2026 ATI RN Fundamentals – Proctored
Exam (3 Versions) | Verified Questions &
Answers | NGN-Style
Q001:
Type: NGN – Extended Multiple Response
Scenario Context: Mr. Delgado, 68 y/o, 1 day post-op L open reduction internal fixation (ORIF)
of tibial plateau fracture, PCA hydromorphone 0.2 mg/mL, 8-min lockout, IV D5NS at 80 mL/hr.
0800 assessment: T 37.1 °C, HR 88, RR 16, BP 124/78, SpO₂ 96 % on room air. He states, “I’m
afraid I’ll get addicted if I press the button too much.”
Question: Which nurse actions support safe and effective PCA use at this time? (Select ALL that
apply.)
Options:
A. Verify the pump’s concentration and lockout settings
B. Reassure that addiction is unlikely with short-term use
C. Coach to wait until pain is severe before dosing
D. Demonstrate how to rate pain on 0–10 scale
E. Check IV insertion site for patency
F. Document baseline sedation score
(Correct: A, B, D, E, F)
Rationale:
Answer: A, B, D, E, F
Why (2026 Standard): Safety checks (A,E), patient education (B,D), and sedation baseline (F)
align with 2026 APS guidelines.
Errors: C perpetuates pain-avoidance cycle; early dosing improves control.
Q002:
Type: Traditional
Scenario Context: (Continuing) At 1400 nurse finds patient difficult to arouse, RR 10, SpO₂ 90
%. PCA paused.
Question: After stimulating airway, immediate priority?
Options:
A. Administer naloxone 0.2 mg IV
B. Increase O₂ to 4 L NC
C. Obtain ABG
D. Call anesthesia provider
(Correct: A)
Rationale:
Answer: A
Why (2026 Standard): Opioid-induced respiratory depression requires prompt reversal;
low-dose naloxone preserves analgesia while restoring ventilation.
Errors: B, C, D delay antidote.
Q003:
, Type: NGN – Matrix
Scenario Context: Ms. Flores, 32 y/o, 28 wks gestation, admitted with influenza A pending PCR,
droplet isolation ordered.
Question: Match action to precaution type required at this time.
Matrix:
Wear surgical mask within 3 ft
Gown/gloves on contact
Place in negative-pressure room
Use dedicated stethoscope
A. Droplet only
B. Contact only
C. Both
Options:
A. 1-A, 2-C, 3-A, 4-B
B. 1-A, 2-B, 3-A, 4-C
C. 1-C, 2-B, 3-A, 4-B
D. 1-A, 2-B, 3-C, 4-B
(Correct: B)
Rationale:
Answer: B
Why (2026 Standard): Influenza is droplet; negative-pressure not required; dedicated equipment
prevents contact spread.
Errors: A misclassifies room; C adds unnecessary contact mask.
Q004:
Type: NGN – Bowtie
Scenario Context: Mr. Klein, 55 y/o, acute asthma, albuterol neb q4h, peak flow 200 L/min
(personal best 480).
Left cues (3): Choose 3
Middle (Correct action): Choose 1
Right complications (2): Choose 2
Left options:
A. RR 32
B. Accessory muscle use
C. Peak flow 42 % predicted
D. O₂ sat 94 % on 2 L
Middle options:
Start albuterol q20min × 3
Give magnesium sulfate
Increase O₂ to 4 L
Obtain chest X-ray
Right options:
X. Respiratory failure
Y. Pneumothorax
Z. Laryngospasm
Exam (3 Versions) | Verified Questions &
Answers | NGN-Style
Q001:
Type: NGN – Extended Multiple Response
Scenario Context: Mr. Delgado, 68 y/o, 1 day post-op L open reduction internal fixation (ORIF)
of tibial plateau fracture, PCA hydromorphone 0.2 mg/mL, 8-min lockout, IV D5NS at 80 mL/hr.
0800 assessment: T 37.1 °C, HR 88, RR 16, BP 124/78, SpO₂ 96 % on room air. He states, “I’m
afraid I’ll get addicted if I press the button too much.”
Question: Which nurse actions support safe and effective PCA use at this time? (Select ALL that
apply.)
Options:
A. Verify the pump’s concentration and lockout settings
B. Reassure that addiction is unlikely with short-term use
C. Coach to wait until pain is severe before dosing
D. Demonstrate how to rate pain on 0–10 scale
E. Check IV insertion site for patency
F. Document baseline sedation score
(Correct: A, B, D, E, F)
Rationale:
Answer: A, B, D, E, F
Why (2026 Standard): Safety checks (A,E), patient education (B,D), and sedation baseline (F)
align with 2026 APS guidelines.
Errors: C perpetuates pain-avoidance cycle; early dosing improves control.
Q002:
Type: Traditional
Scenario Context: (Continuing) At 1400 nurse finds patient difficult to arouse, RR 10, SpO₂ 90
%. PCA paused.
Question: After stimulating airway, immediate priority?
Options:
A. Administer naloxone 0.2 mg IV
B. Increase O₂ to 4 L NC
C. Obtain ABG
D. Call anesthesia provider
(Correct: A)
Rationale:
Answer: A
Why (2026 Standard): Opioid-induced respiratory depression requires prompt reversal;
low-dose naloxone preserves analgesia while restoring ventilation.
Errors: B, C, D delay antidote.
Q003:
, Type: NGN – Matrix
Scenario Context: Ms. Flores, 32 y/o, 28 wks gestation, admitted with influenza A pending PCR,
droplet isolation ordered.
Question: Match action to precaution type required at this time.
Matrix:
Wear surgical mask within 3 ft
Gown/gloves on contact
Place in negative-pressure room
Use dedicated stethoscope
A. Droplet only
B. Contact only
C. Both
Options:
A. 1-A, 2-C, 3-A, 4-B
B. 1-A, 2-B, 3-A, 4-C
C. 1-C, 2-B, 3-A, 4-B
D. 1-A, 2-B, 3-C, 4-B
(Correct: B)
Rationale:
Answer: B
Why (2026 Standard): Influenza is droplet; negative-pressure not required; dedicated equipment
prevents contact spread.
Errors: A misclassifies room; C adds unnecessary contact mask.
Q004:
Type: NGN – Bowtie
Scenario Context: Mr. Klein, 55 y/o, acute asthma, albuterol neb q4h, peak flow 200 L/min
(personal best 480).
Left cues (3): Choose 3
Middle (Correct action): Choose 1
Right complications (2): Choose 2
Left options:
A. RR 32
B. Accessory muscle use
C. Peak flow 42 % predicted
D. O₂ sat 94 % on 2 L
Middle options:
Start albuterol q20min × 3
Give magnesium sulfate
Increase O₂ to 4 L
Obtain chest X-ray
Right options:
X. Respiratory failure
Y. Pneumothorax
Z. Laryngospasm
