ATI RN Fundamentals 2026 Proctored Exam
with NGN 200 Questions and Answers
Section I — Safe, Effective Care Environment
Q1. A nurse is preparing to administer medications to a client. Which action
should the nurse take first to ensure client safety?
A. Verify the client's identity using two identifiers
B. Check the medication against the medication administration record
C. Assess the client's allergy status
D. Ask the client to state their name and date of birth
Correct Answer: A
Rationale: The first action in safe medication administration is to verify the
client's identity using two identifiers (name and date of birth, or name and
medical record number). This is required by The Joint Commission to prevent
medication errors. While checking the MAR, assessing allergies, and asking the
client to state their name are all important steps, verifying identity is the
foundational first action before any medication is administered.
Q2. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with constipation requesting a laxative
B. A client with COPD whose oxygen saturation is 88%
C. A client requesting assistance to the bathroom
D. A client asking for discharge instructions
Correct Answer: B
Rationale: Using the ABC priority framework, impaired oxygenation takes
priority. A client with COPD whose oxygen saturation is 88% is experiencing
hypoxemia, which can rapidly become life-threatening. The other clients have
needs that, while important, are not immediately life-threatening.
Q3. A registered nurse (RN) on a medical-surgical unit is planning client
assignments for the shift. The team consists of one RN, two LPNs, and one UAP.
Which client should the RN assign to themselves rather than delegate to an LPN?
,A. A stable postoperative day-2 client receiving oral analgesics
B. A client admitted 1 hour ago with acute GI bleeding requiring vasopressor
titration
C. A client with a chronic stage III pressure injury requiring a dressing change
D. A client with stable chronic heart failure receiving daily oral furosemide
Correct Answer: B
Rationale: The RN must retain accountability for clients with unstable,
complex, or rapidly changing conditions requiring frequent assessment and
clinical judgment. The client with acute GI bleeding on vasopressors requires
continuous RN-level assessment and titration. Stable postoperative, chronic
wound care, and stable CHF clients are appropriate for LPN assignment under RN
supervision.
Q4. A competent adult client refuses a prescribed blood transfusion due to
religious beliefs, even after being informed of potential life-threatening
consequences. Which action by the RN demonstrates ethical and legal practice?
A. Administer the transfusion anyway because it is life-saving
B. Notify the provider, document the client's refusal, ensure the client
understands the risks, and respect their autonomous decision
C. Obtain a court order to override the refusal
D. Restrain the client and administer the transfusion
Correct Answer: B
Rationale: A competent adult has the legal and ethical right to refuse any
treatment, including life-saving measures, based on autonomy and the Patient
Self-Determination Act. The RN must ensure the client is fully informed (informed
refusal), notify the provider, document thoroughly, and respect the decision.
Forced transfusion constitutes battery.
Q5. A charge nurse is teaching a group of newly licensed nurses about the use of
restraints. In which of the following clinical situations should the nurse apply
restraints?
A. If the client is pacing in the hallway
B. As a part of a fall prevention program
,C. At the request of the client's family
D. When the client poses a threat to self or others
Correct Answer: D
Rationale: Restraints should only be used when there is a threat of harm
to the client or others and less restrictive measures have failed. Restraints are
never used as a form of punishment, convenience, or at family request. They are
not part of a routine fall prevention program.
Q6. A nurse is admitting a client who is malnourished. The client states, "My
wedding ring is loose and I'm worried I will lose it if it falls off." Which of the
following is an appropriate response by the nurse?
A. "I will place it in your drawer so it won't get lost."
B. "I can pin it to your hospital gown so you won't lose it."
C. "I will hold onto it until a family member can take it home."
D. "I can put it in a locked storage unit for you."
Correct Answer: D
Rationale: Valuables should be placed in a locked storage unit or safe
according to facility policy. Placing a ring in a drawer or pinning it to a gown are
unsafe. The nurse should not take personal responsibility for the item unless
facility policy specifically allows it.
Q7. A nurse is preparing to administer a continuous IV infusion of potassium
chloride 40 mEq in 1000 mL of 0.9% sodium chloride. Which of the following
actions is essential to ensure safe administration?
A. Administer the infusion via IV push
B. Ensure the infusion pump is programmed correctly and the concentration does
not exceed 1 mEq/mL
C. Administer the infusion rapidly to correct the deficit
D. Add potassium to the bag while it is hanging
Correct Answer: B
Rationale: IV potassium must never be administered by IV push or rapidly;
it must be diluted and infused via pump at a controlled rate. The concentration
should not exceed 1 mEq/mL. Adding potassium to a hanging bag is unsafe.
, Q8. A nurse is preparing to delegate tasks to assistive personnel (AP). Which of
the following tasks is appropriate for delegation to AP?
A. Administering oral medications
B. Assessing a client's lung sounds
C. Ambulating a stable client
D. Teaching a client about a new medication
Correct Answer: C
Rationale: Ambulating a stable client is within the scope of assistive
personnel. Administering medications, assessing lung sounds, and teaching are
RN responsibilities that cannot be delegated to AP.
Q9. A nurse is caring for a client who has a DNR order. The client's family asks the
nurse to "do everything" when the client's heart stops. Which action should the
nurse take?
A. Honor the family's request and initiate CPR
B. Explain that the DNR order is a legal document that must be honored
C. Ask the provider to change the DNR order
D. Tell the family they need to leave the room
Correct Answer: B
Rationale: A DNR order is a legal document that reflects the client's
wishes. The nurse must honor it. The family cannot override a valid DNR order.
The nurse should explain this compassionately and notify the provider if the
family wishes to discuss changes.
Q10. A nurse is preparing to administer an injection of an opioid medication to a
client. The nurse draws out 1 mL of the medication from a 2 mL vial. Which of the
following actions should the nurse take?
A. Dispose of the remaining medication in the sink
B. Ask another nurse to observe the medication wastage
C. Return the remaining medication to the pharmacy
D. Save the remaining medication for the next dose
Correct Answer: B
with NGN 200 Questions and Answers
Section I — Safe, Effective Care Environment
Q1. A nurse is preparing to administer medications to a client. Which action
should the nurse take first to ensure client safety?
A. Verify the client's identity using two identifiers
B. Check the medication against the medication administration record
C. Assess the client's allergy status
D. Ask the client to state their name and date of birth
Correct Answer: A
Rationale: The first action in safe medication administration is to verify the
client's identity using two identifiers (name and date of birth, or name and
medical record number). This is required by The Joint Commission to prevent
medication errors. While checking the MAR, assessing allergies, and asking the
client to state their name are all important steps, verifying identity is the
foundational first action before any medication is administered.
Q2. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with constipation requesting a laxative
B. A client with COPD whose oxygen saturation is 88%
C. A client requesting assistance to the bathroom
D. A client asking for discharge instructions
Correct Answer: B
Rationale: Using the ABC priority framework, impaired oxygenation takes
priority. A client with COPD whose oxygen saturation is 88% is experiencing
hypoxemia, which can rapidly become life-threatening. The other clients have
needs that, while important, are not immediately life-threatening.
Q3. A registered nurse (RN) on a medical-surgical unit is planning client
assignments for the shift. The team consists of one RN, two LPNs, and one UAP.
Which client should the RN assign to themselves rather than delegate to an LPN?
,A. A stable postoperative day-2 client receiving oral analgesics
B. A client admitted 1 hour ago with acute GI bleeding requiring vasopressor
titration
C. A client with a chronic stage III pressure injury requiring a dressing change
D. A client with stable chronic heart failure receiving daily oral furosemide
Correct Answer: B
Rationale: The RN must retain accountability for clients with unstable,
complex, or rapidly changing conditions requiring frequent assessment and
clinical judgment. The client with acute GI bleeding on vasopressors requires
continuous RN-level assessment and titration. Stable postoperative, chronic
wound care, and stable CHF clients are appropriate for LPN assignment under RN
supervision.
Q4. A competent adult client refuses a prescribed blood transfusion due to
religious beliefs, even after being informed of potential life-threatening
consequences. Which action by the RN demonstrates ethical and legal practice?
A. Administer the transfusion anyway because it is life-saving
B. Notify the provider, document the client's refusal, ensure the client
understands the risks, and respect their autonomous decision
C. Obtain a court order to override the refusal
D. Restrain the client and administer the transfusion
Correct Answer: B
Rationale: A competent adult has the legal and ethical right to refuse any
treatment, including life-saving measures, based on autonomy and the Patient
Self-Determination Act. The RN must ensure the client is fully informed (informed
refusal), notify the provider, document thoroughly, and respect the decision.
Forced transfusion constitutes battery.
Q5. A charge nurse is teaching a group of newly licensed nurses about the use of
restraints. In which of the following clinical situations should the nurse apply
restraints?
A. If the client is pacing in the hallway
B. As a part of a fall prevention program
,C. At the request of the client's family
D. When the client poses a threat to self or others
Correct Answer: D
Rationale: Restraints should only be used when there is a threat of harm
to the client or others and less restrictive measures have failed. Restraints are
never used as a form of punishment, convenience, or at family request. They are
not part of a routine fall prevention program.
Q6. A nurse is admitting a client who is malnourished. The client states, "My
wedding ring is loose and I'm worried I will lose it if it falls off." Which of the
following is an appropriate response by the nurse?
A. "I will place it in your drawer so it won't get lost."
B. "I can pin it to your hospital gown so you won't lose it."
C. "I will hold onto it until a family member can take it home."
D. "I can put it in a locked storage unit for you."
Correct Answer: D
Rationale: Valuables should be placed in a locked storage unit or safe
according to facility policy. Placing a ring in a drawer or pinning it to a gown are
unsafe. The nurse should not take personal responsibility for the item unless
facility policy specifically allows it.
Q7. A nurse is preparing to administer a continuous IV infusion of potassium
chloride 40 mEq in 1000 mL of 0.9% sodium chloride. Which of the following
actions is essential to ensure safe administration?
A. Administer the infusion via IV push
B. Ensure the infusion pump is programmed correctly and the concentration does
not exceed 1 mEq/mL
C. Administer the infusion rapidly to correct the deficit
D. Add potassium to the bag while it is hanging
Correct Answer: B
Rationale: IV potassium must never be administered by IV push or rapidly;
it must be diluted and infused via pump at a controlled rate. The concentration
should not exceed 1 mEq/mL. Adding potassium to a hanging bag is unsafe.
, Q8. A nurse is preparing to delegate tasks to assistive personnel (AP). Which of
the following tasks is appropriate for delegation to AP?
A. Administering oral medications
B. Assessing a client's lung sounds
C. Ambulating a stable client
D. Teaching a client about a new medication
Correct Answer: C
Rationale: Ambulating a stable client is within the scope of assistive
personnel. Administering medications, assessing lung sounds, and teaching are
RN responsibilities that cannot be delegated to AP.
Q9. A nurse is caring for a client who has a DNR order. The client's family asks the
nurse to "do everything" when the client's heart stops. Which action should the
nurse take?
A. Honor the family's request and initiate CPR
B. Explain that the DNR order is a legal document that must be honored
C. Ask the provider to change the DNR order
D. Tell the family they need to leave the room
Correct Answer: B
Rationale: A DNR order is a legal document that reflects the client's
wishes. The nurse must honor it. The family cannot override a valid DNR order.
The nurse should explain this compassionately and notify the provider if the
family wishes to discuss changes.
Q10. A nurse is preparing to administer an injection of an opioid medication to a
client. The nurse draws out 1 mL of the medication from a 2 mL vial. Which of the
following actions should the nurse take?
A. Dispose of the remaining medication in the sink
B. Ask another nurse to observe the medication wastage
C. Return the remaining medication to the pharmacy
D. Save the remaining medication for the next dose
Correct Answer: B
