ATI Fundamentals Comprehensive Study
Guide
Based on Your Missed Questions + Old ATI Questions
1. Priority Framework
Always Ask: “What can kill the client first?”
Priority order:
1. ABCs: airway, breathing, circulation
2. Safety: falls, aspiration, bleeding, seizures, restraints
3. Unstable vs. stable
4. Acute vs. chronic
5. Unexpected vs. expected
ATI priority clues:
● “Post-op + low urine output + worsening pain + abnormal VS” = possible
shock/hemorrhage
● “Aspiration suspected during tube feeding” = stop the feeding first
● “Difficulty breathing while lying down” = sit them up in Fowler’s first
● “Unsafe provider order” = activate chain of command
2. Delegation: RN vs LPN vs AP
RN Responsibilities
The RN keeps anything involving:
● Initial assessment
● Teaching
● Evaluation
● Clinical judgment
, ● Unstable clients
● Care planning
● IV high-risk meds/PCA changes
LPN Can Usually Do
● Reinforce teaching
● Routine care for stable clients
● Tracheostomy care for a stable client
● Collect specimens
● Some suctioning, depending on policy and stability
AP Can Do
● ADLs: bathing, toileting, ambulating
● Routine vital signs
● Intake/output
● Reapply condom catheter
● Use communication board
● Apply SCDs after RN assessment
AP Cannot Do
● Assess pain or swallowing
● Evaluate meds
● Teach cane use
● Feed a high-aspiration-risk client
● Sterile dressing changes
● Catheter irrigation
5 Rights of Delegation
● Right task
● Right circumstance
● Right person
● Right direction/communication
● Right supervision/evaluation
ATI trap
Vitals after a medication = evaluation, so RN should do it.
Routine vitals can be delegated, but “check BP after antihypertensive” cannot.
, 3. Legal, Ethical, and Documentation
Assault vs Battery vs False Imprisonment
● Assault = threat of harm
○ Example: “I’ll put a diaper on you if you don’t use the urinal.”
● Battery = touching/procedure without consent
● False imprisonment = restricting movement
○ Example: giving a sedative to keep a competent client from leaving AMA
Informed Consent
Nurse can:
● Verify consent was obtained
● Witness signature
● Clarify basic facts
● Notify provider if client has questions
Provider must:
● Explain procedure
● Explain risks/benefits
● Explain alternatives
● Explain consequences of refusing
Documentation Rules
Do:
● Date/time all entries
● Use objective language
● Quote client statements
● Document promptly
Do not:
● Use correction fluid
● Chart opinions
● Document “client fell” unless witnessed
● Wait until end of shift
Example:
● Correct: “Client states, ‘I fell in the shower and got back to my chair.’”
Guide
Based on Your Missed Questions + Old ATI Questions
1. Priority Framework
Always Ask: “What can kill the client first?”
Priority order:
1. ABCs: airway, breathing, circulation
2. Safety: falls, aspiration, bleeding, seizures, restraints
3. Unstable vs. stable
4. Acute vs. chronic
5. Unexpected vs. expected
ATI priority clues:
● “Post-op + low urine output + worsening pain + abnormal VS” = possible
shock/hemorrhage
● “Aspiration suspected during tube feeding” = stop the feeding first
● “Difficulty breathing while lying down” = sit them up in Fowler’s first
● “Unsafe provider order” = activate chain of command
2. Delegation: RN vs LPN vs AP
RN Responsibilities
The RN keeps anything involving:
● Initial assessment
● Teaching
● Evaluation
● Clinical judgment
, ● Unstable clients
● Care planning
● IV high-risk meds/PCA changes
LPN Can Usually Do
● Reinforce teaching
● Routine care for stable clients
● Tracheostomy care for a stable client
● Collect specimens
● Some suctioning, depending on policy and stability
AP Can Do
● ADLs: bathing, toileting, ambulating
● Routine vital signs
● Intake/output
● Reapply condom catheter
● Use communication board
● Apply SCDs after RN assessment
AP Cannot Do
● Assess pain or swallowing
● Evaluate meds
● Teach cane use
● Feed a high-aspiration-risk client
● Sterile dressing changes
● Catheter irrigation
5 Rights of Delegation
● Right task
● Right circumstance
● Right person
● Right direction/communication
● Right supervision/evaluation
ATI trap
Vitals after a medication = evaluation, so RN should do it.
Routine vitals can be delegated, but “check BP after antihypertensive” cannot.
, 3. Legal, Ethical, and Documentation
Assault vs Battery vs False Imprisonment
● Assault = threat of harm
○ Example: “I’ll put a diaper on you if you don’t use the urinal.”
● Battery = touching/procedure without consent
● False imprisonment = restricting movement
○ Example: giving a sedative to keep a competent client from leaving AMA
Informed Consent
Nurse can:
● Verify consent was obtained
● Witness signature
● Clarify basic facts
● Notify provider if client has questions
Provider must:
● Explain procedure
● Explain risks/benefits
● Explain alternatives
● Explain consequences of refusing
Documentation Rules
Do:
● Date/time all entries
● Use objective language
● Quote client statements
● Document promptly
Do not:
● Use correction fluid
● Chart opinions
● Document “client fell” unless witnessed
● Wait until end of shift
Example:
● Correct: “Client states, ‘I fell in the shower and got back to my chair.’”
