ATI Fundamentals 2026–2027 | ATI RN Fundamentals Proctored Exam
Study Guide & Nursing Fundamentals Review | ATI Fundamentals Nursing
Practice Questions, Answers & Detailed Rationales | ATI RN Fundamentals
Content Mastery Series, Nursing Process, Clinical Judgment, Patient-
Centered Care, Safety & Infection Control, Vital Signs, Health
Assessment, Communication, Documentation, Nursing Skills, Medication
Administration, Dosage Calculation, Pain Management, Nutrition,
Elimination, Mobility, Skin Integrity, Oxygenation, Fluid & Electrolyte
Balance, Perioperative Care, Legal & Ethical Nursing, Delegation,
Prioritization, Patient Education & NGN-Style Case-Based Practice
Question 1: A nurse is providing care to a client who is
postoperative following abdominal surgery. The client reports
sudden shortness of breath. Which of the following actions should
the nurse take first?
A. Administer oxygen via nasal cannula
B. Check the client's oxygen saturation level
C. Notify the provider
D. Elevate the head of the bed
CORRECT ANSWER: D. Elevate the head of the bed
Rationale: Using the ABC framework, breathing is the priority. Elevating the
head of the bed is an immediate independent nursing intervention that
facilitates lung expansion and improves ventilation. Assessment and
notification follow this immediate positioning intervention .
Question 2: A nurse is preparing to administer a medication to a
client. Which of the following actions is the priority prior to
medication administration?
A. Verify the client's allergies
B. Check the client's vital signs
C. Identify the client using two identifiers
D. Review the client's laboratory results
CORRECT ANSWER: C. Identify the client using two identifiers
Rationale: The most critical safety measure in medication administration is
ensuring the right client receives the medication. Using two identifiers (e.g.,
name and date of birth) is the first and most essential step to prevent
medication errors .
,Question 3: A nurse is assessing a client who has a prescription for
a 24-hour urine collection. Which of the following actions should
the nurse take?
A. Discard the first voiding of the collection period
B. Collect all urine in a sterile container
C. Keep the urine container at room temperature
D. Start the collection after the client's first morning void
CORRECT ANSWER: A. Discard the first voiding of the collection
period
Rationale: For a 24-hour urine collection, the first voided specimen is
discarded to ensure the collection begins with an empty bladder. All
subsequent urine is collected for exactly 24 hours. The container typically
requires refrigeration, not room temperature, and does not need to be
sterile .
Question 4: A nurse is providing discharge teaching to a client who
has a new prescription for a metered-dose inhaler (MDI). Which of
the following instructions should the nurse include?
A. Inhale rapidly and deeply when activating the inhaler
B. Hold the breath for 10 seconds after inhaling the medication
C. Activate the inhaler before beginning to inhale
D. Exhale forcefully immediately after inhalation
CORRECT ANSWER: B. Hold the breath for 10 seconds after
inhaling the medication
Rationale: Holding the breath for approximately 10 seconds allows the
medication to deposit in the lower airways and maximizes its therapeutic
effect. The client should inhale slowly and deeply while activating the
device simultaneously .
Question 5: A nurse is caring for a client who is NPO and has a
nasogastric (NG) tube. Which of the following findings should
indicate to the nurse that the NG tube is in the correct position?
A. The client is able to speak clearly
B. The pH of the gastric aspirate is 4
C. The tube is taped securely to the client's nose
,D. The nurse auscultates a gurgling sound over the epigastric area after
injecting air
CORRECT ANSWER: B. The pH of the gastric aspirate is 4
Rationale: A pH of 4 or less is the most reliable bedside indicator that the
NG tube is in the stomach. Auscultation of injected air is no longer
considered a reliable verification method. Speaking ability and secure
taping do not confirm anatomical placement .
Question 6: A nurse is preparing to administer medications via a
nasogastric tube. Which action best ensures accurate dosing and
prevents tube occlusion?
A. Crush a sustained-release tablet and mix with 30 mL sterile water
B. Administer each medication separately and flush with 15 mL water
between each
C. Mix all crushed medications together in 60 mL of warm water
D. Use the plunger of the syringe to push medication through the tube
rapidly
CORRECT ANSWER: B. Administer each medication separately and
flush with 15 mL water between each
Rationale: Administering each medication separately with water flushes
prevents drug-drug interactions and reduces the risk of tube clogging.
Sustained-release tablets should never be crushed, and rapid pushing can
cause tube rupture or aspiration .
Question 7: A nurse is assessing a client with chest tubes connected
to a dry suction water seal system. Which finding requires
immediate intervention?
A. Intermittent bubbling in the water seal chamber during exhalation
B. Continuous bubbling in the suction control chamber at -20 cm H2O
C. Tidaling in the water seal chamber with respirations
D. No fluctuation in the water seal chamber for 4 hours post-insertion
CORRECT ANSWER: D. No fluctuation in the water seal chamber for
4 hours post-insertion
Rationale: Tidaling (fluctuation) in the water seal chamber is expected with
respirations. Absence of fluctuation for an extended period may indicate a
, blocked or kinked tube, or lung re-expansion. If it occurs suddenly, it
suggests occlusion or disconnection requiring immediate assessment .
Question 8: A nurse is caring for a client with a pressure injury on
the sacrum. The wound bed is covered with yellow slough and has
moderate serosanguinous drainage. Which dressing should the
nurse select?
A. Hydrocolloid dressing
B. Alginate dressing
C. Transparent film dressing
D. Hydrogel dressing
CORRECT ANSWER: B. Alginate dressing
Rationale: Alginate dressings are highly absorbent and appropriate for
wounds with moderate to heavy exudate and slough. Hydrocolloid
dressings are for light exudate, transparent films are for dry wounds, and
hydrogels are for dry wounds with slough .
Question 9: A nurse is teaching a client with a new colostomy
about dietary management. Which statement by the client
indicates understanding?
A. "I will avoid foods like yogurt and buttermilk to prevent odor."
B. "I should eat more high-fiber foods like nuts and seeds to thicken stool."
C. "I need to chew food thoroughly and eat at regular intervals."
D. "I can use a stool softener daily to prevent constipation."
CORRECT ANSWER: C. "I need to chew food thoroughly and eat at
regular intervals."
Rationale: Chewing food thoroughly and eating at regular intervals reduces
gas and blockage risk. Yogurt and buttermilk actually help reduce odor,
high-fiber foods like nuts can cause blockage, and stool softeners are not
routinely recommended .
Question 10: A nurse is preparing to administer a blood
transfusion. Which action should the nurse take first?
A. Start the transfusion slowly at 2 mL/min
B. Notify the provider of the client's blood pressure
C. Obtain a baseline set of vital signs
D. Administer 0.9% sodium chloride with the blood
Study Guide & Nursing Fundamentals Review | ATI Fundamentals Nursing
Practice Questions, Answers & Detailed Rationales | ATI RN Fundamentals
Content Mastery Series, Nursing Process, Clinical Judgment, Patient-
Centered Care, Safety & Infection Control, Vital Signs, Health
Assessment, Communication, Documentation, Nursing Skills, Medication
Administration, Dosage Calculation, Pain Management, Nutrition,
Elimination, Mobility, Skin Integrity, Oxygenation, Fluid & Electrolyte
Balance, Perioperative Care, Legal & Ethical Nursing, Delegation,
Prioritization, Patient Education & NGN-Style Case-Based Practice
Question 1: A nurse is providing care to a client who is
postoperative following abdominal surgery. The client reports
sudden shortness of breath. Which of the following actions should
the nurse take first?
A. Administer oxygen via nasal cannula
B. Check the client's oxygen saturation level
C. Notify the provider
D. Elevate the head of the bed
CORRECT ANSWER: D. Elevate the head of the bed
Rationale: Using the ABC framework, breathing is the priority. Elevating the
head of the bed is an immediate independent nursing intervention that
facilitates lung expansion and improves ventilation. Assessment and
notification follow this immediate positioning intervention .
Question 2: A nurse is preparing to administer a medication to a
client. Which of the following actions is the priority prior to
medication administration?
A. Verify the client's allergies
B. Check the client's vital signs
C. Identify the client using two identifiers
D. Review the client's laboratory results
CORRECT ANSWER: C. Identify the client using two identifiers
Rationale: The most critical safety measure in medication administration is
ensuring the right client receives the medication. Using two identifiers (e.g.,
name and date of birth) is the first and most essential step to prevent
medication errors .
,Question 3: A nurse is assessing a client who has a prescription for
a 24-hour urine collection. Which of the following actions should
the nurse take?
A. Discard the first voiding of the collection period
B. Collect all urine in a sterile container
C. Keep the urine container at room temperature
D. Start the collection after the client's first morning void
CORRECT ANSWER: A. Discard the first voiding of the collection
period
Rationale: For a 24-hour urine collection, the first voided specimen is
discarded to ensure the collection begins with an empty bladder. All
subsequent urine is collected for exactly 24 hours. The container typically
requires refrigeration, not room temperature, and does not need to be
sterile .
Question 4: A nurse is providing discharge teaching to a client who
has a new prescription for a metered-dose inhaler (MDI). Which of
the following instructions should the nurse include?
A. Inhale rapidly and deeply when activating the inhaler
B. Hold the breath for 10 seconds after inhaling the medication
C. Activate the inhaler before beginning to inhale
D. Exhale forcefully immediately after inhalation
CORRECT ANSWER: B. Hold the breath for 10 seconds after
inhaling the medication
Rationale: Holding the breath for approximately 10 seconds allows the
medication to deposit in the lower airways and maximizes its therapeutic
effect. The client should inhale slowly and deeply while activating the
device simultaneously .
Question 5: A nurse is caring for a client who is NPO and has a
nasogastric (NG) tube. Which of the following findings should
indicate to the nurse that the NG tube is in the correct position?
A. The client is able to speak clearly
B. The pH of the gastric aspirate is 4
C. The tube is taped securely to the client's nose
,D. The nurse auscultates a gurgling sound over the epigastric area after
injecting air
CORRECT ANSWER: B. The pH of the gastric aspirate is 4
Rationale: A pH of 4 or less is the most reliable bedside indicator that the
NG tube is in the stomach. Auscultation of injected air is no longer
considered a reliable verification method. Speaking ability and secure
taping do not confirm anatomical placement .
Question 6: A nurse is preparing to administer medications via a
nasogastric tube. Which action best ensures accurate dosing and
prevents tube occlusion?
A. Crush a sustained-release tablet and mix with 30 mL sterile water
B. Administer each medication separately and flush with 15 mL water
between each
C. Mix all crushed medications together in 60 mL of warm water
D. Use the plunger of the syringe to push medication through the tube
rapidly
CORRECT ANSWER: B. Administer each medication separately and
flush with 15 mL water between each
Rationale: Administering each medication separately with water flushes
prevents drug-drug interactions and reduces the risk of tube clogging.
Sustained-release tablets should never be crushed, and rapid pushing can
cause tube rupture or aspiration .
Question 7: A nurse is assessing a client with chest tubes connected
to a dry suction water seal system. Which finding requires
immediate intervention?
A. Intermittent bubbling in the water seal chamber during exhalation
B. Continuous bubbling in the suction control chamber at -20 cm H2O
C. Tidaling in the water seal chamber with respirations
D. No fluctuation in the water seal chamber for 4 hours post-insertion
CORRECT ANSWER: D. No fluctuation in the water seal chamber for
4 hours post-insertion
Rationale: Tidaling (fluctuation) in the water seal chamber is expected with
respirations. Absence of fluctuation for an extended period may indicate a
, blocked or kinked tube, or lung re-expansion. If it occurs suddenly, it
suggests occlusion or disconnection requiring immediate assessment .
Question 8: A nurse is caring for a client with a pressure injury on
the sacrum. The wound bed is covered with yellow slough and has
moderate serosanguinous drainage. Which dressing should the
nurse select?
A. Hydrocolloid dressing
B. Alginate dressing
C. Transparent film dressing
D. Hydrogel dressing
CORRECT ANSWER: B. Alginate dressing
Rationale: Alginate dressings are highly absorbent and appropriate for
wounds with moderate to heavy exudate and slough. Hydrocolloid
dressings are for light exudate, transparent films are for dry wounds, and
hydrogels are for dry wounds with slough .
Question 9: A nurse is teaching a client with a new colostomy
about dietary management. Which statement by the client
indicates understanding?
A. "I will avoid foods like yogurt and buttermilk to prevent odor."
B. "I should eat more high-fiber foods like nuts and seeds to thicken stool."
C. "I need to chew food thoroughly and eat at regular intervals."
D. "I can use a stool softener daily to prevent constipation."
CORRECT ANSWER: C. "I need to chew food thoroughly and eat at
regular intervals."
Rationale: Chewing food thoroughly and eating at regular intervals reduces
gas and blockage risk. Yogurt and buttermilk actually help reduce odor,
high-fiber foods like nuts can cause blockage, and stool softeners are not
routinely recommended .
Question 10: A nurse is preparing to administer a blood
transfusion. Which action should the nurse take first?
A. Start the transfusion slowly at 2 mL/min
B. Notify the provider of the client's blood pressure
C. Obtain a baseline set of vital signs
D. Administer 0.9% sodium chloride with the blood
