ATI RN Fundamentals Proctored Exam 2026/2027 100 Verified Questions | Graded A
ATI RN FUNDAMENTALS
PROCTORED EXAM
Edition
100 Verified Questions with Detailed Answers | Graded A
Format: Multiple Choice (A-D) | Total Questions: 100 | Suggested Time: 180 Minutes
Cognitive Levels: 25% Recall | 50% Application | 25% Analysis
Content aligned with the ATI RN Fundamentals proctored exam blueprint and 2026-2027 test plan updates, including
priority-setting, delegation, medication calculation, and nursing process (ADPIE) integration.
SECTION 1 | QUESTIONS 1-20
Safe, Effective Care Environment: Management of Care
Client Rights | Advocacy | Informed Consent | Advance Directives | HIPAA and Confidentiality | Delegation (RN, LPN, UAP) | Legal
Issues | Ethical Principles | Priority Setting
Q1: A competent adult client who is prepped and draped for an elective cholecystectomy tells the
circulating nurse, 'I have changed my mind. I do not want this surgery.' Which action should the
nurse take first?
A. Remind the client that the surgeon has already explained the risks and benefits of the
procedure.
B. Notify the surgeon and the surgical team that the client is withdrawing consent.
[CORRECT]
C. Ask the client's family to come to the preoperative area to encourage the client to proceed.
D. Document the client's statement in the medical record and continue with preoperative
preparation.
Correct Answer: B
Rationale: A competent client has the legal and ethical right to withdraw consent at any point, even moments
before incision, and the nurse's first duty is advocacy, which requires alerting the surgeon so the procedure is
halted. Reminding the client of the risks and benefits (A) is coercive and violates autonomy, and involving the
family to persuade the client (C) disrespects the client's self-determination. Documentation (D) is essential under
the implementation step of the nursing process, but it must follow, not replace, immediate communication with
the surgical team. This item tests the nurse's role as client advocate within the Management of Care subcategory.
ATI RN Fundamentals Test Bank - Educational Review Copy 1
,ATI RN Fundamentals Proctored Exam 2026/2027 100 Verified Questions | Graded A
Q2: A nurse is caring for a competent adult client who refuses a prescribed blood transfusion for
religious reasons. Which action by the nurse best demonstrates support for the client's right to
self-determination?
A. Explaining that the transfusion is essential and asking the client to reconsider until the
family arrives.
B. Documenting the refusal, notifying the provider, and informing the client of alternatives
such as volume expanders. [CORRECT]
C. Asking the chaplain to speak with the client about the religious prohibition against blood
products.
D. Waiting until the client is under anesthesia to administer the transfusion safely.
Correct Answer: B
Rationale: Supporting autonomy means accepting an informed refusal, documenting it clearly, notifying the
provider so treatment can be modified, and exploring acceptable alternatives with the client, which is exactly
what option B describes. Option A applies pressure and delays care, option C circumvents the client's decision by
recruiting others to change the client's mind, and option D constitutes battery because treatment without consent,
even for a competent refusal, is unlawful touching. In the nursing process, the nurse acts as advocate during
implementation while respecting the client's right to refuse treatment under the Patient Self-Determination Act.
Q3: Which task associated with informed consent for an invasive procedure is within the scope of
practice of the RN?
A. Explaining the procedural risks, benefits, and alternatives to the client.
B. Determining whether the client comprehends the information provided by the surgeon.
C. Witnessing the client's signature on the consent form after the provider has provided the
explanation. [CORRECT]
D. Describing the step-by-step surgical technique so the client can make an informed
decision.
Correct Answer: C
Rationale: The RN's role in informed consent is to witness the voluntary signature, verify that the client appears
competent and informed, and answer clarifying questions, which makes witnessing the signature (C) the clearly
delegated nursing task. The provider, not the nurse, is legally responsible for explaining the diagnosis, nature of
the procedure, risks, benefits, and alternatives, so options A and D exceed nursing scope and create liability.
Option B uses the word 'comprehends' in a judging sense; the nurse only clarifies and alerts the provider if the
client does not appear to understand, because the determination of decision-making capacity belongs to the
provider. This distinction is a frequently tested ATI Management of Care concept.
ATI RN Fundamentals Test Bank - Educational Review Copy 2
,ATI RN Fundamentals Proctored Exam 2026/2027 100 Verified Questions | Graded A
Q4: An unconscious client is brought to the emergency department with massive internal bleeding
following a motor-vehicle crash, and no family can be reached. Life-saving surgery is required.
Which legal principle permits the nurse to prepare the client for surgery without a signed consent
form?
A. Implied consent in an emergency situation when delay would threaten the client's life.
[CORRECT]
B. Informed consent obtained from the hospital administrator on call.
C. Substituted judgment from two registered nurses familiar with the case.
D. Statutory consent obtained from the client's insurance carrier.
Correct Answer: A
Rationale: In a life-threatening emergency when the client cannot consent and no legal representative is
available, treatment proceeds under implied consent, the legal doctrine that a reasonable person would consent to
emergency care to preserve life, so option A is correct. Hospital administrators (B) and insurance carriers (D)
have no legal authority to consent for an adult client, and nurses (C) cannot substitute their judgment for client
consent except within formally established emergency protocols. The nurse should still document the emergency
circumstances and all attempts to reach family, because thorough documentation is part of the legal defense of
the care provided under the Safety and Risk Reduction priority framework.
Q5: A nurse is admitting a 17-year-old client who is married and living independently with her
spouse. The client requires an elective diagnostic procedure. Which action should the nurse take
regarding informed consent?
A. Obtain consent from the client's parents because the client is younger than 18 years.
B. Obtain consent from the client, because marriage establishes emancipated minor status.
[CORRECT]
C. Obtain consent from the client's spouse and her parents jointly before the procedure.
D. Petition the court for a judicial waiver because the procedure is elective.
Correct Answer: B
Rationale: An emancipated minor, which includes clients younger than 18 who are married, self-supporting and
living independently, pregnant, or serving in the armed forces, has the legal capacity to provide his or her own
consent, so the nurse obtains consent from the client. Option A incorrectly applies the age rule without
recognizing emancipated status, and option C unnecessarily adds parents who have relinquished legal
decision-making authority through the client's emancipation. Option D is incorrect because judicial waivers are
only needed when a minor is not emancipated and state law requires court approval. This is an analysis-level item
because the nurse must apply multiple legal criteria to determine who legally signs.
ATI RN Fundamentals Test Bank - Educational Review Copy 3
, ATI RN Fundamentals Proctored Exam 2026/2027 100 Verified Questions | Graded A
Q6: A nurse is reinforcing teaching with a client who has completed a living will. Which client
statement indicates a correct understanding of this advance directive?
A. 'My family will decide about life-sustaining treatment only after I become incompetent.'
B. 'This document allows my daughter to make all health care decisions for me.'
C. 'This written document states the treatments I would accept or refuse if I become unable to
communicate.' [CORRECT]
D. 'My living will gives the hospital permission to withhold all care if I stop breathing.'
Correct Answer: C
Rationale: A living will is a written directive in which a competent adult communicates treatment preferences,
especially regarding life-sustaining measures such as CPR, mechanical ventilation, and artificial nutrition, to be
honored if the client later lacks decision-making capacity, which matches option C. Option B describes a durable
power of attorney for health care, a different advance directive that designates a surrogate decision-maker rather
than written instructions. Option A misstates the purpose, because the living will speaks for the client precisely to
avoid family decision-making, and option D is wrong because a living will specifies limited, client-chosen
refusals and never withholds comfort care, hygiene, or pain management. Clients retain the right to revise or
revoke the document at any time.
Q7: A client becomes unresponsive following a massive stroke, and the family members disagree
about the plan of care. The nurse locates a durable power of attorney for health care that names the
client's brother as the health care proxy. Which action should the nurse take?
A. Contact the client's brother, the designated health care proxy, regarding treatment
decisions. [CORRECT]
B. Ask the client's spouse to sign the consent for treatment because spouses hold legal
priority.
C. Request that the ethics committee appoint the oldest adult child as the decision-maker.
D. Follow the written treatment preferences of the majority of the family members present.
Correct Answer: A
Rationale: A durable power of attorney for health care legally designates a specific surrogate whose authority
activates when the client loses decision-making capacity, and the nurse must direct decision-making questions to
that individual, the brother. Option B is incorrect because a documented proxy designation supersedes default
next-of-kin hierarchy, and option C incorrectly delegates a legal determination to the ethics committee, which
advises on conflicts but does not appoint decision-makers. Option D is invalid because majority family
preference has no legal standing when a named proxy exists. The nurse's role under the Assessment and
Implementation steps of the nursing process is to identify and communicate with the legally authorized
representative while supporting the family through the conflict.
ATI RN Fundamentals Test Bank - Educational Review Copy 4
ATI RN FUNDAMENTALS
PROCTORED EXAM
Edition
100 Verified Questions with Detailed Answers | Graded A
Format: Multiple Choice (A-D) | Total Questions: 100 | Suggested Time: 180 Minutes
Cognitive Levels: 25% Recall | 50% Application | 25% Analysis
Content aligned with the ATI RN Fundamentals proctored exam blueprint and 2026-2027 test plan updates, including
priority-setting, delegation, medication calculation, and nursing process (ADPIE) integration.
SECTION 1 | QUESTIONS 1-20
Safe, Effective Care Environment: Management of Care
Client Rights | Advocacy | Informed Consent | Advance Directives | HIPAA and Confidentiality | Delegation (RN, LPN, UAP) | Legal
Issues | Ethical Principles | Priority Setting
Q1: A competent adult client who is prepped and draped for an elective cholecystectomy tells the
circulating nurse, 'I have changed my mind. I do not want this surgery.' Which action should the
nurse take first?
A. Remind the client that the surgeon has already explained the risks and benefits of the
procedure.
B. Notify the surgeon and the surgical team that the client is withdrawing consent.
[CORRECT]
C. Ask the client's family to come to the preoperative area to encourage the client to proceed.
D. Document the client's statement in the medical record and continue with preoperative
preparation.
Correct Answer: B
Rationale: A competent client has the legal and ethical right to withdraw consent at any point, even moments
before incision, and the nurse's first duty is advocacy, which requires alerting the surgeon so the procedure is
halted. Reminding the client of the risks and benefits (A) is coercive and violates autonomy, and involving the
family to persuade the client (C) disrespects the client's self-determination. Documentation (D) is essential under
the implementation step of the nursing process, but it must follow, not replace, immediate communication with
the surgical team. This item tests the nurse's role as client advocate within the Management of Care subcategory.
ATI RN Fundamentals Test Bank - Educational Review Copy 1
,ATI RN Fundamentals Proctored Exam 2026/2027 100 Verified Questions | Graded A
Q2: A nurse is caring for a competent adult client who refuses a prescribed blood transfusion for
religious reasons. Which action by the nurse best demonstrates support for the client's right to
self-determination?
A. Explaining that the transfusion is essential and asking the client to reconsider until the
family arrives.
B. Documenting the refusal, notifying the provider, and informing the client of alternatives
such as volume expanders. [CORRECT]
C. Asking the chaplain to speak with the client about the religious prohibition against blood
products.
D. Waiting until the client is under anesthesia to administer the transfusion safely.
Correct Answer: B
Rationale: Supporting autonomy means accepting an informed refusal, documenting it clearly, notifying the
provider so treatment can be modified, and exploring acceptable alternatives with the client, which is exactly
what option B describes. Option A applies pressure and delays care, option C circumvents the client's decision by
recruiting others to change the client's mind, and option D constitutes battery because treatment without consent,
even for a competent refusal, is unlawful touching. In the nursing process, the nurse acts as advocate during
implementation while respecting the client's right to refuse treatment under the Patient Self-Determination Act.
Q3: Which task associated with informed consent for an invasive procedure is within the scope of
practice of the RN?
A. Explaining the procedural risks, benefits, and alternatives to the client.
B. Determining whether the client comprehends the information provided by the surgeon.
C. Witnessing the client's signature on the consent form after the provider has provided the
explanation. [CORRECT]
D. Describing the step-by-step surgical technique so the client can make an informed
decision.
Correct Answer: C
Rationale: The RN's role in informed consent is to witness the voluntary signature, verify that the client appears
competent and informed, and answer clarifying questions, which makes witnessing the signature (C) the clearly
delegated nursing task. The provider, not the nurse, is legally responsible for explaining the diagnosis, nature of
the procedure, risks, benefits, and alternatives, so options A and D exceed nursing scope and create liability.
Option B uses the word 'comprehends' in a judging sense; the nurse only clarifies and alerts the provider if the
client does not appear to understand, because the determination of decision-making capacity belongs to the
provider. This distinction is a frequently tested ATI Management of Care concept.
ATI RN Fundamentals Test Bank - Educational Review Copy 2
,ATI RN Fundamentals Proctored Exam 2026/2027 100 Verified Questions | Graded A
Q4: An unconscious client is brought to the emergency department with massive internal bleeding
following a motor-vehicle crash, and no family can be reached. Life-saving surgery is required.
Which legal principle permits the nurse to prepare the client for surgery without a signed consent
form?
A. Implied consent in an emergency situation when delay would threaten the client's life.
[CORRECT]
B. Informed consent obtained from the hospital administrator on call.
C. Substituted judgment from two registered nurses familiar with the case.
D. Statutory consent obtained from the client's insurance carrier.
Correct Answer: A
Rationale: In a life-threatening emergency when the client cannot consent and no legal representative is
available, treatment proceeds under implied consent, the legal doctrine that a reasonable person would consent to
emergency care to preserve life, so option A is correct. Hospital administrators (B) and insurance carriers (D)
have no legal authority to consent for an adult client, and nurses (C) cannot substitute their judgment for client
consent except within formally established emergency protocols. The nurse should still document the emergency
circumstances and all attempts to reach family, because thorough documentation is part of the legal defense of
the care provided under the Safety and Risk Reduction priority framework.
Q5: A nurse is admitting a 17-year-old client who is married and living independently with her
spouse. The client requires an elective diagnostic procedure. Which action should the nurse take
regarding informed consent?
A. Obtain consent from the client's parents because the client is younger than 18 years.
B. Obtain consent from the client, because marriage establishes emancipated minor status.
[CORRECT]
C. Obtain consent from the client's spouse and her parents jointly before the procedure.
D. Petition the court for a judicial waiver because the procedure is elective.
Correct Answer: B
Rationale: An emancipated minor, which includes clients younger than 18 who are married, self-supporting and
living independently, pregnant, or serving in the armed forces, has the legal capacity to provide his or her own
consent, so the nurse obtains consent from the client. Option A incorrectly applies the age rule without
recognizing emancipated status, and option C unnecessarily adds parents who have relinquished legal
decision-making authority through the client's emancipation. Option D is incorrect because judicial waivers are
only needed when a minor is not emancipated and state law requires court approval. This is an analysis-level item
because the nurse must apply multiple legal criteria to determine who legally signs.
ATI RN Fundamentals Test Bank - Educational Review Copy 3
, ATI RN Fundamentals Proctored Exam 2026/2027 100 Verified Questions | Graded A
Q6: A nurse is reinforcing teaching with a client who has completed a living will. Which client
statement indicates a correct understanding of this advance directive?
A. 'My family will decide about life-sustaining treatment only after I become incompetent.'
B. 'This document allows my daughter to make all health care decisions for me.'
C. 'This written document states the treatments I would accept or refuse if I become unable to
communicate.' [CORRECT]
D. 'My living will gives the hospital permission to withhold all care if I stop breathing.'
Correct Answer: C
Rationale: A living will is a written directive in which a competent adult communicates treatment preferences,
especially regarding life-sustaining measures such as CPR, mechanical ventilation, and artificial nutrition, to be
honored if the client later lacks decision-making capacity, which matches option C. Option B describes a durable
power of attorney for health care, a different advance directive that designates a surrogate decision-maker rather
than written instructions. Option A misstates the purpose, because the living will speaks for the client precisely to
avoid family decision-making, and option D is wrong because a living will specifies limited, client-chosen
refusals and never withholds comfort care, hygiene, or pain management. Clients retain the right to revise or
revoke the document at any time.
Q7: A client becomes unresponsive following a massive stroke, and the family members disagree
about the plan of care. The nurse locates a durable power of attorney for health care that names the
client's brother as the health care proxy. Which action should the nurse take?
A. Contact the client's brother, the designated health care proxy, regarding treatment
decisions. [CORRECT]
B. Ask the client's spouse to sign the consent for treatment because spouses hold legal
priority.
C. Request that the ethics committee appoint the oldest adult child as the decision-maker.
D. Follow the written treatment preferences of the majority of the family members present.
Correct Answer: A
Rationale: A durable power of attorney for health care legally designates a specific surrogate whose authority
activates when the client loses decision-making capacity, and the nurse must direct decision-making questions to
that individual, the brother. Option B is incorrect because a documented proxy designation supersedes default
next-of-kin hierarchy, and option C incorrectly delegates a legal determination to the ethics committee, which
advises on conflicts but does not appoint decision-makers. Option D is invalid because majority family
preference has no legal standing when a named proxy exists. The nurse's role under the Assessment and
Implementation steps of the nursing process is to identify and communicate with the legally authorized
representative while supporting the family through the conflict.
ATI RN Fundamentals Test Bank - Educational Review Copy 4
