ATI RN Fundamentals 2026 Proctored Exam with NGN:
150 High-Yield Multiple-Choice Questions and Detailed
Answer Rationales for Top Score Level 3 RN ATI
Fundamentals Nursing 2026 Assessment Per ATI
Marking Scheme
Difficulty Level: Advanced / Hard / Mixed
Target Audience: Pre-licensure RN students (ADN/BSN) preparing for the ATI RN Fundamentals
Proctored Exam and NCLEX-RN
Exam Alignment: 2026 ATI RN Fundamentals Blueprint, NCSBN Clinical Judgment Measurement Model
(CJMM), Next Generation NCLEX (NGN) Item Types
Cognitive Levels: 30% Recall | 50% Application | 20% Analysis
Question Style: 80% Scenario-Based | 20% Direct Recall
Total Questions: 150 Multiple-Choice (Single Best Answer)
Table of Contents
Question
Section Domain
Range
Section Management of Care: Advocacy, Delegation, Ethics,
Q1–Q30
I Legal Issues, Continuity of Care
Safety and Infection Control: Standard/Transmission-
Section
Based Precautions, Fall Prevention, Medication Safety, Q31–Q55
II
Emergency Response
Health Promotion and Maintenance: Screening,
Section
Immunizations, Lifestyle Education, Developmental Q56–Q75
III
Stages, Self-Care
Section Psychosocial Integrity: Therapeutic Communication,
Q76–Q90
IV Coping, Grief, Cultural and Spiritual Health
Section Basic Care and Comfort: ADLs, Hygiene, Positioning,
Q91–Q110
V Pain Management, Nutrition/Fluids, Elimination
, Question
Section Domain
Range
Pharmacological and Parenteral Therapies: Rights of
Section
Medication Administration, Routes, Dosage Q111–Q130
VI
Calculations, IV Therapy, High-Alert Medications
Section Reduction of Risk Potential: Vital Signs Interpretation,
Q131–Q140
VII Diagnostic Tests, Perioperative Care, Wound Care
Physiological Adaptation and NGN Clinical Judgment:
Section
Fluid/Electrolyte Basics, Trend Recognition, Bow-Tie Q141–Q150
VIII
Items, Prioritization
SECTION I: Management of Care (Q1–Q30)
🟢 Q1. A charge nurse is making assignments for a 32-bed medical-surgical unit. The team includes 2 RNs,
2 LPNs, and 2 UAPs. Which client should the charge nurse assign to the most experienced RN?
A. A stable 78-year-old client admitted 3 days ago for cellulitis receiving oral antibiotics
B. A 65-year-old client admitted 2 hours ago with acute GI bleed, BP 92/58, HR 110, receiving IV fluids
and awaiting endoscopy
C. A stable post-op day 2 client with a Foley catheter and a healing abdominal incision
D. A 50-year-old client with chronic back pain requesting PRN acetaminophen
🔴🔴 Correct Answer: B
Rationale: Using ATI priority-setting (Acute vs. Chronic and Unstable vs. Stable), the most experienced
RN should care for the unstable, acute GI bleed client with active hemodynamic compromise (BP 92/58,
HR 110), requiring ongoing assessment, IV titration, frequent vital signs, and preparation for emergent
endoscopy. The cellulitis client (A), post-op day 2 client (C), and chronic pain client (D) are stable and can
be appropriately delegated to LPNs or routine UAP tasks.
🟢 Q2. An RN delegates the following tasks to a UAP. Which task requires immediate intervention by the
RN?
A. Ambulating a stable post-op day 1 client
B. Measuring intake and output for a client with heart failure
C. Feeding a client admitted 24 hours ago with aspiration pneumonia
D. Obtaining a routine blood glucose reading for a stable diabetic client
,🔴🔴 Correct Answer: C
Rationale: Feeding a client with aspiration pneumonia requires swallowing assessment and nursing
judgment due to high risk for aspiration. This task cannot be delegated to UAP. Reapplying a condom
catheter, ambulating stable clients, and measuring I&O are noninvasive, routine procedures that may be
delegated to AP.
🟢 Q3. A nurse is caring for a patient with stage IV colon cancer who privately states he does not want
another round of chemotherapy, but his family insists he continue treatment. Which action by the nurse
BEST demonstrates patient advocacy?
A. Tell the family the patient has the right to make his own decisions
B. Facilitate a family meeting with the provider and social worker to clarify the patient's wishes and
treatment options, supporting the patient's autonomy
C. Encourage the patient to comply with his family's wishes
D. Refuse to discuss the issue because it is the provider's role
🔴🔴 Correct Answer: B
Rationale: Advocacy means supporting the patient's right to make autonomous decisions. The nurse
facilitates communication among the patient, family, and provider to clarify values, ensure informed
consent, and support the patient's autonomy while respecting family concerns. Simply telling the family
(A) dismisses their concerns; encouraging compliance (C) violates autonomy; refusing to discuss (D)
abandons the advocacy role.
🟢 Q4. A nurse manager is assigning care responsibilities. A client is awaiting transfer back from PACU
following thoracic surgery. To which staff member should the nurse assign this client?
A. Charge nurse
B. RN
C. LPN
D. AP
🔴🔴 Correct Answer: B
Rationale: A client returning from surgery requires assessment and plan of care establishment. RNs are
responsible for this; it cannot be delegated to LPNs or AP. The RN must perform the initial postoperative
assessment and develop the plan of care.
🟢 Q5. Which of the following client needs may the nurse assign to an AP?
A. Feeding a client admitted 24 hours ago with aspiration pneumonia
B. Reinforcing teaching with a client learning to walk using a quad cane
C. Reapplying a condom catheter for a client who has urinary incontinence
D. Applying a sterile dressing to a pressure ulcer
, 🔴🔴 Correct Answer: C
Rationale: The application of a condom catheter is a noninvasive, routine procedure that the nurse may
delegate to the AP. Feeding a client with aspiration pneumonia requires swallowing assessment,
reinforcing teaching requires nursing judgment, and sterile dressing changes require licensed nursing
skills.
🟢 Q6. Which of the following assignments should the LPN question?
A. Assisting a 24-hour postop client to use an incentive spirometer
B. Collecting a clean-catch urine specimen
C. Providing nasopharyngeal suctioning for a client with pneumonia
D. Replacing the cartridge and tubing on a PCA pump
🔴🔴 Correct Answer: D
Rationale: The RN is responsible for the PCA pump, including replacing cartridges and tubing. This
requires assessment and evaluation beyond the LPN's scope. LPNs may assist with incentive spirometry,
collect specimens, and perform nasopharyngeal suctioning for stable clients.
🟢 Q7. A nurse is delegating ambulation of a client who had knee arthroplasty to an AP. Which
information should the nurse share? (Select all that apply.)
A. The roommate is up independently
B. The client ambulates with slippers over antiembolic stockings
C. The client uses a front-wheeled walker
D. The client had pain medication 30 minutes ago
E. The client is allergic to codeine
F. The client ate 50% of breakfast
🔴🔴 Correct Answers: B, C, D
Rationale: The nurse must communicate mobility status, equipment used, and pain medication timing.
Roommate status, allergies (unless relevant to activity), and food intake are not directly relevant to safe
ambulation.
🟢 Q8. Which of the following are the "5 Rights of Delegation"? (Select all that apply.)
A. Right client
B. Right supervision/evaluation
C. Right direction/communication
D. Right time
E. Right circumstances
🔴🔴 Correct Answers: B, C, E
Rationale: The 5 Rights of Delegation are: Right Task, Right Circumstance, Right Person, Right
150 High-Yield Multiple-Choice Questions and Detailed
Answer Rationales for Top Score Level 3 RN ATI
Fundamentals Nursing 2026 Assessment Per ATI
Marking Scheme
Difficulty Level: Advanced / Hard / Mixed
Target Audience: Pre-licensure RN students (ADN/BSN) preparing for the ATI RN Fundamentals
Proctored Exam and NCLEX-RN
Exam Alignment: 2026 ATI RN Fundamentals Blueprint, NCSBN Clinical Judgment Measurement Model
(CJMM), Next Generation NCLEX (NGN) Item Types
Cognitive Levels: 30% Recall | 50% Application | 20% Analysis
Question Style: 80% Scenario-Based | 20% Direct Recall
Total Questions: 150 Multiple-Choice (Single Best Answer)
Table of Contents
Question
Section Domain
Range
Section Management of Care: Advocacy, Delegation, Ethics,
Q1–Q30
I Legal Issues, Continuity of Care
Safety and Infection Control: Standard/Transmission-
Section
Based Precautions, Fall Prevention, Medication Safety, Q31–Q55
II
Emergency Response
Health Promotion and Maintenance: Screening,
Section
Immunizations, Lifestyle Education, Developmental Q56–Q75
III
Stages, Self-Care
Section Psychosocial Integrity: Therapeutic Communication,
Q76–Q90
IV Coping, Grief, Cultural and Spiritual Health
Section Basic Care and Comfort: ADLs, Hygiene, Positioning,
Q91–Q110
V Pain Management, Nutrition/Fluids, Elimination
, Question
Section Domain
Range
Pharmacological and Parenteral Therapies: Rights of
Section
Medication Administration, Routes, Dosage Q111–Q130
VI
Calculations, IV Therapy, High-Alert Medications
Section Reduction of Risk Potential: Vital Signs Interpretation,
Q131–Q140
VII Diagnostic Tests, Perioperative Care, Wound Care
Physiological Adaptation and NGN Clinical Judgment:
Section
Fluid/Electrolyte Basics, Trend Recognition, Bow-Tie Q141–Q150
VIII
Items, Prioritization
SECTION I: Management of Care (Q1–Q30)
🟢 Q1. A charge nurse is making assignments for a 32-bed medical-surgical unit. The team includes 2 RNs,
2 LPNs, and 2 UAPs. Which client should the charge nurse assign to the most experienced RN?
A. A stable 78-year-old client admitted 3 days ago for cellulitis receiving oral antibiotics
B. A 65-year-old client admitted 2 hours ago with acute GI bleed, BP 92/58, HR 110, receiving IV fluids
and awaiting endoscopy
C. A stable post-op day 2 client with a Foley catheter and a healing abdominal incision
D. A 50-year-old client with chronic back pain requesting PRN acetaminophen
🔴🔴 Correct Answer: B
Rationale: Using ATI priority-setting (Acute vs. Chronic and Unstable vs. Stable), the most experienced
RN should care for the unstable, acute GI bleed client with active hemodynamic compromise (BP 92/58,
HR 110), requiring ongoing assessment, IV titration, frequent vital signs, and preparation for emergent
endoscopy. The cellulitis client (A), post-op day 2 client (C), and chronic pain client (D) are stable and can
be appropriately delegated to LPNs or routine UAP tasks.
🟢 Q2. An RN delegates the following tasks to a UAP. Which task requires immediate intervention by the
RN?
A. Ambulating a stable post-op day 1 client
B. Measuring intake and output for a client with heart failure
C. Feeding a client admitted 24 hours ago with aspiration pneumonia
D. Obtaining a routine blood glucose reading for a stable diabetic client
,🔴🔴 Correct Answer: C
Rationale: Feeding a client with aspiration pneumonia requires swallowing assessment and nursing
judgment due to high risk for aspiration. This task cannot be delegated to UAP. Reapplying a condom
catheter, ambulating stable clients, and measuring I&O are noninvasive, routine procedures that may be
delegated to AP.
🟢 Q3. A nurse is caring for a patient with stage IV colon cancer who privately states he does not want
another round of chemotherapy, but his family insists he continue treatment. Which action by the nurse
BEST demonstrates patient advocacy?
A. Tell the family the patient has the right to make his own decisions
B. Facilitate a family meeting with the provider and social worker to clarify the patient's wishes and
treatment options, supporting the patient's autonomy
C. Encourage the patient to comply with his family's wishes
D. Refuse to discuss the issue because it is the provider's role
🔴🔴 Correct Answer: B
Rationale: Advocacy means supporting the patient's right to make autonomous decisions. The nurse
facilitates communication among the patient, family, and provider to clarify values, ensure informed
consent, and support the patient's autonomy while respecting family concerns. Simply telling the family
(A) dismisses their concerns; encouraging compliance (C) violates autonomy; refusing to discuss (D)
abandons the advocacy role.
🟢 Q4. A nurse manager is assigning care responsibilities. A client is awaiting transfer back from PACU
following thoracic surgery. To which staff member should the nurse assign this client?
A. Charge nurse
B. RN
C. LPN
D. AP
🔴🔴 Correct Answer: B
Rationale: A client returning from surgery requires assessment and plan of care establishment. RNs are
responsible for this; it cannot be delegated to LPNs or AP. The RN must perform the initial postoperative
assessment and develop the plan of care.
🟢 Q5. Which of the following client needs may the nurse assign to an AP?
A. Feeding a client admitted 24 hours ago with aspiration pneumonia
B. Reinforcing teaching with a client learning to walk using a quad cane
C. Reapplying a condom catheter for a client who has urinary incontinence
D. Applying a sterile dressing to a pressure ulcer
, 🔴🔴 Correct Answer: C
Rationale: The application of a condom catheter is a noninvasive, routine procedure that the nurse may
delegate to the AP. Feeding a client with aspiration pneumonia requires swallowing assessment,
reinforcing teaching requires nursing judgment, and sterile dressing changes require licensed nursing
skills.
🟢 Q6. Which of the following assignments should the LPN question?
A. Assisting a 24-hour postop client to use an incentive spirometer
B. Collecting a clean-catch urine specimen
C. Providing nasopharyngeal suctioning for a client with pneumonia
D. Replacing the cartridge and tubing on a PCA pump
🔴🔴 Correct Answer: D
Rationale: The RN is responsible for the PCA pump, including replacing cartridges and tubing. This
requires assessment and evaluation beyond the LPN's scope. LPNs may assist with incentive spirometry,
collect specimens, and perform nasopharyngeal suctioning for stable clients.
🟢 Q7. A nurse is delegating ambulation of a client who had knee arthroplasty to an AP. Which
information should the nurse share? (Select all that apply.)
A. The roommate is up independently
B. The client ambulates with slippers over antiembolic stockings
C. The client uses a front-wheeled walker
D. The client had pain medication 30 minutes ago
E. The client is allergic to codeine
F. The client ate 50% of breakfast
🔴🔴 Correct Answers: B, C, D
Rationale: The nurse must communicate mobility status, equipment used, and pain medication timing.
Roommate status, allergies (unless relevant to activity), and food intake are not directly relevant to safe
ambulation.
🟢 Q8. Which of the following are the "5 Rights of Delegation"? (Select all that apply.)
A. Right client
B. Right supervision/evaluation
C. Right direction/communication
D. Right time
E. Right circumstances
🔴🔴 Correct Answers: B, C, E
Rationale: The 5 Rights of Delegation are: Right Task, Right Circumstance, Right Person, Right
