RN Fundamentals ATI Proctored Exam NGN Style
Questions Case Scenarios Actual Exam
2026/2027 – ATI Content Mastery Aligned with
Detailed Rationales – Pass Guaranteed – A+
Graded
SECTION 1: STAND-ALONE QUESTIONS (Questions 1-60)
Q1: A nurse is caring for four clients. Which client should the nurse assess first?
A. A client who is 2 days postoperative and reports incisional pain rated 4/10
B. A client who is receiving IV antibiotics and reports a rash on the chest
C. A client who has a nasogastric tube and reports abdominal distention
D. A client who is 1 hour postoperative and has absent breath sounds on the right side
Correct Answer: D
Rationale: Using ATI prioritization (ABCs), absent breath sounds indicate a potential
pneumothorax or airway obstruction, representing an immediate threat to life that
requires assessment first. While pain, rash (possible allergic reaction), and distention
require intervention, they do not pose an immediate threat to the ABCs. The
postoperative client with respiratory compromise takes priority. [CORRECT]
Q2: A nurse is delegating tasks to an assistive personnel (AP). Which task is appropriate
for the nurse to delegate?
A. Assessing a client's pain level after receiving pain medication
B. Measuring the intake and output for a client with heart failure
C. Reinforcing teaching about wound care to a client who had surgery
D. Evaluating the effectiveness of a client's antihypertensive medication
Correct Answer: B
Rationale: According to ATI delegation guidelines (5 rights of delegation), measuring
intake and output is a non-invasive, routine task that does not require nursing judgment
,and is within the AP's scope of practice. Assessment, teaching, and evaluation require
the education, knowledge, and scope of the registered nurse. [CORRECT]
Q3: A nurse is preparing to administer digoxin 0.125 mg PO to an adult client. The
client's vital signs are: heart rate 52/min, blood pressure 118/76 mm Hg, respiratory rate
16/min, temperature 37.0°C (98.6°F). Which action should the nurse take?
A. Administer the medication as prescribed
B. Hold the medication and notify the provider
C. Recheck the heart rate in 30 minutes
D. Administer half the prescribed dose
Correct Answer: B
Rationale: ATI pharmacology guidelines indicate that digoxin should be held and the
provider notified if the apical pulse is <60/min in adults (or <70/min in infants) due to
the risk of bradycardia and toxicity. The nurse should not administer the medication,
give a partial dose, or delay intervention when the pulse is below the safety threshold.
[CORRECT]
Q4: A nurse is caring for a client who has a new diagnosis of heart failure. The client is
prescribed furosemide 40 mg daily. Which instruction should the nurse include in the
teaching? (Select all that apply)
A. "Take the medication in the morning to avoid nighttime urination"
B. "Weigh yourself daily at the same time wearing similar clothing"
C. "Increase your intake of potassium-rich foods such as bananas"
D. "Notify your provider if you gain more than 2 pounds in one day"
E. "Elevate your legs when sitting to reduce swelling"
Correct Answer: A, B, C, D, E
Rationale: ATI heart failure management includes: taking diuretics in the morning to
prevent nocturia, daily weights (most accurate indicator of fluid status), potassium
replacement (furosemide is potassium-wasting), reporting weight gain >2-3 lbs/day or
>5 lbs/week (indicates fluid retention), and leg elevation to reduce edema. All options
represent appropriate self-management strategies. [CORRECT]
,Q5: A nurse is calculating the IV flow rate for a client receiving 0.9% sodium chloride
1,000 mL over 8 hours. The drop factor is 15 gtt/mL. How many gtt/min should the
nurse set the IV flow rate to deliver? (Round to the nearest whole number)
A. 31 gtt/min
B. 32 gtt/min
C. 33 gtt/min
D. 34 gtt/min
Correct Answer: A
Rationale: Using the ATI formula: Total volume (mL) × Drop factor (gtt/mL) ÷ Time in
minutes = Flow rate (gtt/min). Calculation: 1,000 mL × 15 gtt/mL ÷ 480 minutes (8
hours) = 15,000 ÷ 480 = 31.25, rounded to 31 gtt/min. [CORRECT]
Q6: A nurse is preparing to insert an indwelling urinary catheter for a female client.
Which sequence of actions demonstrates correct aseptic technique? (Ordered
Response)
A. Open the sterile kit and don sterile gloves
B. Cleanse the perineal area with soap and water
C. Separate the labia with the non-dominant hand
D. Cleanse the meatus with antiseptic solution using a downward stroke
E. Advance the catheter until urine flows, then advance an additional 2.5-5 cm (1-2
inches)
Correct Order: B, A, C, D, E
Rationale: ATI catheterization procedure: First cleanse the perineal area with soap and
water (clean technique), then open the sterile kit and don sterile gloves (sterile
technique begins), separate labia with non-dominant hand (which becomes
contaminated), cleanse meatus with antiseptic in a downward motion (front to back),
and advance catheter appropriately to ensure balloon is in bladder. [CORRECT]
Q7: A nurse is caring for a client who is postoperative day 3 following abdominal
surgery. The client reports sudden severe abdominal pain and the nurse notes a heart
rate of 118/min and blood pressure 92/58 mm Hg. Which action should the nurse take
first?
A. Administer the prescribed PRN analgesic
B. Notify the surgeon immediately
, C. Assess the surgical incision for dehiscence or evisceration
D. Position the client in high-Fowler's position
Correct Answer: C
Rationale: Using ATI clinical judgment, the nurse must assess (recognize cues) before
acting. Sudden severe pain with tachycardia and hypotension postoperatively suggests
possible dehiscence (wound separation) or evisceration (protrusion of organs), or
internal hemorrhage. Visual assessment of the wound is the immediate priority to
identify the problem before notifying the surgeon or administering medications.
[CORRECT]
Q8: A nurse is reinforcing teaching about standard precautions with a newly hired
assistive personnel. Which statement by the AP indicates understanding?
A. "I need to wear gloves when feeding a client"
B. "I should wear a gown when bathing a client"
C. "I must wash my hands after removing gloves"
D. "I need to wear a mask when taking a client's blood pressure"
Correct Answer: C
Rationale: ATI infection control guidelines require hand hygiene after glove removal, as
gloves may have micro-tears or contamination. Gloves are not required for feeding
unless contact with bodily fluids is anticipated. Gowns are for contact precautions or
when clothing may become soiled. Masks are not required for blood pressure
measurement unless splash/spray is anticipated. [CORRECT]
Q9: A nurse is caring for a client who has a prescription for wrist restraints due to
confusion and attempting to pull out an IV line. Which actions should the nurse take?
(Select all that apply)
A. Secure the restraints to the bed frame using a quick-release knot
B. Remove the restraints every 2 hours to assess skin integrity and provide range of
motion
C. Document the client's behavior and condition every 15 minutes
D. Ensure that two fingers can be inserted between the restraint and the client's wrist
E. Obtain a prescription for restraints within 1 hour of application
Correct Answer: A, B, D
Questions Case Scenarios Actual Exam
2026/2027 – ATI Content Mastery Aligned with
Detailed Rationales – Pass Guaranteed – A+
Graded
SECTION 1: STAND-ALONE QUESTIONS (Questions 1-60)
Q1: A nurse is caring for four clients. Which client should the nurse assess first?
A. A client who is 2 days postoperative and reports incisional pain rated 4/10
B. A client who is receiving IV antibiotics and reports a rash on the chest
C. A client who has a nasogastric tube and reports abdominal distention
D. A client who is 1 hour postoperative and has absent breath sounds on the right side
Correct Answer: D
Rationale: Using ATI prioritization (ABCs), absent breath sounds indicate a potential
pneumothorax or airway obstruction, representing an immediate threat to life that
requires assessment first. While pain, rash (possible allergic reaction), and distention
require intervention, they do not pose an immediate threat to the ABCs. The
postoperative client with respiratory compromise takes priority. [CORRECT]
Q2: A nurse is delegating tasks to an assistive personnel (AP). Which task is appropriate
for the nurse to delegate?
A. Assessing a client's pain level after receiving pain medication
B. Measuring the intake and output for a client with heart failure
C. Reinforcing teaching about wound care to a client who had surgery
D. Evaluating the effectiveness of a client's antihypertensive medication
Correct Answer: B
Rationale: According to ATI delegation guidelines (5 rights of delegation), measuring
intake and output is a non-invasive, routine task that does not require nursing judgment
,and is within the AP's scope of practice. Assessment, teaching, and evaluation require
the education, knowledge, and scope of the registered nurse. [CORRECT]
Q3: A nurse is preparing to administer digoxin 0.125 mg PO to an adult client. The
client's vital signs are: heart rate 52/min, blood pressure 118/76 mm Hg, respiratory rate
16/min, temperature 37.0°C (98.6°F). Which action should the nurse take?
A. Administer the medication as prescribed
B. Hold the medication and notify the provider
C. Recheck the heart rate in 30 minutes
D. Administer half the prescribed dose
Correct Answer: B
Rationale: ATI pharmacology guidelines indicate that digoxin should be held and the
provider notified if the apical pulse is <60/min in adults (or <70/min in infants) due to
the risk of bradycardia and toxicity. The nurse should not administer the medication,
give a partial dose, or delay intervention when the pulse is below the safety threshold.
[CORRECT]
Q4: A nurse is caring for a client who has a new diagnosis of heart failure. The client is
prescribed furosemide 40 mg daily. Which instruction should the nurse include in the
teaching? (Select all that apply)
A. "Take the medication in the morning to avoid nighttime urination"
B. "Weigh yourself daily at the same time wearing similar clothing"
C. "Increase your intake of potassium-rich foods such as bananas"
D. "Notify your provider if you gain more than 2 pounds in one day"
E. "Elevate your legs when sitting to reduce swelling"
Correct Answer: A, B, C, D, E
Rationale: ATI heart failure management includes: taking diuretics in the morning to
prevent nocturia, daily weights (most accurate indicator of fluid status), potassium
replacement (furosemide is potassium-wasting), reporting weight gain >2-3 lbs/day or
>5 lbs/week (indicates fluid retention), and leg elevation to reduce edema. All options
represent appropriate self-management strategies. [CORRECT]
,Q5: A nurse is calculating the IV flow rate for a client receiving 0.9% sodium chloride
1,000 mL over 8 hours. The drop factor is 15 gtt/mL. How many gtt/min should the
nurse set the IV flow rate to deliver? (Round to the nearest whole number)
A. 31 gtt/min
B. 32 gtt/min
C. 33 gtt/min
D. 34 gtt/min
Correct Answer: A
Rationale: Using the ATI formula: Total volume (mL) × Drop factor (gtt/mL) ÷ Time in
minutes = Flow rate (gtt/min). Calculation: 1,000 mL × 15 gtt/mL ÷ 480 minutes (8
hours) = 15,000 ÷ 480 = 31.25, rounded to 31 gtt/min. [CORRECT]
Q6: A nurse is preparing to insert an indwelling urinary catheter for a female client.
Which sequence of actions demonstrates correct aseptic technique? (Ordered
Response)
A. Open the sterile kit and don sterile gloves
B. Cleanse the perineal area with soap and water
C. Separate the labia with the non-dominant hand
D. Cleanse the meatus with antiseptic solution using a downward stroke
E. Advance the catheter until urine flows, then advance an additional 2.5-5 cm (1-2
inches)
Correct Order: B, A, C, D, E
Rationale: ATI catheterization procedure: First cleanse the perineal area with soap and
water (clean technique), then open the sterile kit and don sterile gloves (sterile
technique begins), separate labia with non-dominant hand (which becomes
contaminated), cleanse meatus with antiseptic in a downward motion (front to back),
and advance catheter appropriately to ensure balloon is in bladder. [CORRECT]
Q7: A nurse is caring for a client who is postoperative day 3 following abdominal
surgery. The client reports sudden severe abdominal pain and the nurse notes a heart
rate of 118/min and blood pressure 92/58 mm Hg. Which action should the nurse take
first?
A. Administer the prescribed PRN analgesic
B. Notify the surgeon immediately
, C. Assess the surgical incision for dehiscence or evisceration
D. Position the client in high-Fowler's position
Correct Answer: C
Rationale: Using ATI clinical judgment, the nurse must assess (recognize cues) before
acting. Sudden severe pain with tachycardia and hypotension postoperatively suggests
possible dehiscence (wound separation) or evisceration (protrusion of organs), or
internal hemorrhage. Visual assessment of the wound is the immediate priority to
identify the problem before notifying the surgeon or administering medications.
[CORRECT]
Q8: A nurse is reinforcing teaching about standard precautions with a newly hired
assistive personnel. Which statement by the AP indicates understanding?
A. "I need to wear gloves when feeding a client"
B. "I should wear a gown when bathing a client"
C. "I must wash my hands after removing gloves"
D. "I need to wear a mask when taking a client's blood pressure"
Correct Answer: C
Rationale: ATI infection control guidelines require hand hygiene after glove removal, as
gloves may have micro-tears or contamination. Gloves are not required for feeding
unless contact with bodily fluids is anticipated. Gowns are for contact precautions or
when clothing may become soiled. Masks are not required for blood pressure
measurement unless splash/spray is anticipated. [CORRECT]
Q9: A nurse is caring for a client who has a prescription for wrist restraints due to
confusion and attempting to pull out an IV line. Which actions should the nurse take?
(Select all that apply)
A. Secure the restraints to the bed frame using a quick-release knot
B. Remove the restraints every 2 hours to assess skin integrity and provide range of
motion
C. Document the client's behavior and condition every 15 minutes
D. Ensure that two fingers can be inserted between the restraint and the client's wrist
E. Obtain a prescription for restraints within 1 hour of application
Correct Answer: A, B, D
