ATI RN Fundamentals – Proctored Exam (3
Versions) | Verified Questions & Answers |
NGN-Style
Q001: 001
Type: NGN - Bowtie
Scenario Context: 68-year-old post-op hip replacement, POD #2, PCA morphine, history
of COPD & hypertension.
Question: Identify the priority assessment finding that would trigger the nurse to pause
morphine PCA and notify the provider.
Options:
A. Respiratory rate 8/min
B. Pain score 8/10
C. SpO₂ 94 % on 2 L O₂
D. Pupils 3 mm, equal
(Correct: A)
Rationale:
● Answer: A
, ● Why (2026 Standard): Morphine-induced respiratory depression (<10/min) is the
most life-threatening opioid complication; immediate naloxone protocol per 2026
AORN guidelines.
● Errors: B—pain is expected POD #2; C—SpO₂ 94 % acceptable for COPD;
D—pupils unchanged.
Q002: 002
Type: NGN - Extended Multiple Response
Scenario Context: Same patient (Q001).
Question: Select all nursing actions the nurse should implement within the next 5
minutes.
Options:
A. Stimulate patient verbally
B. Administer naloxone 0.4 mg IVP
C. Increase PCA basal rate
D. Apply high-flow O₂ non-rebreather
E. Notify respiratory therapy
F. Document pain score
(Correct: A, B, D, E)
Rationale:
● Answer: A, B, D, E
● Why (2026 Standard): Rapid-response sequence for opioid-induced respiratory
depression per 2026 ISMP.
, ● Errors: C—would worsen depression; F—documentation done after stabilization.
Q003: 003
Type: Traditional
Scenario Context: New patient: 34-year-old with pyelonephritis receiving ceftriaxone 1 g
IV q12h.
Question: Which lab value requires immediate intervention before the next dose?
Options:
A. WBC 12 000/mm³
B. Creatinine 3.2 mg/dL
C. Potassium 3.8 mEq/L
D. AST 38 U/L
(Correct: B)
Rationale:
● Answer: B
● Why (2026 Standard): Ceftriaxone is renally excreted; Cr >3 mg/dL risks
neurotoxicity—dose adjustment required.
● Errors: A—expected elevation; C & D—within acceptable limits.
Q004: 004
Type: NGN - Drag-and-Drop
Scenario Context: 55-year-old diabetic receiving sliding-scale insulin. Morning
accu-check 320 mg/dL, urine negative for ketones.
, Question: Drag the correct sequence of steps to prepare 12 units of regular insulin from a
100-unit vial.
Options (drag order):
1.Clean rubber top with alcohol
2.Inject 12 mL air into vial
3.Withdraw 12 units insulin
4.Check expiration date
5.Roll vial gently
(Correct sequence: 4→5→1→2→3)
Rationale:
● Answer: 4→5→1→2→3
● Why (2026 Standard): 2026 ADA injection safety sequence prevents dosing
errors.
● Errors: Any other order risks contamination or incorrect dose.
Q005: 005
Type: NGN - Matrix
Scenario Context: 78-year-old on warfarin for AFib; INR 5.8.
Question: Match intervention to urgency level.
Matrix Rows:
A. Hold next warfarin dose
B. Administer 2.5 mg vitamin K IV
C. Check for active bleeding
D. Teach about dark-green vegetables
Matrix Columns:
Versions) | Verified Questions & Answers |
NGN-Style
Q001: 001
Type: NGN - Bowtie
Scenario Context: 68-year-old post-op hip replacement, POD #2, PCA morphine, history
of COPD & hypertension.
Question: Identify the priority assessment finding that would trigger the nurse to pause
morphine PCA and notify the provider.
Options:
A. Respiratory rate 8/min
B. Pain score 8/10
C. SpO₂ 94 % on 2 L O₂
D. Pupils 3 mm, equal
(Correct: A)
Rationale:
● Answer: A
, ● Why (2026 Standard): Morphine-induced respiratory depression (<10/min) is the
most life-threatening opioid complication; immediate naloxone protocol per 2026
AORN guidelines.
● Errors: B—pain is expected POD #2; C—SpO₂ 94 % acceptable for COPD;
D—pupils unchanged.
Q002: 002
Type: NGN - Extended Multiple Response
Scenario Context: Same patient (Q001).
Question: Select all nursing actions the nurse should implement within the next 5
minutes.
Options:
A. Stimulate patient verbally
B. Administer naloxone 0.4 mg IVP
C. Increase PCA basal rate
D. Apply high-flow O₂ non-rebreather
E. Notify respiratory therapy
F. Document pain score
(Correct: A, B, D, E)
Rationale:
● Answer: A, B, D, E
● Why (2026 Standard): Rapid-response sequence for opioid-induced respiratory
depression per 2026 ISMP.
, ● Errors: C—would worsen depression; F—documentation done after stabilization.
Q003: 003
Type: Traditional
Scenario Context: New patient: 34-year-old with pyelonephritis receiving ceftriaxone 1 g
IV q12h.
Question: Which lab value requires immediate intervention before the next dose?
Options:
A. WBC 12 000/mm³
B. Creatinine 3.2 mg/dL
C. Potassium 3.8 mEq/L
D. AST 38 U/L
(Correct: B)
Rationale:
● Answer: B
● Why (2026 Standard): Ceftriaxone is renally excreted; Cr >3 mg/dL risks
neurotoxicity—dose adjustment required.
● Errors: A—expected elevation; C & D—within acceptable limits.
Q004: 004
Type: NGN - Drag-and-Drop
Scenario Context: 55-year-old diabetic receiving sliding-scale insulin. Morning
accu-check 320 mg/dL, urine negative for ketones.
, Question: Drag the correct sequence of steps to prepare 12 units of regular insulin from a
100-unit vial.
Options (drag order):
1.Clean rubber top with alcohol
2.Inject 12 mL air into vial
3.Withdraw 12 units insulin
4.Check expiration date
5.Roll vial gently
(Correct sequence: 4→5→1→2→3)
Rationale:
● Answer: 4→5→1→2→3
● Why (2026 Standard): 2026 ADA injection safety sequence prevents dosing
errors.
● Errors: Any other order risks contamination or incorrect dose.
Q005: 005
Type: NGN - Matrix
Scenario Context: 78-year-old on warfarin for AFib; INR 5.8.
Question: Match intervention to urgency level.
Matrix Rows:
A. Hold next warfarin dose
B. Administer 2.5 mg vitamin K IV
C. Check for active bleeding
D. Teach about dark-green vegetables
Matrix Columns:
