ATI RN FUNDAMENTALS 2026
ULTIMATE EXAM
CHALLENGING QUESTIONS
AND ANSWERS WITH
DETAILED RATIONALES
Management of Care (Advocacy, Delegation, Ethics,
Legal Issues, Continuity of Care)
1. A nurse is caring for a client who is scheduled for an elective
surgical procedure. The client states, "I am still not entirely
sure what the surgeon is planning to do, but I signed the
form anyway." Which of the following actions should the
nurse take?
A. Reassure the client that the surgeon is highly qualified.
B. Explain the risks and benefits of the planned surgical
procedure.
C. Notify the provider that the client requires further
explanation of the procedure.
D. Document that informed consent was obtained and
proceed with preoperative care.
,CORRECT ANSWER: C
RATiONAlE: The nurse's role in informed consent is to
witness the client's signature and verify that the client
understands the procedure. If the client expresses confusion or
lack of knowledge, the nurse must advocate for the client by
notifying the provider to explain the procedure before the client
goes to surgery. It is within the provider's scope, not the nurse's,
to explain the risks and benefits.
2. A registered nurse (RN) is planning the client care
assignments for a shift. Which of the following tasks should
the RN delegate to an assistive personnel (AP)?
A. Assisting a client who is 24 hours postoperative following
an abdominal surgery to ambulate for the first time.
B. Reapplying a condom catheter for a client who has urinary
incontinence.
C. Providing discharge teaching to a client regarding their
new medication regimen.
D. Adjusting the flow rate of an established continuous
sequential intravenous infusion.
CORRECT ANSWER: B
RATiONAlE: Reapplying a non-invasive condom catheter is a
standard, repetitive skill that falls within the scope of practice for
an AP. Initial ambulation of a postoperative client requires
clinical judgment and assessment by the RN. Discharge teaching
and managing intravenous fluid rates are complex tasks that
cannot be delegated to an AP.
, 3. A nurse on a medical-surgical unit is reviewing the ethical
principle of fidelity. Which of the following actions by the
nurse demonstrates this principle?
A. Providing identical, high-quality care to a client regardless
of their socioeconomic status.
B. Allowing a competent client to refuse a prescribed blood
transfusion.
C. Returning to a client's room at the exact time promised to
administer an analgesic.
D. Telling the truth to a client about a terminal diagnostic
result.
CORRECT ANSWER: C
RATiONAlE: Fidelity refers to the duty to be faithful, keep
promises, and honor commitments made to clients. By returning
at the promised time, the nurse exhibits fidelity. Providing equal
care refers to justice. Allowing a client to refuse treatment refers
to autonomy. Telling the truth refers to veracity.
4. A nurse is preparing to transfer an older adult client to a
long-term care facility. Which of the following information is
the priority for the nurse to include in the transfer report?
A. The client's preferred daily routine and waking time.
B. A list of the client's current prescription medications,
dosages, and last administered times.
C. The names and phone numbers of the client's extended
family members.
D. A summary of the client's historical medical events from
childhood.
, CORRECT ANSWER: B
RATiONAlE: Continuity of care and medication safety during
transfers are paramount. To prevent adverse drug events and
omission errors, a precise, reconciled list of current medications
with their last administration times is the highest priority data
element. Family contact details and routines are secondary to
immediate safety needs.
5. A nurse enters a client's room and finds the client lying on
the floor. After performing an immediate assessment,
assisting the client back to bed, and notifying the provider,
the nurse completes an incident report. Which of the
following actions should the nurse take regarding
documentation?
A. Record a detailed summary of the incident report contents
in the client's electronic health record.
B. Document a factual description of the event, the client's
vital signs, and the provider notification in the progress
notes.
C. Write "Incident report completed and forwarded to risk
management" in the nurse's notes.
D. Place a copy of the completed incident report inside the
client's paper chart.
CORRECT ANSWER: B
RATiONAlE: The client's medical record should contain only
objective, factual observations of the event, assessments, and
interventions provided. It should never mention that an incident
report or variance report was completed, as doing so makes the
internal quality tracking document discoverable in legal
ULTIMATE EXAM
CHALLENGING QUESTIONS
AND ANSWERS WITH
DETAILED RATIONALES
Management of Care (Advocacy, Delegation, Ethics,
Legal Issues, Continuity of Care)
1. A nurse is caring for a client who is scheduled for an elective
surgical procedure. The client states, "I am still not entirely
sure what the surgeon is planning to do, but I signed the
form anyway." Which of the following actions should the
nurse take?
A. Reassure the client that the surgeon is highly qualified.
B. Explain the risks and benefits of the planned surgical
procedure.
C. Notify the provider that the client requires further
explanation of the procedure.
D. Document that informed consent was obtained and
proceed with preoperative care.
,CORRECT ANSWER: C
RATiONAlE: The nurse's role in informed consent is to
witness the client's signature and verify that the client
understands the procedure. If the client expresses confusion or
lack of knowledge, the nurse must advocate for the client by
notifying the provider to explain the procedure before the client
goes to surgery. It is within the provider's scope, not the nurse's,
to explain the risks and benefits.
2. A registered nurse (RN) is planning the client care
assignments for a shift. Which of the following tasks should
the RN delegate to an assistive personnel (AP)?
A. Assisting a client who is 24 hours postoperative following
an abdominal surgery to ambulate for the first time.
B. Reapplying a condom catheter for a client who has urinary
incontinence.
C. Providing discharge teaching to a client regarding their
new medication regimen.
D. Adjusting the flow rate of an established continuous
sequential intravenous infusion.
CORRECT ANSWER: B
RATiONAlE: Reapplying a non-invasive condom catheter is a
standard, repetitive skill that falls within the scope of practice for
an AP. Initial ambulation of a postoperative client requires
clinical judgment and assessment by the RN. Discharge teaching
and managing intravenous fluid rates are complex tasks that
cannot be delegated to an AP.
, 3. A nurse on a medical-surgical unit is reviewing the ethical
principle of fidelity. Which of the following actions by the
nurse demonstrates this principle?
A. Providing identical, high-quality care to a client regardless
of their socioeconomic status.
B. Allowing a competent client to refuse a prescribed blood
transfusion.
C. Returning to a client's room at the exact time promised to
administer an analgesic.
D. Telling the truth to a client about a terminal diagnostic
result.
CORRECT ANSWER: C
RATiONAlE: Fidelity refers to the duty to be faithful, keep
promises, and honor commitments made to clients. By returning
at the promised time, the nurse exhibits fidelity. Providing equal
care refers to justice. Allowing a client to refuse treatment refers
to autonomy. Telling the truth refers to veracity.
4. A nurse is preparing to transfer an older adult client to a
long-term care facility. Which of the following information is
the priority for the nurse to include in the transfer report?
A. The client's preferred daily routine and waking time.
B. A list of the client's current prescription medications,
dosages, and last administered times.
C. The names and phone numbers of the client's extended
family members.
D. A summary of the client's historical medical events from
childhood.
, CORRECT ANSWER: B
RATiONAlE: Continuity of care and medication safety during
transfers are paramount. To prevent adverse drug events and
omission errors, a precise, reconciled list of current medications
with their last administration times is the highest priority data
element. Family contact details and routines are secondary to
immediate safety needs.
5. A nurse enters a client's room and finds the client lying on
the floor. After performing an immediate assessment,
assisting the client back to bed, and notifying the provider,
the nurse completes an incident report. Which of the
following actions should the nurse take regarding
documentation?
A. Record a detailed summary of the incident report contents
in the client's electronic health record.
B. Document a factual description of the event, the client's
vital signs, and the provider notification in the progress
notes.
C. Write "Incident report completed and forwarded to risk
management" in the nurse's notes.
D. Place a copy of the completed incident report inside the
client's paper chart.
CORRECT ANSWER: B
RATiONAlE: The client's medical record should contain only
objective, factual observations of the event, assessments, and
interventions provided. It should never mention that an incident
report or variance report was completed, as doing so makes the
internal quality tracking document discoverable in legal
