ATI PN Fundamentals Proctored Exam – 2026/2027 Verified Questions & Answers
ATI PN Fundamentals Proctored Exam
2026/2027 Edition with Verified Questions and Answers
150 Comprehensive Multiple-Choice Questions Aligned with the ATI PN Fundamentals Test Blueprint and
NCLEX-PN Test Plan
Total Questions: 150
Cognitive Levels: 20% Recall · 50% Application · 30% Analysis
Question Style: 75% Scenario-based · 25% Direct Knowledge
Special Inclusions: 20 Priority-Setting · 15 Pharmacology · 15 Delegation · 5 Integrated Case Studies
Aligned With: ATI PN Fundamentals Test Blueprint · NCLEX-PN Test Plan · Practical Nursing Core Competencies
Section 1: Safe & Effective Care Environment – Management of Care
Q1: A licensed practical nurse (LPN) is caring for a client who speaks only Spanish. The client is
scheduled for surgery and the surgeon obtains informed consent using an English form. Which action by
the LPN is most appropriate?
A. Witness the signature and document that the client appeared to understand the procedure.
B. Translate the form word-for-word and have the client sign it.
C. Advocate for the client by notifying the RN that a qualified medical interpreter is needed before
consent is obtained. *[CORRECT]*
D. Ask a family member who speaks English to translate the consent for the client.
Correct Answer: C
Rationale: Informed consent requires the client to receive full information in a language they understand; using a
qualified medical interpreter ensures accurate, unbiased translation. The LPN should advocate by notifying the RN rather
than witnessing a signature the client may not understand. Family translators risk errors and bias, and the LPN is not
qualified to perform medical translation of consent forms.
Q2: Which task is most appropriate for the LPN to delegate to an unlicensed assistive personnel (UAP) on
a medical-surgical unit?
A. Reinforce teaching about a low-sodium diet to a client with heart failure.
B. Measure intake and output for a stable postoperative client. *[CORRECT]*
C. Assess a client's surgical incision for signs of infection.
D. Evaluate the effectiveness of a newly administered analgesic.
Correct Answer: B
Rationale: Measuring intake and output is a routine, standardized task within the UAP scope for stable clients.
Reinforcing teaching requires nursing knowledge and must be done by licensed staff. Assessment, evaluation, and
teaching reinforcement are nursing functions that cannot be delegated to UAP per NCLEX-PN delegation guidelines.
Q3: A client with end-stage chronic obstructive pulmonary disease has a living will stating no intubation
or mechanical ventilation. The client becomes unresponsive and the family demands full life-saving
measures. Which action should the LPN take first?
Page 1 | ATI PN Fundamentals 2026/2027
,ATI PN Fundamentals Proctored Exam – 2026/2027 Verified Questions & Answers
A. Call the rapid response team and prepare for intubation.
B. Notify the RN and provider immediately so the advance directive can be honored. *[CORRECT]*
C. Ask the family to sign a consent overriding the advance directive.
D. Provide comfort measures and document the family's request.
Correct Answer: B
Rationale: Advance directives are legally binding documents that must be honored; the LPN's role is to notify the RN
and provider immediately so care aligns with the client's documented wishes. Overriding the directive requires
legal/ethical review and is not the LPN's decision. Comfort care follows once the team confirms the directive is being
honored.
Q4: An LPN discovers a coworker taking a client's prescribed opioid pain medication from the automated
dispensing cabinet. Which action should the LPN take first?
A. Confront the coworker privately and demand they return the medication.
B. Report the observation to the charge nurse or supervisor immediately. *[CORRECT]*
C. Document the incident in the client's medical record.
D. Wait and observe again before taking any action to ensure accuracy.
Correct Answer: B
Rationale: Diversion of controlled substances is a patient safety violation requiring immediate reporting through the
chain of command. Confronting the coworker directly may compromise safety and an investigation. Documentation in the
client record is inappropriate because this is a staff issue, not a client care issue, and waiting delays intervention.
Q5: A client is scheduled for a colonoscopy and the provider has explained the procedure, risks, and
alternatives. The client signs the consent form. Five minutes later the client tells the LPN, 'I'm not really
sure what they're going to do.' What should the LPN do?
A. Witness the consent and reassure the client that the provider explained everything.
B. Notify the provider so they can return and re-explain the procedure before the consent is
considered valid. *[CORRECT]*
C. Tell the client the procedure is routine and there is nothing to worry about.
D. Cancel the procedure and notify the surgical team.
Correct Answer: B
Rationale: Valid informed consent requires comprehension; if the client is unsure, the provider must re-explain. The
LPN's role is to advocate for the client by notifying the provider, not to witness an incomplete consent or offer false
reassurance. Cancelling the procedure is premature unless the provider determines consent cannot be obtained.
Q6: Which of the following clients should the LPN assess first after receiving shift report?
A. A 2-day postoperative client requesting pain medication for incisional pain rated 4/10.
B. A client with chronic kidney disease whose potassium level was 5.1 mEq/L on the morning lab
draw. *[CORRECT]*
C. A client admitted with pneumonia who is resting quietly on 2 L nasal cannula.
D. A stable client with a stage 2 pressure injury scheduled for wound care.
Correct Answer: B
Rationale: The potassium of 5.1 mEq/L (slightly elevated) requires priority assessment because hyperkalemia can cause
life-threatening cardiac dysrhythmias; the LPN must assess cardiac status and notify the RN/provider. The postoperative
pain request and stable pneumonia are important but not immediately life-threatening. Pressure injury wound care is
routine and lowest priority.
Q7: An LPN is assigned four clients. Which client should the LPN recognize as requiring assignment
reassessment with the charge nurse?
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,ATI PN Fundamentals Proctored Exam – 2026/2027 Verified Questions & Answers
A. A stable postoperative client requiring intermittent bladder catheterization.
B. A newly admitted client with acute GI bleeding and unstable vital signs. *[CORRECT]*
C. A client receiving oral antibiotics for a urinary tract infection.
D. A client receiving continuous IV fluids at a maintenance rate.
Correct Answer: B
Rationale: A client with acute GI bleeding and unstable vital signs requires RN-level assessment and intervention,
exceeding the LPN scope. The LPN should advocate for reassignment of unstable clients to the RN. Stable postoperative
care, oral medications, and maintenance IV fluids are within LPN scope.
Q8: A 17-year-old client presents to the clinic seeking treatment for a sexually transmitted infection (STI).
The LPN knows that under the doctrine of emancipated minors this client may:
A. Consent to STI treatment without parental notification. *[CORRECT]*
B. Receive treatment only with parental consent.
C. Receive treatment only if a court order is obtained.
D. Be treated only in the presence of a parent or guardian.
Correct Answer: A
Rationale: Minors seeking diagnosis and treatment of STIs are typically granted confidentiality and may consent to
treatment without parental notification under emancipation statutes. The other options are incorrect because they impose
barriers the law specifically removes for STI care.
Q9: Which situation represents a violation of HIPAA that the LPN must report?
A. A nurse discusses a client's diagnosis with the client's spouse after the client verbally consents.
B. A nurse discusses a client's condition in an elevator where visitors can overhear. *[CORRECT]*
C. A nurse accesses a client's own medical record to review lab results.
D. A nurse shares information with the oncoming shift during handoff report.
Correct Answer: B
Rationale: Discussing client information in public areas where unauthorized persons may overhear is a HIPAA violation
because the information is not protected. Conversations with the spouse after client consent, accessing one's own record,
and shift handoff are appropriate if done under the minimum-necessary rule.
Q10: A client receiving care tells the LPN, 'I don't want student nurses participating in my care anymore.'
Which response by the LPN demonstrates advocacy?
A. 'I'll let the students know they can still observe from the doorway.'
B. 'You have the right to refuse student participation. I'll notify the care team of your request.'
*[CORRECT]*
C. 'The students need to learn, so we have to let them care for you.'
D. 'I'll ask the doctor to talk with you about this.'
Correct Answer: B
Rationale: The Patient's Bill of Rights guarantees the client's right to refuse participation in educational experiences. The
LPN advocates by acknowledging the right and notifying the team. Continued student observation violates the refusal, and
citing student learning need does not override client autonomy.
Q11: An LPN notes that a coworker's breath smells of alcohol at the start of the shift. What is the LPN's
most appropriate action?
A. Ignore it unless the coworker makes a medication error.
B. Notify the nursing supervisor immediately so client safety is protected. *[CORRECT]*
C. Talk to the coworker's friends to confirm before reporting.
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, ATI PN Fundamentals Proctored Exam – 2026/2027 Verified Questions & Answers
D. Wait until after the shift to document concerns.
Correct Answer: B
Rationale: Suspected impairment is a client safety emergency requiring immediate supervisor notification. Waiting for
an error, gathering informal confirmation, or delaying report endangers clients. The supervisor follows facility policy for
reasonable suspicion testing and removal from patient care.
Q12: Which statement by a client indicates understanding of the Patient's Bill of Rights?
A. 'I cannot see my medical records unless my doctor approves.'
B. 'I have the right to review my medical record and request amendments.' *[CORRECT]*
C. 'My family has unrestricted access to my health information.'
D. 'I must accept all treatments the doctor recommends.'
Correct Answer: B
Rationale: Under HIPAA and the Patient's Bill of Rights, clients may access and request amendments to their medical
records. Family access requires the client's authorization, and clients may refuse any treatment. Physician approval is not
required for record access.
Q13: A nurse is preparing to delegate ambulation of a stable postoperative client to a UAP. Which action
must the LPN take first?
A. Instruct the UAP to ambulate the client in the hallway.
B. Assess the client's stability, vital signs, and ambulation tolerance before delegation.
*[CORRECT]*
C. Tell the UAP to ambulate the client as tolerated.
D. Document the delegation in the client's medical record.
Correct Answer: B
Rationale: Assessment of the client's current status must occur before delegation to ensure the task is safe for the UAP.
The LPN retains accountability for delegation decisions and must provide specific instructions and supervision.
Documentation occurs after the task, not before assessment.
Q14: An LPN is caring for a client who is Jehovah's Witness and is scheduled for surgery. The client
refuses blood products. Which nursing action is most appropriate?
A. Encourage the client to accept blood products to prevent surgical complications.
B. Document the refusal, notify the provider, and support the client's decision. *[CORRECT]*
C. Ask the family to override the client's decision.
D. Withhold surgery until the client consents to blood products.
Correct Answer: B
Rationale: Clients have the right to refuse treatment based on religious beliefs; the LPN must document, notify the
provider, and support the decision. Encouraging the client to violate beliefs, asking family to override, or withholding
surgery violates autonomy and ethical nursing practice.
Q15: Which of the following statements best reflects the LPN's scope of practice regarding IV therapy?
A. LPNs may administer IV push medications independently.
B. LPNs may monitor a stable client's continuous IV infusion and report changes. *[CORRECT]*
C. LPNs may insert central venous catheters.
D. LPNs may titrate vasoactive IV medications without supervision.
Correct Answer: B
Rationale: LPNs may monitor stable IV infusions and report changes to the RN, but IV push, central line insertion, and
titration of vasoactive drugs typically require RN-level scope per state nurse practice acts. The LPN's role is supportive
Page 4 | ATI PN Fundamentals 2026/2027
ATI PN Fundamentals Proctored Exam
2026/2027 Edition with Verified Questions and Answers
150 Comprehensive Multiple-Choice Questions Aligned with the ATI PN Fundamentals Test Blueprint and
NCLEX-PN Test Plan
Total Questions: 150
Cognitive Levels: 20% Recall · 50% Application · 30% Analysis
Question Style: 75% Scenario-based · 25% Direct Knowledge
Special Inclusions: 20 Priority-Setting · 15 Pharmacology · 15 Delegation · 5 Integrated Case Studies
Aligned With: ATI PN Fundamentals Test Blueprint · NCLEX-PN Test Plan · Practical Nursing Core Competencies
Section 1: Safe & Effective Care Environment – Management of Care
Q1: A licensed practical nurse (LPN) is caring for a client who speaks only Spanish. The client is
scheduled for surgery and the surgeon obtains informed consent using an English form. Which action by
the LPN is most appropriate?
A. Witness the signature and document that the client appeared to understand the procedure.
B. Translate the form word-for-word and have the client sign it.
C. Advocate for the client by notifying the RN that a qualified medical interpreter is needed before
consent is obtained. *[CORRECT]*
D. Ask a family member who speaks English to translate the consent for the client.
Correct Answer: C
Rationale: Informed consent requires the client to receive full information in a language they understand; using a
qualified medical interpreter ensures accurate, unbiased translation. The LPN should advocate by notifying the RN rather
than witnessing a signature the client may not understand. Family translators risk errors and bias, and the LPN is not
qualified to perform medical translation of consent forms.
Q2: Which task is most appropriate for the LPN to delegate to an unlicensed assistive personnel (UAP) on
a medical-surgical unit?
A. Reinforce teaching about a low-sodium diet to a client with heart failure.
B. Measure intake and output for a stable postoperative client. *[CORRECT]*
C. Assess a client's surgical incision for signs of infection.
D. Evaluate the effectiveness of a newly administered analgesic.
Correct Answer: B
Rationale: Measuring intake and output is a routine, standardized task within the UAP scope for stable clients.
Reinforcing teaching requires nursing knowledge and must be done by licensed staff. Assessment, evaluation, and
teaching reinforcement are nursing functions that cannot be delegated to UAP per NCLEX-PN delegation guidelines.
Q3: A client with end-stage chronic obstructive pulmonary disease has a living will stating no intubation
or mechanical ventilation. The client becomes unresponsive and the family demands full life-saving
measures. Which action should the LPN take first?
Page 1 | ATI PN Fundamentals 2026/2027
,ATI PN Fundamentals Proctored Exam – 2026/2027 Verified Questions & Answers
A. Call the rapid response team and prepare for intubation.
B. Notify the RN and provider immediately so the advance directive can be honored. *[CORRECT]*
C. Ask the family to sign a consent overriding the advance directive.
D. Provide comfort measures and document the family's request.
Correct Answer: B
Rationale: Advance directives are legally binding documents that must be honored; the LPN's role is to notify the RN
and provider immediately so care aligns with the client's documented wishes. Overriding the directive requires
legal/ethical review and is not the LPN's decision. Comfort care follows once the team confirms the directive is being
honored.
Q4: An LPN discovers a coworker taking a client's prescribed opioid pain medication from the automated
dispensing cabinet. Which action should the LPN take first?
A. Confront the coworker privately and demand they return the medication.
B. Report the observation to the charge nurse or supervisor immediately. *[CORRECT]*
C. Document the incident in the client's medical record.
D. Wait and observe again before taking any action to ensure accuracy.
Correct Answer: B
Rationale: Diversion of controlled substances is a patient safety violation requiring immediate reporting through the
chain of command. Confronting the coworker directly may compromise safety and an investigation. Documentation in the
client record is inappropriate because this is a staff issue, not a client care issue, and waiting delays intervention.
Q5: A client is scheduled for a colonoscopy and the provider has explained the procedure, risks, and
alternatives. The client signs the consent form. Five minutes later the client tells the LPN, 'I'm not really
sure what they're going to do.' What should the LPN do?
A. Witness the consent and reassure the client that the provider explained everything.
B. Notify the provider so they can return and re-explain the procedure before the consent is
considered valid. *[CORRECT]*
C. Tell the client the procedure is routine and there is nothing to worry about.
D. Cancel the procedure and notify the surgical team.
Correct Answer: B
Rationale: Valid informed consent requires comprehension; if the client is unsure, the provider must re-explain. The
LPN's role is to advocate for the client by notifying the provider, not to witness an incomplete consent or offer false
reassurance. Cancelling the procedure is premature unless the provider determines consent cannot be obtained.
Q6: Which of the following clients should the LPN assess first after receiving shift report?
A. A 2-day postoperative client requesting pain medication for incisional pain rated 4/10.
B. A client with chronic kidney disease whose potassium level was 5.1 mEq/L on the morning lab
draw. *[CORRECT]*
C. A client admitted with pneumonia who is resting quietly on 2 L nasal cannula.
D. A stable client with a stage 2 pressure injury scheduled for wound care.
Correct Answer: B
Rationale: The potassium of 5.1 mEq/L (slightly elevated) requires priority assessment because hyperkalemia can cause
life-threatening cardiac dysrhythmias; the LPN must assess cardiac status and notify the RN/provider. The postoperative
pain request and stable pneumonia are important but not immediately life-threatening. Pressure injury wound care is
routine and lowest priority.
Q7: An LPN is assigned four clients. Which client should the LPN recognize as requiring assignment
reassessment with the charge nurse?
Page 2 | ATI PN Fundamentals 2026/2027
,ATI PN Fundamentals Proctored Exam – 2026/2027 Verified Questions & Answers
A. A stable postoperative client requiring intermittent bladder catheterization.
B. A newly admitted client with acute GI bleeding and unstable vital signs. *[CORRECT]*
C. A client receiving oral antibiotics for a urinary tract infection.
D. A client receiving continuous IV fluids at a maintenance rate.
Correct Answer: B
Rationale: A client with acute GI bleeding and unstable vital signs requires RN-level assessment and intervention,
exceeding the LPN scope. The LPN should advocate for reassignment of unstable clients to the RN. Stable postoperative
care, oral medications, and maintenance IV fluids are within LPN scope.
Q8: A 17-year-old client presents to the clinic seeking treatment for a sexually transmitted infection (STI).
The LPN knows that under the doctrine of emancipated minors this client may:
A. Consent to STI treatment without parental notification. *[CORRECT]*
B. Receive treatment only with parental consent.
C. Receive treatment only if a court order is obtained.
D. Be treated only in the presence of a parent or guardian.
Correct Answer: A
Rationale: Minors seeking diagnosis and treatment of STIs are typically granted confidentiality and may consent to
treatment without parental notification under emancipation statutes. The other options are incorrect because they impose
barriers the law specifically removes for STI care.
Q9: Which situation represents a violation of HIPAA that the LPN must report?
A. A nurse discusses a client's diagnosis with the client's spouse after the client verbally consents.
B. A nurse discusses a client's condition in an elevator where visitors can overhear. *[CORRECT]*
C. A nurse accesses a client's own medical record to review lab results.
D. A nurse shares information with the oncoming shift during handoff report.
Correct Answer: B
Rationale: Discussing client information in public areas where unauthorized persons may overhear is a HIPAA violation
because the information is not protected. Conversations with the spouse after client consent, accessing one's own record,
and shift handoff are appropriate if done under the minimum-necessary rule.
Q10: A client receiving care tells the LPN, 'I don't want student nurses participating in my care anymore.'
Which response by the LPN demonstrates advocacy?
A. 'I'll let the students know they can still observe from the doorway.'
B. 'You have the right to refuse student participation. I'll notify the care team of your request.'
*[CORRECT]*
C. 'The students need to learn, so we have to let them care for you.'
D. 'I'll ask the doctor to talk with you about this.'
Correct Answer: B
Rationale: The Patient's Bill of Rights guarantees the client's right to refuse participation in educational experiences. The
LPN advocates by acknowledging the right and notifying the team. Continued student observation violates the refusal, and
citing student learning need does not override client autonomy.
Q11: An LPN notes that a coworker's breath smells of alcohol at the start of the shift. What is the LPN's
most appropriate action?
A. Ignore it unless the coworker makes a medication error.
B. Notify the nursing supervisor immediately so client safety is protected. *[CORRECT]*
C. Talk to the coworker's friends to confirm before reporting.
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, ATI PN Fundamentals Proctored Exam – 2026/2027 Verified Questions & Answers
D. Wait until after the shift to document concerns.
Correct Answer: B
Rationale: Suspected impairment is a client safety emergency requiring immediate supervisor notification. Waiting for
an error, gathering informal confirmation, or delaying report endangers clients. The supervisor follows facility policy for
reasonable suspicion testing and removal from patient care.
Q12: Which statement by a client indicates understanding of the Patient's Bill of Rights?
A. 'I cannot see my medical records unless my doctor approves.'
B. 'I have the right to review my medical record and request amendments.' *[CORRECT]*
C. 'My family has unrestricted access to my health information.'
D. 'I must accept all treatments the doctor recommends.'
Correct Answer: B
Rationale: Under HIPAA and the Patient's Bill of Rights, clients may access and request amendments to their medical
records. Family access requires the client's authorization, and clients may refuse any treatment. Physician approval is not
required for record access.
Q13: A nurse is preparing to delegate ambulation of a stable postoperative client to a UAP. Which action
must the LPN take first?
A. Instruct the UAP to ambulate the client in the hallway.
B. Assess the client's stability, vital signs, and ambulation tolerance before delegation.
*[CORRECT]*
C. Tell the UAP to ambulate the client as tolerated.
D. Document the delegation in the client's medical record.
Correct Answer: B
Rationale: Assessment of the client's current status must occur before delegation to ensure the task is safe for the UAP.
The LPN retains accountability for delegation decisions and must provide specific instructions and supervision.
Documentation occurs after the task, not before assessment.
Q14: An LPN is caring for a client who is Jehovah's Witness and is scheduled for surgery. The client
refuses blood products. Which nursing action is most appropriate?
A. Encourage the client to accept blood products to prevent surgical complications.
B. Document the refusal, notify the provider, and support the client's decision. *[CORRECT]*
C. Ask the family to override the client's decision.
D. Withhold surgery until the client consents to blood products.
Correct Answer: B
Rationale: Clients have the right to refuse treatment based on religious beliefs; the LPN must document, notify the
provider, and support the decision. Encouraging the client to violate beliefs, asking family to override, or withholding
surgery violates autonomy and ethical nursing practice.
Q15: Which of the following statements best reflects the LPN's scope of practice regarding IV therapy?
A. LPNs may administer IV push medications independently.
B. LPNs may monitor a stable client's continuous IV infusion and report changes. *[CORRECT]*
C. LPNs may insert central venous catheters.
D. LPNs may titrate vasoactive IV medications without supervision.
Correct Answer: B
Rationale: LPNs may monitor stable IV infusions and report changes to the RN, but IV push, central line insertion, and
titration of vasoactive drugs typically require RN-level scope per state nurse practice acts. The LPN's role is supportive
Page 4 | ATI PN Fundamentals 2026/2027
