2026 ATI RN Fundamentals – Proctored Actual Exam (3
Versions) | Verified Questions & Answers | NGN-Style
Q001:
Type: NGN - Extended Multiple Response
Scenario Context: Mr. Thomas, a 72-year-old male recovering from pneumonia, is on 2L
NC oxygen. He has a history of COPD and coronary artery disease. During morning
assessment, his SpO2 is 95%, but he appears increasingly somnolent and his respiratory
rate has decreased to 10 breaths/min.
Question: Which assessment findings require immediate intervention by the nurse?
(Select all that apply)
Options:
A. Somnolence in a patient with baseline alertness
B. SpO2 of 95% on 2L NC
C. Respiratory rate of 10 breaths/min
D. Fine crackles in lung bases
E. Oxygen flow rate set at 2L/min
F. Patient unable to cough effectively
Correct: A, C, F
Rationale:
● Answer: A, C, F
● Why (2026 Standard): Somnolence with decreased RR suggests CO2 narcosis in
COPD patients—requires immediate ABG and possible ventilation support per
2026 GOLD guidelines. RR <12 is abnormal. Ineffective cough impairs secretion
clearance, increasing atelectasis risk. SpO2 of 95% can be misleading in chronic
CO2 retainers.
● Errors: B is acceptable for COPD. D is resolving pneumonia finding. E is
prescribed rate.
Q002:
Type: NGN - Matrix
,Scenario Context: Ms. Chen, a 38-year-old postpartum day 2, is being discharged after a
vaginal delivery with midline episiotomy. She is breastfeeding and taking ibuprofen for
pain. The nurse is providing discharge teaching.
Question: Categorize each instruction as Critical Teaching, Important Teaching, or
Non-Essential for this patient.
Options:
A. Perform perineal care with warm water after each voiding
B. Take ibuprofen 800 mg every 6 hours on empty stomach
C. Report clots larger than a golf ball
D. Expect lochia rubra for 2-3 weeks
E. Use stool softeners to prevent constipation
F. Resume sexual intercourse when lochia stops
Correct: A=Critical Teaching, B=Non-Essential, C=Critical Teaching, D=Non-Essential,
E=Important Teaching, F=Important Teaching
Rationale:
● Answer: A=Critical Teaching, B=Non-Essential, C=Critical Teaching,
D=Non-Essential, E=Important Teaching, F=Important Teaching
● Why (2026 Standard): Proper perineal care prevents infection and promotes
healing—critical. Large clots indicate hemorrhage—critical. Stool softeners
prevent wound disruption—important. NSAIDs should be taken with food (B is
wrong teaching). Lochia rubra lasts 3-5 days, not weeks (D is incorrect). Resume
intercourse after 4-6 weeks and provider clearance, not when lochia stops.
● Errors: B incorrect administration. D incorrect timeline. F incomplete guidance.
Q003:
Type: Traditional
Scenario Context: A patient is prescribed cephalexin 500 mg PO QID for 7 days. The
pharmacy dispenses 250 mg capsules. How many capsules should the nurse administer
per dose?
Options:
A. 1 capsule
B. 2 capsules
C. 3 capsules
D. 4 capsules
Correct: B
,Rationale:
● Answer: B
● Why (2026 Standard): Simple conversion: 500 mg ÷ 250 mg/capsule = 2 capsules.
Per ISMP 2026, verify calculation with another RN for high-alert patients.
● Errors: A underdose, C and D overdose.
Q004:
Type: NGN - Bowtie
Scenario Context: Ms. Rodriguez, a 54-year-old with type 1 diabetes, is admitted with a
blood glucose of 45 mg/dL. She is conscious but diaphoretic and trembling. She reports
taking her usual insulin dose but eating very little due to nausea.
Question: Complete the bowtie by selecting: (1) Priority Nursing Diagnosis, (2)
Immediate Action, (3) Potential Complication if Untreated.
Options:
A. Risk for Unstable Glucose
B. Risk for Injury
C. Give 15 g fast-acting carbohydrates PO
D. Start D5W IV infusion
E. Give glucagon 1 mg IM
F. Seizure Activity
Correct: A, C, F
Rationale:
● Answer: A, C, F
● Why (2026 Standard): Conscious hypoglycemia gets 15-20g fast-acting carbs PO
per 2026 ADA guidelines—raises glucose in 15 minutes. Risk for unstable glucose
is priority diagnosis. Untreated hypoglycemia leads to seizures, coma, death. IV
dextrose is for unconscious patients. Glucagon is for severe hypoglycemia when
PO contraindicated.
● Errors: B non-specific. D wrong route for conscious patient. E wrong severity
level.
Q005:
Type: NGN - Extended Multiple Response
, Scenario Context: A 79-year-old resident in long-term care with dementia is refusing
morning medications, stating "those are poison." The nurse attempts medication
administration.
Question: Which actions are appropriate in this situation? (Select all that apply)
Options:
A. Crush medications and mix in applesauce without telling patient
B. Explain purpose of each medication simply
C. Return in 30 minutes to try again
D. Hold all medications until patient is cooperative
E. Use liquid formulations when available
F. Document refusal and notify provider
Correct: B, C, E, F
Rationale:
● Answer: B, C, E, F
● Why (2026 Standard): Patient has right to refuse—even with dementia. Attempt
education, reapproach, use easier forms, document, and notify. Crushing and
hiding violates patient rights and is false imprisonment per 2026 ANA Code of
Ethics. Holding all meds without provider order is inappropriate.
● Errors: A violates autonomy and is potentially unsafe. D requires provider input.
Q006:
Type: NGN - Drag-and-Drop
Scenario Context: You are delegating morning care for four patients to one UAP. Patient
A: post-op appy day 1, stable. Patient B: acute COPD exacerbation, on 4L O2. Patient C:
new colostomy, learning self-care. Patient D: admission VS and height.
Question: Drag each patient to the appropriate caregiver (UAP alone, RN alone, or Both
must assist).
Options:
A. Patient A → UAP alone
B. Patient B → Both must assist
C. Patient C → RN alone
D. Patient D → UAP alone
Correct: A, B, C, D
Versions) | Verified Questions & Answers | NGN-Style
Q001:
Type: NGN - Extended Multiple Response
Scenario Context: Mr. Thomas, a 72-year-old male recovering from pneumonia, is on 2L
NC oxygen. He has a history of COPD and coronary artery disease. During morning
assessment, his SpO2 is 95%, but he appears increasingly somnolent and his respiratory
rate has decreased to 10 breaths/min.
Question: Which assessment findings require immediate intervention by the nurse?
(Select all that apply)
Options:
A. Somnolence in a patient with baseline alertness
B. SpO2 of 95% on 2L NC
C. Respiratory rate of 10 breaths/min
D. Fine crackles in lung bases
E. Oxygen flow rate set at 2L/min
F. Patient unable to cough effectively
Correct: A, C, F
Rationale:
● Answer: A, C, F
● Why (2026 Standard): Somnolence with decreased RR suggests CO2 narcosis in
COPD patients—requires immediate ABG and possible ventilation support per
2026 GOLD guidelines. RR <12 is abnormal. Ineffective cough impairs secretion
clearance, increasing atelectasis risk. SpO2 of 95% can be misleading in chronic
CO2 retainers.
● Errors: B is acceptable for COPD. D is resolving pneumonia finding. E is
prescribed rate.
Q002:
Type: NGN - Matrix
,Scenario Context: Ms. Chen, a 38-year-old postpartum day 2, is being discharged after a
vaginal delivery with midline episiotomy. She is breastfeeding and taking ibuprofen for
pain. The nurse is providing discharge teaching.
Question: Categorize each instruction as Critical Teaching, Important Teaching, or
Non-Essential for this patient.
Options:
A. Perform perineal care with warm water after each voiding
B. Take ibuprofen 800 mg every 6 hours on empty stomach
C. Report clots larger than a golf ball
D. Expect lochia rubra for 2-3 weeks
E. Use stool softeners to prevent constipation
F. Resume sexual intercourse when lochia stops
Correct: A=Critical Teaching, B=Non-Essential, C=Critical Teaching, D=Non-Essential,
E=Important Teaching, F=Important Teaching
Rationale:
● Answer: A=Critical Teaching, B=Non-Essential, C=Critical Teaching,
D=Non-Essential, E=Important Teaching, F=Important Teaching
● Why (2026 Standard): Proper perineal care prevents infection and promotes
healing—critical. Large clots indicate hemorrhage—critical. Stool softeners
prevent wound disruption—important. NSAIDs should be taken with food (B is
wrong teaching). Lochia rubra lasts 3-5 days, not weeks (D is incorrect). Resume
intercourse after 4-6 weeks and provider clearance, not when lochia stops.
● Errors: B incorrect administration. D incorrect timeline. F incomplete guidance.
Q003:
Type: Traditional
Scenario Context: A patient is prescribed cephalexin 500 mg PO QID for 7 days. The
pharmacy dispenses 250 mg capsules. How many capsules should the nurse administer
per dose?
Options:
A. 1 capsule
B. 2 capsules
C. 3 capsules
D. 4 capsules
Correct: B
,Rationale:
● Answer: B
● Why (2026 Standard): Simple conversion: 500 mg ÷ 250 mg/capsule = 2 capsules.
Per ISMP 2026, verify calculation with another RN for high-alert patients.
● Errors: A underdose, C and D overdose.
Q004:
Type: NGN - Bowtie
Scenario Context: Ms. Rodriguez, a 54-year-old with type 1 diabetes, is admitted with a
blood glucose of 45 mg/dL. She is conscious but diaphoretic and trembling. She reports
taking her usual insulin dose but eating very little due to nausea.
Question: Complete the bowtie by selecting: (1) Priority Nursing Diagnosis, (2)
Immediate Action, (3) Potential Complication if Untreated.
Options:
A. Risk for Unstable Glucose
B. Risk for Injury
C. Give 15 g fast-acting carbohydrates PO
D. Start D5W IV infusion
E. Give glucagon 1 mg IM
F. Seizure Activity
Correct: A, C, F
Rationale:
● Answer: A, C, F
● Why (2026 Standard): Conscious hypoglycemia gets 15-20g fast-acting carbs PO
per 2026 ADA guidelines—raises glucose in 15 minutes. Risk for unstable glucose
is priority diagnosis. Untreated hypoglycemia leads to seizures, coma, death. IV
dextrose is for unconscious patients. Glucagon is for severe hypoglycemia when
PO contraindicated.
● Errors: B non-specific. D wrong route for conscious patient. E wrong severity
level.
Q005:
Type: NGN - Extended Multiple Response
, Scenario Context: A 79-year-old resident in long-term care with dementia is refusing
morning medications, stating "those are poison." The nurse attempts medication
administration.
Question: Which actions are appropriate in this situation? (Select all that apply)
Options:
A. Crush medications and mix in applesauce without telling patient
B. Explain purpose of each medication simply
C. Return in 30 minutes to try again
D. Hold all medications until patient is cooperative
E. Use liquid formulations when available
F. Document refusal and notify provider
Correct: B, C, E, F
Rationale:
● Answer: B, C, E, F
● Why (2026 Standard): Patient has right to refuse—even with dementia. Attempt
education, reapproach, use easier forms, document, and notify. Crushing and
hiding violates patient rights and is false imprisonment per 2026 ANA Code of
Ethics. Holding all meds without provider order is inappropriate.
● Errors: A violates autonomy and is potentially unsafe. D requires provider input.
Q006:
Type: NGN - Drag-and-Drop
Scenario Context: You are delegating morning care for four patients to one UAP. Patient
A: post-op appy day 1, stable. Patient B: acute COPD exacerbation, on 4L O2. Patient C:
new colostomy, learning self-care. Patient D: admission VS and height.
Question: Drag each patient to the appropriate caregiver (UAP alone, RN alone, or Both
must assist).
Options:
A. Patient A → UAP alone
B. Patient B → Both must assist
C. Patient C → RN alone
D. Patient D → UAP alone
Correct: A, B, C, D
