ATI RN Fundamentals – Proctored actual
Exam (3 Versions) | 2026 Verified Questions &
Answers | NGN-Style
Q001: Type: NGN - Extended Multiple Response
Scenario Context: 78-year-old female, Ms. Alvarez, post-op R hip ORIF, POD #1,
morphine PCA, history of COPD & HTN.
Question: Which assessments require immediate follow-up to reduce risk for respiratory
compromise? (Select all that apply.)
Options:
A. Respiratory rate 8/min
B. Oxygen saturation 89 % on 2 L NC
C. Patient difficult to arouse
D. PCA attempts 4 in last hour
E. Bilateral crackles auscultated
(Correct: A, B, C)
Rationale:
● Answer: A, B, C
, ● Why (2026 Standard): RR <10, SpO₂ <90 %, and altered LOC are early signs of
opioid-induced respiratory depression; prompt naloxone & provider notification
required.
● Errors: D reflects adequate analgesia seeking, not toxicity; E indicates fluid
overload unrelated to opioid risk.
Q002: Type: NGN - Matrix
Scenario Context: Continue Ms. Alvarez. Nurse reviews 0800 MAR.
Question: Identify which medications are appropriate to administer now. (Check “Give”
or “Hold” for each.)
Matrix:
┌──────────────────────┬──────┬──────┐
│ Medication │ Give │ Hold │
├──────────────────────┼──────┼──────┤
│ Morphine 8 mg IV PCA │ ☐ │ ☐ │
│ Lisinopril 10 mg PO │ ☐ │ ☐ │
│ Enoxaparin 40 mg SC │ ☐ │ ☐ │
│ Albuterol 2.5 mg NEB │ ☐ │ ☐ │
└──────────────────────┴──────┴──────┘
(Correct: Give Enoxaparin & Albuterol; Hold Morphine & Lisinopril)
Rationale:
, ● Answer: Hold morphine (RR 8), hold Lisinopril (SBP 98); give enoxaparin (DVT
prophylaxis OK) & albuterol (COPD).
● Errors: Giving morphine worsens respiratory status; Lisinopril risks further
hypotension.
Q003: Type: Traditional
Scenario Context: New patient: 8-year-old, cystic fibrosis, admitted for PT exacerbation.
Question: Which dietary addition best promotes basic care & comfort?
Options:
A. Clear liquids only
B. High-calorie, high-protein snacks
C. Low-sodium diet
D. Lactose-free meals
(Correct: B)
Rationale:
● Answer: B
● Why (2026 Standard): CF causes malabsorption; energy-dense snacks support
growth.
● Errors: A insufficient calories; C unnecessary; D not universally needed.
Q004: Type: NGN - Bowtie
Scenario Context: 54-year-old male, new percutaneous endoscopic gastrostomy (PEG),
receives 250 mL formula over 30 min at 0800.
Question: Complete bowtie to prevent aspiration.
, Left risk factors:
1.High Fowler position
2.Cough during feeding
3.Residual 250 mL
4.G-tube clogged
Center action:
☐
Right outcomes:
A. Decrease aspiration risk
B. Increase aspiration risk
C. No effect
(Draw line: 2 → Center → B; 3 → Center → B; 1 → Center → A)
(Correct: 2-B, 3-B, 1-A)
Rationale:
● Answer: Cough & high residual indicate intolerance → hold feeding (aspiration
risk); High Fowler reduces risk.
● Errors: Clogged tube unrelated to aspiration directly.
Q005: Type: Traditional
Scenario Context: 33-week gestational age neonate, thermoregulation isolette.
Question: Priority nursing action to maintain neutral thermal environment?
Options:
A. Bathe every 8 h
B. Swaddle in blanket
C. Skin-to-skin with parent
D. Cover head with stockinet
(Correct: D)
Exam (3 Versions) | 2026 Verified Questions &
Answers | NGN-Style
Q001: Type: NGN - Extended Multiple Response
Scenario Context: 78-year-old female, Ms. Alvarez, post-op R hip ORIF, POD #1,
morphine PCA, history of COPD & HTN.
Question: Which assessments require immediate follow-up to reduce risk for respiratory
compromise? (Select all that apply.)
Options:
A. Respiratory rate 8/min
B. Oxygen saturation 89 % on 2 L NC
C. Patient difficult to arouse
D. PCA attempts 4 in last hour
E. Bilateral crackles auscultated
(Correct: A, B, C)
Rationale:
● Answer: A, B, C
, ● Why (2026 Standard): RR <10, SpO₂ <90 %, and altered LOC are early signs of
opioid-induced respiratory depression; prompt naloxone & provider notification
required.
● Errors: D reflects adequate analgesia seeking, not toxicity; E indicates fluid
overload unrelated to opioid risk.
Q002: Type: NGN - Matrix
Scenario Context: Continue Ms. Alvarez. Nurse reviews 0800 MAR.
Question: Identify which medications are appropriate to administer now. (Check “Give”
or “Hold” for each.)
Matrix:
┌──────────────────────┬──────┬──────┐
│ Medication │ Give │ Hold │
├──────────────────────┼──────┼──────┤
│ Morphine 8 mg IV PCA │ ☐ │ ☐ │
│ Lisinopril 10 mg PO │ ☐ │ ☐ │
│ Enoxaparin 40 mg SC │ ☐ │ ☐ │
│ Albuterol 2.5 mg NEB │ ☐ │ ☐ │
└──────────────────────┴──────┴──────┘
(Correct: Give Enoxaparin & Albuterol; Hold Morphine & Lisinopril)
Rationale:
, ● Answer: Hold morphine (RR 8), hold Lisinopril (SBP 98); give enoxaparin (DVT
prophylaxis OK) & albuterol (COPD).
● Errors: Giving morphine worsens respiratory status; Lisinopril risks further
hypotension.
Q003: Type: Traditional
Scenario Context: New patient: 8-year-old, cystic fibrosis, admitted for PT exacerbation.
Question: Which dietary addition best promotes basic care & comfort?
Options:
A. Clear liquids only
B. High-calorie, high-protein snacks
C. Low-sodium diet
D. Lactose-free meals
(Correct: B)
Rationale:
● Answer: B
● Why (2026 Standard): CF causes malabsorption; energy-dense snacks support
growth.
● Errors: A insufficient calories; C unnecessary; D not universally needed.
Q004: Type: NGN - Bowtie
Scenario Context: 54-year-old male, new percutaneous endoscopic gastrostomy (PEG),
receives 250 mL formula over 30 min at 0800.
Question: Complete bowtie to prevent aspiration.
, Left risk factors:
1.High Fowler position
2.Cough during feeding
3.Residual 250 mL
4.G-tube clogged
Center action:
☐
Right outcomes:
A. Decrease aspiration risk
B. Increase aspiration risk
C. No effect
(Draw line: 2 → Center → B; 3 → Center → B; 1 → Center → A)
(Correct: 2-B, 3-B, 1-A)
Rationale:
● Answer: Cough & high residual indicate intolerance → hold feeding (aspiration
risk); High Fowler reduces risk.
● Errors: Clogged tube unrelated to aspiration directly.
Q005: Type: Traditional
Scenario Context: 33-week gestational age neonate, thermoregulation isolette.
Question: Priority nursing action to maintain neutral thermal environment?
Options:
A. Bathe every 8 h
B. Swaddle in blanket
C. Skin-to-skin with parent
D. Cover head with stockinet
(Correct: D)
