ATI RN 2026 NGN Proctored Exam
Ultimate Prep: High-Yield Questions
& Evidence-Based Rationales for
Clinical Judgment Mastery
Fundamentals of Nursing (Questions 1–30)
1. A nurse is preparing to insert an indwelling urinary catheter for a
female client. Which action should the nurse take first?
A) Apply sterile gloves
B) Open the catheter kit
C) Assess the client's allergies
D) Perform hand hygiene
Answer: D) Perform hand hygiene
Rationale: Hand hygiene is the first and most important action before any
invasive procedure to prevent infection transmission. While sterile
technique is essential for catheter insertion, hand hygiene must precede all
other steps.
,2. A client has an order for 1,000 mL of normal saline to infuse over 8
hours. The drop factor is 15 gtt/mL. What is the drip rate in gtt/min?
A) 31 gtt/min
B) 125 gtt/min
C) 21 gtt/min
D) 42 gtt/min
Answer: A) 31 gtt/min
Rationale: Calculate: 1000 mL ÷ 8 hours = 125 mL/hr. 125 mL/hr × 15
gtt/mL = 1875 gtt/hr. 1875 ÷ 60 min = 31.25 → 31 gtt/min. Accurate IV
calculation is essential for safe medication administration.
3. A nurse is caring for a client who is on fall precautions. Which
intervention should the nurse implement?
A) Keep the bed in the lowest position
B) Place all four side rails up
C) Keep the call light out of reach
D) Apply wrist restraints
Answer: A) Keep the bed in the lowest position
Rationale: Keeping the bed in the lowest position reduces injury risk if the
client falls. Side rails should not all be raised as this can be considered a
restraint. The call light must be within reach, and restraints require a specific
order.
,4. A client reports pain rated 8/10. The nurse administers morphine 4
mg IV. Thirty minutes later, the client rates pain 3/10. Which action
should the nurse take?
A) Document the response as effective
B) Administer another dose of morphine
C) Notify the provider of inadequate relief
D) Reassess in 4 hours
Answer: A) Document the response as effective
Rationale: Pain reduction from 8/10 to 3/10 indicates effective analgesia.
Documentation should include the assessment, intervention, and client
response. Reassessment should occur per facility policy, typically within 30-
60 minutes.
5. Which client is at highest risk for developing a pressure injury?
A) Client with urinary incontinence
B) Client who is ambulatory with a walker
C) Client who is bedridden and incontinent
D) Client with a fractured wrist
Answer: C) Client who is bedridden and incontinent
Rationale: Immobility combined with moisture from incontinence
significantly increases pressure injury risk. The Braden Scale identifies these
as major risk factors.
, 6. A nurse is performing a sterile dressing change. Which action
indicates a break in sterile technique?
A) Opening the sterile package away from the body
B) Placing sterile items within the 1-inch border of the field
C) Reaching over the sterile field to obtain an item
D) Using sterile gloves to handle sterile supplies
Answer: C) Reaching over the sterile field to obtain an item
Rationale: Reaching over the sterile field contaminates it. The 1-inch
border of a sterile field is considered contaminated. All other actions
maintain sterility.
7. A client with an NG tube has a gastric residual volume of 350 mL.
What should the nurse do?
A) Continue the feeding at the current rate
B) Increase the feeding rate
C) Hold the feeding and notify the provider
D) Flush the tube with 50 mL of water
Answer: C) Hold the feeding and notify the provider
Rationale: A residual volume exceeding 250-300 mL may indicate delayed
gastric emptying and increased aspiration risk. The feeding should be held
and the provider notified.
Ultimate Prep: High-Yield Questions
& Evidence-Based Rationales for
Clinical Judgment Mastery
Fundamentals of Nursing (Questions 1–30)
1. A nurse is preparing to insert an indwelling urinary catheter for a
female client. Which action should the nurse take first?
A) Apply sterile gloves
B) Open the catheter kit
C) Assess the client's allergies
D) Perform hand hygiene
Answer: D) Perform hand hygiene
Rationale: Hand hygiene is the first and most important action before any
invasive procedure to prevent infection transmission. While sterile
technique is essential for catheter insertion, hand hygiene must precede all
other steps.
,2. A client has an order for 1,000 mL of normal saline to infuse over 8
hours. The drop factor is 15 gtt/mL. What is the drip rate in gtt/min?
A) 31 gtt/min
B) 125 gtt/min
C) 21 gtt/min
D) 42 gtt/min
Answer: A) 31 gtt/min
Rationale: Calculate: 1000 mL ÷ 8 hours = 125 mL/hr. 125 mL/hr × 15
gtt/mL = 1875 gtt/hr. 1875 ÷ 60 min = 31.25 → 31 gtt/min. Accurate IV
calculation is essential for safe medication administration.
3. A nurse is caring for a client who is on fall precautions. Which
intervention should the nurse implement?
A) Keep the bed in the lowest position
B) Place all four side rails up
C) Keep the call light out of reach
D) Apply wrist restraints
Answer: A) Keep the bed in the lowest position
Rationale: Keeping the bed in the lowest position reduces injury risk if the
client falls. Side rails should not all be raised as this can be considered a
restraint. The call light must be within reach, and restraints require a specific
order.
,4. A client reports pain rated 8/10. The nurse administers morphine 4
mg IV. Thirty minutes later, the client rates pain 3/10. Which action
should the nurse take?
A) Document the response as effective
B) Administer another dose of morphine
C) Notify the provider of inadequate relief
D) Reassess in 4 hours
Answer: A) Document the response as effective
Rationale: Pain reduction from 8/10 to 3/10 indicates effective analgesia.
Documentation should include the assessment, intervention, and client
response. Reassessment should occur per facility policy, typically within 30-
60 minutes.
5. Which client is at highest risk for developing a pressure injury?
A) Client with urinary incontinence
B) Client who is ambulatory with a walker
C) Client who is bedridden and incontinent
D) Client with a fractured wrist
Answer: C) Client who is bedridden and incontinent
Rationale: Immobility combined with moisture from incontinence
significantly increases pressure injury risk. The Braden Scale identifies these
as major risk factors.
, 6. A nurse is performing a sterile dressing change. Which action
indicates a break in sterile technique?
A) Opening the sterile package away from the body
B) Placing sterile items within the 1-inch border of the field
C) Reaching over the sterile field to obtain an item
D) Using sterile gloves to handle sterile supplies
Answer: C) Reaching over the sterile field to obtain an item
Rationale: Reaching over the sterile field contaminates it. The 1-inch
border of a sterile field is considered contaminated. All other actions
maintain sterility.
7. A client with an NG tube has a gastric residual volume of 350 mL.
What should the nurse do?
A) Continue the feeding at the current rate
B) Increase the feeding rate
C) Hold the feeding and notify the provider
D) Flush the tube with 50 mL of water
Answer: C) Hold the feeding and notify the provider
Rationale: A residual volume exceeding 250-300 mL may indicate delayed
gastric emptying and increased aspiration risk. The feeding should be held
and the provider notified.
