ATI RN Fundamentals Exam – NGN Style 2026/2027 Questionss
& Case Scenarios – Verified Rationales – 100% Guarantee Pass
Item ID: ATI-FUND-EXAM-001
Item Type: NGN - Extended Multiple Response
Case Scenario Context: Ms. Alvarez, 72, is 4 h post-open cholecystectomy. She is
drowsy but arousable, receiving morphine 2 mg IV q2h PRN. Vital signs: BP 118/62, HR
94, RR 10/min, shallow, SpO₂ 89% on 2 L NC, tympanic 36.8 °C.
Question Stem & Data:
Which assessment findings require immediate follow-up to prevent postoperative
complications? Select all that apply.
1. Respiratory rate 10/min and shallow
2. Oxygen saturation 89% on 2 L NC
3. Patient drowsy but easily aroused
4. BP 118/62 mmHg
5. Temperature 36.8 °C
6. Pain rating 8/10 on arrival to PACU 2 h ago (last documented)
Options/Response Fields:
1, 2, 6
(Correct Answer: 1, 2, 6)
,Rationale (Verified | 100% Guarantee | NGN Clinical Judgment):
● Correct Answer: 1, 2, 6
● Clinical Judgment Analysis: Recognize Cues—opioid-induced respiratory
depression (RR 10, shallow) and hypoxemia (SpO₂ 89%) are urgent safety threats.
Analyze Cues—unrelieved pain (8/10) may escalate opioid dose, worsening
sedation. Prioritize Hypotheses—airway/oxygenation is first. Generate
Solutions—stimulate patient, notify provider, consider naloxone, escalate oxygen,
reassess pain plan. Take Action—raise O₂, obtain ABG, hold next morphine.
Evaluate Outcomes—target SpO₂ ≥94, RR 12–20. 2026 AORN guidelines stress
hourly respiratory monitoring for first 12 h post-op.
● Distractor Justification: Drowsiness alone is expected; BP and temperature are
within normal ranges and do not indicate immediate compromise.
Item ID: ATI-FUND-EXAM-002
Item Type: NGN - Matrix Grid
Case Scenario Context: Mr. Dubois, 58, admitted with dehydration and sodium 152
mEq/L. Prescribed 0.45% NaCl 100 mL/h × 8 h.
Question Stem & Data:
For each potential complication of hypotonic fluid therapy, indicate whether it is a high,
moderate, or low risk for Mr. Dubois during the prescribed regimen.
TableCopy
, Potential Complication High Risk Moderate Risk Low Risk
A. Cerebral edema
B. Fluid overload
C. Hyponatremia overcorrection
(Correct Answer: A—High, B—Low, C—Moderate)
Rationale (Verified | 100% Guarantee | NGN Clinical Judgment):
● Correct Answer: Rapid reduction in serum sodium with 0.45% NaCl places
hypernatremic patients at high risk for cerebral edema (osmotic shift). His age
and absence of cardiac history place fluid overload risk low. Overcorrection to
below normal is possible but moderate if rate closely monitored per 2026
Infusion Nurses Society standards.
● Distractor Justification: Selecting “High” for fluid overload ignores absence of
renal/cardiac comorbidity; selecting “Low” for cerebral edema misses hallmark
risk of rapid serum osmolality change.
Item ID: ATI-FUND-EXAM-003
, Item Type: Traditional Application
Case Scenario Context: Nurse is preparing to insert an indwelling urinary catheter in a
female patient.
Question Stem & Data:
Which action is essential immediately after inflating the balloon?
1. Secure catheter to upper thigh
2. Pull catheter gently until resistance felt
3. Attach to drainage bag positioned above bladder
4. Obtain urine specimen from catheter port
Options/Response Fields:
1
(Correct Answer: 1)
Rationale (Verified | 100% Guarantee | NGN Clinical Judgment):
● Correct Answer: 1
● Clinical Judgment Analysis: Securing prevents traction on urethra, reducing
trauma risk. 2026 SHEA guidelines cite securement devices as tier-1 intervention
to prevent CAUTI.
● Distractor Justification: Pulling creates trauma; drainage bag must hang below
bladder; specimen obtained later unless ordered stat.
& Case Scenarios – Verified Rationales – 100% Guarantee Pass
Item ID: ATI-FUND-EXAM-001
Item Type: NGN - Extended Multiple Response
Case Scenario Context: Ms. Alvarez, 72, is 4 h post-open cholecystectomy. She is
drowsy but arousable, receiving morphine 2 mg IV q2h PRN. Vital signs: BP 118/62, HR
94, RR 10/min, shallow, SpO₂ 89% on 2 L NC, tympanic 36.8 °C.
Question Stem & Data:
Which assessment findings require immediate follow-up to prevent postoperative
complications? Select all that apply.
1. Respiratory rate 10/min and shallow
2. Oxygen saturation 89% on 2 L NC
3. Patient drowsy but easily aroused
4. BP 118/62 mmHg
5. Temperature 36.8 °C
6. Pain rating 8/10 on arrival to PACU 2 h ago (last documented)
Options/Response Fields:
1, 2, 6
(Correct Answer: 1, 2, 6)
,Rationale (Verified | 100% Guarantee | NGN Clinical Judgment):
● Correct Answer: 1, 2, 6
● Clinical Judgment Analysis: Recognize Cues—opioid-induced respiratory
depression (RR 10, shallow) and hypoxemia (SpO₂ 89%) are urgent safety threats.
Analyze Cues—unrelieved pain (8/10) may escalate opioid dose, worsening
sedation. Prioritize Hypotheses—airway/oxygenation is first. Generate
Solutions—stimulate patient, notify provider, consider naloxone, escalate oxygen,
reassess pain plan. Take Action—raise O₂, obtain ABG, hold next morphine.
Evaluate Outcomes—target SpO₂ ≥94, RR 12–20. 2026 AORN guidelines stress
hourly respiratory monitoring for first 12 h post-op.
● Distractor Justification: Drowsiness alone is expected; BP and temperature are
within normal ranges and do not indicate immediate compromise.
Item ID: ATI-FUND-EXAM-002
Item Type: NGN - Matrix Grid
Case Scenario Context: Mr. Dubois, 58, admitted with dehydration and sodium 152
mEq/L. Prescribed 0.45% NaCl 100 mL/h × 8 h.
Question Stem & Data:
For each potential complication of hypotonic fluid therapy, indicate whether it is a high,
moderate, or low risk for Mr. Dubois during the prescribed regimen.
TableCopy
, Potential Complication High Risk Moderate Risk Low Risk
A. Cerebral edema
B. Fluid overload
C. Hyponatremia overcorrection
(Correct Answer: A—High, B—Low, C—Moderate)
Rationale (Verified | 100% Guarantee | NGN Clinical Judgment):
● Correct Answer: Rapid reduction in serum sodium with 0.45% NaCl places
hypernatremic patients at high risk for cerebral edema (osmotic shift). His age
and absence of cardiac history place fluid overload risk low. Overcorrection to
below normal is possible but moderate if rate closely monitored per 2026
Infusion Nurses Society standards.
● Distractor Justification: Selecting “High” for fluid overload ignores absence of
renal/cardiac comorbidity; selecting “Low” for cerebral edema misses hallmark
risk of rapid serum osmolality change.
Item ID: ATI-FUND-EXAM-003
, Item Type: Traditional Application
Case Scenario Context: Nurse is preparing to insert an indwelling urinary catheter in a
female patient.
Question Stem & Data:
Which action is essential immediately after inflating the balloon?
1. Secure catheter to upper thigh
2. Pull catheter gently until resistance felt
3. Attach to drainage bag positioned above bladder
4. Obtain urine specimen from catheter port
Options/Response Fields:
1
(Correct Answer: 1)
Rationale (Verified | 100% Guarantee | NGN Clinical Judgment):
● Correct Answer: 1
● Clinical Judgment Analysis: Securing prevents traction on urethra, reducing
trauma risk. 2026 SHEA guidelines cite securement devices as tier-1 intervention
to prevent CAUTI.
● Distractor Justification: Pulling creates trauma; drainage bag must hang below
bladder; specimen obtained later unless ordered stat.
