ATI RN Fundamentals Proctored Exam 2026 Complete Test
Bank Questions and Answers with Expert Rationales - 140
Questions with Answers
Page 1
,Q1. A nurse is preparing to administer a continuous IV infusion of heparin. The
prescription reads: 'Administer 25,000 units in 500 mL of 0.9% sodium chloride at
1,000 units/hr.' The nurse should set the infusion pump to deliver how many mL/hr?
A. 15 mL/hr
B. 20 mL/hr
C. 25 mL/hr
D. 30 mL/hr
Correct Answer: B. 20 mL/hr
Rationale: To calculate the rate: (prescribed dose ÷ total dose) × total volume = (1,000
units/hr ÷ 25,000 units) × 500 mL = 0.04 × 500 = 20 mL/hr. This ensures the correct
concentration is delivered.
Why Wrong:
A - Incorrect calculation likely from dividing 500 by 25,000 and multiplying by 1,000
incorrectly.
C - Incorrect if the total volume is divided by the total units without considering the
hourly dose.
D - Incorrect due to a math error in the ratio proportion.
Reference: ATI Fundamentals of Nursing, 12th Edition, Ch. 44: Intravenous Therapy
Q2. A nurse is caring for a patient who has a nasogastric tube connected to low
intermittent suction. Which finding requires immediate intervention?
A. Gastric pH of 3.5
B. Dark brown, coffee-ground aspirate
C. Absent bowel sounds in all four quadrants
D. A small amount of clear, yellow aspirate
Correct Answer: B. Dark brown, coffee-ground aspirate
Rationale: Coffee-ground aspirate indicates upper GI bleeding, which is a medical
emergency. The nurse should stop the feeding, assess vital signs, and notify the provider.
Other findings are expected or benign.
Why Wrong:
A - Gastric pH of 3.5 is within normal acidic range and not concerning.
C - Absent bowel sounds may be normal postoperatively or with certain conditions,
but not an immediate emergency.
D - Clear, yellow aspirate is typical and does not require intervention.
Reference: ATI Fundamentals of Nursing, 12th Edition, Ch. 45: Nasogastric Intubation
Q3. A nurse is reviewing a patient's arterial blood gas results: pH 7.30, PaCO2 50
mm Hg, HCO3 24 mEq/L. Which condition does the nurse identify?
A. Metabolic acidosis
Page 2
, B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: B. Respiratory acidosis
Rationale: The pH is below 7.35 (acidosis), and the PaCO2 is elevated (>45 mm Hg),
indicating respiratory acidosis. The HCO3 is normal, ruling out metabolic causes. This
often results from hypoventilation.
Why Wrong:
A - Metabolic acidosis would show a low HCO3, not elevated PaCO2.
C - Alkalosis would have a pH above 7.45.
D - Metabolic alkalosis would have elevated pH and HCO3.
Reference: ATI Fundamentals of Nursing, 12th Edition, Ch. 40: Acid-Base Balance
Q4. A nurse is preparing to administer a blood transfusion. Which action is most
important to prevent a hemolytic transfusion reaction?
A. Verify the patient's identity and blood product with two identifiers.
B. Obtain baseline vital signs before starting the transfusion.
C. Prime the blood tubing with 0.9% sodium chloride.
D. Monitor the patient for signs of a reaction during the first 15 minutes.
Correct Answer: A. Verify the patient's identity and blood product with two
identifiers.
Rationale: The most critical step is verifying the patient and blood product to prevent
ABO incompatibility, which causes hemolytic reactions. This must be done by two licensed
professionals.
Why Wrong:
B - Baseline vital signs are important but do not prevent a reaction.
C - Priming with saline is standard but not the primary preventive measure.
D - Monitoring is essential but does not prevent the reaction.
Reference: ATI Fundamentals of Nursing, 12th Edition, Ch. 43: Blood Transfusions
Q5. A patient is prescribed a medication that is a weak acid. Which statement best
describes the drug's distribution in the body?
A. It will be more ionized in acidic environments, enhancing absorption.
B. It will be more lipid-soluble in acidic environments, enhancing tissue penetration.
C. It will be more ionized in alkaline environments, reducing renal reabsorption.
D. It will be more non-ionized in alkaline environments, increasing excretion.
Correct Answer: C. It will be more ionized in alkaline environments, reducing renal
reabsorption.
Page 3
, Rationale: Weak acids are more ionized in alkaline environments (high pH), making them
less lipid-soluble and less able to cross membranes. This promotes excretion in urine. In
acidic urine, they are non-ionized and reabsorbed.
Why Wrong:
A - Weak acids are more non-ionized in acidic environments, not ionized.
B - Lipid solubility is higher when non-ionized, which occurs in acidic environments.
D - In alkaline environments, weak acids are more ionized, not non-ionized, so
excretion is enhanced.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 4:
Pharmacokinetics
Q6. A nurse is teaching a patient about a low-glycemic index diet. Which food choice
demonstrates understanding?
A. White bread
B. Steel-cut oats
C. Corn flakes
D. Instant mashed potatoes
Correct Answer: B. Steel-cut oats
Rationale: Steel-cut oats have a low glycemic index, leading to slower glucose absorption.
White bread, corn flakes, and instant potatoes are high-GI foods that cause rapid spikes in
blood glucose.
Why Wrong:
A - White bread has a high glycemic index.
C - Corn flakes are processed and high glycemic.
D - Instant mashed potatoes are high glycemic.
Reference: ATI Nutrition for Nursing, 8th Edition, Ch. 8: Carbohydrates
Q7. A nurse is evaluating a patient's risk for falls. Which assessment finding indicates
the highest risk?
A. History of a fall in the past 6 months
B. Orthostatic blood pressure changes of 10 mm Hg
C. Use of a walker for ambulation
D. Intermittent confusion in the evening
Correct Answer: A. History of a fall in the past 6 months
Rationale: A history of a previous fall is one of the strongest predictors of future falls.
While orthostatic hypotension, assistive devices, and confusion are risk factors, they are
not as strong as a prior fall.
Why Wrong:
B - Orthostatic BP change of 10 mm Hg is borderline and not as high risk as a
Page 4
Bank Questions and Answers with Expert Rationales - 140
Questions with Answers
Page 1
,Q1. A nurse is preparing to administer a continuous IV infusion of heparin. The
prescription reads: 'Administer 25,000 units in 500 mL of 0.9% sodium chloride at
1,000 units/hr.' The nurse should set the infusion pump to deliver how many mL/hr?
A. 15 mL/hr
B. 20 mL/hr
C. 25 mL/hr
D. 30 mL/hr
Correct Answer: B. 20 mL/hr
Rationale: To calculate the rate: (prescribed dose ÷ total dose) × total volume = (1,000
units/hr ÷ 25,000 units) × 500 mL = 0.04 × 500 = 20 mL/hr. This ensures the correct
concentration is delivered.
Why Wrong:
A - Incorrect calculation likely from dividing 500 by 25,000 and multiplying by 1,000
incorrectly.
C - Incorrect if the total volume is divided by the total units without considering the
hourly dose.
D - Incorrect due to a math error in the ratio proportion.
Reference: ATI Fundamentals of Nursing, 12th Edition, Ch. 44: Intravenous Therapy
Q2. A nurse is caring for a patient who has a nasogastric tube connected to low
intermittent suction. Which finding requires immediate intervention?
A. Gastric pH of 3.5
B. Dark brown, coffee-ground aspirate
C. Absent bowel sounds in all four quadrants
D. A small amount of clear, yellow aspirate
Correct Answer: B. Dark brown, coffee-ground aspirate
Rationale: Coffee-ground aspirate indicates upper GI bleeding, which is a medical
emergency. The nurse should stop the feeding, assess vital signs, and notify the provider.
Other findings are expected or benign.
Why Wrong:
A - Gastric pH of 3.5 is within normal acidic range and not concerning.
C - Absent bowel sounds may be normal postoperatively or with certain conditions,
but not an immediate emergency.
D - Clear, yellow aspirate is typical and does not require intervention.
Reference: ATI Fundamentals of Nursing, 12th Edition, Ch. 45: Nasogastric Intubation
Q3. A nurse is reviewing a patient's arterial blood gas results: pH 7.30, PaCO2 50
mm Hg, HCO3 24 mEq/L. Which condition does the nurse identify?
A. Metabolic acidosis
Page 2
, B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: B. Respiratory acidosis
Rationale: The pH is below 7.35 (acidosis), and the PaCO2 is elevated (>45 mm Hg),
indicating respiratory acidosis. The HCO3 is normal, ruling out metabolic causes. This
often results from hypoventilation.
Why Wrong:
A - Metabolic acidosis would show a low HCO3, not elevated PaCO2.
C - Alkalosis would have a pH above 7.45.
D - Metabolic alkalosis would have elevated pH and HCO3.
Reference: ATI Fundamentals of Nursing, 12th Edition, Ch. 40: Acid-Base Balance
Q4. A nurse is preparing to administer a blood transfusion. Which action is most
important to prevent a hemolytic transfusion reaction?
A. Verify the patient's identity and blood product with two identifiers.
B. Obtain baseline vital signs before starting the transfusion.
C. Prime the blood tubing with 0.9% sodium chloride.
D. Monitor the patient for signs of a reaction during the first 15 minutes.
Correct Answer: A. Verify the patient's identity and blood product with two
identifiers.
Rationale: The most critical step is verifying the patient and blood product to prevent
ABO incompatibility, which causes hemolytic reactions. This must be done by two licensed
professionals.
Why Wrong:
B - Baseline vital signs are important but do not prevent a reaction.
C - Priming with saline is standard but not the primary preventive measure.
D - Monitoring is essential but does not prevent the reaction.
Reference: ATI Fundamentals of Nursing, 12th Edition, Ch. 43: Blood Transfusions
Q5. A patient is prescribed a medication that is a weak acid. Which statement best
describes the drug's distribution in the body?
A. It will be more ionized in acidic environments, enhancing absorption.
B. It will be more lipid-soluble in acidic environments, enhancing tissue penetration.
C. It will be more ionized in alkaline environments, reducing renal reabsorption.
D. It will be more non-ionized in alkaline environments, increasing excretion.
Correct Answer: C. It will be more ionized in alkaline environments, reducing renal
reabsorption.
Page 3
, Rationale: Weak acids are more ionized in alkaline environments (high pH), making them
less lipid-soluble and less able to cross membranes. This promotes excretion in urine. In
acidic urine, they are non-ionized and reabsorbed.
Why Wrong:
A - Weak acids are more non-ionized in acidic environments, not ionized.
B - Lipid solubility is higher when non-ionized, which occurs in acidic environments.
D - In alkaline environments, weak acids are more ionized, not non-ionized, so
excretion is enhanced.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 4:
Pharmacokinetics
Q6. A nurse is teaching a patient about a low-glycemic index diet. Which food choice
demonstrates understanding?
A. White bread
B. Steel-cut oats
C. Corn flakes
D. Instant mashed potatoes
Correct Answer: B. Steel-cut oats
Rationale: Steel-cut oats have a low glycemic index, leading to slower glucose absorption.
White bread, corn flakes, and instant potatoes are high-GI foods that cause rapid spikes in
blood glucose.
Why Wrong:
A - White bread has a high glycemic index.
C - Corn flakes are processed and high glycemic.
D - Instant mashed potatoes are high glycemic.
Reference: ATI Nutrition for Nursing, 8th Edition, Ch. 8: Carbohydrates
Q7. A nurse is evaluating a patient's risk for falls. Which assessment finding indicates
the highest risk?
A. History of a fall in the past 6 months
B. Orthostatic blood pressure changes of 10 mm Hg
C. Use of a walker for ambulation
D. Intermittent confusion in the evening
Correct Answer: A. History of a fall in the past 6 months
Rationale: A history of a previous fall is one of the strongest predictors of future falls.
While orthostatic hypotension, assistive devices, and confusion are risk factors, they are
not as strong as a prior fall.
Why Wrong:
B - Orthostatic BP change of 10 mm Hg is borderline and not as high risk as a
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