2026 ATI RN Fundamentals Exam! Get instant access
to screenshots of 70 proctored exam questions
featuring the latest Next Generation NCLEX (NGN)
Question 1
A nurse is preparing to administer a blood transfusion. Which gauge IV catheter
should the nurse select?
• A) 18-gauge
• B) 20-gauge
• C) 22-gauge
• D) 24-gauge
Correct Answer: A) 18-gauge
Rationale: An 18-gauge catheter is the preferred size for blood transfusions
because it allows adequate flow rate without causing hemolysis of red blood cells.
Smaller gauges (20-24) can cause hemolysis due to the pressure needed to infuse
blood through a smaller lumen.
Question 2
A nurse is assessing a client's peripheral vascular status. Which finding should
the nurse report to the provider immediately?
• A) +1 pedal pulses bilaterally
• B) Capillary refill of 2 seconds
, • C) Cool, pale extremities with absent pulses
• D) Slight edema in both lower extremities
Correct Answer: C) Cool, pale extremities with absent pulses
Rationale: Cool, pale extremities with absent pulses indicate acute arterial
insufficiency, which is a medical emergency requiring immediate intervention to
prevent tissue necrosis and potential limb loss.
Question 3
A nurse is providing tracheostomy care to a client. Which action should the
nurse take?
• A) Clean the inner cannula with hydrogen peroxide
• B) Cut a 4" x 4" gauze pad to place around the stoma
• C) Use cotton balls to clean around the stoma
• D) Sterile technique should be used for tracheostomy suctioning
Correct Answer: D) Sterile technique should be used for tracheostomy
suctioning
Rationale: Tracheostomy suctioning requires sterile technique to prevent
introduction of pathogens into the lower respiratory tract. Hydrogen peroxide is not
recommended for inner cannula cleaning as it can cause tissue damage.
Question 4
,A nurse is caring for a client who has a new prescription for a nasogastric (NG)
tube. Which of the following actions should the nurse take first?
• A) Measure the length of the tube from the nose to the ear to the xiphoid
process
• B) Place the client in a high-Fowler's position
• C) Lubricate the tip of the tube with water-soluble lubricant
• D) Check the pH of the gastric aspirate after insertion
Correct Answer: B) Place the client in a high-Fowler's position
Rationale: The first action is to position the client in a high-Fowler's position to
facilitate swallowing and reduce the risk of aspiration during NG tube insertion.
Positioning is a priority before any procedural steps.
Question 5
A nurse is preparing to administer medications to a client. The client states, "I
don't want to take that medication." Which of the following actions should the
nurse take?
• A) Document the client's refusal and notify the provider
• B) Crush the medication and hide it in food
• C) Insist the client take the medication
• D) Administer the medication as a different route without telling the client
Correct Answer: A) Document the client's refusal and notify the provider
Rationale: Clients have the right to refuse medication. The nurse should respect
the client's autonomy, document the refusal, and notify the provider. Coercion or
deception is unethical and illegal.
, Question 6
A nurse is calculating a client's intake and output. The client drank 8 oz of
water, 6 oz of juice, and 4 oz of milk. The client received 100 mL of IV fluids.
How many mL should the nurse document as total intake?
• A) 540 mL
• B) 640 mL
• C) 740 mL
• D) 840 mL
Correct Answer: B) 640 mL
Rationale: 8 oz water = 240 mL, 6 oz juice = 180 mL, 4 oz milk = 120 mL, 100 mL IV
= 100 mL. Total = 240 + 180 + 120 + 100 = 640 mL.
Question 7
A nurse is caring for a client who has a wound infection. Which of the following
actions should the nurse take first?
• A) Obtain a wound culture
• B) Apply a sterile dressing
• C) Administer prescribed antibiotics
• D) Assess the wound for drainage and odor
Correct Answer: D) Assess the wound for drainage and odor
to screenshots of 70 proctored exam questions
featuring the latest Next Generation NCLEX (NGN)
Question 1
A nurse is preparing to administer a blood transfusion. Which gauge IV catheter
should the nurse select?
• A) 18-gauge
• B) 20-gauge
• C) 22-gauge
• D) 24-gauge
Correct Answer: A) 18-gauge
Rationale: An 18-gauge catheter is the preferred size for blood transfusions
because it allows adequate flow rate without causing hemolysis of red blood cells.
Smaller gauges (20-24) can cause hemolysis due to the pressure needed to infuse
blood through a smaller lumen.
Question 2
A nurse is assessing a client's peripheral vascular status. Which finding should
the nurse report to the provider immediately?
• A) +1 pedal pulses bilaterally
• B) Capillary refill of 2 seconds
, • C) Cool, pale extremities with absent pulses
• D) Slight edema in both lower extremities
Correct Answer: C) Cool, pale extremities with absent pulses
Rationale: Cool, pale extremities with absent pulses indicate acute arterial
insufficiency, which is a medical emergency requiring immediate intervention to
prevent tissue necrosis and potential limb loss.
Question 3
A nurse is providing tracheostomy care to a client. Which action should the
nurse take?
• A) Clean the inner cannula with hydrogen peroxide
• B) Cut a 4" x 4" gauze pad to place around the stoma
• C) Use cotton balls to clean around the stoma
• D) Sterile technique should be used for tracheostomy suctioning
Correct Answer: D) Sterile technique should be used for tracheostomy
suctioning
Rationale: Tracheostomy suctioning requires sterile technique to prevent
introduction of pathogens into the lower respiratory tract. Hydrogen peroxide is not
recommended for inner cannula cleaning as it can cause tissue damage.
Question 4
,A nurse is caring for a client who has a new prescription for a nasogastric (NG)
tube. Which of the following actions should the nurse take first?
• A) Measure the length of the tube from the nose to the ear to the xiphoid
process
• B) Place the client in a high-Fowler's position
• C) Lubricate the tip of the tube with water-soluble lubricant
• D) Check the pH of the gastric aspirate after insertion
Correct Answer: B) Place the client in a high-Fowler's position
Rationale: The first action is to position the client in a high-Fowler's position to
facilitate swallowing and reduce the risk of aspiration during NG tube insertion.
Positioning is a priority before any procedural steps.
Question 5
A nurse is preparing to administer medications to a client. The client states, "I
don't want to take that medication." Which of the following actions should the
nurse take?
• A) Document the client's refusal and notify the provider
• B) Crush the medication and hide it in food
• C) Insist the client take the medication
• D) Administer the medication as a different route without telling the client
Correct Answer: A) Document the client's refusal and notify the provider
Rationale: Clients have the right to refuse medication. The nurse should respect
the client's autonomy, document the refusal, and notify the provider. Coercion or
deception is unethical and illegal.
, Question 6
A nurse is calculating a client's intake and output. The client drank 8 oz of
water, 6 oz of juice, and 4 oz of milk. The client received 100 mL of IV fluids.
How many mL should the nurse document as total intake?
• A) 540 mL
• B) 640 mL
• C) 740 mL
• D) 840 mL
Correct Answer: B) 640 mL
Rationale: 8 oz water = 240 mL, 6 oz juice = 180 mL, 4 oz milk = 120 mL, 100 mL IV
= 100 mL. Total = 240 + 180 + 120 + 100 = 640 mL.
Question 7
A nurse is caring for a client who has a wound infection. Which of the following
actions should the nurse take first?
• A) Obtain a wound culture
• B) Apply a sterile dressing
• C) Administer prescribed antibiotics
• D) Assess the wound for drainage and odor
Correct Answer: D) Assess the wound for drainage and odor
