse treatment, including blood transfusions, even if refusal may result in death. The nurse
must respect client autonomy, document the refusal, and notify the provider. Coercing the client, threatening, or involving family
to override the client's decision violates ethical principles of autonomy and informed consent.
Q4: A nurse is assigning tasks to an LPN and a UAP on a medical-surgical unit. Which of the following tasks should
the nurse delegate to the LPN?
A. A. Obtaining a client's admission vital signs and weight.
B. B. Administering oral and intramuscular medications to stable clients. [CORRECT]
C. C. Providing total assistance with all activities of daily living.
D. D. Performing initial assessment on a newly admitted client.
Correct Answer: B
Rationale: LPNs can administer oral, IM, and SubQ medications to stable clients under RN supervision. Obtaining admission
vital signs is within UAP scope. Total ADL assistance can be delegated to UAPs. Initial assessment requires RN-level education
and clinical judgment and cannot be delegated to an LPN.
Q5: Which of the following tasks is appropriate for a nurse to delegate to an unlicensed assistive personnel (UAP)?
A. A. Performing a wound assessment on a postoperative client.
B. B. Teaching a client about insulin self-administration.
C. C. Recording intake and output and assisting with ambulation. [CORRECT]
D. D. Evaluating a client's response to pain medication.
Correct Answer: C
Rationale: UAPs can perform tasks such as recording intake and output, assisting with ambulation, measuring vital signs, and
basic ADLs. Wound assessment, client teaching, and evaluating responses to medications require RN-level education and
clinical judgment and cannot be delegated to UAPs per the Five Rights of Delegation.
Q6: A nurse is preparing to delegate a task. Which of the following reflects the "right direction/communication"
component of the Five Rights of Delegation?
A. A. Ensuring the delegatee has the appropriate scope of practice.
B. B. Providing clear, specific instructions about the task to be completed. [CORRECT]
C. C. Evaluating the delegatee's performance of the task after completion.
D. D. Assessing whether the client's condition is stable enough for delegation.
Correct Answer: B
Rationale: The Five Rights of Delegation include: right task, right circumstance, right person, right direction/communication,
and right supervision/evaluation. "Right direction/communication" means the nurse provides clear, specific instructions about
what needs to be done, including any specific observations or reporting requirements. Scope of practice is the "right person,"
evaluation is the "right supervision," and client stability is the "right circumstance."
, ATI Fundamentals Proctored Exam Study Guide | 2026/2027
Q7: A nurse receives a phone call from a person requesting information about a client's diagnosis. Which of the
following responses by the nurse is appropriate?
A. A. "I can confirm the client is here but cannot share diagnosis information."
B. B. "You will need to contact the client directly for any medical information." [CORRECT]
C. C. "The client was admitted for pneumonia and is improving."
D. D. "I can transfer you to the client's nurse for an update."
Correct Answer: B
Rationale: HIPAA requires that all client information remain confidential. The nurse cannot confirm or deny a client's presence
in the facility or share any health information without the client's written authorization. Even confirming a client is in the facility
constitutes a privacy violation. The caller should be directed to contact the client directly.
Q8: A nurse is caring for a client who wishes to complete a Durable Power of Attorney for Healthcare (DPOA-HC).
The nurse should explain that this document does which of the following?
A. A. Specifies the client's end-of-life treatment preferences in writing.
B. B. Appoints a designated individual to make healthcare decisions if the client becomes incapacitated.
[CORRECT]
C. C. Takes effect immediately upon signing regardless of cognitive status.
D. D. Requires notarization by two healthcare providers to be valid.
Correct Answer: B
Rationale: A DPOA-HC designates a specific person (healthcare agent/proxy) to make medical decisions on the client's behalf if
the client loses decision-making capacity. Unlike a living will, it does not specify treatment preferences but names a
decision-maker. It takes effect only when the client is determined incapacitated. Notarization requirements vary by state but do
not require two healthcare providers.
Q9: A nurse observes a colleague discussing a client's laboratory results in the hospital elevator where other people
are present. Which of the following actions should the nurse take?
A. A. Report the colleague to the state board of nursing immediately.
B. B. Confront the colleague privately and remind them about HIPAA confidentiality. [CORRECT]
C. C. Document the incident in the client's medical record.
D. D. Ignore the discussion because the colleague is also a healthcare provider.
Correct Answer: B
Rationale: Discussing client information in public areas violates HIPAA confidentiality standards. The nurse should first address
the colleague privately to provide education and promote compliance. If the behavior continues or is egregious, escalation to a
supervisor may be warranted. Initial reporting to the state board is premature without first attempting to resolve the issue. The
client's medical record is not the place for colleague incident reports.
Q10: A nurse is providing care based on the ethical principle of beneficence. Which of the following nursing actions
demonstrates this principle?
A. A. Respecting a client's decision to refuse a blood transfusion.
B. B. Administering prescribed analgesic medication to relieve a client's pain. [CORRECT]
C. C. Ensuring equal distribution of nursing time among all assigned clients.
D. D. Providing honest information about a client's prognosis to the family.
Correct Answer: B
Rationale: Beneficence means acting in the client's best interest to promote good and prevent harm. Administering prescribed
analgesia to relieve pain directly promotes the client's well-being. Respecting refusal of treatment is autonomy. Equal
distribution of resources reflects justice. Providing honest information reflects veracity.
, ATI Fundamentals Proctored Exam Study Guide | 2026/2027
Q11: A client with a DNR order experiences cardiac arrest. Which of the following actions should the nurse take?
A. A. Begin CPR immediately and then verify the DNR status.
B. B. Contact the provider to confirm the DNR order and withhold resuscitation. [CORRECT]
C. C. Ask the family if they want to override the DNR order.
D. D. Document the cardiac arrest and wait for the provider to arrive.
Correct Answer: B
Rationale: When a client has a valid DNR order, the nurse should verify the order is current in the medical record and withhold
resuscitation efforts. The nurse should contact the provider to confirm the order. CPR should not be initiated if a valid DNR is
confirmed. The family cannot override the client's own DNR directive. The nurse should provide comfort measures and document
the event.
Q12: A nurse is caring for a client scheduled for surgery. The client states, "I do not understand what the surgeon is
going to do." Which of the following actions should the nurse take first?
A. A. Have the client sign the consent form and proceed to surgery.
B. B. Notify the surgeon that the client needs additional explanation before signing. [CORRECT]
C. C. Explain the surgical procedure to the client using anatomical models.
D. D. Document that the client does not understand and continue preoperative preparation.
Correct Answer: B
Rationale: The provider/surgeon is responsible for explaining the procedure, risks, benefits, and alternatives. If the client does
not understand, the nurse should notify the provider so they can provide further explanation. The client cannot give valid
informed consent without understanding. The nurse should not explain the procedure (that is the provider's responsibility) or
proceed without valid consent.
Q13: A nurse is reviewing the medical record of a client who has a do-not-resuscitate (DNR) order. The nurse notes
that the client's condition has significantly changed. Which of the following actions is most appropriate?
A. A. Continue the current DNR order without modification.
B. B. Reassess the DNR status with the client, family, and provider. [CORRECT]
C. C. Automatically revoke the DNR order due to the change in condition.
D. D. Transfer the client to a higher level of care and suspend the DNR.
Correct Answer: B
Rationale: DNR orders should be reassessed when there is a significant change in the client's condition. The nurse should
facilitate a discussion involving the client (if capable), family, and provider to determine if the DNR still reflects the client's
wishes. DNR orders do not automatically change with condition changes, nor should they be unilaterally revoked or suspended.
Q14: A nurse is caring for four clients. Which of the following tasks can be safely delegated to an LPN?
A. A. Developing the nursing care plan for a newly admitted client.
B. B. Reinforcing teaching about crutch walking that was originally provided by the RN. [CORRECT]
C. C. Performing the initial postoperative assessment.
D. D. Evaluating the effectiveness of a new pain management regimen.
Correct Answer: B
Rationale: LPNs can reinforce teaching that was originally provided by the RN. Developing care plans, performing initial
assessments, and evaluating the effectiveness of interventions require RN-level education and clinical judgment. Reinforcing
teaching is within the LPN scope of practice under RN supervision.
ATI Fundamentals Proctored Exam Study Guide
Latest 2026/2027 Edition
200 Comprehensive Questions with Rationales
Aligned with NCLEX-Style Competency Standards
Section 1: Safe, Effective Care Environment
(Management of Care | Safety and Infection Control)
Q1: A nurse is caring for a client who asks about the purpose of a living will. Which of the following responses by
the nurse is appropriate?
A. A. "It authorizes someone to make financial decisions for you."
B. B. "It documents your wishes regarding medical treatment if you become unable to communicate."
[CORRECT]
C. C. "It is required for all hospital admissions."
D. D. "It allows your provider to override your family's wishes."
Correct Answer: B
Rationale: A living will is a legal advance directive that documents a client's wishes regarding medical treatment in the event
they lose decision-making capacity. It does not address financial decisions (power of attorney does that), is not mandatory for
admission, and does not authorize providers to override family wishes. The nurse's role includes providing information and
ensuring the client understands the document.
Q2: A nurse is witnessing a client sign an informed consent form for a surgical procedure. Which of the following
actions should the nurse take?
A. A. Explain the risks and benefits of the procedure to the client.
B. B. Ensure the client understands the procedure, risks, benefits, and alternatives before signing.
[CORRECT]
C. C. Sign the consent form as the primary witness on behalf of the facility.
D. D. Contact the family to obtain verbal consent before the client signs.
Correct Answer: B
Rationale: The nurse witnessing informed consent must verify that the client understands the procedure, its risks, benefits, and
alternatives, and that consent is voluntary. The provider is responsible for explaining the procedure. The nurse serves as a
witness to the signature, not as the primary explainer. Family consent does not replace the competent client's own consent.
, ATI Fundamentals Proctored Exam Study Guide | 2026/2027
Q3: A nurse is caring for a client who states, "I do not want the blood transfusion." Which of the following responses
by the nurse is best?
A. A. "You must have the transfusion; it is an order from your provider."
B. B. "I will document your refusal and notify your provider of your decision." [CORRECT]
C. C. "Let me call your family so they can convince you to accept it."
D. D. "If you refuse, you could die from blood loss."
Correct Answer: B
Rationale: Clients have the right to refuse treatment, including blood transfusions, even if refusal may result in death. The nurse
must respect client autonomy, document the refusal, and notify the provider. Coercing the client, threatening, or involving family
to override the client's decision violates ethical principles of autonomy and informed consent.
Q4: A nurse is assigning tasks to an LPN and a UAP on a medical-surgical unit. Which of the following tasks should
the nurse delegate to the LPN?
A. A. Obtaining a client's admission vital signs and weight.
B. B. Administering oral and intramuscular medications to stable clients. [CORRECT]
C. C. Providing total assistance with all activities of daily living.
D. D. Performing initial assessment on a newly admitted client.
Correct Answer: B
Rationale: LPNs can administer oral, IM, and SubQ medications to stable clients under RN supervision. Obtaining admission
vital signs is within UAP scope. Total ADL assistance can be delegated to UAPs. Initial assessment requires RN-level education
and clinical judgment and cannot be delegated to an LPN.
Q5: Which of the following tasks is appropriate for a nurse to delegate to an unlicensed assistive personnel (UAP)?
A. A. Performing a wound assessment on a postoperative client.
B. B. Teaching a client about insulin self-administration.
C. C. Recording intake and output and assisting with ambulation. [CORRECT]
D. D. Evaluating a client's response to pain medication.
Correct Answer: C
Rationale: UAPs can perform tasks such as recording intake and output, assisting with ambulation, measuring vital signs, and
basic ADLs. Wound assessment, client teaching, and evaluating responses to medications require RN-level education and
clinical judgment and cannot be delegated to UAPs per the Five Rights of Delegation.
Q6: A nurse is preparing to delegate a task. Which of the following reflects the "right direction/communication"
component of the Five Rights of Delegation?
A. A. Ensuring the delegatee has the appropriate scope of practice.
B. B. Providing clear, specific instructions about the task to be completed. [CORRECT]
C. C. Evaluating the delegatee's performance of the task after completion.
D. D. Assessing whether the client's condition is stable enough for delegation.
Correct Answer: B
Rationale: The Five Rights of Delegation include: right task, right circumstance, right person, right direction/communication,
and right supervision/evaluation. "Right direction/communication" means the nurse provides clear, specific instructions about
what needs to be done, including any specific observations or reporting requirements. Scope of practice is the "right person,"
evaluation is the "right supervision," and client stability is the "right circumstance."
, ATI Fundamentals Proctored Exam Study Guide | 2026/2027
Q7: A nurse receives a phone call from a person requesting information about a client's diagnosis. Which of the
following responses by the nurse is appropriate?
A. A. "I can confirm the client is here but cannot share diagnosis information."
B. B. "You will need to contact the client directly for any medical information." [CORRECT]
C. C. "The client was admitted for pneumonia and is improving."
D. D. "I can transfer you to the client's nurse for an update."
Correct Answer: B
Rationale: HIPAA requires that all client information remain confidential. The nurse cannot confirm or deny a client's presence
in the facility or share any health information without the client's written authorization. Even confirming a client is in the facility
constitutes a privacy violation. The caller should be directed to contact the client directly.
Q8: A nurse is caring for a client who wishes to complete a Durable Power of Attorney for Healthcare (DPOA-HC).
The nurse should explain that this document does which of the following?
A. A. Specifies the client's end-of-life treatment preferences in writing.
B. B. Appoints a designated individual to make healthcare decisions if the client becomes incapacitated.
[CORRECT]
C. C. Takes effect immediately upon signing regardless of cognitive status.
D. D. Requires notarization by two healthcare providers to be valid.
Correct Answer: B
Rationale: A DPOA-HC designates a specific person (healthcare agent/proxy) to make medical decisions on the client's behalf if
the client loses decision-making capacity. Unlike a living will, it does not specify treatment preferences but names a
decision-maker. It takes effect only when the client is determined incapacitated. Notarization requirements vary by state but do
not require two healthcare providers.
Q9: A nurse observes a colleague discussing a client's laboratory results in the hospital elevator where other people
are present. Which of the following actions should the nurse take?
A. A. Report the colleague to the state board of nursing immediately.
B. B. Confront the colleague privately and remind them about HIPAA confidentiality. [CORRECT]
C. C. Document the incident in the client's medical record.
D. D. Ignore the discussion because the colleague is also a healthcare provider.
Correct Answer: B
Rationale: Discussing client information in public areas violates HIPAA confidentiality standards. The nurse should first address
the colleague privately to provide education and promote compliance. If the behavior continues or is egregious, escalation to a
supervisor may be warranted. Initial reporting to the state board is premature without first attempting to resolve the issue. The
client's medical record is not the place for colleague incident reports.
Q10: A nurse is providing care based on the ethical principle of beneficence. Which of the following nursing actions
demonstrates this principle?
A. A. Respecting a client's decision to refuse a blood transfusion.
B. B. Administering prescribed analgesic medication to relieve a client's pain. [CORRECT]
C. C. Ensuring equal distribution of nursing time among all assigned clients.
D. D. Providing honest information about a client's prognosis to the family.
Correct Answer: B
Rationale: Beneficence means acting in the client's best interest to promote good and prevent harm. Administering prescribed
analgesia to relieve pain directly promotes the client's well-being. Respecting refusal of treatment is autonomy. Equal
distribution of resources reflects justice. Providing honest information reflects veracity.
, ATI Fundamentals Proctored Exam Study Guide | 2026/2027
Q11: A client with a DNR order experiences cardiac arrest. Which of the following actions should the nurse take?
A. A. Begin CPR immediately and then verify the DNR status.
B. B. Contact the provider to confirm the DNR order and withhold resuscitation. [CORRECT]
C. C. Ask the family if they want to override the DNR order.
D. D. Document the cardiac arrest and wait for the provider to arrive.
Correct Answer: B
Rationale: When a client has a valid DNR order, the nurse should verify the order is current in the medical record and withhold
resuscitation efforts. The nurse should contact the provider to confirm the order. CPR should not be initiated if a valid DNR is
confirmed. The family cannot override the client's own DNR directive. The nurse should provide comfort measures and document
the event.
Q12: A nurse is caring for a client scheduled for surgery. The client states, "I do not understand what the surgeon is
going to do." Which of the following actions should the nurse take first?
A. A. Have the client sign the consent form and proceed to surgery.
B. B. Notify the surgeon that the client needs additional explanation before signing. [CORRECT]
C. C. Explain the surgical procedure to the client using anatomical models.
D. D. Document that the client does not understand and continue preoperative preparation.
Correct Answer: B
Rationale: The provider/surgeon is responsible for explaining the procedure, risks, benefits, and alternatives. If the client does
not understand, the nurse should notify the provider so they can provide further explanation. The client cannot give valid
informed consent without understanding. The nurse should not explain the procedure (that is the provider's responsibility) or
proceed without valid consent.
Q13: A nurse is reviewing the medical record of a client who has a do-not-resuscitate (DNR) order. The nurse notes
that the client's condition has significantly changed. Which of the following actions is most appropriate?
A. A. Continue the current DNR order without modification.
B. B. Reassess the DNR status with the client, family, and provider. [CORRECT]
C. C. Automatically revoke the DNR order due to the change in condition.
D. D. Transfer the client to a higher level of care and suspend the DNR.
Correct Answer: B
Rationale: DNR orders should be reassessed when there is a significant change in the client's condition. The nurse should
facilitate a discussion involving the client (if capable), family, and provider to determine if the DNR still reflects the client's
wishes. DNR orders do not automatically change with condition changes, nor should they be unilaterally revoked or suspended.
Q14: A nurse is caring for four clients. Which of the following tasks can be safely delegated to an LPN?
A. A. Developing the nursing care plan for a newly admitted client.
B. B. Reinforcing teaching about crutch walking that was originally provided by the RN. [CORRECT]
C. C. Performing the initial postoperative assessment.
D. D. Evaluating the effectiveness of a new pain management regimen.
Correct Answer: B
Rationale: LPNs can reinforce teaching that was originally provided by the RN. Developing care plans, performing initial
assessments, and evaluating the effectiveness of interventions require RN-level education and clinical judgment. Reinforcing
teaching is within the LPN scope of practice under RN supervision.
