ATI RN Fundamentals Proctored Exam - 2026 | 2027 Comprehensive Practice - 150 Questions
ATI RN Fundamentals Proctored Exam - 2026 | 2027
Comprehensive Practice Questions and Verified Answers
Aligned with 2026-2027 NCLEX Test Plan & ATI RN Fundamentals Blueprint | 150 Questions | Cognitive Distribution: 25% Recall,
50% Application, 25% Analysis | 75% Scenario-Based, 25% Recall/Calculation | 100% Pass Grade A+
Instructions: This comprehensive practice exam contains 150 multiple-choice questions organized into eight content
domains aligned with the ATI RN Fundamentals Proctored Examination blueprint. Each question has one correct answer
(A-D) identified by the [CORRECT] marker and confirmed on the Correct Answer: line. Rationales provide ATI-specific
nursing reasoning grounded in the nursing process (ADPIE), priority-setting frameworks (ABCs, Maslow's Hierarchy, Safety,
Least Restrictive), the Five Rights of Delegation, evidence-based practice, and current NCLEX test plan competencies. Use
this exam to assess knowledge, identify weak areas, and reinforce safe, client-centered nursing practice.
Section 1: Safe, Effective Care Environment - Management of Care
Topics: Client Rights, Advocacy, Delegation, Legal/Ethical Issues, Informed Consent, HIPAA, Advance Directives (Q1-Q30)
Q1: A 78-year-old client with stage IV ovarian cancer signs a do-not-resuscitate (DNR) order after a thorough
discussion with the oncologist and her family. The client's daughter storms into the nurses' station demanding that
the nurse resuscitate her mother if she stops breathing, stating, "I am her only child and I have power of attorney."
Which action by the nurse best reflects advocacy and the ethical principle of autonomy?
A. Notify the provider immediately and request that the DNR be rescinded based on the daughter's legal
authority.
B. Explain to the daughter that the client's autonomous decision, documented in the advance directive, must be
honored, and offer to facilitate a family meeting with the care team. [CORRECT]
C. Contact the hospital's legal department to determine whether the durable power of attorney supersedes the
client's written directive.
D. Reassure the daughter that the nursing staff will perform CPR if the client arrests, since family wishes must
always be respected in end-of-life situations.
Correct Answer: B
Rationale: Autonomy requires that a competent client's informed healthcare decisions, including a signed DNR, be
respected even when family members disagree. The durable power of attorney for healthcare only becomes active when
the client loses decision-making capacity; a competent client's own directive always takes precedence. As an advocate, the
nurse should clarify the client's wishes, validate the daughter's feelings, and facilitate communication with the provider and
ethics team rather than overriding the client's decision. Options A and D violate the client's autonomy, and option C delays
advocacy by shifting responsibility to legal counsel when the clinical path is clear.
Q2: A nurse is caring for a 54-year-old client scheduled for an elective cholecystectomy. The surgeon hands the
consent form to the client and leaves the room. The client asks the nurse, "Can you explain what they're going to
do? I don't really understand the surgery." Which response by the nurse is most appropriate?
A. I can describe the procedure to you, and then we can both sign the form as witnesses.
B. I will notify the surgeon so that she can return to answer your questions and obtain your informed consent.
[CORRECT]
C. I can explain the surgery, the risks, benefits, and alternatives, and then you can sign the form.
D. Let me give you this pamphlet about cholecystectomy, and after you read it, you can sign the consent.
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,ATI RN Fundamentals Proctored Exam - 2026 | 2027 Comprehensive Practice - 150 Questions
Correct Answer: B
Rationale: Informed consent requires that the provider performing the procedure disclose the diagnosis, proposed
treatment, risks, benefits, and alternatives, and verify the client's understanding. The nurse's role is to witness the signature
and clarify that consent is voluntary, not to obtain consent or provide the primary explanation. Because the client's
understanding is incomplete, the nurse must notify the surgeon to return and provide the necessary information before the
form is signed. Options A, C, and D overstep the nurse's scope and undermine the legal validity of the consent.
Q3: A charge nurse on a 32-bed medical-surgical unit is preparing assignments for the shift. The team includes one
RN, two LPNs, and one unlicensed assistive personnel (UAP). Which client should the RN assign to herself rather
than delegating to an LPN?
A. A 67-year-old client receiving IV antibiotics for cellulitis, with a stable vital sign trend over 24 hours.
B. A 72-year-old client admitted 6 hours ago for acute GI bleeding who received 2 units of PRBCs and has a
hemoglobin pending recheck. [CORRECT]
C. An 81-year-old client with a stage III sacral pressure injury requiring wet-to-dry dressing changes twice per
shift.
D. A 45-year-old client 3 days post-total knee replacement receiving physical therapy twice daily.
Correct Answer: B
Rationale: The RN must retain clients with unstable or rapidly changing conditions requiring frequent assessment, complex
clinical judgment, and potential rapid intervention. A client with acute GI bleeding and a recent transfusion requires ongoing
hemodynamic assessment, evaluation of the hemoglobin trend, and recognition of deterioration. Stable clients receiving
routine IV antibiotics, scheduled wound care, or postoperative rehabilitation are appropriate for LPN delegation under
supervision. The Five Rights of Delegation (right task, right circumstance, right person, right direction/communication, right
supervision/evaluation) guide this decision. Option B is the only client with potential for sudden decline.
Q4: A client tells the nurse, "I do not want my daughter to know I have HIV." The daughter phones the unit and asks
the nurse for her mother's diagnosis. Which response by the nurse best complies with HIPAA regulations?
A. I can confirm that your mother is here, but I cannot share her diagnosis without her written authorization.
B. I cannot even confirm that your mother is a patient at this facility without her permission. [CORRECT]
C. Because you are her daughter, I can share the diagnosis with you as long as you verify your identity.
D. Let me ask your mother if she wants me to tell you, and I will call you back within the hour.
Correct Answer: B
Rationale: Under HIPAA's Privacy Rule, protected health information (PHI) - including the very fact that a person is admitted
to a facility - cannot be disclosed without the client's authorization unless an exception applies (treatment, payment,
operations, or required by law). The client has explicitly requested that her HIV status remain confidential, and the nurse
must protect both the diagnosis and the admission itself. Option A would still constitute a disclosure of PHI; options C and D
fail to protect confidentiality in real time. The correct action is to neither confirm nor deny admission without the client's
authorization.
Q5: A nurse on a telemetry unit witnesses a nursing assistant forcefully hold a confused elderly client in bed by the
wrists while shouting, "Stay down!" The client has no orders for restraints. Which legal concept best describes the
nursing assistant's action?
A. Assault, because the client was placed in fear of imminent harmful contact.
B. Battery, because there was intentional harmful or offensive touching without consent. [CORRECT]
C. False imprisonment, because the client was intentionally confined without legal authority.
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,ATI RN Fundamentals Proctored Exam - 2026 | 2027 Comprehensive Practice - 150 Questions
D. Negligence, because the standard of care for restraints was not followed.
Correct Answer: B
Rationale: Battery is the intentional harmful or offensive touching of another person without consent; physically holding a
client without an order constitutes unauthorized contact. False imprisonment involves intentional confinement (physical or
verbal restraint) without legal authority; this could also apply, but the question emphasizes the touching component.
Assault requires reasonable apprehension of imminent harmful contact, not actual contact. Negligence requires breach of a
duty causing harm and does not require intent. Because the act was intentional touching without consent, battery is the
most precise characterization.
Q6: A nurse administers 50 mg of metoprolol to a client when the prescribed dose was 25 mg. The client's heart rate
drops to 48 beats/min and blood pressure to 86/52 mmHg. After stabilizing the client, the nurse completes an
incident report. Which statement by the nurse best reflects the purpose of incident reporting?
A. I am completing this report so that the hospital's legal team can defend against a malpractice claim.
B. I am completing this report as a quality-improvement tool to identify system factors contributing to the error.
[CORRECT]
C. I am completing this report so that disciplinary action can be taken against the nurse who made the error.
D. I am completing this report to fulfill the requirement that all errors be reported to The Joint Commission
within 24 hours.
Correct Answer: B
Rationale: Incident reports are internal quality-improvement documents used to identify trends, analyze root causes (e.g.,
look-alike/sound-alike medications, unclear orders, staffing issues), and implement changes that prevent recurrence. They
are not part of the medical record, are not used for punitive purposes, and are not filed with The Joint Commission for every
error (Sentinel Events have separate reporting requirements). While the report may be discoverable in litigation, its primary
purpose is patient safety, not legal defense. Option B accurately describes the quality-improvement purpose; options A, C,
and D misrepresent the function of the incident report.
Q7: A client with a terminal illness tells the nurse, "I want everything done to keep me alive, no matter what." The
client has no advance directive. The client's spouse says privately, "If she goes into cardiac arrest, please don't
resuscitate her - she wouldn't want to live like this." Which action by the nurse is most appropriate?
A. Honor the spouse's request because next of kin may make decisions for an incapacitated client.
B. Initiate a code status discussion with the client, provider, and spouse present, and encourage the client to
complete an advance directive. [CORRECT]
C. Document the spouse's request and follow the spouse's wishes if the client arrests.
D. Request an ethics consult to override the client's stated preference for full code status.
Correct Answer: B
Rationale: A competent client's expressed wishes for full code status must be honored, even if family disagrees. The nurse's
role is to advocate for the client by facilitating a discussion with the provider, the client, and the spouse, exploring the
client's values and prognosis, and encouraging completion of an advance directive to ensure future wishes are documented.
The spouse's preferences cannot override a competent client's decisions, even when the spouse is next of kin. An ethics
consult may be appropriate if the client lacks capacity and there is conflict, but cannot override a competent client's
autonomous decision.
Q8: A charge nurse is planning care for a group of clients and must delegate tasks appropriately. Which of the
following tasks is most appropriate to delegate to unlicensed assistive personnel (UAP)?
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, ATI RN Fundamentals Proctored Exam - 2026 | 2027 Comprehensive Practice - 150 Questions
A. Reinforcing a teaching plan for a newly diagnosed diabetic client on insulin injection technique.
B. Measuring intake and output, weight, and vital signs on stable postoperative clients. [CORRECT]
C. Assessing a surgical wound for signs of infection and reporting findings to the RN.
D. Administering an oral analgesic to a client reporting pain rated 6/10.
Correct Answer: B
Rationale: UAP may perform routine, noninvasive tasks with predictable outcomes that do not require clinical judgment,
such as measuring vital signs, intake and output, and weight on stable clients. Teaching requires RN-level knowledge and
cannot be delegated. Wound assessment involves evaluation and clinical judgment reserved for the RN, although UAP may
report observable changes. Medication administration requires licensure and cannot be delegated to UAP. The Five Rights
of Delegation guide the RN: right task (routine care), right circumstance (stable clients), right person (UAP for these tasks),
right communication, and right supervision.
Q9: An elderly client with mild dementia repeatedly tries to climb out of bed and has fallen twice in the past 24
hours. The provider orders a vest restraint. Which action by the nurse demonstrates adherence to least restrictive
intervention principles?
A. Apply the vest restraint as ordered and reassess the client every 2 hours.
B. Implement a bed alarm, lower the bed, place fall mats, and reassess the need for restraints at each shift
change before applying the vest. [CORRECT]
C. Refuse to apply the restraint because restraints are never appropriate for clients with dementia.
D. Apply wrist restraints instead because they are less restrictive than a vest restraint.
Correct Answer: B
Rationale: The least restrictive intervention principle requires that less invasive alternatives be tried before physical
restraints and that restraints be used only when needed to protect the client from imminent harm. Bed alarms, low bed
position, fall mats, frequent toileting, and family/sitter presence are first-line interventions. If a vest restraint is ultimately
required, the order must be time-limited (maximum 4 hours for adults, with face-to-face reassessment by the provider
within 24 hours), and the nurse must reassess circulation, skin, and need continuously. Option A jumps to restraint without
trying alternatives; C overstates the prohibition on restraints; D is incorrect because wrist restraints are not necessarily less
restrictive and can cause greater injury.
Q10: A nurse is preparing to administer a blood transfusion to a client who is a Jehovah's Witness. The client states,
"I cannot receive blood products under any circumstances due to my religious beliefs." The provider has ordered 2
units of PRBCs. Which action by the nurse reflects the ethical principle of beneficence balanced with autonomy?
A. Administer the blood because beneficence requires acting in the client's best medical interest.
B. Withhold the transfusion, notify the provider of the client's refusal, and document the discussion and refusal
in the medical record. [CORRECT]
C. Administer a small amount of blood and ask the client not to tell anyone.
D. Call the hospital's legal department to obtain a court order for the transfusion.
Correct Answer: B
Rationale: Autonomy - the client's right to refuse treatment based on personal values - supersedes beneficence when a
competent adult explicitly refuses care. A competent Jehovah's Witness's refusal of blood products must be honored even if
refusal is likely to result in death. The nurse should notify the provider, explore alternatives (e.g., volume expanders,
erythropoietin), ensure the client understands the consequences of refusal, and document the discussion and refusal
thoroughly. Administering blood against the client's wishes constitutes battery; covert administration is unethical and
illegal; court orders are reserved for situations involving minors or incapacity.
Verified Answers - 100% Pass Grade A+ Page 4 ATI NCLEX Test Plan Aligned
ATI RN Fundamentals Proctored Exam - 2026 | 2027
Comprehensive Practice Questions and Verified Answers
Aligned with 2026-2027 NCLEX Test Plan & ATI RN Fundamentals Blueprint | 150 Questions | Cognitive Distribution: 25% Recall,
50% Application, 25% Analysis | 75% Scenario-Based, 25% Recall/Calculation | 100% Pass Grade A+
Instructions: This comprehensive practice exam contains 150 multiple-choice questions organized into eight content
domains aligned with the ATI RN Fundamentals Proctored Examination blueprint. Each question has one correct answer
(A-D) identified by the [CORRECT] marker and confirmed on the Correct Answer: line. Rationales provide ATI-specific
nursing reasoning grounded in the nursing process (ADPIE), priority-setting frameworks (ABCs, Maslow's Hierarchy, Safety,
Least Restrictive), the Five Rights of Delegation, evidence-based practice, and current NCLEX test plan competencies. Use
this exam to assess knowledge, identify weak areas, and reinforce safe, client-centered nursing practice.
Section 1: Safe, Effective Care Environment - Management of Care
Topics: Client Rights, Advocacy, Delegation, Legal/Ethical Issues, Informed Consent, HIPAA, Advance Directives (Q1-Q30)
Q1: A 78-year-old client with stage IV ovarian cancer signs a do-not-resuscitate (DNR) order after a thorough
discussion with the oncologist and her family. The client's daughter storms into the nurses' station demanding that
the nurse resuscitate her mother if she stops breathing, stating, "I am her only child and I have power of attorney."
Which action by the nurse best reflects advocacy and the ethical principle of autonomy?
A. Notify the provider immediately and request that the DNR be rescinded based on the daughter's legal
authority.
B. Explain to the daughter that the client's autonomous decision, documented in the advance directive, must be
honored, and offer to facilitate a family meeting with the care team. [CORRECT]
C. Contact the hospital's legal department to determine whether the durable power of attorney supersedes the
client's written directive.
D. Reassure the daughter that the nursing staff will perform CPR if the client arrests, since family wishes must
always be respected in end-of-life situations.
Correct Answer: B
Rationale: Autonomy requires that a competent client's informed healthcare decisions, including a signed DNR, be
respected even when family members disagree. The durable power of attorney for healthcare only becomes active when
the client loses decision-making capacity; a competent client's own directive always takes precedence. As an advocate, the
nurse should clarify the client's wishes, validate the daughter's feelings, and facilitate communication with the provider and
ethics team rather than overriding the client's decision. Options A and D violate the client's autonomy, and option C delays
advocacy by shifting responsibility to legal counsel when the clinical path is clear.
Q2: A nurse is caring for a 54-year-old client scheduled for an elective cholecystectomy. The surgeon hands the
consent form to the client and leaves the room. The client asks the nurse, "Can you explain what they're going to
do? I don't really understand the surgery." Which response by the nurse is most appropriate?
A. I can describe the procedure to you, and then we can both sign the form as witnesses.
B. I will notify the surgeon so that she can return to answer your questions and obtain your informed consent.
[CORRECT]
C. I can explain the surgery, the risks, benefits, and alternatives, and then you can sign the form.
D. Let me give you this pamphlet about cholecystectomy, and after you read it, you can sign the consent.
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,ATI RN Fundamentals Proctored Exam - 2026 | 2027 Comprehensive Practice - 150 Questions
Correct Answer: B
Rationale: Informed consent requires that the provider performing the procedure disclose the diagnosis, proposed
treatment, risks, benefits, and alternatives, and verify the client's understanding. The nurse's role is to witness the signature
and clarify that consent is voluntary, not to obtain consent or provide the primary explanation. Because the client's
understanding is incomplete, the nurse must notify the surgeon to return and provide the necessary information before the
form is signed. Options A, C, and D overstep the nurse's scope and undermine the legal validity of the consent.
Q3: A charge nurse on a 32-bed medical-surgical unit is preparing assignments for the shift. The team includes one
RN, two LPNs, and one unlicensed assistive personnel (UAP). Which client should the RN assign to herself rather
than delegating to an LPN?
A. A 67-year-old client receiving IV antibiotics for cellulitis, with a stable vital sign trend over 24 hours.
B. A 72-year-old client admitted 6 hours ago for acute GI bleeding who received 2 units of PRBCs and has a
hemoglobin pending recheck. [CORRECT]
C. An 81-year-old client with a stage III sacral pressure injury requiring wet-to-dry dressing changes twice per
shift.
D. A 45-year-old client 3 days post-total knee replacement receiving physical therapy twice daily.
Correct Answer: B
Rationale: The RN must retain clients with unstable or rapidly changing conditions requiring frequent assessment, complex
clinical judgment, and potential rapid intervention. A client with acute GI bleeding and a recent transfusion requires ongoing
hemodynamic assessment, evaluation of the hemoglobin trend, and recognition of deterioration. Stable clients receiving
routine IV antibiotics, scheduled wound care, or postoperative rehabilitation are appropriate for LPN delegation under
supervision. The Five Rights of Delegation (right task, right circumstance, right person, right direction/communication, right
supervision/evaluation) guide this decision. Option B is the only client with potential for sudden decline.
Q4: A client tells the nurse, "I do not want my daughter to know I have HIV." The daughter phones the unit and asks
the nurse for her mother's diagnosis. Which response by the nurse best complies with HIPAA regulations?
A. I can confirm that your mother is here, but I cannot share her diagnosis without her written authorization.
B. I cannot even confirm that your mother is a patient at this facility without her permission. [CORRECT]
C. Because you are her daughter, I can share the diagnosis with you as long as you verify your identity.
D. Let me ask your mother if she wants me to tell you, and I will call you back within the hour.
Correct Answer: B
Rationale: Under HIPAA's Privacy Rule, protected health information (PHI) - including the very fact that a person is admitted
to a facility - cannot be disclosed without the client's authorization unless an exception applies (treatment, payment,
operations, or required by law). The client has explicitly requested that her HIV status remain confidential, and the nurse
must protect both the diagnosis and the admission itself. Option A would still constitute a disclosure of PHI; options C and D
fail to protect confidentiality in real time. The correct action is to neither confirm nor deny admission without the client's
authorization.
Q5: A nurse on a telemetry unit witnesses a nursing assistant forcefully hold a confused elderly client in bed by the
wrists while shouting, "Stay down!" The client has no orders for restraints. Which legal concept best describes the
nursing assistant's action?
A. Assault, because the client was placed in fear of imminent harmful contact.
B. Battery, because there was intentional harmful or offensive touching without consent. [CORRECT]
C. False imprisonment, because the client was intentionally confined without legal authority.
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,ATI RN Fundamentals Proctored Exam - 2026 | 2027 Comprehensive Practice - 150 Questions
D. Negligence, because the standard of care for restraints was not followed.
Correct Answer: B
Rationale: Battery is the intentional harmful or offensive touching of another person without consent; physically holding a
client without an order constitutes unauthorized contact. False imprisonment involves intentional confinement (physical or
verbal restraint) without legal authority; this could also apply, but the question emphasizes the touching component.
Assault requires reasonable apprehension of imminent harmful contact, not actual contact. Negligence requires breach of a
duty causing harm and does not require intent. Because the act was intentional touching without consent, battery is the
most precise characterization.
Q6: A nurse administers 50 mg of metoprolol to a client when the prescribed dose was 25 mg. The client's heart rate
drops to 48 beats/min and blood pressure to 86/52 mmHg. After stabilizing the client, the nurse completes an
incident report. Which statement by the nurse best reflects the purpose of incident reporting?
A. I am completing this report so that the hospital's legal team can defend against a malpractice claim.
B. I am completing this report as a quality-improvement tool to identify system factors contributing to the error.
[CORRECT]
C. I am completing this report so that disciplinary action can be taken against the nurse who made the error.
D. I am completing this report to fulfill the requirement that all errors be reported to The Joint Commission
within 24 hours.
Correct Answer: B
Rationale: Incident reports are internal quality-improvement documents used to identify trends, analyze root causes (e.g.,
look-alike/sound-alike medications, unclear orders, staffing issues), and implement changes that prevent recurrence. They
are not part of the medical record, are not used for punitive purposes, and are not filed with The Joint Commission for every
error (Sentinel Events have separate reporting requirements). While the report may be discoverable in litigation, its primary
purpose is patient safety, not legal defense. Option B accurately describes the quality-improvement purpose; options A, C,
and D misrepresent the function of the incident report.
Q7: A client with a terminal illness tells the nurse, "I want everything done to keep me alive, no matter what." The
client has no advance directive. The client's spouse says privately, "If she goes into cardiac arrest, please don't
resuscitate her - she wouldn't want to live like this." Which action by the nurse is most appropriate?
A. Honor the spouse's request because next of kin may make decisions for an incapacitated client.
B. Initiate a code status discussion with the client, provider, and spouse present, and encourage the client to
complete an advance directive. [CORRECT]
C. Document the spouse's request and follow the spouse's wishes if the client arrests.
D. Request an ethics consult to override the client's stated preference for full code status.
Correct Answer: B
Rationale: A competent client's expressed wishes for full code status must be honored, even if family disagrees. The nurse's
role is to advocate for the client by facilitating a discussion with the provider, the client, and the spouse, exploring the
client's values and prognosis, and encouraging completion of an advance directive to ensure future wishes are documented.
The spouse's preferences cannot override a competent client's decisions, even when the spouse is next of kin. An ethics
consult may be appropriate if the client lacks capacity and there is conflict, but cannot override a competent client's
autonomous decision.
Q8: A charge nurse is planning care for a group of clients and must delegate tasks appropriately. Which of the
following tasks is most appropriate to delegate to unlicensed assistive personnel (UAP)?
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, ATI RN Fundamentals Proctored Exam - 2026 | 2027 Comprehensive Practice - 150 Questions
A. Reinforcing a teaching plan for a newly diagnosed diabetic client on insulin injection technique.
B. Measuring intake and output, weight, and vital signs on stable postoperative clients. [CORRECT]
C. Assessing a surgical wound for signs of infection and reporting findings to the RN.
D. Administering an oral analgesic to a client reporting pain rated 6/10.
Correct Answer: B
Rationale: UAP may perform routine, noninvasive tasks with predictable outcomes that do not require clinical judgment,
such as measuring vital signs, intake and output, and weight on stable clients. Teaching requires RN-level knowledge and
cannot be delegated. Wound assessment involves evaluation and clinical judgment reserved for the RN, although UAP may
report observable changes. Medication administration requires licensure and cannot be delegated to UAP. The Five Rights
of Delegation guide the RN: right task (routine care), right circumstance (stable clients), right person (UAP for these tasks),
right communication, and right supervision.
Q9: An elderly client with mild dementia repeatedly tries to climb out of bed and has fallen twice in the past 24
hours. The provider orders a vest restraint. Which action by the nurse demonstrates adherence to least restrictive
intervention principles?
A. Apply the vest restraint as ordered and reassess the client every 2 hours.
B. Implement a bed alarm, lower the bed, place fall mats, and reassess the need for restraints at each shift
change before applying the vest. [CORRECT]
C. Refuse to apply the restraint because restraints are never appropriate for clients with dementia.
D. Apply wrist restraints instead because they are less restrictive than a vest restraint.
Correct Answer: B
Rationale: The least restrictive intervention principle requires that less invasive alternatives be tried before physical
restraints and that restraints be used only when needed to protect the client from imminent harm. Bed alarms, low bed
position, fall mats, frequent toileting, and family/sitter presence are first-line interventions. If a vest restraint is ultimately
required, the order must be time-limited (maximum 4 hours for adults, with face-to-face reassessment by the provider
within 24 hours), and the nurse must reassess circulation, skin, and need continuously. Option A jumps to restraint without
trying alternatives; C overstates the prohibition on restraints; D is incorrect because wrist restraints are not necessarily less
restrictive and can cause greater injury.
Q10: A nurse is preparing to administer a blood transfusion to a client who is a Jehovah's Witness. The client states,
"I cannot receive blood products under any circumstances due to my religious beliefs." The provider has ordered 2
units of PRBCs. Which action by the nurse reflects the ethical principle of beneficence balanced with autonomy?
A. Administer the blood because beneficence requires acting in the client's best medical interest.
B. Withhold the transfusion, notify the provider of the client's refusal, and document the discussion and refusal
in the medical record. [CORRECT]
C. Administer a small amount of blood and ask the client not to tell anyone.
D. Call the hospital's legal department to obtain a court order for the transfusion.
Correct Answer: B
Rationale: Autonomy - the client's right to refuse treatment based on personal values - supersedes beneficence when a
competent adult explicitly refuses care. A competent Jehovah's Witness's refusal of blood products must be honored even if
refusal is likely to result in death. The nurse should notify the provider, explore alternatives (e.g., volume expanders,
erythropoietin), ensure the client understands the consequences of refusal, and document the discussion and refusal
thoroughly. Administering blood against the client's wishes constitutes battery; covert administration is unethical and
illegal; court orders are reserved for situations involving minors or incapacity.
Verified Answers - 100% Pass Grade A+ Page 4 ATI NCLEX Test Plan Aligned
