ATI PN Fundamentals Exam 2026: Comprehensive NGN Proctored
Practice Test — Nursing Principles, Patient Safety, Infection Control,
Basic Care, Vital Signs, Clinical Skills & Nursing Judgment —
Practice Questions with Answers & Detailed Rationales
SECTION 1: SAFE, EFFECTIVE CARE ENVIRONMENT — MANAGEMENT OF CARE (Questions
1–35)
Question 1
A nurse is preparing to delegate tasks to unlicensed assistive personnel (UAP). Which task is
appropriate for the nurse to delegate?
A. Reinforce teaching about a low-sodium diet to a client with heart failure.
B. Measure intake and output for a stable postoperative client.
C. Assess a client's surgical incision for signs of infection.
D. Evaluate the effectiveness of a newly administered analgesic.
Correct Answer: B
Explanation: Measuring intake and output is a routine, standardized task within the UAP
scope for stable clients. Assessment, evaluation, and teaching reinforcement require nursing
knowledge and cannot be delegated.
Question 2
A client with end-stage chronic obstructive pulmonary disease has a living will stating no
intubation or mechanical ventilation. The client becomes unresponsive and family members
demand full life-saving measures. Which action should the LPN take first?
A. Call the rapid response team and prepare for intubation.
B. Notify the RN and provider immediately so the advance directive can be honored.
,C. Ask the family to sign a consent overriding the advance directive.
D. Provide comfort measures and document the family's request.
Correct Answer: B
Explanation: Advance directives are legally binding; the LPN must notify the RN and provider
immediately so care aligns with documented wishes. Overriding requires legal review and is
not the nurse's decision.
Question 3
An LPN discovers a coworker taking a client's prescribed opioid pain medication from the
automated dispensing cabinet. Which action should the LPN take?
A. Confront the coworker privately and demand they return the medication.
B. Report the observation to the charge nurse or supervisor immediately.
C. Document the incident in the client's medical record.
D. Wait and observe again before taking action to ensure accuracy.
Correct Answer: B
Explanation: Diversion of controlled substances is a patient safety violation requiring
immediate reporting through the chain of command. Documentation in the client record is
inappropriate because this is a staff issue, not client care.
Question 4
A client is scheduled for a colonoscopy and the provider has explained the procedure, risks,
and alternatives. The client signs the consent form. Five minutes later the client tells the
LPN, "I'm not really sure what they're going to do." What should the LPN do?
A. Witness the consent and reassure the client that the provider explained everything.
,B. Notify the provider so they can return and re-explain the procedure before the consent is
considered valid.
C. Tell the client the procedure is routine and there is nothing to worry about.
D. Cancel the procedure and notify the surgical team.
Correct Answer: B
Explanation: Valid informed consent requires comprehension; if the client is unsure, the
provider must re-explain. Cancelling is premature unless the provider determines consent
cannot be obtained.
Question 5
Which client should the LPN assess first after receiving shift report?
A. A 2-day postoperative client requesting pain medication for incisional pain rated 4/10.
B. A client with chronic kidney disease whose potassium level was 5.1 mEq/L on the morning
lab draw.
C. A client admitted with pneumonia who is resting quietly on 2 L nasal cannula.
D. A stable client with a stage 2 pressure injury scheduled for wound care.
Correct Answer: B
Explanation: The potassium of 5.1 mEq/L requires priority assessment because hyperkalemia
can cause life-threatening cardiac dysrhythmias. Postoperative pain and stable pneumonia
are important but not immediately life-threatening.
Question 6
An LPN is assigned four clients. Which client should the LPN recognize as requiring
assignment reassessment with the charge nurse?
, A. A stable postoperative client requiring intermittent bladder catheterization.
B. A newly admitted client with acute GI bleeding and unstable vital signs.
C. A client receiving oral antibiotics for a urinary tract infection.
D. A client receiving continuous IV fluids at a maintenance rate.
Correct Answer: B
Explanation: A client with acute GI bleeding and unstable vital signs requires RN-level
assessment and intervention beyond LPN scope. The LPN should request reassignment of
this client.
Question 7
A nurse is reviewing the plan of care for a client who practices Islam. The client requests to
face Mecca during daily prayers. Which action should the nurse take?
A. Inform the client that religious practices cannot interfere with hospital routines.
B. Notify the provider to obtain an order for religious accommodation.
C. Assist the client in determining the appropriate direction and provide privacy when
possible.
D. Document the request and continue with scheduled care activities.
Correct Answer: C
Explanation: Culturally competent care includes accommodating religious practices when
safe. The nurse should assist with the request and provide privacy without requiring a
provider order.
Question 8
A nurse is caring for a client who is terminally ill and has just died. The family is present and
visibly distressed. Which action should the nurse take first?
Practice Test — Nursing Principles, Patient Safety, Infection Control,
Basic Care, Vital Signs, Clinical Skills & Nursing Judgment —
Practice Questions with Answers & Detailed Rationales
SECTION 1: SAFE, EFFECTIVE CARE ENVIRONMENT — MANAGEMENT OF CARE (Questions
1–35)
Question 1
A nurse is preparing to delegate tasks to unlicensed assistive personnel (UAP). Which task is
appropriate for the nurse to delegate?
A. Reinforce teaching about a low-sodium diet to a client with heart failure.
B. Measure intake and output for a stable postoperative client.
C. Assess a client's surgical incision for signs of infection.
D. Evaluate the effectiveness of a newly administered analgesic.
Correct Answer: B
Explanation: Measuring intake and output is a routine, standardized task within the UAP
scope for stable clients. Assessment, evaluation, and teaching reinforcement require nursing
knowledge and cannot be delegated.
Question 2
A client with end-stage chronic obstructive pulmonary disease has a living will stating no
intubation or mechanical ventilation. The client becomes unresponsive and family members
demand full life-saving measures. Which action should the LPN take first?
A. Call the rapid response team and prepare for intubation.
B. Notify the RN and provider immediately so the advance directive can be honored.
,C. Ask the family to sign a consent overriding the advance directive.
D. Provide comfort measures and document the family's request.
Correct Answer: B
Explanation: Advance directives are legally binding; the LPN must notify the RN and provider
immediately so care aligns with documented wishes. Overriding requires legal review and is
not the nurse's decision.
Question 3
An LPN discovers a coworker taking a client's prescribed opioid pain medication from the
automated dispensing cabinet. Which action should the LPN take?
A. Confront the coworker privately and demand they return the medication.
B. Report the observation to the charge nurse or supervisor immediately.
C. Document the incident in the client's medical record.
D. Wait and observe again before taking action to ensure accuracy.
Correct Answer: B
Explanation: Diversion of controlled substances is a patient safety violation requiring
immediate reporting through the chain of command. Documentation in the client record is
inappropriate because this is a staff issue, not client care.
Question 4
A client is scheduled for a colonoscopy and the provider has explained the procedure, risks,
and alternatives. The client signs the consent form. Five minutes later the client tells the
LPN, "I'm not really sure what they're going to do." What should the LPN do?
A. Witness the consent and reassure the client that the provider explained everything.
,B. Notify the provider so they can return and re-explain the procedure before the consent is
considered valid.
C. Tell the client the procedure is routine and there is nothing to worry about.
D. Cancel the procedure and notify the surgical team.
Correct Answer: B
Explanation: Valid informed consent requires comprehension; if the client is unsure, the
provider must re-explain. Cancelling is premature unless the provider determines consent
cannot be obtained.
Question 5
Which client should the LPN assess first after receiving shift report?
A. A 2-day postoperative client requesting pain medication for incisional pain rated 4/10.
B. A client with chronic kidney disease whose potassium level was 5.1 mEq/L on the morning
lab draw.
C. A client admitted with pneumonia who is resting quietly on 2 L nasal cannula.
D. A stable client with a stage 2 pressure injury scheduled for wound care.
Correct Answer: B
Explanation: The potassium of 5.1 mEq/L requires priority assessment because hyperkalemia
can cause life-threatening cardiac dysrhythmias. Postoperative pain and stable pneumonia
are important but not immediately life-threatening.
Question 6
An LPN is assigned four clients. Which client should the LPN recognize as requiring
assignment reassessment with the charge nurse?
, A. A stable postoperative client requiring intermittent bladder catheterization.
B. A newly admitted client with acute GI bleeding and unstable vital signs.
C. A client receiving oral antibiotics for a urinary tract infection.
D. A client receiving continuous IV fluids at a maintenance rate.
Correct Answer: B
Explanation: A client with acute GI bleeding and unstable vital signs requires RN-level
assessment and intervention beyond LPN scope. The LPN should request reassignment of
this client.
Question 7
A nurse is reviewing the plan of care for a client who practices Islam. The client requests to
face Mecca during daily prayers. Which action should the nurse take?
A. Inform the client that religious practices cannot interfere with hospital routines.
B. Notify the provider to obtain an order for religious accommodation.
C. Assist the client in determining the appropriate direction and provide privacy when
possible.
D. Document the request and continue with scheduled care activities.
Correct Answer: C
Explanation: Culturally competent care includes accommodating religious practices when
safe. The nurse should assist with the request and provide privacy without requiring a
provider order.
Question 8
A nurse is caring for a client who is terminally ill and has just died. The family is present and
visibly distressed. Which action should the nurse take first?
