ATI Fundamentals 2026/2027 | ATI RN Fundamentals
Proctored Exam & Content Mastery Series (CMS) Study
Guide | ATI Fundamentals for Nursing Practice Questions,
Answers & Detailed Rationales | Nursing Fundamentals,
Nursing Process, Clinical Judgment, Patient-Centered
Care, Safety & Infection Control, Vital Signs, Health
Assessment, Communication, Documentation, Medication
Administration, Dosage Calculations, Pain Management,
Nutrition, Elimination, Mobility, Skin Integrity,
Oxygenation, Fluid & Electrolyte Balance, Perioperative
Nursing, Legal & Ethical Nursing, Patient Education,
Prioritization, Delegation & NGN Case-Based Practice
Question 1: A nurse is preparing to administer a medication to a client. Which
of the following is the most reliable method to verify the client's identity?
A. Checking the client's room number
B. Asking the client's family member to confirm identity
C. Using two identifiers, such as name and date of birth
D. Verifying the client's identity by looking at the medication administration record
alone
CORRECT ANSWER: C. Using two identifiers, such as name and date of birth
Rationale: The Joint Commission requires the use of two client identifiers when
administering medications, blood products, or treatments. Acceptable identifiers include
the client's name, medical record number, date of birth, or telephone number. Room
numbers and family member confirmations are not reliable identifiers.
Question 2: A nurse is preparing to insert an indwelling urinary catheter.
Which of the following actions requires immediate correction?
A. Using sterile technique throughout the procedure
B. Inflating the balloon with sterile water after urine is visualized
C. Lubricating the catheter with petroleum jelly before insertion
D. Cleansing the meatus with antiseptic solution before insertion
CORRECT ANSWER: C. Lubricating the catheter with petroleum jelly before
insertion
Rationale: Petroleum jelly is oil-based and can damage the catheter material, making it
more susceptible to breakage or infection. Water-soluble lubricant should be used for
urinary catheter insertion. Sterile technique, inflating the balloon after urine
visualization, and antiseptic cleansing are all correct actions.
,Question 3: A nurse is teaching a client who has a new prescription for
nitroglycerin sublingual tablets. Which of the following statements by the
client indicates a need for further teaching?
A. "I will take one tablet at the onset of chest pain."
B. "I will sit or lie down before taking this medication."
C. "I will swallow the tablet with a full glass of water."
D. "I will call 911 if my chest pain does not improve after 5 minutes."
CORRECT ANSWER: C. "I will swallow the tablet with a full glass of water."
Rationale: Sublingual nitroglycerin tablets must be placed under the tongue and allowed
to dissolve completely. Swallowing the tablet with water would prevent absorption
through the sublingual mucosa. Sitting or lying down is correct to prevent hypotension.
Calling 911 after 5 minutes of unrelieved pain is appropriate.
Question 4: A nurse is caring for a client who is receiving continuous enteral
feedings via a nasogastric tube. Which of the following actions is the priority
when the nurse suspects aspiration of the feeding?
A. Auscultate breath sounds
B. Stop the feeding
C. Obtain a chest x-ray
D. Initiate oxygen therapy
CORRECT ANSWER: B. Stop the feeding
Rationale: The priority action when aspiration is suspected is to immediately stop the
feeding to prevent further aspiration of formula into the lungs. Auscultating breath
sounds, obtaining a chest x-ray, and initiating oxygen are subsequent actions after the
source has been stopped.
Question 5: A nurse is preparing to administer a blood transfusion. The client's
vital signs are: BP 98/60 mm Hg, HR 110/min, RR 22/min, temperature 37.1°C
(98.8°F). Which action should the nurse take first?
A. Start the transfusion slowly at 2 mL/min
B. Notify the provider of the low blood pressure
C. Obtain a baseline set of vital signs
D. Administer 0.9% sodium chloride with the blood
CORRECT ANSWER: C. Obtain a baseline set of vital signs
Rationale: Obtaining baseline vital signs before initiating a blood transfusion is essential
to compare against measurements during and after the transfusion to detect a
,transfusion reaction. Starting the transfusion without baseline vital signs is unsafe. The
BP is within acceptable range for transfusion. Saline is used but is not the first action.
Question 6: A nurse is caring for a client who has a chest tube connected to a
water-seal drainage system. Which of the following findings indicates that the
chest tube is functioning properly?
A. Constant bubbling in the water-seal chamber
B. Intermittent bubbling in the water-seal chamber with respirations
C. No fluctuation in the water-seal chamber for 4 hours
D. Drainage of 200 mL of bright red blood in 1 hour
CORRECT ANSWER: B. Intermittent bubbling in the water-seal chamber with
respirations
Rationale: Intermittent bubbling (tidaling) in the water-seal chamber with respirations
indicates that air is being evacuated from the pleural space and the system is patent.
Constant bubbling may indicate an air leak. No fluctuation may indicate tube blockage.
Drainage of 200 mL of bright red blood in 1 hour is excessive and requires immediate
intervention.
Question 7: A nurse is preparing to administer medication via a nasogastric
tube. Which action best ensures accurate dosing and prevents tube occlusion?
A. Crush a sustained-release tablet and mix with 30 mL sterile water
B. Administer each medication separately and flush with 15 mL water between each
C. Mix all crushed medications together in 60 mL of warm water
D. Use the plunger of the syringe to push medication through the tube rapidly
CORRECT ANSWER: B. Administer each medication separately and flush with
15 mL water between each
Rationale: Administering each medication separately with a water flush between each
prevents drug-drug interactions and tube clogging. Sustained-release tablets should
never be crushed. Mixing multiple drugs together increases the risk of incompatibility.
Rapid pushing can cause tube rupture or aspiration.
Question 8: A nurse is caring for a client who has a pressure injury on the
sacrum. The wound bed is covered with yellow slough and has moderate
serosanguineous drainage. Which dressing should the nurse select?
A. Hydrocolloid dressing
B. Alginate dressing
C. Transparent film dressing
D. Hydrogel dressing
, CORRECT ANSWER: B. Alginate dressing
Rationale: Alginate dressings are highly absorbent and appropriate for wounds with
moderate to heavy exudate and slough. Hydrocolloid dressings are for light exudate.
Transparent film dressings are for dry wounds or protection. Hydrogel dressings are for
dry wounds with slough but are not suitable for moderate drainage.
Question 9: A nurse is teaching a client with a new colostomy about dietary
management. Which statement by the client indicates understanding?
A. "I will avoid foods like yogurt and buttermilk to prevent odor."
B. "I should eat more high-fiber foods like nuts and seeds to thicken stool."
C. "I need to chew food thoroughly and eat at regular intervals."
D. "I can use a stool softener daily to prevent constipation."
CORRECT ANSWER: C. "I need to chew food thoroughly and eat at regular
intervals."
Rationale: Chewing food thoroughly and eating at regular intervals reduces gas
production and the risk of blockage. Yogurt and buttermilk actually help reduce odor.
High-fiber foods like nuts and seeds can cause blockage. Stool softeners are not
routinely recommended.
Question 10: A nurse is reinforcing teaching with a client about living wills.
Which client statement indicates understanding?
A. "The living will appoints someone to make financial decisions for me."
B. "The living will directs my medical care when I am unable to make decisions."
C. "The living will allows my family to override my medical wishes."
D. "The living will only applies after I am declared brain dead."
CORRECT ANSWER: B. "The living will directs my medical care when I am
unable to make decisions."
Rationale: A living will is a legal document that outlines the medical treatments a client
wants or refuses if they become incapacitated and cannot make decisions. It is different
from a durable power of attorney for healthcare, which appoints someone to make
decisions. Family members cannot override a valid living will.
Question 11: A nurse is explaining ethical principles to a newly licensed nurse.
Allowing a client to make a decision about treatment is an example of which
ethical principle?
A. Justice
B. Autonomy
C. Fidelity
Proctored Exam & Content Mastery Series (CMS) Study
Guide | ATI Fundamentals for Nursing Practice Questions,
Answers & Detailed Rationales | Nursing Fundamentals,
Nursing Process, Clinical Judgment, Patient-Centered
Care, Safety & Infection Control, Vital Signs, Health
Assessment, Communication, Documentation, Medication
Administration, Dosage Calculations, Pain Management,
Nutrition, Elimination, Mobility, Skin Integrity,
Oxygenation, Fluid & Electrolyte Balance, Perioperative
Nursing, Legal & Ethical Nursing, Patient Education,
Prioritization, Delegation & NGN Case-Based Practice
Question 1: A nurse is preparing to administer a medication to a client. Which
of the following is the most reliable method to verify the client's identity?
A. Checking the client's room number
B. Asking the client's family member to confirm identity
C. Using two identifiers, such as name and date of birth
D. Verifying the client's identity by looking at the medication administration record
alone
CORRECT ANSWER: C. Using two identifiers, such as name and date of birth
Rationale: The Joint Commission requires the use of two client identifiers when
administering medications, blood products, or treatments. Acceptable identifiers include
the client's name, medical record number, date of birth, or telephone number. Room
numbers and family member confirmations are not reliable identifiers.
Question 2: A nurse is preparing to insert an indwelling urinary catheter.
Which of the following actions requires immediate correction?
A. Using sterile technique throughout the procedure
B. Inflating the balloon with sterile water after urine is visualized
C. Lubricating the catheter with petroleum jelly before insertion
D. Cleansing the meatus with antiseptic solution before insertion
CORRECT ANSWER: C. Lubricating the catheter with petroleum jelly before
insertion
Rationale: Petroleum jelly is oil-based and can damage the catheter material, making it
more susceptible to breakage or infection. Water-soluble lubricant should be used for
urinary catheter insertion. Sterile technique, inflating the balloon after urine
visualization, and antiseptic cleansing are all correct actions.
,Question 3: A nurse is teaching a client who has a new prescription for
nitroglycerin sublingual tablets. Which of the following statements by the
client indicates a need for further teaching?
A. "I will take one tablet at the onset of chest pain."
B. "I will sit or lie down before taking this medication."
C. "I will swallow the tablet with a full glass of water."
D. "I will call 911 if my chest pain does not improve after 5 minutes."
CORRECT ANSWER: C. "I will swallow the tablet with a full glass of water."
Rationale: Sublingual nitroglycerin tablets must be placed under the tongue and allowed
to dissolve completely. Swallowing the tablet with water would prevent absorption
through the sublingual mucosa. Sitting or lying down is correct to prevent hypotension.
Calling 911 after 5 minutes of unrelieved pain is appropriate.
Question 4: A nurse is caring for a client who is receiving continuous enteral
feedings via a nasogastric tube. Which of the following actions is the priority
when the nurse suspects aspiration of the feeding?
A. Auscultate breath sounds
B. Stop the feeding
C. Obtain a chest x-ray
D. Initiate oxygen therapy
CORRECT ANSWER: B. Stop the feeding
Rationale: The priority action when aspiration is suspected is to immediately stop the
feeding to prevent further aspiration of formula into the lungs. Auscultating breath
sounds, obtaining a chest x-ray, and initiating oxygen are subsequent actions after the
source has been stopped.
Question 5: A nurse is preparing to administer a blood transfusion. The client's
vital signs are: BP 98/60 mm Hg, HR 110/min, RR 22/min, temperature 37.1°C
(98.8°F). Which action should the nurse take first?
A. Start the transfusion slowly at 2 mL/min
B. Notify the provider of the low blood pressure
C. Obtain a baseline set of vital signs
D. Administer 0.9% sodium chloride with the blood
CORRECT ANSWER: C. Obtain a baseline set of vital signs
Rationale: Obtaining baseline vital signs before initiating a blood transfusion is essential
to compare against measurements during and after the transfusion to detect a
,transfusion reaction. Starting the transfusion without baseline vital signs is unsafe. The
BP is within acceptable range for transfusion. Saline is used but is not the first action.
Question 6: A nurse is caring for a client who has a chest tube connected to a
water-seal drainage system. Which of the following findings indicates that the
chest tube is functioning properly?
A. Constant bubbling in the water-seal chamber
B. Intermittent bubbling in the water-seal chamber with respirations
C. No fluctuation in the water-seal chamber for 4 hours
D. Drainage of 200 mL of bright red blood in 1 hour
CORRECT ANSWER: B. Intermittent bubbling in the water-seal chamber with
respirations
Rationale: Intermittent bubbling (tidaling) in the water-seal chamber with respirations
indicates that air is being evacuated from the pleural space and the system is patent.
Constant bubbling may indicate an air leak. No fluctuation may indicate tube blockage.
Drainage of 200 mL of bright red blood in 1 hour is excessive and requires immediate
intervention.
Question 7: A nurse is preparing to administer medication via a nasogastric
tube. Which action best ensures accurate dosing and prevents tube occlusion?
A. Crush a sustained-release tablet and mix with 30 mL sterile water
B. Administer each medication separately and flush with 15 mL water between each
C. Mix all crushed medications together in 60 mL of warm water
D. Use the plunger of the syringe to push medication through the tube rapidly
CORRECT ANSWER: B. Administer each medication separately and flush with
15 mL water between each
Rationale: Administering each medication separately with a water flush between each
prevents drug-drug interactions and tube clogging. Sustained-release tablets should
never be crushed. Mixing multiple drugs together increases the risk of incompatibility.
Rapid pushing can cause tube rupture or aspiration.
Question 8: A nurse is caring for a client who has a pressure injury on the
sacrum. The wound bed is covered with yellow slough and has moderate
serosanguineous drainage. Which dressing should the nurse select?
A. Hydrocolloid dressing
B. Alginate dressing
C. Transparent film dressing
D. Hydrogel dressing
, CORRECT ANSWER: B. Alginate dressing
Rationale: Alginate dressings are highly absorbent and appropriate for wounds with
moderate to heavy exudate and slough. Hydrocolloid dressings are for light exudate.
Transparent film dressings are for dry wounds or protection. Hydrogel dressings are for
dry wounds with slough but are not suitable for moderate drainage.
Question 9: A nurse is teaching a client with a new colostomy about dietary
management. Which statement by the client indicates understanding?
A. "I will avoid foods like yogurt and buttermilk to prevent odor."
B. "I should eat more high-fiber foods like nuts and seeds to thicken stool."
C. "I need to chew food thoroughly and eat at regular intervals."
D. "I can use a stool softener daily to prevent constipation."
CORRECT ANSWER: C. "I need to chew food thoroughly and eat at regular
intervals."
Rationale: Chewing food thoroughly and eating at regular intervals reduces gas
production and the risk of blockage. Yogurt and buttermilk actually help reduce odor.
High-fiber foods like nuts and seeds can cause blockage. Stool softeners are not
routinely recommended.
Question 10: A nurse is reinforcing teaching with a client about living wills.
Which client statement indicates understanding?
A. "The living will appoints someone to make financial decisions for me."
B. "The living will directs my medical care when I am unable to make decisions."
C. "The living will allows my family to override my medical wishes."
D. "The living will only applies after I am declared brain dead."
CORRECT ANSWER: B. "The living will directs my medical care when I am
unable to make decisions."
Rationale: A living will is a legal document that outlines the medical treatments a client
wants or refuses if they become incapacitated and cannot make decisions. It is different
from a durable power of attorney for healthcare, which appoints someone to make
decisions. Family members cannot override a valid living will.
Question 11: A nurse is explaining ethical principles to a newly licensed nurse.
Allowing a client to make a decision about treatment is an example of which
ethical principle?
A. Justice
B. Autonomy
C. Fidelity
