EXAM SERIES
ATI RN Fundamentals
Actual Exam
Comprehensive Exam — Questions and Answers
100 Questions
with Answers and Complete Rationales
01 Scenario-based, direct, and clinical judgment multiple-choice questions
02 Answers with explanatory rationales
03 Organized by fundamentals, safety, skills, and professional practice
competencies
04 Complete questions and answers
2026 EDITION
Questions and Answers • Complete Rationales
, Instructions to the Learner
This exam contains 100 multiple-choice questions covering RN Fundamentals of Nursing content.
Each question has four options labeled A through D and exactly one best answer.
Select the single best response for each item. Answers and rationales appear directly beneath
each question so that you can review your reasoning and reinforce correct clinical judgment.
The exam is organized into four sections: Nursing Process and Clinical Judgment; Safety,
Infection Control, and Medication Administration; Fundamental Nursing Skills and Patient Care;
and Communication, Teaching, Documentation, and Professionalism. Pace yourself accordingly.
Section 1: Nursing Process and Clinical Judgment
Next Generation NCLEX-style items applied to fundamental nursing care (Q1-Q25).
Q1. A nurse is explaining the nursing process to a nursing student. Which statement by the
student indicates understanding of the assessment phase?
A. I will collect subjective and objective data about the patient.
B. I will write measurable patient goals before meeting the patient.
C. I will implement interventions before assessment is complete.
D. I will evaluate whether outcomes were met at the time of admission.
Correct Answer: A. I will collect subjective and objective data about the patient.
Rationale: Assessment is the first step of the nursing process and involves gathering subjective
(patient-reported) and objective (measurable) data. Planning, implementing, and evaluating occur after
assessment is complete, so the other options describe later phases.
Q2. A nurse is caring for a patient who suddenly reports crushing chest pressure. Using the
nursing process, which action should the nurse take first?
A. Administer the patient's prescribed nitroglycerin immediately.
B. Call the rapid response team for transport to the ICU.
C. Perform a focused cardiovascular and respiratory assessment.
D. Document the new finding in the electronic health record.
Correct Answer: C. Perform a focused cardiovascular and respiratory assessment.
Rationale: The first step of the nursing process is assessment. Before intervening with medications or
escalation, the nurse must gather assessment data (vital signs, pain characteristics, airway, breathing,
circulation). Implementation and documentation follow assessment.
,Q3. An older adult patient with heart failure becomes more dyspneic and confused during the
shift. Which cue should the nurse recognize as the priority finding requiring immediate action?
A. Weight gain of 1 kg documented over the past three days.
B. Two-plus pitting edema present in both lower extremities.
C. Bibasilar crackles noted on posterior auscultation.
D. New-onset confusion with increased work of breathing.
Correct Answer: D. New-onset confusion with increased work of breathing.
Rationale: New confusion with increased work of breathing signals acute hypoxemia and possible
clinical deterioration, which is the highest priority cue. Edema, weight gain, and crackles are expected
heart failure findings but are not immediately life-threatening compared to acute respiratory
compromise.
Q4. A patient receiving IV antibiotics suddenly develops hives, wheezing, and throat tightness.
Which hypothesis should the nurse prioritize forming?
A. Fluid volume overload related to rapid IV infusion.
B. Anaphylaxis related to antibiotic hypersensitivity.
C. Impaired skin integrity related to antibiotic reaction.
D. Anxiety related to new onset of unfamiliar symptoms.
Correct Answer: B. Anaphylaxis related to antibiotic hypersensitivity.
Rationale: Hives, wheezing, and throat tightness together form a classic syndrome of anaphylaxis.
The nurse should generate the hypothesis of anaphylaxis and act immediately with airway support,
stopping the antibiotic, and provider notification. The other hypotheses do not match the constellation
of symptoms.
Q5. A patient's expected outcome is: "Patient will ambulate 50 feet with assistance by discharge."
After two days of intervention, the patient ambulates 30 feet with assistance. Which evaluation
statement is most accurate?
A. Goal was met; discontinue physical therapy consultation.
B. Goal was not met; the plan of care was ineffective overall.
C. Goal was not met; lower the distance required to 30 feet.
D. Goal was partially met; revise the plan and continue interventions.
Correct Answer: D. Goal was partially met; revise the plan and continue interventions.
Rationale: The patient progressed toward but did not fully reach the 50-foot goal. The most accurate
evaluation is that the goal was partially met, which prompts the nurse to revise the plan and continue
interventions rather than discontinue or weaken the goal.
, Q6. Which of the following is the best example of a measurable patient outcome?
A. Patient will feel better each day.
B. Patient will have less pain overall.
C. Patient will report pain rated 3 or lower on a 0 to 10 scale within 24 hours.
D. Patient will be compliant with the prescribed treatment plan.
Correct Answer: C. Patient will report pain rated 3 or lower on a 0 to 10 scale within 24 hours.
Rationale: A measurable outcome includes a specific subject, action verb, measurable criterion, and
time frame. Only the pain outcome includes a numeric value and a time frame, allowing the nurse to
evaluate achievement objectively.
Q7. A nurse is prioritizing care for four patients assigned at the start of the shift. Which patient
should the nurse assess first?
A. A patient requesting medication for a mild headache rated 2/10.
B. A patient who is two hours postoperative with stable vital signs.
C. A patient reporting new-onset shortness of breath.
D. A patient awaiting discharge teaching before going home.
Correct Answer: C. A patient reporting new-onset shortness of breath.
Rationale: Using the airway, breathing, and circulation (ABC) framework, the patient with new-onset
shortness of breath is the highest priority because acute respiratory compromise is immediately life-
threatening. The other patients require care but are more stable.
Q8. In the ABC priority framework used in acute care, what does the letter C represent?
A. Circulation
B. Cognition
C. Communication
D. Comfort
Correct Answer: A. Circulation
Rationale: The ABC framework stands for Airway, Breathing, and Circulation. These three priorities
guide the nurse in addressing the most immediately life-threatening problems first during acute patient
care.
ATI RN Fundamentals
Actual Exam
Comprehensive Exam — Questions and Answers
100 Questions
with Answers and Complete Rationales
01 Scenario-based, direct, and clinical judgment multiple-choice questions
02 Answers with explanatory rationales
03 Organized by fundamentals, safety, skills, and professional practice
competencies
04 Complete questions and answers
2026 EDITION
Questions and Answers • Complete Rationales
, Instructions to the Learner
This exam contains 100 multiple-choice questions covering RN Fundamentals of Nursing content.
Each question has four options labeled A through D and exactly one best answer.
Select the single best response for each item. Answers and rationales appear directly beneath
each question so that you can review your reasoning and reinforce correct clinical judgment.
The exam is organized into four sections: Nursing Process and Clinical Judgment; Safety,
Infection Control, and Medication Administration; Fundamental Nursing Skills and Patient Care;
and Communication, Teaching, Documentation, and Professionalism. Pace yourself accordingly.
Section 1: Nursing Process and Clinical Judgment
Next Generation NCLEX-style items applied to fundamental nursing care (Q1-Q25).
Q1. A nurse is explaining the nursing process to a nursing student. Which statement by the
student indicates understanding of the assessment phase?
A. I will collect subjective and objective data about the patient.
B. I will write measurable patient goals before meeting the patient.
C. I will implement interventions before assessment is complete.
D. I will evaluate whether outcomes were met at the time of admission.
Correct Answer: A. I will collect subjective and objective data about the patient.
Rationale: Assessment is the first step of the nursing process and involves gathering subjective
(patient-reported) and objective (measurable) data. Planning, implementing, and evaluating occur after
assessment is complete, so the other options describe later phases.
Q2. A nurse is caring for a patient who suddenly reports crushing chest pressure. Using the
nursing process, which action should the nurse take first?
A. Administer the patient's prescribed nitroglycerin immediately.
B. Call the rapid response team for transport to the ICU.
C. Perform a focused cardiovascular and respiratory assessment.
D. Document the new finding in the electronic health record.
Correct Answer: C. Perform a focused cardiovascular and respiratory assessment.
Rationale: The first step of the nursing process is assessment. Before intervening with medications or
escalation, the nurse must gather assessment data (vital signs, pain characteristics, airway, breathing,
circulation). Implementation and documentation follow assessment.
,Q3. An older adult patient with heart failure becomes more dyspneic and confused during the
shift. Which cue should the nurse recognize as the priority finding requiring immediate action?
A. Weight gain of 1 kg documented over the past three days.
B. Two-plus pitting edema present in both lower extremities.
C. Bibasilar crackles noted on posterior auscultation.
D. New-onset confusion with increased work of breathing.
Correct Answer: D. New-onset confusion with increased work of breathing.
Rationale: New confusion with increased work of breathing signals acute hypoxemia and possible
clinical deterioration, which is the highest priority cue. Edema, weight gain, and crackles are expected
heart failure findings but are not immediately life-threatening compared to acute respiratory
compromise.
Q4. A patient receiving IV antibiotics suddenly develops hives, wheezing, and throat tightness.
Which hypothesis should the nurse prioritize forming?
A. Fluid volume overload related to rapid IV infusion.
B. Anaphylaxis related to antibiotic hypersensitivity.
C. Impaired skin integrity related to antibiotic reaction.
D. Anxiety related to new onset of unfamiliar symptoms.
Correct Answer: B. Anaphylaxis related to antibiotic hypersensitivity.
Rationale: Hives, wheezing, and throat tightness together form a classic syndrome of anaphylaxis.
The nurse should generate the hypothesis of anaphylaxis and act immediately with airway support,
stopping the antibiotic, and provider notification. The other hypotheses do not match the constellation
of symptoms.
Q5. A patient's expected outcome is: "Patient will ambulate 50 feet with assistance by discharge."
After two days of intervention, the patient ambulates 30 feet with assistance. Which evaluation
statement is most accurate?
A. Goal was met; discontinue physical therapy consultation.
B. Goal was not met; the plan of care was ineffective overall.
C. Goal was not met; lower the distance required to 30 feet.
D. Goal was partially met; revise the plan and continue interventions.
Correct Answer: D. Goal was partially met; revise the plan and continue interventions.
Rationale: The patient progressed toward but did not fully reach the 50-foot goal. The most accurate
evaluation is that the goal was partially met, which prompts the nurse to revise the plan and continue
interventions rather than discontinue or weaken the goal.
, Q6. Which of the following is the best example of a measurable patient outcome?
A. Patient will feel better each day.
B. Patient will have less pain overall.
C. Patient will report pain rated 3 or lower on a 0 to 10 scale within 24 hours.
D. Patient will be compliant with the prescribed treatment plan.
Correct Answer: C. Patient will report pain rated 3 or lower on a 0 to 10 scale within 24 hours.
Rationale: A measurable outcome includes a specific subject, action verb, measurable criterion, and
time frame. Only the pain outcome includes a numeric value and a time frame, allowing the nurse to
evaluate achievement objectively.
Q7. A nurse is prioritizing care for four patients assigned at the start of the shift. Which patient
should the nurse assess first?
A. A patient requesting medication for a mild headache rated 2/10.
B. A patient who is two hours postoperative with stable vital signs.
C. A patient reporting new-onset shortness of breath.
D. A patient awaiting discharge teaching before going home.
Correct Answer: C. A patient reporting new-onset shortness of breath.
Rationale: Using the airway, breathing, and circulation (ABC) framework, the patient with new-onset
shortness of breath is the highest priority because acute respiratory compromise is immediately life-
threatening. The other patients require care but are more stable.
Q8. In the ABC priority framework used in acute care, what does the letter C represent?
A. Circulation
B. Cognition
C. Communication
D. Comfort
Correct Answer: A. Circulation
Rationale: The ABC framework stands for Airway, Breathing, and Circulation. These three priorities
guide the nurse in addressing the most immediately life-threatening problems first during acute patient
care.
