Next Generation NCLEX RN Fundamentals
2025/2026 – ATI Proctored Exam with NGN
Questions and 100% Verified Answers
Instructions
The following 80 questions are designed to reflect the Next Generation NCLEX (NGN)
format for the ATI RN Fundamentals Proctored Exam. Each question includes four
answer options, one verified correct answer, and a rationale based on clinical judgment
and ATI RN Fundamentals content. Questions assess foundational nursing knowledge,
patient safety, infection control, communication, pharmacology, and clinical decision-
making.
Questions
1. A nurse is caring for a client with a new colostomy who reports feeling
overwhelmed about self-care. Which action should the nurse prioritize?
a) Teach the client to change the colostomy bag independently.
b) Assess the client’s emotional readiness to learn about colostomy care. (Correct)
c) Provide written instructions for colostomy care.
d) Schedule a follow-up with a wound care specialist.
Rationale: Assessing the client’s emotional readiness aligns with the NGN Clinical
Judgment Measurement Model, specifically recognizing cues and analyzing emo-
tional barriers to learning. Overwhelm may indicate anxiety, which can hinder
learning. Addressing emotional readiness (b) ensures effective teaching, whereas
(a) and (c) assume readiness, and (d) defers education. ATI Fundamentals empha-
sizes patient-centered care and readiness to learn.
2. A client with pneumonia is receiving oxygen at 2 L/min via nasal can-
nula. The nurse notes a respiratory rate of 28 breaths/min and SpO2 of
90%. What should the nurse do next?
a) Increase oxygen to 4 L/min.
b) Encourage deep breathing exercises.
c) Notify the provider of the client’s status. (Correct)
d) Reposition the client to semi-Fowler’s.
Rationale: The client’s SpO2 of 90% and tachypnea (28 breaths/min) indicate
respiratory distress. Notifying the provider (c) is the priority to address potential
hypoxemia, per ATI Fundamentals’ emphasis on timely escalation. Increasing oxy-
gen (a) requires a prescription, (b) may not address acute hypoxia, and (d) is less
urgent than notifying the provider.
3. A nurse is preparing to administer a medication via a nasogastric tube.
Which action ensures safe administration?
a) Crush the medication and mix it with water.
b) Verify tube placement before administration. (Correct)
c) Flush the tube with 60 mL of water post-administration.
d) Administer the medication with enteral feeding.
1
, Rationale: Verifying tube placement (b) is critical to prevent aspiration, as per
ATI Fundamentals’ safety protocols. Crushing medication (a) may not be appro-
priate for all drugs, (c) is a post-administration step, and (d) risks clogging or
incompatibility.
4. A client with a history of heart failure reports new-onset dyspnea. Which
assessment finding requires immediate action?
a) Blood pressure of 130/80 mmHg.
b) Crackles in bilateral lung bases. (Correct)
c) Heart rate of 88 beats/min.
d) Peripheral edema in ankles.
Rationale: Crackles in lung bases (b) suggest pulmonary edema, a life-threatening
complication of heart failure requiring immediate intervention. Normal blood pres-
sure (a), heart rate (c), and peripheral edema (d) are less urgent, per ATI Funda-
mentals’ prioritization principles.
5. A nurse is delegating tasks to an unlicensed assistive personnel (UAP).
Which task is appropriate to delegate?
a) Assessing a client’s pain level.
b) Assisting a client with ambulation. (Correct)
c) Administering oral medications.
d) Developing a client’s care plan.
Rationale: Delegating ambulation assistance (b) is within the UAP’s scope, as per
ATI Fundamentals’ delegation guidelines. Assessing pain (a), administering medi-
cations (c), and care planning (d) require nursing judgment and are inappropriate
for delegation.
6. A client with diabetes mellitus is receiving insulin. The nurse notes a
blood glucose of 50 mg/dL. What is the priority action?
a) Administer 15 g of carbohydrates. (Correct)
b) Recheck blood glucose in 30 minutes.
c) Notify the provider immediately.
d) Hold the next insulin dose.
Rationale: A blood glucose of 50 mg/dL indicates hypoglycemia, requiring imme-
diate administration of 15 g of carbohydrates (a), per ATI Fundamentals’ protocol.
Rechecking (b) follows treatment, notifying the provider (c) is secondary, and hold-
ing insulin (d) is not immediate.
7. A nurse is preparing to transfer a client from bed to a wheelchair. Which
action ensures safety?
a) Position the wheelchair at a 90-degree angle to the bed.
b) Lock the wheelchair brakes before transfer. (Correct)
c) Lower the bed to its highest position.
d) Instruct the client to stand quickly.
Rationale: Locking the wheelchair brakes (b) prevents movement during transfer,
ensuring safety, per ATI Fundamentals’ mobility guidelines. Incorrect positioning
(a), raising the bed (c), or rushing the client (d) increases fall risk.
8. A client with a urinary tract infection is prescribed antibiotics. Which
statement by the client indicates a need for further teaching?
2
, a) “I’ll take the medication with food.”
b) “I’ll stop the medication if I feel better.” (Correct)
c) “I’ll drink more water while on this medication.”
d) “I’ll report any side effects to my provider.”
Rationale: Stopping antibiotics early (b) can lead to resistance or relapse, indicat-
ing a need for teaching, per ATI Fundamentals’ pharmacology principles. Options
(a), (c), and (d) reflect appropriate understanding.
9. A nurse is caring for a client with a pressure injury. Which intervention
promotes healing?
a) Cleanse the wound with alcohol-based solution.
b) Apply a moist wound dressing. (Correct)
c) Massage the surrounding tissue.
d) Leave the wound open to air.
Rationale: A moist wound dressing (b) promotes healing by maintaining a moist
environment, per ATI Fundamentals’ wound care guidelines. Alcohol (a) is drying,
massage (c) can damage tissue, and open air (d) delays healing.
10. A client is receiving IV fluids and reports pain at the insertion site. The
nurse notes redness and swelling. What is the priority action?
a) Slow the IV infusion rate.
b) Discontinue the IV line. (Correct)
c) Apply a warm compress.
d) Elevate the affected limb.
Rationale: Redness and swelling suggest infiltration or phlebitis, requiring IV
discontinuation (b) to prevent further tissue damage, per ATI Fundamentals’ IV
therapy protocols. Other options (a, c, d) do not address the immediate risk.
11. A nurse is teaching a client about fall prevention. Which instruction is
most appropriate?
a) “Keep the floor cluttered to avoid slipping.”
b) “Use a nightlight in the bathroom.” (Correct)
c) “Wear socks without shoes at home.”
d) “Place rugs loosely on the floor.”
Rationale: A nightlight (b) reduces fall risk by improving visibility, per ATI Fun-
damentals’ safety guidelines. Clutter (a), socks without shoes (c), and loose rugs
(d) increase fall risk.
12. A client with chronic obstructive pulmonary disease (COPD) is using an
incentive spirometer. Which finding indicates correct use?
a) The client inhales rapidly and holds their breath for 1 second.
b) The indicator reaches the prescribed goal during inhalation. (Correct)
c) The client exhales forcefully into the device.
d) The client uses the spirometer once daily.
Rationale: Reaching the prescribed goal during inhalation (b) indicates correct
use, per ATI Fundamentals’ respiratory therapy guidelines. Rapid inhalation (a),
exhalation (c), or infrequent use (d) is incorrect.
13. A nurse is preparing to administer a subcutaneous injection. Which site
is most appropriate?
3
2025/2026 – ATI Proctored Exam with NGN
Questions and 100% Verified Answers
Instructions
The following 80 questions are designed to reflect the Next Generation NCLEX (NGN)
format for the ATI RN Fundamentals Proctored Exam. Each question includes four
answer options, one verified correct answer, and a rationale based on clinical judgment
and ATI RN Fundamentals content. Questions assess foundational nursing knowledge,
patient safety, infection control, communication, pharmacology, and clinical decision-
making.
Questions
1. A nurse is caring for a client with a new colostomy who reports feeling
overwhelmed about self-care. Which action should the nurse prioritize?
a) Teach the client to change the colostomy bag independently.
b) Assess the client’s emotional readiness to learn about colostomy care. (Correct)
c) Provide written instructions for colostomy care.
d) Schedule a follow-up with a wound care specialist.
Rationale: Assessing the client’s emotional readiness aligns with the NGN Clinical
Judgment Measurement Model, specifically recognizing cues and analyzing emo-
tional barriers to learning. Overwhelm may indicate anxiety, which can hinder
learning. Addressing emotional readiness (b) ensures effective teaching, whereas
(a) and (c) assume readiness, and (d) defers education. ATI Fundamentals empha-
sizes patient-centered care and readiness to learn.
2. A client with pneumonia is receiving oxygen at 2 L/min via nasal can-
nula. The nurse notes a respiratory rate of 28 breaths/min and SpO2 of
90%. What should the nurse do next?
a) Increase oxygen to 4 L/min.
b) Encourage deep breathing exercises.
c) Notify the provider of the client’s status. (Correct)
d) Reposition the client to semi-Fowler’s.
Rationale: The client’s SpO2 of 90% and tachypnea (28 breaths/min) indicate
respiratory distress. Notifying the provider (c) is the priority to address potential
hypoxemia, per ATI Fundamentals’ emphasis on timely escalation. Increasing oxy-
gen (a) requires a prescription, (b) may not address acute hypoxia, and (d) is less
urgent than notifying the provider.
3. A nurse is preparing to administer a medication via a nasogastric tube.
Which action ensures safe administration?
a) Crush the medication and mix it with water.
b) Verify tube placement before administration. (Correct)
c) Flush the tube with 60 mL of water post-administration.
d) Administer the medication with enteral feeding.
1
, Rationale: Verifying tube placement (b) is critical to prevent aspiration, as per
ATI Fundamentals’ safety protocols. Crushing medication (a) may not be appro-
priate for all drugs, (c) is a post-administration step, and (d) risks clogging or
incompatibility.
4. A client with a history of heart failure reports new-onset dyspnea. Which
assessment finding requires immediate action?
a) Blood pressure of 130/80 mmHg.
b) Crackles in bilateral lung bases. (Correct)
c) Heart rate of 88 beats/min.
d) Peripheral edema in ankles.
Rationale: Crackles in lung bases (b) suggest pulmonary edema, a life-threatening
complication of heart failure requiring immediate intervention. Normal blood pres-
sure (a), heart rate (c), and peripheral edema (d) are less urgent, per ATI Funda-
mentals’ prioritization principles.
5. A nurse is delegating tasks to an unlicensed assistive personnel (UAP).
Which task is appropriate to delegate?
a) Assessing a client’s pain level.
b) Assisting a client with ambulation. (Correct)
c) Administering oral medications.
d) Developing a client’s care plan.
Rationale: Delegating ambulation assistance (b) is within the UAP’s scope, as per
ATI Fundamentals’ delegation guidelines. Assessing pain (a), administering medi-
cations (c), and care planning (d) require nursing judgment and are inappropriate
for delegation.
6. A client with diabetes mellitus is receiving insulin. The nurse notes a
blood glucose of 50 mg/dL. What is the priority action?
a) Administer 15 g of carbohydrates. (Correct)
b) Recheck blood glucose in 30 minutes.
c) Notify the provider immediately.
d) Hold the next insulin dose.
Rationale: A blood glucose of 50 mg/dL indicates hypoglycemia, requiring imme-
diate administration of 15 g of carbohydrates (a), per ATI Fundamentals’ protocol.
Rechecking (b) follows treatment, notifying the provider (c) is secondary, and hold-
ing insulin (d) is not immediate.
7. A nurse is preparing to transfer a client from bed to a wheelchair. Which
action ensures safety?
a) Position the wheelchair at a 90-degree angle to the bed.
b) Lock the wheelchair brakes before transfer. (Correct)
c) Lower the bed to its highest position.
d) Instruct the client to stand quickly.
Rationale: Locking the wheelchair brakes (b) prevents movement during transfer,
ensuring safety, per ATI Fundamentals’ mobility guidelines. Incorrect positioning
(a), raising the bed (c), or rushing the client (d) increases fall risk.
8. A client with a urinary tract infection is prescribed antibiotics. Which
statement by the client indicates a need for further teaching?
2
, a) “I’ll take the medication with food.”
b) “I’ll stop the medication if I feel better.” (Correct)
c) “I’ll drink more water while on this medication.”
d) “I’ll report any side effects to my provider.”
Rationale: Stopping antibiotics early (b) can lead to resistance or relapse, indicat-
ing a need for teaching, per ATI Fundamentals’ pharmacology principles. Options
(a), (c), and (d) reflect appropriate understanding.
9. A nurse is caring for a client with a pressure injury. Which intervention
promotes healing?
a) Cleanse the wound with alcohol-based solution.
b) Apply a moist wound dressing. (Correct)
c) Massage the surrounding tissue.
d) Leave the wound open to air.
Rationale: A moist wound dressing (b) promotes healing by maintaining a moist
environment, per ATI Fundamentals’ wound care guidelines. Alcohol (a) is drying,
massage (c) can damage tissue, and open air (d) delays healing.
10. A client is receiving IV fluids and reports pain at the insertion site. The
nurse notes redness and swelling. What is the priority action?
a) Slow the IV infusion rate.
b) Discontinue the IV line. (Correct)
c) Apply a warm compress.
d) Elevate the affected limb.
Rationale: Redness and swelling suggest infiltration or phlebitis, requiring IV
discontinuation (b) to prevent further tissue damage, per ATI Fundamentals’ IV
therapy protocols. Other options (a, c, d) do not address the immediate risk.
11. A nurse is teaching a client about fall prevention. Which instruction is
most appropriate?
a) “Keep the floor cluttered to avoid slipping.”
b) “Use a nightlight in the bathroom.” (Correct)
c) “Wear socks without shoes at home.”
d) “Place rugs loosely on the floor.”
Rationale: A nightlight (b) reduces fall risk by improving visibility, per ATI Fun-
damentals’ safety guidelines. Clutter (a), socks without shoes (c), and loose rugs
(d) increase fall risk.
12. A client with chronic obstructive pulmonary disease (COPD) is using an
incentive spirometer. Which finding indicates correct use?
a) The client inhales rapidly and holds their breath for 1 second.
b) The indicator reaches the prescribed goal during inhalation. (Correct)
c) The client exhales forcefully into the device.
d) The client uses the spirometer once daily.
Rationale: Reaching the prescribed goal during inhalation (b) indicates correct
use, per ATI Fundamentals’ respiratory therapy guidelines. Rapid inhalation (a),
exhalation (c), or infrequent use (d) is incorrect.
13. A nurse is preparing to administer a subcutaneous injection. Which site
is most appropriate?
3
