ATI Fundamentals Proctored Exam Test Bank (2026/2027)
Questions and Answers with Rationale | Latest Edition | Already Verified Answers | Graded A+
150 Multiple-Choice Questions with Rationale | Latest Edition | Already Verified Answers | Graded A+
Section 1: Safe, Effective Care Environment
(Management of Care, Legal/Ethical Issues, Delegation, & Safety/Infection Control) - Q1-Q35
Q1. A nurse on a medical-surgical unit is caring for four clients. Which client should the nurse assess FIRST?
A. A client who is 2 days postoperative requesting pain medication
B. A client with chronic obstructive pulmonary disease (COPD) with an oxygen saturation of 90% on room air
C. A client who is 1 day postoperative with a temperature of 100.8 F (38.2 C)
D. A client with asthma who has wheezing after a breathing treatment [CORRECT]
Correct Answer: D. A client with asthma who has wheezing after a breathing treatment
Rationale: Using the ATI airway/breathing/circulation (ABC) priority framework, the asthma client with continued wheezing
after treatment indicates ongoing bronchospasm requiring immediate assessment and possible escalation. Wheezing after
treatment suggests worsening respiratory distress. The COPD client at 90% is within expected baseline for COPD. Postoperative
low-grade fever and pain medication request are stable needs. ABC always takes priority over pain, low-grade fever, or chronic
baseline findings.
Q2. A nurse is planning care for a client who has a prescription for a wrist restraint. Which of the following actions
should the nurse include in the plan?
A. Remove the restraint every 4 hours to assess circulation
B. Secure the restraint to the bed frame using a slip knot
C. Ensure the restraint is tied to the movable part of the bed frame [CORRECT]
D. Pad bony prominences before applying the restraint only if skin breakdown develops
Correct Answer: C. Ensure the restraint is tied to the movable part of the bed frame
Rationale: Restraints must be secured to the movable part of the bed frame (not the side rail, which moves), using a
quick-release knot or buckle so it can be released in an emergency. ATI standards require removal every 2 hours (not 4) for
assessment, circulation check, range of motion, and toileting. Padding should be applied prophylactically, not only after skin
breakdown develops. Slip knots are inappropriate for restraints.
Q3. A nurse is delegating client care tasks to an assistive personnel (AP). Which of the following tasks is appropriate
for the nurse to delegate to the AP?
A. Teaching a client about a low-sodium diet
B. Administering a cleansing enema to a client
C. Measuring and recording a client's intake and output [CORRECT]
D. Assessing a client's surgical incision
Correct Answer: C. Measuring and recording a client's intake and output
Rationale: Measuring and recording intake and output is within the AP scope of practice because it is a routine, noninvasive task
with predictable outcomes. Teaching requires RN-level knowledge. Administering enemas may involve assessment for
complications and is generally not delegated to AP. Assessment is an RN responsibility and cannot be delegated. ATI delegation
principles follow the Five Rights of Delegation: right task, right circumstance, right person, right direction/communication, and
right supervision.
ATI Fundamentals Proctored Exam Test Bank (2026/2027) | Page 1
,ATI Fundamentals Proctored Exam Test Bank
Q4. A client is scheduled for a cholecystectomy and tells the nurse, "I do not want to sign the consent form because I
am not sure what the surgery involves." Which of the following responses should the nurse make?
A. I will explain the procedure to you so you can sign the form.
B. The provider will explain the procedure to you before the surgery. [CORRECT]
C. You should sign the form because it is required for surgery.
D. I can explain the major risks of the procedure.
Correct Answer: B. The provider will explain the procedure to you before the surgery.
Rationale: Informed consent requires the provider (not the nurse) to explain the procedure, risks, benefits, and alternatives. The
nurse's role is to witness the signature and ensure consent is voluntary. The nurse can reinforce teaching but cannot obtain
consent. The nurse should notify the provider to return and explain the procedure. Telling the client to sign because it is required
is coercive. ATI emphasizes that obtaining informed consent is a provider responsibility, while witnessing is a nursing role.
Q5. A nurse is caring for a client who has a prescription for a clear liquid diet. Which of the following foods should
the nurse offer the client?
A. Vanilla pudding
B. Beef broth [CORRECT]
C. Milk
D. Orange juice with pulp
Correct Answer: B. Beef broth
Rationale: Beef broth is transparent and is included in a clear liquid diet. Vanilla pudding and milk are not allowed on a clear
liquid diet because they are opaque. Orange juice with pulp is not clear. Clear liquids include broth, gelatin, clear juices (no
pulp), tea, coffee, and water. ATI classifies clear liquid diet as transparent liquids that leave minimal residue and are easy to
digest.
Q6. A nurse is preparing to administer a medication to a client. Which of the following actions should the nurse take
FIRST?
A. Check the medication against the MAR [CORRECT]
B. Identify the client using two identifiers
C. Calculate the dose of the medication
D. Document the medication administration
Correct Answer: A. Check the medication against the MAR
Rationale: The first step in medication administration is comparing the medication label to the Medication Administration
Record (MAR) three times: when retrieving the medication, when preparing the dose, and before administering. After verifying
the medication, the nurse identifies the client using two identifiers, calculates the dose if needed, and documents after
administration. ATI follows the Six Rights of Medication Administration: right medication, right dose, right client, right route,
right time, and right documentation.
Q7. A nurse is caring for a client who is on contact precautions for Clostridium difficile. Which of the following
actions should the nurse take?
A. Wear a surgical mask when providing client care
B. Use an alcohol-based hand rub after removing gloves
C. Place the client in a negative-pressure room
D. Use soap and water for hand hygiene after client care [CORRECT]
Correct Answer: D. Use soap and water for hand hygiene after client care
Rationale: C. difficile spores are resistant to alcohol-based hand sanitizers, so hand hygiene must be performed with soap and
water to physically remove spores. Contact precautions require a gown and gloves, not a mask. C. difficile does not require
ATI Fundamentals Proctored Exam Test Bank (2026/2027) | Page 2
,ATI Fundamentals Proctored Exam Test Bank
negative-pressure rooms (used for airborne precautions). ATI emphasizes correct hand hygiene based on the pathogen: soap and
water for C. difficile; alcohol-based hand rubs are sufficient for most other pathogens.
Q8. A nurse is caring for a client who refuses a prescribed blood transfusion due to religious beliefs. Which of the
following actions should the nurse take FIRST?
A. Notify the provider of the client's refusal [CORRECT]
B. Explain the risks of refusing the transfusion
C. Document the client's refusal in the medical record
D. Ask a family member to convince the client
Correct Answer: A. Notify the provider of the client's refusal
Rationale: When a client refuses a treatment, the nurse's first action is to notify the provider so the provider can discuss risks
and alternatives with the client. The nurse should not attempt to convince the client, involve family without consent, or document
before ensuring the provider has been notified. ATI principles support client autonomy and informed refusal, with the nurse's
role to ensure the client has full information and notify the provider.
Q9. A nurse is planning care for a client who is at high risk for falls. Which of the following interventions should the
nurse include in the plan of care?
A. Keep the bed in the highest position
B. Use a bed alarm only at night
C. Place the client close to the nurses' station [CORRECT]
D. Keep the side rails in the up position on all four sides
Correct Answer: C. Place the client close to the nurses' station
Rationale: Placing the client close to the nurses' station allows for close observation and rapid response if the client attempts to
get out of bed. The bed should be in the lowest position to minimize fall distance. Bed alarms should be used at all times, not only
at night. Four side rails are considered a restraint and require a restraint order. ATI fall prevention interventions include bed in
lowest position, locked wheels, call light within reach, and hourly rounding.
Q10. A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The client goes into cardiac arrest.
Which of the following actions should the nurse take?
A. Initiate cardiopulmonary resuscitation (CPR)
B. Call the rapid response team
C. Notify the provider and document the event [CORRECT]
D. Contact the family for permission to resuscitate
Correct Answer: C. Notify the provider and document the event
Rationale: A DNR order means the client should not receive CPR in the event of cardiac arrest. The nurse should not initiate
CPR, call a rapid response team, or contact the family for permission. The nurse's role is to provide comfort measures, notify the
provider, and document the event and the actions taken. ATI emphasizes respect for advance directives and DNR orders;
resuscitation would violate the client's wishes and could constitute battery.
Q11. A nurse is preparing to transfer a client from a bed to a wheelchair. Which of the following actions should the
nurse take?
A. Place the wheelchair on the client's stronger side [CORRECT]
B. Lock the wheels of the wheelchair after the transfer
C. Position the bed in a low position
D. Ask the client to stand on a wet floor
Correct Answer: A. Place the wheelchair on the client's stronger side
ATI Fundamentals Proctored Exam Test Bank (2026/2027) | Page 3
, ATI Fundamentals Proctored Exam Test Bank
Rationale: Placing the wheelchair on the client's stronger side allows the client to use the stronger leg to pivot and sit safely. The
wheelchair wheels should be locked before the transfer (not after). The bed should be at a height that allows the client's feet to
touch the floor during transfer. A wet floor creates a fall hazard. ATI transfer principles include: lock wheels, use transfer belt,
position wheelchair on stronger side, and ensure client wears stable shoes.
Q12. A nurse is caring for a client who has a Stage III pressure injury on the sacrum. Which of the following findings
should the nurse expect to observe?
A. Non-blanchable erythema of intact skin
B. Partial-thickness skin loss involving the epidermis and dermis
C. Full-thickness tissue loss with visible subcutaneous fat [CORRECT]
D. Full-thickness tissue loss with exposed bone or muscle
Correct Answer: C. Full-thickness tissue loss with visible subcutaneous fat
Rationale: Stage III pressure injuries involve full-thickness skin loss with visible subcutaneous fat, but bone, tendon, or muscle
are not exposed. Stage I is non-blanchable erythema of intact skin. Stage II is partial-thickness loss involving the epidermis and
dermis. Stage IV involves exposed bone, muscle, or tendon. ATI follows the National Pressure Injury Advisory Panel staging
system, with unstageable injuries having obscured depth by slough or eschar.
Q13. A nurse is caring for a client who is in restraints. How often should the nurse assess the client's circulation, skin
integrity, and comfort while in restraints?
A. Every 15 minutes [CORRECT]
B. Every 30 minutes
C. Every 1 hour
D. Every 2 hours
Correct Answer: A. Every 15 minutes
Rationale: For clients in restraints, the nurse must assess circulation, skin integrity, sensation, and comfort every 15 minutes
(per ATI standards) for the first 2 hours, then every hour. Restraints must be released every 2 hours for range of motion,
toileting, and circulation assessment. The provider must reassess and reissue the restraint order within 24 hours. Frequent
assessment prevents complications such as impaired circulation, skin breakdown, and respiratory compromise.
Q14. A nurse is preparing to administer an intramuscular injection to an adult client using the ventrogluteal site.
Which of the following needle lengths should the nurse use for a client with average adipose tissue?
A. 5/8 inch
B. 1 inch
C. 1 1/2 inches [CORRECT]
D. 2 inches
Correct Answer: C. 1 1/2 inches
Rationale: For an adult ventrogluteal injection, the needle length is typically 1 1/2 inches for a client with average adipose
tissue, allowing the medication to reach the gluteus muscle. A 5/8 inch needle is used for subcutaneous injections. A 1 inch needle
may be appropriate for deltoid or smaller adults. A 2 inch needle is used for clients with significant adipose tissue. ATI specifies
needle selection based on client size, injection site, and medication characteristics.
Q15. A nurse is caring for a client who has a nasogastric tube for enteral feedings. Which of the following actions
should the nurse take to verify tube placement before administering a feeding?
A. Auscultate the abdomen while injecting air
B. Measure the pH of the aspirate [CORRECT]
C. Check the marking on the tube at the nostril
ATI Fundamentals Proctored Exam Test Bank (2026/2027) | Page 4
Questions and Answers with Rationale | Latest Edition | Already Verified Answers | Graded A+
150 Multiple-Choice Questions with Rationale | Latest Edition | Already Verified Answers | Graded A+
Section 1: Safe, Effective Care Environment
(Management of Care, Legal/Ethical Issues, Delegation, & Safety/Infection Control) - Q1-Q35
Q1. A nurse on a medical-surgical unit is caring for four clients. Which client should the nurse assess FIRST?
A. A client who is 2 days postoperative requesting pain medication
B. A client with chronic obstructive pulmonary disease (COPD) with an oxygen saturation of 90% on room air
C. A client who is 1 day postoperative with a temperature of 100.8 F (38.2 C)
D. A client with asthma who has wheezing after a breathing treatment [CORRECT]
Correct Answer: D. A client with asthma who has wheezing after a breathing treatment
Rationale: Using the ATI airway/breathing/circulation (ABC) priority framework, the asthma client with continued wheezing
after treatment indicates ongoing bronchospasm requiring immediate assessment and possible escalation. Wheezing after
treatment suggests worsening respiratory distress. The COPD client at 90% is within expected baseline for COPD. Postoperative
low-grade fever and pain medication request are stable needs. ABC always takes priority over pain, low-grade fever, or chronic
baseline findings.
Q2. A nurse is planning care for a client who has a prescription for a wrist restraint. Which of the following actions
should the nurse include in the plan?
A. Remove the restraint every 4 hours to assess circulation
B. Secure the restraint to the bed frame using a slip knot
C. Ensure the restraint is tied to the movable part of the bed frame [CORRECT]
D. Pad bony prominences before applying the restraint only if skin breakdown develops
Correct Answer: C. Ensure the restraint is tied to the movable part of the bed frame
Rationale: Restraints must be secured to the movable part of the bed frame (not the side rail, which moves), using a
quick-release knot or buckle so it can be released in an emergency. ATI standards require removal every 2 hours (not 4) for
assessment, circulation check, range of motion, and toileting. Padding should be applied prophylactically, not only after skin
breakdown develops. Slip knots are inappropriate for restraints.
Q3. A nurse is delegating client care tasks to an assistive personnel (AP). Which of the following tasks is appropriate
for the nurse to delegate to the AP?
A. Teaching a client about a low-sodium diet
B. Administering a cleansing enema to a client
C. Measuring and recording a client's intake and output [CORRECT]
D. Assessing a client's surgical incision
Correct Answer: C. Measuring and recording a client's intake and output
Rationale: Measuring and recording intake and output is within the AP scope of practice because it is a routine, noninvasive task
with predictable outcomes. Teaching requires RN-level knowledge. Administering enemas may involve assessment for
complications and is generally not delegated to AP. Assessment is an RN responsibility and cannot be delegated. ATI delegation
principles follow the Five Rights of Delegation: right task, right circumstance, right person, right direction/communication, and
right supervision.
ATI Fundamentals Proctored Exam Test Bank (2026/2027) | Page 1
,ATI Fundamentals Proctored Exam Test Bank
Q4. A client is scheduled for a cholecystectomy and tells the nurse, "I do not want to sign the consent form because I
am not sure what the surgery involves." Which of the following responses should the nurse make?
A. I will explain the procedure to you so you can sign the form.
B. The provider will explain the procedure to you before the surgery. [CORRECT]
C. You should sign the form because it is required for surgery.
D. I can explain the major risks of the procedure.
Correct Answer: B. The provider will explain the procedure to you before the surgery.
Rationale: Informed consent requires the provider (not the nurse) to explain the procedure, risks, benefits, and alternatives. The
nurse's role is to witness the signature and ensure consent is voluntary. The nurse can reinforce teaching but cannot obtain
consent. The nurse should notify the provider to return and explain the procedure. Telling the client to sign because it is required
is coercive. ATI emphasizes that obtaining informed consent is a provider responsibility, while witnessing is a nursing role.
Q5. A nurse is caring for a client who has a prescription for a clear liquid diet. Which of the following foods should
the nurse offer the client?
A. Vanilla pudding
B. Beef broth [CORRECT]
C. Milk
D. Orange juice with pulp
Correct Answer: B. Beef broth
Rationale: Beef broth is transparent and is included in a clear liquid diet. Vanilla pudding and milk are not allowed on a clear
liquid diet because they are opaque. Orange juice with pulp is not clear. Clear liquids include broth, gelatin, clear juices (no
pulp), tea, coffee, and water. ATI classifies clear liquid diet as transparent liquids that leave minimal residue and are easy to
digest.
Q6. A nurse is preparing to administer a medication to a client. Which of the following actions should the nurse take
FIRST?
A. Check the medication against the MAR [CORRECT]
B. Identify the client using two identifiers
C. Calculate the dose of the medication
D. Document the medication administration
Correct Answer: A. Check the medication against the MAR
Rationale: The first step in medication administration is comparing the medication label to the Medication Administration
Record (MAR) three times: when retrieving the medication, when preparing the dose, and before administering. After verifying
the medication, the nurse identifies the client using two identifiers, calculates the dose if needed, and documents after
administration. ATI follows the Six Rights of Medication Administration: right medication, right dose, right client, right route,
right time, and right documentation.
Q7. A nurse is caring for a client who is on contact precautions for Clostridium difficile. Which of the following
actions should the nurse take?
A. Wear a surgical mask when providing client care
B. Use an alcohol-based hand rub after removing gloves
C. Place the client in a negative-pressure room
D. Use soap and water for hand hygiene after client care [CORRECT]
Correct Answer: D. Use soap and water for hand hygiene after client care
Rationale: C. difficile spores are resistant to alcohol-based hand sanitizers, so hand hygiene must be performed with soap and
water to physically remove spores. Contact precautions require a gown and gloves, not a mask. C. difficile does not require
ATI Fundamentals Proctored Exam Test Bank (2026/2027) | Page 2
,ATI Fundamentals Proctored Exam Test Bank
negative-pressure rooms (used for airborne precautions). ATI emphasizes correct hand hygiene based on the pathogen: soap and
water for C. difficile; alcohol-based hand rubs are sufficient for most other pathogens.
Q8. A nurse is caring for a client who refuses a prescribed blood transfusion due to religious beliefs. Which of the
following actions should the nurse take FIRST?
A. Notify the provider of the client's refusal [CORRECT]
B. Explain the risks of refusing the transfusion
C. Document the client's refusal in the medical record
D. Ask a family member to convince the client
Correct Answer: A. Notify the provider of the client's refusal
Rationale: When a client refuses a treatment, the nurse's first action is to notify the provider so the provider can discuss risks
and alternatives with the client. The nurse should not attempt to convince the client, involve family without consent, or document
before ensuring the provider has been notified. ATI principles support client autonomy and informed refusal, with the nurse's
role to ensure the client has full information and notify the provider.
Q9. A nurse is planning care for a client who is at high risk for falls. Which of the following interventions should the
nurse include in the plan of care?
A. Keep the bed in the highest position
B. Use a bed alarm only at night
C. Place the client close to the nurses' station [CORRECT]
D. Keep the side rails in the up position on all four sides
Correct Answer: C. Place the client close to the nurses' station
Rationale: Placing the client close to the nurses' station allows for close observation and rapid response if the client attempts to
get out of bed. The bed should be in the lowest position to minimize fall distance. Bed alarms should be used at all times, not only
at night. Four side rails are considered a restraint and require a restraint order. ATI fall prevention interventions include bed in
lowest position, locked wheels, call light within reach, and hourly rounding.
Q10. A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The client goes into cardiac arrest.
Which of the following actions should the nurse take?
A. Initiate cardiopulmonary resuscitation (CPR)
B. Call the rapid response team
C. Notify the provider and document the event [CORRECT]
D. Contact the family for permission to resuscitate
Correct Answer: C. Notify the provider and document the event
Rationale: A DNR order means the client should not receive CPR in the event of cardiac arrest. The nurse should not initiate
CPR, call a rapid response team, or contact the family for permission. The nurse's role is to provide comfort measures, notify the
provider, and document the event and the actions taken. ATI emphasizes respect for advance directives and DNR orders;
resuscitation would violate the client's wishes and could constitute battery.
Q11. A nurse is preparing to transfer a client from a bed to a wheelchair. Which of the following actions should the
nurse take?
A. Place the wheelchair on the client's stronger side [CORRECT]
B. Lock the wheels of the wheelchair after the transfer
C. Position the bed in a low position
D. Ask the client to stand on a wet floor
Correct Answer: A. Place the wheelchair on the client's stronger side
ATI Fundamentals Proctored Exam Test Bank (2026/2027) | Page 3
, ATI Fundamentals Proctored Exam Test Bank
Rationale: Placing the wheelchair on the client's stronger side allows the client to use the stronger leg to pivot and sit safely. The
wheelchair wheels should be locked before the transfer (not after). The bed should be at a height that allows the client's feet to
touch the floor during transfer. A wet floor creates a fall hazard. ATI transfer principles include: lock wheels, use transfer belt,
position wheelchair on stronger side, and ensure client wears stable shoes.
Q12. A nurse is caring for a client who has a Stage III pressure injury on the sacrum. Which of the following findings
should the nurse expect to observe?
A. Non-blanchable erythema of intact skin
B. Partial-thickness skin loss involving the epidermis and dermis
C. Full-thickness tissue loss with visible subcutaneous fat [CORRECT]
D. Full-thickness tissue loss with exposed bone or muscle
Correct Answer: C. Full-thickness tissue loss with visible subcutaneous fat
Rationale: Stage III pressure injuries involve full-thickness skin loss with visible subcutaneous fat, but bone, tendon, or muscle
are not exposed. Stage I is non-blanchable erythema of intact skin. Stage II is partial-thickness loss involving the epidermis and
dermis. Stage IV involves exposed bone, muscle, or tendon. ATI follows the National Pressure Injury Advisory Panel staging
system, with unstageable injuries having obscured depth by slough or eschar.
Q13. A nurse is caring for a client who is in restraints. How often should the nurse assess the client's circulation, skin
integrity, and comfort while in restraints?
A. Every 15 minutes [CORRECT]
B. Every 30 minutes
C. Every 1 hour
D. Every 2 hours
Correct Answer: A. Every 15 minutes
Rationale: For clients in restraints, the nurse must assess circulation, skin integrity, sensation, and comfort every 15 minutes
(per ATI standards) for the first 2 hours, then every hour. Restraints must be released every 2 hours for range of motion,
toileting, and circulation assessment. The provider must reassess and reissue the restraint order within 24 hours. Frequent
assessment prevents complications such as impaired circulation, skin breakdown, and respiratory compromise.
Q14. A nurse is preparing to administer an intramuscular injection to an adult client using the ventrogluteal site.
Which of the following needle lengths should the nurse use for a client with average adipose tissue?
A. 5/8 inch
B. 1 inch
C. 1 1/2 inches [CORRECT]
D. 2 inches
Correct Answer: C. 1 1/2 inches
Rationale: For an adult ventrogluteal injection, the needle length is typically 1 1/2 inches for a client with average adipose
tissue, allowing the medication to reach the gluteus muscle. A 5/8 inch needle is used for subcutaneous injections. A 1 inch needle
may be appropriate for deltoid or smaller adults. A 2 inch needle is used for clients with significant adipose tissue. ATI specifies
needle selection based on client size, injection site, and medication characteristics.
Q15. A nurse is caring for a client who has a nasogastric tube for enteral feedings. Which of the following actions
should the nurse take to verify tube placement before administering a feeding?
A. Auscultate the abdomen while injecting air
B. Measure the pH of the aspirate [CORRECT]
C. Check the marking on the tube at the nostril
ATI Fundamentals Proctored Exam Test Bank (2026/2027) | Page 4
