2026 ATI RN Fundamentals Proctored Exam Preparation |
Actual-Style, Retake and CMS Practice | 70 NGN Screenshot
Questions with Approved Answers and Rationales
Section 1: Management of Care (Questions 1–20)
Q1. A nurse is caring for four clients on a medical-surgical unit. Which client
should the nurse assess first?
A. A client who is 2 days postoperative requesting assistance to ambulate to the
bathroom
B. A client with pneumonia whose respiratory rate increased from 18 to 28
breaths/min
C. A client scheduled for discharge in 1 hour asking for pain medication
D. A client with a urinary catheter requesting a bedpan
Correct Answer: B
Rationale: An increase in respiratory rate from 18 to 28 in a client with
pneumonia suggests increasing respiratory distress and possible deterioration.
Using the ABC priority framework, airway and breathing take precedence. Options
A, C, and D are important but not immediately life-threatening. The nurse should
assess the client with pneumonia first (e.g., lung sounds, oxygen saturation, work
of breathing).
Q2. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which
task is appropriate to delegate?
A. Administering a PRN oral analgesic to a stable client
B. Teaching a client how to use an incentive spirometer
C. Measuring and recording vital signs for a stable postoperative client
D. Assessing a client's new report of incisional pain
Correct Answer: C
Rationale: Measuring and recording vital signs for a stable client is a routine,
noninvasive task with a predictable outcome and falls within UAP scope.
,Medication administration (A), client teaching (B), and pain assessment (D)
require RN clinical judgment and licensure and cannot be delegated to UAP.
Q3. A client who speaks limited English is scheduled for a surgical procedure. The
consent form has been signed. Which action by the nurse is most appropriate?
A. Ask the client's adult child to interpret the consent discussion
B. Verify the client's understanding using a qualified medical interpreter
C. Proceed with the procedure because the surgeon obtained the signature
D. Have the client sign a second consent form in the nurse's presence
Correct Answer: B
Rationale: The nurse is responsible for verifying that the client understands
the procedure, risks, benefits, and alternatives before witnessing the consent
signature. A qualified medical interpreter must be used; family members should not
interpret for consent because of privacy, accuracy, and coercion concerns. The
surgeon is responsible for explaining the procedure, but the nurse verifies
comprehension and witnesses the signature.
Q4. A nurse receives a telephone call from an unidentified person asking whether a
client is "still in the hospital." Which response by the nurse is correct?
A. "I can confirm the client is here, but I cannot give details."
B. "I cannot confirm or deny whether anyone by that name is here."
C. "Let me transfer you to the information desk so they can update you."
D. "The client is here, but you will need to come in person."
Correct Answer: B
Rationale: Under HIPAA, the nurse may neither confirm nor deny that a client
is receiving care without the client's authorization. Options A, C, and D all disclose
protected health information to an unverified caller. The nurse may offer to take the
caller's information and pass it to the client so the client can decide whether to
make contact.
,Q5. A nurse is caring for a client who has a new prescription for physical restraints.
Which action should the nurse take first?
A. Apply the restraints and document the client's behavior
B. Attempt less restrictive alternatives and document the findings
C. Obtain a signed consent from the client's family
D. Notify the provider that restraints require a new order every 24 hours
Correct Answer: B
Rationale: Restraints are a last resort. The nurse must first attempt and
document less restrictive interventions (e.g., redirecting, involving family,
environmental modification). Restraints require a provider order and do not require
family consent when properly ordered for safety. In acute care, restraint orders are
typically limited to 24 hours or less and require frequent monitoring. Applying
restraints before trying alternatives violates the least-restrictive principle.
Q6. Which task is appropriate for the RN to delegate to a licensed practical nurse
(LPN)?
A. Performing the initial admission assessment on a newly admitted client
B. Administering oral medications to a stable client with a predictable condition
C. Developing the nursing care plan for a client with heart failure
D. Evaluating whether a client's pain medication was effective
Correct Answer: B
Rationale: LPNs may administer medications, including oral medications, to
stable clients with predictable outcomes. The initial assessment (A), care plan
development (C), and evaluation of care outcomes (D) are RN-level
responsibilities that require analysis and clinical judgment.
, Q7. A nurse is caring for a client who has just been informed of a terminal
diagnosis. The client states, "I want to discuss advance directives." Which response
by the nurse is most appropriate?
A. "You should focus on your treatment right now and discuss that later."
B. "I can talk with you about advance directives and provide written information."
C. "Only your provider can discuss advance directives with you."
D. "Why do you want to discuss that at a time like this?"
Correct Answer: B
Rationale: The nurse's role includes providing information and supporting the
client's autonomy in end-of-life planning. Advance directives include living wills
and durable power of attorney for health care. The nurse can discuss the purpose of
these documents and provide brochures. Deflecting the conversation (A, D)
dismisses the client's concerns. While the provider also discusses advance
directives, the nurse is not prohibited from doing so (C).
Q8. A nurse is preparing to administer a blood transfusion. Which action is the
priority to prevent a hemolytic transfusion reaction?
A. Obtain the client's vital signs before starting the transfusion
B. Verify the blood product with a second nurse using two client identifiers
C. Administer the blood through a filter with 0.9% sodium chloride
D. Premedicate the client with an antihistamine 30 minutes before the transfusion
Correct Answer: B
Rationale: The priority action to prevent a hemolytic reaction is verifying the
blood product with a second qualified person using two client identifiers and
confirming ABO/Rh compatibility. Vital signs (A) and filter use (C) are important
safety steps but do not prevent a hemolytic reaction. Premedication with an
antihistamine (D) is not standard for preventing hemolytic reactions and may mask
early signs of a reaction.
Actual-Style, Retake and CMS Practice | 70 NGN Screenshot
Questions with Approved Answers and Rationales
Section 1: Management of Care (Questions 1–20)
Q1. A nurse is caring for four clients on a medical-surgical unit. Which client
should the nurse assess first?
A. A client who is 2 days postoperative requesting assistance to ambulate to the
bathroom
B. A client with pneumonia whose respiratory rate increased from 18 to 28
breaths/min
C. A client scheduled for discharge in 1 hour asking for pain medication
D. A client with a urinary catheter requesting a bedpan
Correct Answer: B
Rationale: An increase in respiratory rate from 18 to 28 in a client with
pneumonia suggests increasing respiratory distress and possible deterioration.
Using the ABC priority framework, airway and breathing take precedence. Options
A, C, and D are important but not immediately life-threatening. The nurse should
assess the client with pneumonia first (e.g., lung sounds, oxygen saturation, work
of breathing).
Q2. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which
task is appropriate to delegate?
A. Administering a PRN oral analgesic to a stable client
B. Teaching a client how to use an incentive spirometer
C. Measuring and recording vital signs for a stable postoperative client
D. Assessing a client's new report of incisional pain
Correct Answer: C
Rationale: Measuring and recording vital signs for a stable client is a routine,
noninvasive task with a predictable outcome and falls within UAP scope.
,Medication administration (A), client teaching (B), and pain assessment (D)
require RN clinical judgment and licensure and cannot be delegated to UAP.
Q3. A client who speaks limited English is scheduled for a surgical procedure. The
consent form has been signed. Which action by the nurse is most appropriate?
A. Ask the client's adult child to interpret the consent discussion
B. Verify the client's understanding using a qualified medical interpreter
C. Proceed with the procedure because the surgeon obtained the signature
D. Have the client sign a second consent form in the nurse's presence
Correct Answer: B
Rationale: The nurse is responsible for verifying that the client understands
the procedure, risks, benefits, and alternatives before witnessing the consent
signature. A qualified medical interpreter must be used; family members should not
interpret for consent because of privacy, accuracy, and coercion concerns. The
surgeon is responsible for explaining the procedure, but the nurse verifies
comprehension and witnesses the signature.
Q4. A nurse receives a telephone call from an unidentified person asking whether a
client is "still in the hospital." Which response by the nurse is correct?
A. "I can confirm the client is here, but I cannot give details."
B. "I cannot confirm or deny whether anyone by that name is here."
C. "Let me transfer you to the information desk so they can update you."
D. "The client is here, but you will need to come in person."
Correct Answer: B
Rationale: Under HIPAA, the nurse may neither confirm nor deny that a client
is receiving care without the client's authorization. Options A, C, and D all disclose
protected health information to an unverified caller. The nurse may offer to take the
caller's information and pass it to the client so the client can decide whether to
make contact.
,Q5. A nurse is caring for a client who has a new prescription for physical restraints.
Which action should the nurse take first?
A. Apply the restraints and document the client's behavior
B. Attempt less restrictive alternatives and document the findings
C. Obtain a signed consent from the client's family
D. Notify the provider that restraints require a new order every 24 hours
Correct Answer: B
Rationale: Restraints are a last resort. The nurse must first attempt and
document less restrictive interventions (e.g., redirecting, involving family,
environmental modification). Restraints require a provider order and do not require
family consent when properly ordered for safety. In acute care, restraint orders are
typically limited to 24 hours or less and require frequent monitoring. Applying
restraints before trying alternatives violates the least-restrictive principle.
Q6. Which task is appropriate for the RN to delegate to a licensed practical nurse
(LPN)?
A. Performing the initial admission assessment on a newly admitted client
B. Administering oral medications to a stable client with a predictable condition
C. Developing the nursing care plan for a client with heart failure
D. Evaluating whether a client's pain medication was effective
Correct Answer: B
Rationale: LPNs may administer medications, including oral medications, to
stable clients with predictable outcomes. The initial assessment (A), care plan
development (C), and evaluation of care outcomes (D) are RN-level
responsibilities that require analysis and clinical judgment.
, Q7. A nurse is caring for a client who has just been informed of a terminal
diagnosis. The client states, "I want to discuss advance directives." Which response
by the nurse is most appropriate?
A. "You should focus on your treatment right now and discuss that later."
B. "I can talk with you about advance directives and provide written information."
C. "Only your provider can discuss advance directives with you."
D. "Why do you want to discuss that at a time like this?"
Correct Answer: B
Rationale: The nurse's role includes providing information and supporting the
client's autonomy in end-of-life planning. Advance directives include living wills
and durable power of attorney for health care. The nurse can discuss the purpose of
these documents and provide brochures. Deflecting the conversation (A, D)
dismisses the client's concerns. While the provider also discusses advance
directives, the nurse is not prohibited from doing so (C).
Q8. A nurse is preparing to administer a blood transfusion. Which action is the
priority to prevent a hemolytic transfusion reaction?
A. Obtain the client's vital signs before starting the transfusion
B. Verify the blood product with a second nurse using two client identifiers
C. Administer the blood through a filter with 0.9% sodium chloride
D. Premedicate the client with an antihistamine 30 minutes before the transfusion
Correct Answer: B
Rationale: The priority action to prevent a hemolytic reaction is verifying the
blood product with a second qualified person using two client identifiers and
confirming ABO/Rh compatibility. Vital signs (A) and filter use (C) are important
safety steps but do not prevent a hemolytic reaction. Premedication with an
antihistamine (D) is not standard for preventing hemolytic reactions and may mask
early signs of a reaction.
