ATI RN FUNDAMENTALS
Proctored Actual Exam with NGN
70 Questions and Answers
NGN Questions Latest Update 2026
All Questions Correctly Answered | A+ Graded
Total Questions 70 (sequential, single best answer)
Sections 9 integrated content areas
Format 80% scenario-based with NGN, 20% direct recall
Cognitive Levels 30% Recall | 50% Application | 20% Analysis
Frameworks ADPIE, ABCs, Maslow, Safety, Least Restrictive, CJMM
NGN Item Types Case study, Bow-tie, Extended Multiple Response, Drag/Drop, Trend
Time Allotted 85 minutes (~1.2 min/question)
Audience RN students preparing for ATI Fundamentals Proctored + NGN NCLEX
Edition 2026 Latest Update — current ATI blueprint and NGN test plan
Instructions: Select the single best answer for each question unless an item is marked as an NGN extended-response
item. Rationales integrate the nursing process (ADPIE), ATI priority-setting frameworks (ABCs, Maslow, Safety,
Least Restrictive), the NCSBN Clinical Judgment Measurement Model (CJMM: Recognize Cues, Analyze Cues,
Prioritize Hypotheses, Generate Solutions, Take Action, Evaluate Outcomes), Six Rights of medication
administration, and evidence-based fundamentals practice. Use this exam for self-assessment, remediation, and NGN
NCLEX readiness.
,ATI RN Fundamentals Proctored Actual Exam with NGN — 2026 Latest Update Page 2
SECTION 1 — Safe, Effective Care Environment (Q1–Q15)
Management of Care, Client Rights, Advocacy, Delegation, and Legal/Ethical Issues. The RN applies the Nurse Practice
Act, ANA Standards, HIPAA, the Patient Self-Determination Act, and the Five Rights of Delegation while prioritizing
client safety and advocating for client autonomy.
Q1:
A charge nurse is making assignments for a 32-bed medical-surgical unit. Team includes 2 RNs, 2 LPNs, and 2
UAPs. Which client should the charge nurse assign to the most experienced RN?
A. A stable 78-year-old client admitted 3 days ago for cellulitis receiving oral antibiotics
B. A 65-year-old client admitted 2 hours ago with acute GI bleed, BP 92/58, HR 110, receiving IV fluids and
awaiting endoscopy [CORRECT]
C. A stable post-op day 2 client with a Foley catheter and a healing abdominal incision
D. A 50-year-old client with chronic back pain requesting PRN acetaminophen
Correct Answer: B
Rationale: Using ATI priority-setting (Acute vs. Chronic and Unstable vs. Stable), the most experienced RN should care for the
unstable, acute GI bleed client with active hemodynamic compromise (BP 92/58, HR 110), requiring ongoing assessment, IV
titration, frequent vital signs, and preparation for emergent endoscopy. The cellulitis client (A), post-op day 2 client (C), and
chronic pain client (D) are stable and can be appropriately delegated to LPNs (with the RN supervising and handling complex
assessments) or routine UAP tasks. The RN retains accountability for all delegated care and must reassess unstable clients
frequently.
Q2:
An RN delegates the following tasks to a UAP. Which task requires the RN to intervene and reassign or revise the
delegation?
A. Measuring vital signs on a stable 24-hour post-op client
B. Ambulating a client who received IV morphine 4 mg 20 minutes ago for the first time postoperatively
[CORRECT]
C. Feeding a stable client with right-sided weakness from a recent stroke who has had a swallow evaluation
D. Performing morning hygiene and perineal care for a stable client
Correct Answer: B
Rationale: Per the Five Rights of Delegation, the RN must match the task, circumstance, and person. A client who received IV
morphine 20 minutes ago is at peak risk for opioid-induced respiratory depression, hypotension, and sedation; first-time
postoperative ambulation under these conditions requires RN assessment of sedation level, orthostatic vitals, and respiratory
status before and during ambulation — this is outside UAP scope. The stable vital signs (A), feeding a stroke client post-swallow
evaluation (C), and routine hygiene (D) are appropriate UAP tasks. The RN should personally ambulate the post-morphine client
or postpone ambulation until peak opioid effect has passed.
ATI RN Fundamentals | 70 NGN Questions | A+ Graded | Verified Solutions
,ATI RN Fundamentals Proctored Actual Exam with NGN — 2026 Latest Update Page 3
Q3:
A 56-year-old client is scheduled for an elective cholecystectomy. The surgeon has explained the procedure, risks,
benefits, and alternatives, and the client has signed the consent form. As the RN prepares to administer preoperative
medications, the client says, "Wait — I'm not really sure what they're going to do." Which action should the RN take
first?
A. Administer the preoperative medication to calm the client and proceed
B. Stop, notify the surgeon that the client cannot explain the procedure (indicating lack of informed consent),
and do not administer preoperative medications until the surgeon re-explains and the client consents
[CORRECT]
C. Explain the surgical procedure to the client in detail yourself
D. Document the client's statement and proceed because the form is already signed
Correct Answer: B
Rationale: Informed consent requires: capacity, disclosure, understanding, and voluntariness. If the RN identifies that the client
does not understand, the consent is invalid — even with a signed form. The RN must notify the surgeon (who holds responsibility
for explaining the procedure) and not administer preoperative sedatives, which would further impair capacity. Option C exceeds
RN scope — explaining the surgical procedure is the surgeon's legal responsibility (RN reinforces teaching but does not obtain
surgical consent). Option A and D ignore the legal/ethical obligation. The Patient Self-Determination Act and HIPAA support
this process. The RN serves as client advocate.
Q4:
A client with end-stage COPD has a valid DNR (Do Not Resuscitate) order in the chart. The client becomes
unresponsive, apneic, and pulseless. A new graduate nurse calls a Code Blue. Which action by the charge nurse is
most appropriate?
A. Continue the code; once called, it cannot be stopped
B. Immediately stop the code, verify the DNR order, provide comfort measures, support the family, and
document [CORRECT]
C. Call the family to ask if they want the code to continue
D. Continue resuscitation because the nurse has a duty to preserve life at all costs
Correct Answer: B
Rationale: A valid DNR is a medical order that must be honored. Calling a code on a client with a valid DNR is a common error;
the correct action is to stop the code immediately, verify the order, and provide comfort measures (positioning, family presence,
spiritual support). The ethical principle is client autonomy. Continuing (A, D) violates client autonomy and the order. Calling
family (C) delays honoring the client's prior autonomous decision; the DNR reflects the client's wishes. The RN should verify
code status on admission and at each handoff and ensure DNR orders are clearly documented and visible (per Joint Commission
standards).
ATI RN Fundamentals | 70 NGN Questions | A+ Graded | Verified Solutions
, ATI RN Fundamentals Proctored Actual Exam with NGN — 2026 Latest Update Page 4
Q5:
A client's family member approaches the nurse in the hallway and asks, "How is my mother doing?" The nurse
knows the mother is a private person who has not specifically authorized sharing information with this family
member. Which response best protects client privacy under HIPAA?
A. Provide a brief update since family members are entitled to information
B. Verify with the client (if able) that she consents to sharing information; if the client is unable, assess
whether the family member is involved in the client's care and limit disclosure to the minimum necessary
[CORRECT]
C. Refuse to discuss the client at all under any circumstances
D. Provide full medical details to demonstrate caring
Correct Answer: B
Rationale: HIPAA's Privacy Rule allows nurses to share Protected Health Information (PHI) with family members, friends, or
others involved in the client's care or payment for care, IF the client does not object (or if the client is unable to communicate
and the nurse exercises professional judgment that sharing is in the client's best interest). The disclosure must be limited to the
minimum necessary. Option A assumes entitlement without verification. Option C is overly rigid — HIPAA permits sharing under
the conditions described. Option D over-discloses. The RN should ask the client on admission who may receive information and
document the client's preferences.
Q6:
An RN overhears a colleague telling a client, "If you don't take your medication, I'll have to put restraints on you."
Which action by the RN best reflects client advocacy and professional boundaries?
A. Ignore the comment to avoid conflict with a colleague
B. Address the colleague privately, report the behavior to the nurse manager (it constitutes a boundary
violation and coercion), and ensure the client is safe and informed of their rights [CORRECT]
C. Confront the colleague loudly in front of the client
D. Apologize to the client but take no further action
Correct Answer: B
Rationale: Threatening a client with restraints as punishment for refusing medication is a serious professional boundary
violation, coercion, and potentially abusive behavior. The RN must: (1) ensure client safety, (2) address the colleague privately
and professionally, (3) report through the chain of command (nurse manager) for investigation and remediation, and (4)
document factually. Ignoring (A) enables future violations. Confronting in front of the client (C) is unprofessional. Apologizing
without action (D) fails to address the systemic issue. The ANA Code of Ethics and NCSBN Professional Boundaries guidance
support this response; mandatory reporting to the Board of Nursing may be required for serious violations.
ATI RN Fundamentals | 70 NGN Questions | A+ Graded | Verified Solutions
Proctored Actual Exam with NGN
70 Questions and Answers
NGN Questions Latest Update 2026
All Questions Correctly Answered | A+ Graded
Total Questions 70 (sequential, single best answer)
Sections 9 integrated content areas
Format 80% scenario-based with NGN, 20% direct recall
Cognitive Levels 30% Recall | 50% Application | 20% Analysis
Frameworks ADPIE, ABCs, Maslow, Safety, Least Restrictive, CJMM
NGN Item Types Case study, Bow-tie, Extended Multiple Response, Drag/Drop, Trend
Time Allotted 85 minutes (~1.2 min/question)
Audience RN students preparing for ATI Fundamentals Proctored + NGN NCLEX
Edition 2026 Latest Update — current ATI blueprint and NGN test plan
Instructions: Select the single best answer for each question unless an item is marked as an NGN extended-response
item. Rationales integrate the nursing process (ADPIE), ATI priority-setting frameworks (ABCs, Maslow, Safety,
Least Restrictive), the NCSBN Clinical Judgment Measurement Model (CJMM: Recognize Cues, Analyze Cues,
Prioritize Hypotheses, Generate Solutions, Take Action, Evaluate Outcomes), Six Rights of medication
administration, and evidence-based fundamentals practice. Use this exam for self-assessment, remediation, and NGN
NCLEX readiness.
,ATI RN Fundamentals Proctored Actual Exam with NGN — 2026 Latest Update Page 2
SECTION 1 — Safe, Effective Care Environment (Q1–Q15)
Management of Care, Client Rights, Advocacy, Delegation, and Legal/Ethical Issues. The RN applies the Nurse Practice
Act, ANA Standards, HIPAA, the Patient Self-Determination Act, and the Five Rights of Delegation while prioritizing
client safety and advocating for client autonomy.
Q1:
A charge nurse is making assignments for a 32-bed medical-surgical unit. Team includes 2 RNs, 2 LPNs, and 2
UAPs. Which client should the charge nurse assign to the most experienced RN?
A. A stable 78-year-old client admitted 3 days ago for cellulitis receiving oral antibiotics
B. A 65-year-old client admitted 2 hours ago with acute GI bleed, BP 92/58, HR 110, receiving IV fluids and
awaiting endoscopy [CORRECT]
C. A stable post-op day 2 client with a Foley catheter and a healing abdominal incision
D. A 50-year-old client with chronic back pain requesting PRN acetaminophen
Correct Answer: B
Rationale: Using ATI priority-setting (Acute vs. Chronic and Unstable vs. Stable), the most experienced RN should care for the
unstable, acute GI bleed client with active hemodynamic compromise (BP 92/58, HR 110), requiring ongoing assessment, IV
titration, frequent vital signs, and preparation for emergent endoscopy. The cellulitis client (A), post-op day 2 client (C), and
chronic pain client (D) are stable and can be appropriately delegated to LPNs (with the RN supervising and handling complex
assessments) or routine UAP tasks. The RN retains accountability for all delegated care and must reassess unstable clients
frequently.
Q2:
An RN delegates the following tasks to a UAP. Which task requires the RN to intervene and reassign or revise the
delegation?
A. Measuring vital signs on a stable 24-hour post-op client
B. Ambulating a client who received IV morphine 4 mg 20 minutes ago for the first time postoperatively
[CORRECT]
C. Feeding a stable client with right-sided weakness from a recent stroke who has had a swallow evaluation
D. Performing morning hygiene and perineal care for a stable client
Correct Answer: B
Rationale: Per the Five Rights of Delegation, the RN must match the task, circumstance, and person. A client who received IV
morphine 20 minutes ago is at peak risk for opioid-induced respiratory depression, hypotension, and sedation; first-time
postoperative ambulation under these conditions requires RN assessment of sedation level, orthostatic vitals, and respiratory
status before and during ambulation — this is outside UAP scope. The stable vital signs (A), feeding a stroke client post-swallow
evaluation (C), and routine hygiene (D) are appropriate UAP tasks. The RN should personally ambulate the post-morphine client
or postpone ambulation until peak opioid effect has passed.
ATI RN Fundamentals | 70 NGN Questions | A+ Graded | Verified Solutions
,ATI RN Fundamentals Proctored Actual Exam with NGN — 2026 Latest Update Page 3
Q3:
A 56-year-old client is scheduled for an elective cholecystectomy. The surgeon has explained the procedure, risks,
benefits, and alternatives, and the client has signed the consent form. As the RN prepares to administer preoperative
medications, the client says, "Wait — I'm not really sure what they're going to do." Which action should the RN take
first?
A. Administer the preoperative medication to calm the client and proceed
B. Stop, notify the surgeon that the client cannot explain the procedure (indicating lack of informed consent),
and do not administer preoperative medications until the surgeon re-explains and the client consents
[CORRECT]
C. Explain the surgical procedure to the client in detail yourself
D. Document the client's statement and proceed because the form is already signed
Correct Answer: B
Rationale: Informed consent requires: capacity, disclosure, understanding, and voluntariness. If the RN identifies that the client
does not understand, the consent is invalid — even with a signed form. The RN must notify the surgeon (who holds responsibility
for explaining the procedure) and not administer preoperative sedatives, which would further impair capacity. Option C exceeds
RN scope — explaining the surgical procedure is the surgeon's legal responsibility (RN reinforces teaching but does not obtain
surgical consent). Option A and D ignore the legal/ethical obligation. The Patient Self-Determination Act and HIPAA support
this process. The RN serves as client advocate.
Q4:
A client with end-stage COPD has a valid DNR (Do Not Resuscitate) order in the chart. The client becomes
unresponsive, apneic, and pulseless. A new graduate nurse calls a Code Blue. Which action by the charge nurse is
most appropriate?
A. Continue the code; once called, it cannot be stopped
B. Immediately stop the code, verify the DNR order, provide comfort measures, support the family, and
document [CORRECT]
C. Call the family to ask if they want the code to continue
D. Continue resuscitation because the nurse has a duty to preserve life at all costs
Correct Answer: B
Rationale: A valid DNR is a medical order that must be honored. Calling a code on a client with a valid DNR is a common error;
the correct action is to stop the code immediately, verify the order, and provide comfort measures (positioning, family presence,
spiritual support). The ethical principle is client autonomy. Continuing (A, D) violates client autonomy and the order. Calling
family (C) delays honoring the client's prior autonomous decision; the DNR reflects the client's wishes. The RN should verify
code status on admission and at each handoff and ensure DNR orders are clearly documented and visible (per Joint Commission
standards).
ATI RN Fundamentals | 70 NGN Questions | A+ Graded | Verified Solutions
, ATI RN Fundamentals Proctored Actual Exam with NGN — 2026 Latest Update Page 4
Q5:
A client's family member approaches the nurse in the hallway and asks, "How is my mother doing?" The nurse
knows the mother is a private person who has not specifically authorized sharing information with this family
member. Which response best protects client privacy under HIPAA?
A. Provide a brief update since family members are entitled to information
B. Verify with the client (if able) that she consents to sharing information; if the client is unable, assess
whether the family member is involved in the client's care and limit disclosure to the minimum necessary
[CORRECT]
C. Refuse to discuss the client at all under any circumstances
D. Provide full medical details to demonstrate caring
Correct Answer: B
Rationale: HIPAA's Privacy Rule allows nurses to share Protected Health Information (PHI) with family members, friends, or
others involved in the client's care or payment for care, IF the client does not object (or if the client is unable to communicate
and the nurse exercises professional judgment that sharing is in the client's best interest). The disclosure must be limited to the
minimum necessary. Option A assumes entitlement without verification. Option C is overly rigid — HIPAA permits sharing under
the conditions described. Option D over-discloses. The RN should ask the client on admission who may receive information and
document the client's preferences.
Q6:
An RN overhears a colleague telling a client, "If you don't take your medication, I'll have to put restraints on you."
Which action by the RN best reflects client advocacy and professional boundaries?
A. Ignore the comment to avoid conflict with a colleague
B. Address the colleague privately, report the behavior to the nurse manager (it constitutes a boundary
violation and coercion), and ensure the client is safe and informed of their rights [CORRECT]
C. Confront the colleague loudly in front of the client
D. Apologize to the client but take no further action
Correct Answer: B
Rationale: Threatening a client with restraints as punishment for refusing medication is a serious professional boundary
violation, coercion, and potentially abusive behavior. The RN must: (1) ensure client safety, (2) address the colleague privately
and professionally, (3) report through the chain of command (nurse manager) for investigation and remediation, and (4)
document factually. Ignoring (A) enables future violations. Confronting in front of the client (C) is unprofessional. Apologizing
without action (D) fails to address the systemic issue. The ANA Code of Ethics and NCSBN Professional Boundaries guidance
support this response; mandatory reporting to the Board of Nursing may be required for serious violations.
ATI RN Fundamentals | 70 NGN Questions | A+ Graded | Verified Solutions
