ATI FUNDAMENTALS PROCTORED EXAM MAIN
STUDY SET 2026/2027 | Updated for ATI Blueprint,
NCLEX-RN 2026 Test Plan & NCSBN CJMM | Pass
Guaranteed - A+ Graded
SECTION 1: MANAGEMENT OF CARE – PROCTORED EMPHASIS
(Questions 1–20)
Question 1
A 78-year-old client with terminal cancer tells the nurse, "I don't want any more
chemotherapy. I want to go home and spend my remaining time with my family."
The client's adult children insist the nurse convince their parent to continue
treatment. What is the nurse's best response?
A. "Your parent has the right to refuse treatment, and I must honor that decision."
B. "Let me call the physician to discuss this with your family."
C. "I understand this is difficult, but your parent's wishes are documented in their
advance directive, and those wishes must be respected."
D. "The physician will make the final decision about treatment."
Correct Answer: C
Rationale: Autonomy is the ethical principle of self-determination, and advance
directives (living will, DPOA-HC) legally express a client's wishes when they have
capacity. The nurse must advocate for the client's documented preferences. Option A
states the principle but does not address the family's distress or reference the
advance directive. Option B defers to the physician when the issue is ethical, not
medical. Option D violates autonomy by suggesting the physician overrides the
client's wishes. ATI/NCLEX strategy: When family conflicts with client wishes, the
client's autonomy and advance directives take priority.
,Question 2
A nurse is caring for a client who is scheduled for surgery. The surgeon obtained
informed consent, and the client signed the form. The nurse's role in this process is
to:
A. Explain the risks and benefits of the procedure to the client
B. Witness the client's signature and verify the consent is voluntary and informed
C. Obtain the client's signature if the surgeon is unavailable
D. Decide whether the client has the capacity to consent
Correct Answer: B
Rationale: The nurse's role is to witness the signature and ensure the consent is
voluntary, the client understands, and there is no coercion. Explaining risks/benefits
(A) is the provider's duty. Obtaining consent (C) and determining capacity (D) are
provider responsibilities, not nursing functions. ATI/NCLEX strategy: Know the
boundary between nursing and provider roles in informed consent.
Question 3
A client with a history of bipolar disorder is admitted for appendicitis. The client
refuses surgery, stating, "The government is trying to implant a tracking device in
me." The client is oriented to person, place, and time but persists in this belief. What
is the nurse's priority action?
A. Proceed with preoperative preparations because the surgery is medically
necessary
B. Notify the provider to assess the client's decision-making capacity
C. Ask the client's family to sign the consent form instead
D. Sedate the client and proceed with surgery
Correct Answer: B
Rationale: Capacity is task-specific and must be assessed by the provider when a
client refuses potentially life-saving treatment. The nurse must report the refusal to
,the provider for capacity evaluation. Option A violates autonomy and could
constitute battery. Option C is invalid—family cannot override a competent adult's
refusal. Option D is assault/battery and false imprisonment. ATI/NCLEX strategy:
Capacity assessment is a provider responsibility; the nurse reports and advocates.
Question 4
A nurse is reviewing advance directives with a client. Which statement by the client
indicates a need for further teaching?
A. "My durable power of attorney for healthcare can make decisions for me if I
become unable."
B. "A living will tells my doctor what treatments I want or don't want if I can't speak
for myself."
C. "My POLST form is valid in every state and replaces my living will."
D. "I can change my advance directive at any time as long as I have decision-making
capacity."
Correct Answer: C
Rationale: POLST/MOLST forms are medical orders for specific treatments and are
not universally valid across all states; they complement but do not replace living wills.
Options A, B, and D are correct statements. ATI/NCLEX strategy: POLST is for
seriously ill/frail patients and translates wishes into actionable medical orders, but
portability varies by state.
Question 5
A nurse is assigned four clients. Which client should the nurse assess first?
A. A client with pneumonia who has a temperature of 38.2°C (100.8°F) and is
receiving antibiotics
B. A client post-appendectomy who reports pain of 6/10 and has stable vital signs
C. A client with a new tracheostomy who has thick secretions and an oxygen
, saturation of 88%
D. A client with heart failure who has 2+ pitting edema and is on a fluid restriction
Correct Answer: C
Rationale: Airway and breathing take absolute priority (ABCs). An oxygen saturation
of 88% with thick secretions indicates potential airway obstruction and hypoxemia—
an immediate threat to life. Options A, B, and D are stable or less acute. ATI/NCLEX
strategy: Always apply ABCs first. Any airway/breathing compromise is the highest
priority over circulation, pain, or edema.
Question 6
A registered nurse (RN) is delegating tasks on a busy medical-surgical unit. Which
task is appropriate to delegate to a licensed practical/vocational nurse (LPN/LVN)?
A. Developing a discharge plan for a client going home with a new colostomy
B. Administering an IV piggyback antibiotic to a client with stable vital signs
C. Performing the initial admission assessment on a client transferred from the ICU
D. Teaching a newly diagnosed diabetic client about insulin administration
Correct Answer: B
Rationale: Administering IV piggyback medications to stable clients is within LPN
scope in most states (verify state-specific regulations). Initial assessments (C),
discharge planning (A), and client teaching (D) require RN-level judgment and cannot
be delegated. ATI/NCLEX strategy: The five rights of delegation include right task,
right circumstance, right person, right direction/communication, and right
supervision. Teaching and initial assessment are RN-only.
Question 7
Which task is appropriate to delegate to an assistive personnel (AP)?
A. Obtaining vital signs on a client who is 2 hours post-op after abdominal surgery
B. Assisting a stable client with ambulation to the bathroom
STUDY SET 2026/2027 | Updated for ATI Blueprint,
NCLEX-RN 2026 Test Plan & NCSBN CJMM | Pass
Guaranteed - A+ Graded
SECTION 1: MANAGEMENT OF CARE – PROCTORED EMPHASIS
(Questions 1–20)
Question 1
A 78-year-old client with terminal cancer tells the nurse, "I don't want any more
chemotherapy. I want to go home and spend my remaining time with my family."
The client's adult children insist the nurse convince their parent to continue
treatment. What is the nurse's best response?
A. "Your parent has the right to refuse treatment, and I must honor that decision."
B. "Let me call the physician to discuss this with your family."
C. "I understand this is difficult, but your parent's wishes are documented in their
advance directive, and those wishes must be respected."
D. "The physician will make the final decision about treatment."
Correct Answer: C
Rationale: Autonomy is the ethical principle of self-determination, and advance
directives (living will, DPOA-HC) legally express a client's wishes when they have
capacity. The nurse must advocate for the client's documented preferences. Option A
states the principle but does not address the family's distress or reference the
advance directive. Option B defers to the physician when the issue is ethical, not
medical. Option D violates autonomy by suggesting the physician overrides the
client's wishes. ATI/NCLEX strategy: When family conflicts with client wishes, the
client's autonomy and advance directives take priority.
,Question 2
A nurse is caring for a client who is scheduled for surgery. The surgeon obtained
informed consent, and the client signed the form. The nurse's role in this process is
to:
A. Explain the risks and benefits of the procedure to the client
B. Witness the client's signature and verify the consent is voluntary and informed
C. Obtain the client's signature if the surgeon is unavailable
D. Decide whether the client has the capacity to consent
Correct Answer: B
Rationale: The nurse's role is to witness the signature and ensure the consent is
voluntary, the client understands, and there is no coercion. Explaining risks/benefits
(A) is the provider's duty. Obtaining consent (C) and determining capacity (D) are
provider responsibilities, not nursing functions. ATI/NCLEX strategy: Know the
boundary between nursing and provider roles in informed consent.
Question 3
A client with a history of bipolar disorder is admitted for appendicitis. The client
refuses surgery, stating, "The government is trying to implant a tracking device in
me." The client is oriented to person, place, and time but persists in this belief. What
is the nurse's priority action?
A. Proceed with preoperative preparations because the surgery is medically
necessary
B. Notify the provider to assess the client's decision-making capacity
C. Ask the client's family to sign the consent form instead
D. Sedate the client and proceed with surgery
Correct Answer: B
Rationale: Capacity is task-specific and must be assessed by the provider when a
client refuses potentially life-saving treatment. The nurse must report the refusal to
,the provider for capacity evaluation. Option A violates autonomy and could
constitute battery. Option C is invalid—family cannot override a competent adult's
refusal. Option D is assault/battery and false imprisonment. ATI/NCLEX strategy:
Capacity assessment is a provider responsibility; the nurse reports and advocates.
Question 4
A nurse is reviewing advance directives with a client. Which statement by the client
indicates a need for further teaching?
A. "My durable power of attorney for healthcare can make decisions for me if I
become unable."
B. "A living will tells my doctor what treatments I want or don't want if I can't speak
for myself."
C. "My POLST form is valid in every state and replaces my living will."
D. "I can change my advance directive at any time as long as I have decision-making
capacity."
Correct Answer: C
Rationale: POLST/MOLST forms are medical orders for specific treatments and are
not universally valid across all states; they complement but do not replace living wills.
Options A, B, and D are correct statements. ATI/NCLEX strategy: POLST is for
seriously ill/frail patients and translates wishes into actionable medical orders, but
portability varies by state.
Question 5
A nurse is assigned four clients. Which client should the nurse assess first?
A. A client with pneumonia who has a temperature of 38.2°C (100.8°F) and is
receiving antibiotics
B. A client post-appendectomy who reports pain of 6/10 and has stable vital signs
C. A client with a new tracheostomy who has thick secretions and an oxygen
, saturation of 88%
D. A client with heart failure who has 2+ pitting edema and is on a fluid restriction
Correct Answer: C
Rationale: Airway and breathing take absolute priority (ABCs). An oxygen saturation
of 88% with thick secretions indicates potential airway obstruction and hypoxemia—
an immediate threat to life. Options A, B, and D are stable or less acute. ATI/NCLEX
strategy: Always apply ABCs first. Any airway/breathing compromise is the highest
priority over circulation, pain, or edema.
Question 6
A registered nurse (RN) is delegating tasks on a busy medical-surgical unit. Which
task is appropriate to delegate to a licensed practical/vocational nurse (LPN/LVN)?
A. Developing a discharge plan for a client going home with a new colostomy
B. Administering an IV piggyback antibiotic to a client with stable vital signs
C. Performing the initial admission assessment on a client transferred from the ICU
D. Teaching a newly diagnosed diabetic client about insulin administration
Correct Answer: B
Rationale: Administering IV piggyback medications to stable clients is within LPN
scope in most states (verify state-specific regulations). Initial assessments (C),
discharge planning (A), and client teaching (D) require RN-level judgment and cannot
be delegated. ATI/NCLEX strategy: The five rights of delegation include right task,
right circumstance, right person, right direction/communication, and right
supervision. Teaching and initial assessment are RN-only.
Question 7
Which task is appropriate to delegate to an assistive personnel (AP)?
A. Obtaining vital signs on a client who is 2 hours post-op after abdominal surgery
B. Assisting a stable client with ambulation to the bathroom
