ATI RN Fundamentals – Proctored 2026
Exam (3 Versions) | Verified Questions &
Answers | NGN-Style
Q001:
Type: NGN - Extended Multiple Response
Scenario Context: Mrs. Alvarez, 72 y/o, 2 days post-op R total hip replacement, has a PCA
pump (morphine 1 mg/mL, 6 min lock-out), IV D5½NS at 83 mL/hr, and is on bed-rest with
abductor pillow. Vital signs at 0800: T 37.2 °C, HR 92, RR 14, BP 118/72, SpO₂ 94 % on 2 L NC.
She tells the nurse, “I’m afraid to push the button too often.”
Question: Which assessments or actions are priority to ensure safe PCA pain management at
this time? (Select ALL that apply.)
Options:
A. Verify the PCA prescription includes dose, lock-out, and 4-hr limit settings
B. Assess the surgical dressing for fresh bleeding while in the room
C. Coach Mrs. Alvarez to push the button only when she cannot tolerate the pain
D. Evaluate her sedation level using a standardized scale
E. Compare current pain score with her acceptable goal
F. Check the IV insertion site for patency and signs of infiltration
(Correct: A, D, E, F)
Rationale:
Answer: A, D, E, F
Why (2026 Standard): PCA safety requires confirmation of programmed parameters (A), regular
sedation monitoring to prevent respiratory depression (D), pain goal evaluation to guide use (E),
and IV patency to ensure delivery (F).
Errors: B is routine but not PCA-specific; C perpetuates misconceptions—patients should be
taught to anticipate pain and use PCA proactively.
Q002:
Type: Traditional
Scenario Context: (Continuing) Mrs. Alvarez’s 1400 sedation score is +3 (difficult to arouse).
Question: After stopping the PCA pump, what is the nurse’s next immediate action?
Options:
A. Administer naloxone 0.4 mg IV push
B. Stimulate the patient verbally and physically
C. Increase NC to 4 L/min and apply pulse oximetry
D. Prepare to transfer to ICU
(Correct: A)
Rationale:
Answer: A
Why (2026 Standard): Sedation score ≥ +3 indicates respiratory depression; naloxone reverses
opioid effect per 2026 AORN guidelines.
,Errors: B delays antidote; C is adjunct after airway secured; D premature until reversal
attempted.
Q003:
Type: NGN - Matrix
Scenario Context: New scenario: Mr. Haggerty, 55 y/o, admitted for rule-out C. diff after 3 days
watery diarrhea while on oral clindamycin. Isolation pending PCR result.
Question: Match the action to the correct transmission-based precaution category (A-C) for this
patient at this time.
Matrix:
Wear disposable gown & gloves when entering room
Use dedicated BP cuff
Place patient in private room with door closed
Don surgical mask when within 3 ft
A. Contact only
B. Droplet only
C. Contact + Droplet
Options (rows 1-4):
A. 1-A, 2-A, 3-A, 4-B
B. 1-C, 2-A, 3-A, 4-C
C. 1-A, 2-A, 3-A, 4-not required
D. 1-C, 2-B, 3-C, 4-B
(Correct: C)
Rationale:
Answer: C
Why (2026 Standard): C. diff requires Contact precautions; no droplet risk, so mask not needed.
Errors: B & D add unnecessary droplet; A incorrectly assigns mask to droplet.
Q004:
Type: NGN - Bowtie
Scenario Context: Ms. Hwan, 28 y/o, G2P1, 6 h post-cesarean, indwelling catheter, reports “I
need to urinate but the bag is empty.”
Left side (Risk cues): Choose 3
Middle (Correct action): Choose 1
Right side (Potential complications): Choose 2
Left options:
A. Catheter tubing kinked under blanket
B. Bladder scan 680 mL
C. Maternal BP 88/50
D. Oral temp 37.9 °C
Middle options:
Milk tubing and release kink
Encourage use of call light
Administer acetaminophen
Increase IV rate
Right options:
,X. Bladder overdistention
Y. Post-spinal hypotension
Z. Paralytic ileus
(Correct: Left—A,B,C; Middle—1; Right—X,Y)
Rationale:
Answer: Combination above
Why (2026 Standard): Kink (A) and high scan (B) indicate mechanical obstruction; hypotension
(C) may reduce renal perfusion. Releasing kink (1) restores flow, preventing overdistention (X)
and accentuating hypotension (Y).
Errors: Choosing D shifts focus to fever, not acute urinary issue.
Q005:
Type: Traditional
Scenario Context: (Continuing) After unkinking, 750 mL amber urine drains.
Question: The nurse documents this output as:
Options:
A. Normal post-cesarean diuresis
B. Possible fluid overload
C. Early sign diabetes insipidus
D. Inadequate compared to intake
(Correct: A)
Rationale:
Answer: A
Why (2026 Standard): Postpartum physiological diuresis expected within 24 h.
Errors: B needs additional S/S; C unrelated; D requires 8-hr totals.
Q006:
Type: NGN - Drag-and-Drop
Scenario Context: Mr. D’Angelo, 68 y/o, newly diagnosed heart failure, will discharge on
furosemide 40 mg PO daily and potassium chloride 20 mEq PO BID.
Question: Drag the education point to the appropriate time (Morning only, Evening only, Any
time of day, or Avoid). Each drag item used once.
Drag items:
Take furosemide
Take potassium with food
Weigh yourself
Drink 1 L sports drink to replace potassium
Drop targets:
Morning only / Evening only / Any time / Avoid
(Correct: Morning-furosemide; Any time-potassium with food; Morning-weigh; Avoid-sports
drink)
Rationale:
Answer: Sequence above
Why (2026 Standard): Furosemide timed to avoid nocturia; daily weights at same time; sports
drink adds sodium & sugar—avoid in HF.
Errors: Evening furosemide increases falls; unscheduled weights reduce trending value.
, Q007:
Type: Traditional
Scenario Context: While teaching, Mr. D’Angelo asks, “Why must I stand up slowly?”
Options:
A. Prevent hypokalemia-induced arrhythmia
B. Reduce risk of orthostatic hypotension
C. Avoid sudden increase preload
D. Minimize risk of drug–food interaction
(Correct: B)
Rationale:
Answer: B
Why (2026 Standard): Loop diuretics decrease circulating volume → orthostasis.
Errors: A relates to K⁺ but not position change; C opposite physiology; D irrelevant.
Q008:
Type: NGN - Extended Multiple Response
Scenario Context: Baby Lee, 4 m/o, brought to clinic for 2-day history of vomiting, weight loss 6
%, fontanel depressed. Provider orders oral rehydration (ORT) instead of IV.
Question: Which caregiver instructions support successful ORT? (Select ALL.)
Options:
A. Offer ½ teaspoon ORS every 5 min for first hour
B. Continue regular formula between ORS doses
C. Stop rehydration once vomiting ceases
D. Monitor number of wet diapers
E. Bring child back if unable to keep ORS down after 4 h
F. Use commercial oral rehydration solution only
(Correct: A, D, E, F)
Rationale:
Answer: A, D, E, F
Why (2026 Standard): Small frequent volumes (A) enhance absorption; ORS only (F) ensures
correct osmolality; output tracking (D) gauges success; E provides clear return criteria.
Errors: B dilutes strategy; C premature—replace deficit then resume feeds.
Q009:
Type: Traditional
Scenario Context: (Continuing) Weight after 4 h ORT is up 120 g, fontanel soft, 3 wet diapers.
Question: Priority next action?
Options:
A. Resume ad lib formula
B. Advance to rice cereal
C. Obtain serum electrolytes
D. Continue same ORT rate
(Correct: A)
Rationale:
Answer: A
Exam (3 Versions) | Verified Questions &
Answers | NGN-Style
Q001:
Type: NGN - Extended Multiple Response
Scenario Context: Mrs. Alvarez, 72 y/o, 2 days post-op R total hip replacement, has a PCA
pump (morphine 1 mg/mL, 6 min lock-out), IV D5½NS at 83 mL/hr, and is on bed-rest with
abductor pillow. Vital signs at 0800: T 37.2 °C, HR 92, RR 14, BP 118/72, SpO₂ 94 % on 2 L NC.
She tells the nurse, “I’m afraid to push the button too often.”
Question: Which assessments or actions are priority to ensure safe PCA pain management at
this time? (Select ALL that apply.)
Options:
A. Verify the PCA prescription includes dose, lock-out, and 4-hr limit settings
B. Assess the surgical dressing for fresh bleeding while in the room
C. Coach Mrs. Alvarez to push the button only when she cannot tolerate the pain
D. Evaluate her sedation level using a standardized scale
E. Compare current pain score with her acceptable goal
F. Check the IV insertion site for patency and signs of infiltration
(Correct: A, D, E, F)
Rationale:
Answer: A, D, E, F
Why (2026 Standard): PCA safety requires confirmation of programmed parameters (A), regular
sedation monitoring to prevent respiratory depression (D), pain goal evaluation to guide use (E),
and IV patency to ensure delivery (F).
Errors: B is routine but not PCA-specific; C perpetuates misconceptions—patients should be
taught to anticipate pain and use PCA proactively.
Q002:
Type: Traditional
Scenario Context: (Continuing) Mrs. Alvarez’s 1400 sedation score is +3 (difficult to arouse).
Question: After stopping the PCA pump, what is the nurse’s next immediate action?
Options:
A. Administer naloxone 0.4 mg IV push
B. Stimulate the patient verbally and physically
C. Increase NC to 4 L/min and apply pulse oximetry
D. Prepare to transfer to ICU
(Correct: A)
Rationale:
Answer: A
Why (2026 Standard): Sedation score ≥ +3 indicates respiratory depression; naloxone reverses
opioid effect per 2026 AORN guidelines.
,Errors: B delays antidote; C is adjunct after airway secured; D premature until reversal
attempted.
Q003:
Type: NGN - Matrix
Scenario Context: New scenario: Mr. Haggerty, 55 y/o, admitted for rule-out C. diff after 3 days
watery diarrhea while on oral clindamycin. Isolation pending PCR result.
Question: Match the action to the correct transmission-based precaution category (A-C) for this
patient at this time.
Matrix:
Wear disposable gown & gloves when entering room
Use dedicated BP cuff
Place patient in private room with door closed
Don surgical mask when within 3 ft
A. Contact only
B. Droplet only
C. Contact + Droplet
Options (rows 1-4):
A. 1-A, 2-A, 3-A, 4-B
B. 1-C, 2-A, 3-A, 4-C
C. 1-A, 2-A, 3-A, 4-not required
D. 1-C, 2-B, 3-C, 4-B
(Correct: C)
Rationale:
Answer: C
Why (2026 Standard): C. diff requires Contact precautions; no droplet risk, so mask not needed.
Errors: B & D add unnecessary droplet; A incorrectly assigns mask to droplet.
Q004:
Type: NGN - Bowtie
Scenario Context: Ms. Hwan, 28 y/o, G2P1, 6 h post-cesarean, indwelling catheter, reports “I
need to urinate but the bag is empty.”
Left side (Risk cues): Choose 3
Middle (Correct action): Choose 1
Right side (Potential complications): Choose 2
Left options:
A. Catheter tubing kinked under blanket
B. Bladder scan 680 mL
C. Maternal BP 88/50
D. Oral temp 37.9 °C
Middle options:
Milk tubing and release kink
Encourage use of call light
Administer acetaminophen
Increase IV rate
Right options:
,X. Bladder overdistention
Y. Post-spinal hypotension
Z. Paralytic ileus
(Correct: Left—A,B,C; Middle—1; Right—X,Y)
Rationale:
Answer: Combination above
Why (2026 Standard): Kink (A) and high scan (B) indicate mechanical obstruction; hypotension
(C) may reduce renal perfusion. Releasing kink (1) restores flow, preventing overdistention (X)
and accentuating hypotension (Y).
Errors: Choosing D shifts focus to fever, not acute urinary issue.
Q005:
Type: Traditional
Scenario Context: (Continuing) After unkinking, 750 mL amber urine drains.
Question: The nurse documents this output as:
Options:
A. Normal post-cesarean diuresis
B. Possible fluid overload
C. Early sign diabetes insipidus
D. Inadequate compared to intake
(Correct: A)
Rationale:
Answer: A
Why (2026 Standard): Postpartum physiological diuresis expected within 24 h.
Errors: B needs additional S/S; C unrelated; D requires 8-hr totals.
Q006:
Type: NGN - Drag-and-Drop
Scenario Context: Mr. D’Angelo, 68 y/o, newly diagnosed heart failure, will discharge on
furosemide 40 mg PO daily and potassium chloride 20 mEq PO BID.
Question: Drag the education point to the appropriate time (Morning only, Evening only, Any
time of day, or Avoid). Each drag item used once.
Drag items:
Take furosemide
Take potassium with food
Weigh yourself
Drink 1 L sports drink to replace potassium
Drop targets:
Morning only / Evening only / Any time / Avoid
(Correct: Morning-furosemide; Any time-potassium with food; Morning-weigh; Avoid-sports
drink)
Rationale:
Answer: Sequence above
Why (2026 Standard): Furosemide timed to avoid nocturia; daily weights at same time; sports
drink adds sodium & sugar—avoid in HF.
Errors: Evening furosemide increases falls; unscheduled weights reduce trending value.
, Q007:
Type: Traditional
Scenario Context: While teaching, Mr. D’Angelo asks, “Why must I stand up slowly?”
Options:
A. Prevent hypokalemia-induced arrhythmia
B. Reduce risk of orthostatic hypotension
C. Avoid sudden increase preload
D. Minimize risk of drug–food interaction
(Correct: B)
Rationale:
Answer: B
Why (2026 Standard): Loop diuretics decrease circulating volume → orthostasis.
Errors: A relates to K⁺ but not position change; C opposite physiology; D irrelevant.
Q008:
Type: NGN - Extended Multiple Response
Scenario Context: Baby Lee, 4 m/o, brought to clinic for 2-day history of vomiting, weight loss 6
%, fontanel depressed. Provider orders oral rehydration (ORT) instead of IV.
Question: Which caregiver instructions support successful ORT? (Select ALL.)
Options:
A. Offer ½ teaspoon ORS every 5 min for first hour
B. Continue regular formula between ORS doses
C. Stop rehydration once vomiting ceases
D. Monitor number of wet diapers
E. Bring child back if unable to keep ORS down after 4 h
F. Use commercial oral rehydration solution only
(Correct: A, D, E, F)
Rationale:
Answer: A, D, E, F
Why (2026 Standard): Small frequent volumes (A) enhance absorption; ORS only (F) ensures
correct osmolality; output tracking (D) gauges success; E provides clear return criteria.
Errors: B dilutes strategy; C premature—replace deficit then resume feeds.
Q009:
Type: Traditional
Scenario Context: (Continuing) Weight after 4 h ORT is up 120 g, fontanel soft, 3 wet diapers.
Question: Priority next action?
Options:
A. Resume ad lib formula
B. Advance to rice cereal
C. Obtain serum electrolytes
D. Continue same ORT rate
(Correct: A)
Rationale:
Answer: A
