ATI FUNDAMENTALS PROCTORED EXAM TEST BANK
2026/2027
Questions and Answers with Rationale | Latest Edition | Already Verified Answers | Graded A+
This test bank contains 200 NCLEX-style multiple-choice questions across 8 content areas aligned with the ATI Fundamentals of
Nursing Content Mastery Series. Each question includes the correct answer and a rationale referencing ATI Fundamentals standards
and the NCLEX-RN Test Plan.
Section 1: Safe & Effective Care Environment - Management of Care
Q1. A charge nurse is assigning care for four clients on a medical-surgical unit. Which client should be
assigned to the most experienced RN?
A. A client who is 3 days postoperative from a hip replacement and ambulating with a walker.
B. A client admitted with acute gastrointestinal bleeding who is receiving a unit of packed RBCs.
[CORRECT]
C. A client with chronic obstructive pulmonary disease receiving nebulized albuterol every 4 hours.
D. A client with type 2 diabetes mellitus who needs reinforcement of insulin injection technique.
Correct Answer: B
Rationale: The client with acute GI bleeding receiving blood requires close hemodynamic monitoring, frequent
assessment of VS and bleeding status, and complex clinical judgment that only an experienced RN can deliver,
consistent with the ANA Principles of Delegation and the ATI Fundamentals delegation hierarchy. The other clients
have predictable, stable needs that can be safely delegated to an LPN or, with teaching exception, addressed by an RN
after priority clients are stabilized.
Q2. A nurse is caring for a client scheduled for an elective coronary artery bypass graft. The client states, "I
am not sure I want this surgery." Which action should the nurse take first?
A. Notify the surgeon to delay the procedure.
B. Document the client's statement and continue preoperative teaching.
C. Explore the client's concerns and ask what they understand about the procedure. [CORRECT]
D. Remind the client that the consent form was already signed and the procedure is scheduled.
Correct Answer: C
Rationale: Informed consent is a process, not just a signature; when a client expresses uncertainty, the nurse must first
assess understanding and explore concerns, per ATI Fundamentals informed consent principles and the Patient
Self-Determination Act. The provider must be notified if the client remains undecided, but exploration comes before
delay notification or coercion to proceed.
ATI Fundamentals Proctored Exam Test Bank 2026/2027 | Page 1
,ATI Fundamentals Proctored Exam Test Bank 2026/2027
Q3. A nurse delegates morning care for four clients to a UAP. Which task requires the nurse to intervene?
A. The UAP measures oral temperature for a client who is 1 day postoperative.
B. The UAP ambulates a client who received IV morphine 30 minutes ago. [CORRECT]
C. The UAP assists a stable client with feeding after a stroke.
D. The UAP records intake and output for a client with a Foley catheter.
Correct Answer: B
Rationale: Ambulating a client who recently received IV morphine requires ongoing assessment for sedation,
hypotension, and fall risk, which is outside the UAP scope of practice per the ATI Fundamentals 5 Rights of
Delegation (Right Person, Right Task, Right Circumstance, Right Direction, Right Supervision). The other tasks are
routine, predictable, and within UAP scope with stable clients.
Q4. A client asks the nurse to keep their new diagnosis of HIV confidential from their spouse. Which response
by the nurse is appropriate?
A. "Your spouse has a right to know because of the risk of transmission."
B. "I will keep your diagnosis confidential, but I encourage you to discuss this with your spouse and provider."
[CORRECT]
C. "I have to report this to the health department and they will notify your spouse."
D. "I cannot keep this information from your spouse because they are listed as your emergency contact."
Correct Answer: B
Rationale: HIPAA protects client confidentiality, and the nurse must honor the client's request while encouraging
disclosure to at-risk partners, consistent with ATI Fundamentals and ANA Code of Ethics provisions on privacy and
advocacy. Mandatory reporting applies to specific conditions and partner notification is typically handled by public
health with the client's involvement, not by the nurse unilaterally.
Q5. A nurse is preparing to discharge a client with a new colostomy. The client appears anxious and states, "I
don't think I can manage this at home." Which action by the nurse is priority?
A. Provide written discharge instructions and a stoma care pamphlet.
B. Notify the provider to delay discharge until the client feels ready.
C. Assess what specific aspects of care worry the client and demonstrate stoma care. [CORRECT]
D. Refer the client to a home health agency and arrange follow-up.
Correct Answer: C
Rationale: Discharge planning requires assessment of the client's knowledge, skills, and anxiety barriers before
referral or instruction, per ATI Fundamentals discharge planning principles. The nurse first identifies the client's
learning needs and demonstrates care to build confidence; only after this assessment should referrals and written
instructions be tailored and a discharge delay considered if learning is incomplete.
ATI Fundamentals Proctored Exam Test Bank 2026/2027 | Page 2
,ATI Fundamentals Proctored Exam Test Bank 2026/2027
Q6. A nurse manager is reviewing incident reports from the past month. Which finding indicates a sentinel
event that requires immediate root cause analysis?
A. A client fell while ambulating to the bathroom with assistance.
B. A client received the wrong dose of an oral antihypertensive with no harm.
C. A client underwent surgery on the wrong body site. [CORRECT]
D. A UAP sustained a needlestick injury from an uncapped needle.
Correct Answer: C
Rationale: Wrong-site surgery is a sentinel event per The Joint Commission, defined as an unexpected occurrence
involving death, serious physical or psychological injury, or risk thereof, mandating immediate investigation and root
cause analysis. The other events are reportable incidents requiring investigation and corrective action but do not meet
sentinel event criteria, although the needlestick warrants OSHA follow-up.
Q7. A nurse is caring for a client who refuses a prescribed blood transfusion due to religious beliefs. The
provider insists the transfusion is life-saving. Which action by the nurse is correct?
A. Administer the transfusion because the client's life is at risk.
B. Notify the hospital ethics committee and continue supportive care.
C. Honor the client's refusal and document the refusal, provider notification, and client teaching. [CORRECT]
D. Ask the family to consent to the transfusion on the client's behalf.
Correct Answer: C
Rationale: A competent adult has the legal and ethical right to refuse any treatment, including life-saving transfusions,
based on autonomy and the Patient Self-Determination Act as reinforced in ATI Fundamentals. The nurse must honor
the refusal, ensure informed refusal teaching, notify the provider, and document thoroughly; family consent is invalid
unless the client lacks capacity.
Q8. A nurse is preparing to administer medications to four clients. Using the principle of prioritization, which
client should the nurse assess first?
A. A client requesting pain medication for a headache rated 4/10.
B. A client scheduled for a physical therapy session in 30 minutes.
C. A client reporting new onset shortness of breath and chest tightness. [CORRECT]
D. A client whose blood pressure is 148/92 mmHg after ambulation.
Correct Answer: C
Rationale: The ABC priority framework (Airway, Breathing, Circulation) directs the nurse to the client with new
onset shortness of breath and chest tightness, which may indicate a life-threatening cardiopulmonary event requiring
immediate assessment. The other clients have non-urgent needs that can be addressed after stabilization, even though
pain and elevated BP require follow-up.
ATI Fundamentals Proctored Exam Test Bank 2026/2027 | Page 3
, ATI Fundamentals Proctored Exam Test Bank 2026/2027
Q9. A nurse is preparing a handoff report using SBAR. Which statement appropriately represents the
"Recommendation" component?
A. "The client's blood pressure has dropped from 134/82 to 96/58 over the past 2 hours."
B. "The client is 2 days postoperative from a bowel resection with a history of hypertension."
C. "I think the client may be hypovolemic from inadequate fluid replacement."
D. "I recommend you evaluate the client for fluid bolus and reassess vital signs in 30 minutes." [CORRECT]
Correct Answer: D
Rationale: SBAR's Recommendation component specifies the action the nurse is requesting from the next provider,
consistent with ATI Fundamentals communication tools. Option A is Background-adjacent data, B is Background, and
C is Assessment; only D proposes a clear actionable recommendation for follow-up.
Q10. A nurse discovers a coworker diverting controlled substances. Which action is appropriate first?
A. Confront the coworker directly and demand they stop.
B. Report the suspicion to the nurse manager or supervisor. [CORRECT]
C. Document the observations and continue to monitor the coworker.
D. Notify law enforcement immediately.
Correct Answer: B
Rationale: Suspected substance diversion must be reported through the chain of command starting with the nurse
manager, per institutional policy and the ANA Code of Ethics, to protect clients and allow proper investigation. Direct
confrontation risks escalation and evidence destruction, while notifying law enforcement is the organization's role, not
the individual nurse's first step.
Q11. A client is admitted with an advance directive specifying no artificial nutrition or hydration. The family
demands the client receive tube feedings. Which action should the nurse take?
A. Administer tube feedings as requested by the family.
B. Notify the provider to obtain a court order to enforce the advance directive.
C. Honor the advance directive and provide supportive comfort care. [CORRECT]
D. Ask the client to confirm the advance directive if they are alert.
Correct Answer: C
Rationale: A valid advance directive must be honored as it represents the client's autonomous wishes per the Patient
Self-Determination Act and ATI Fundamentals. Family requests cannot override a written directive; if the client is
alert and capable, confirming the directive is appropriate, but the directive remains the legal basis for care decisions.
ATI Fundamentals Proctored Exam Test Bank 2026/2027 | Page 4
2026/2027
Questions and Answers with Rationale | Latest Edition | Already Verified Answers | Graded A+
This test bank contains 200 NCLEX-style multiple-choice questions across 8 content areas aligned with the ATI Fundamentals of
Nursing Content Mastery Series. Each question includes the correct answer and a rationale referencing ATI Fundamentals standards
and the NCLEX-RN Test Plan.
Section 1: Safe & Effective Care Environment - Management of Care
Q1. A charge nurse is assigning care for four clients on a medical-surgical unit. Which client should be
assigned to the most experienced RN?
A. A client who is 3 days postoperative from a hip replacement and ambulating with a walker.
B. A client admitted with acute gastrointestinal bleeding who is receiving a unit of packed RBCs.
[CORRECT]
C. A client with chronic obstructive pulmonary disease receiving nebulized albuterol every 4 hours.
D. A client with type 2 diabetes mellitus who needs reinforcement of insulin injection technique.
Correct Answer: B
Rationale: The client with acute GI bleeding receiving blood requires close hemodynamic monitoring, frequent
assessment of VS and bleeding status, and complex clinical judgment that only an experienced RN can deliver,
consistent with the ANA Principles of Delegation and the ATI Fundamentals delegation hierarchy. The other clients
have predictable, stable needs that can be safely delegated to an LPN or, with teaching exception, addressed by an RN
after priority clients are stabilized.
Q2. A nurse is caring for a client scheduled for an elective coronary artery bypass graft. The client states, "I
am not sure I want this surgery." Which action should the nurse take first?
A. Notify the surgeon to delay the procedure.
B. Document the client's statement and continue preoperative teaching.
C. Explore the client's concerns and ask what they understand about the procedure. [CORRECT]
D. Remind the client that the consent form was already signed and the procedure is scheduled.
Correct Answer: C
Rationale: Informed consent is a process, not just a signature; when a client expresses uncertainty, the nurse must first
assess understanding and explore concerns, per ATI Fundamentals informed consent principles and the Patient
Self-Determination Act. The provider must be notified if the client remains undecided, but exploration comes before
delay notification or coercion to proceed.
ATI Fundamentals Proctored Exam Test Bank 2026/2027 | Page 1
,ATI Fundamentals Proctored Exam Test Bank 2026/2027
Q3. A nurse delegates morning care for four clients to a UAP. Which task requires the nurse to intervene?
A. The UAP measures oral temperature for a client who is 1 day postoperative.
B. The UAP ambulates a client who received IV morphine 30 minutes ago. [CORRECT]
C. The UAP assists a stable client with feeding after a stroke.
D. The UAP records intake and output for a client with a Foley catheter.
Correct Answer: B
Rationale: Ambulating a client who recently received IV morphine requires ongoing assessment for sedation,
hypotension, and fall risk, which is outside the UAP scope of practice per the ATI Fundamentals 5 Rights of
Delegation (Right Person, Right Task, Right Circumstance, Right Direction, Right Supervision). The other tasks are
routine, predictable, and within UAP scope with stable clients.
Q4. A client asks the nurse to keep their new diagnosis of HIV confidential from their spouse. Which response
by the nurse is appropriate?
A. "Your spouse has a right to know because of the risk of transmission."
B. "I will keep your diagnosis confidential, but I encourage you to discuss this with your spouse and provider."
[CORRECT]
C. "I have to report this to the health department and they will notify your spouse."
D. "I cannot keep this information from your spouse because they are listed as your emergency contact."
Correct Answer: B
Rationale: HIPAA protects client confidentiality, and the nurse must honor the client's request while encouraging
disclosure to at-risk partners, consistent with ATI Fundamentals and ANA Code of Ethics provisions on privacy and
advocacy. Mandatory reporting applies to specific conditions and partner notification is typically handled by public
health with the client's involvement, not by the nurse unilaterally.
Q5. A nurse is preparing to discharge a client with a new colostomy. The client appears anxious and states, "I
don't think I can manage this at home." Which action by the nurse is priority?
A. Provide written discharge instructions and a stoma care pamphlet.
B. Notify the provider to delay discharge until the client feels ready.
C. Assess what specific aspects of care worry the client and demonstrate stoma care. [CORRECT]
D. Refer the client to a home health agency and arrange follow-up.
Correct Answer: C
Rationale: Discharge planning requires assessment of the client's knowledge, skills, and anxiety barriers before
referral or instruction, per ATI Fundamentals discharge planning principles. The nurse first identifies the client's
learning needs and demonstrates care to build confidence; only after this assessment should referrals and written
instructions be tailored and a discharge delay considered if learning is incomplete.
ATI Fundamentals Proctored Exam Test Bank 2026/2027 | Page 2
,ATI Fundamentals Proctored Exam Test Bank 2026/2027
Q6. A nurse manager is reviewing incident reports from the past month. Which finding indicates a sentinel
event that requires immediate root cause analysis?
A. A client fell while ambulating to the bathroom with assistance.
B. A client received the wrong dose of an oral antihypertensive with no harm.
C. A client underwent surgery on the wrong body site. [CORRECT]
D. A UAP sustained a needlestick injury from an uncapped needle.
Correct Answer: C
Rationale: Wrong-site surgery is a sentinel event per The Joint Commission, defined as an unexpected occurrence
involving death, serious physical or psychological injury, or risk thereof, mandating immediate investigation and root
cause analysis. The other events are reportable incidents requiring investigation and corrective action but do not meet
sentinel event criteria, although the needlestick warrants OSHA follow-up.
Q7. A nurse is caring for a client who refuses a prescribed blood transfusion due to religious beliefs. The
provider insists the transfusion is life-saving. Which action by the nurse is correct?
A. Administer the transfusion because the client's life is at risk.
B. Notify the hospital ethics committee and continue supportive care.
C. Honor the client's refusal and document the refusal, provider notification, and client teaching. [CORRECT]
D. Ask the family to consent to the transfusion on the client's behalf.
Correct Answer: C
Rationale: A competent adult has the legal and ethical right to refuse any treatment, including life-saving transfusions,
based on autonomy and the Patient Self-Determination Act as reinforced in ATI Fundamentals. The nurse must honor
the refusal, ensure informed refusal teaching, notify the provider, and document thoroughly; family consent is invalid
unless the client lacks capacity.
Q8. A nurse is preparing to administer medications to four clients. Using the principle of prioritization, which
client should the nurse assess first?
A. A client requesting pain medication for a headache rated 4/10.
B. A client scheduled for a physical therapy session in 30 minutes.
C. A client reporting new onset shortness of breath and chest tightness. [CORRECT]
D. A client whose blood pressure is 148/92 mmHg after ambulation.
Correct Answer: C
Rationale: The ABC priority framework (Airway, Breathing, Circulation) directs the nurse to the client with new
onset shortness of breath and chest tightness, which may indicate a life-threatening cardiopulmonary event requiring
immediate assessment. The other clients have non-urgent needs that can be addressed after stabilization, even though
pain and elevated BP require follow-up.
ATI Fundamentals Proctored Exam Test Bank 2026/2027 | Page 3
, ATI Fundamentals Proctored Exam Test Bank 2026/2027
Q9. A nurse is preparing a handoff report using SBAR. Which statement appropriately represents the
"Recommendation" component?
A. "The client's blood pressure has dropped from 134/82 to 96/58 over the past 2 hours."
B. "The client is 2 days postoperative from a bowel resection with a history of hypertension."
C. "I think the client may be hypovolemic from inadequate fluid replacement."
D. "I recommend you evaluate the client for fluid bolus and reassess vital signs in 30 minutes." [CORRECT]
Correct Answer: D
Rationale: SBAR's Recommendation component specifies the action the nurse is requesting from the next provider,
consistent with ATI Fundamentals communication tools. Option A is Background-adjacent data, B is Background, and
C is Assessment; only D proposes a clear actionable recommendation for follow-up.
Q10. A nurse discovers a coworker diverting controlled substances. Which action is appropriate first?
A. Confront the coworker directly and demand they stop.
B. Report the suspicion to the nurse manager or supervisor. [CORRECT]
C. Document the observations and continue to monitor the coworker.
D. Notify law enforcement immediately.
Correct Answer: B
Rationale: Suspected substance diversion must be reported through the chain of command starting with the nurse
manager, per institutional policy and the ANA Code of Ethics, to protect clients and allow proper investigation. Direct
confrontation risks escalation and evidence destruction, while notifying law enforcement is the organization's role, not
the individual nurse's first step.
Q11. A client is admitted with an advance directive specifying no artificial nutrition or hydration. The family
demands the client receive tube feedings. Which action should the nurse take?
A. Administer tube feedings as requested by the family.
B. Notify the provider to obtain a court order to enforce the advance directive.
C. Honor the advance directive and provide supportive comfort care. [CORRECT]
D. Ask the client to confirm the advance directive if they are alert.
Correct Answer: C
Rationale: A valid advance directive must be honored as it represents the client's autonomous wishes per the Patient
Self-Determination Act and ATI Fundamentals. Family requests cannot override a written directive; if the client is
alert and capable, confirming the directive is appropriate, but the directive remains the legal basis for care decisions.
ATI Fundamentals Proctored Exam Test Bank 2026/2027 | Page 4
