1|Page
Comprehensive Test Bank ATI Fundamentals
Proctored Exam with NGN Next Generation NCLEX-
Style Questions | High-Yield Practice | Detailed
Rationales 2026-2027 Edition | Graded A+.
Structure & Organization
This test bank is organized according to the ATI Fundamentals
Proctored Exam content outline, incorporating Next Generation NCLEX
(NGN) item types including case studies, bow-tie questions, and
enhanced hot spots.
NGN
Traditional Total
Domain Topics Covered Case
Q&A Items
Studies
Safe & Effective
I 20 2 30
Care Environment
Health Promotion
II 20 2 30
& Maintenance
Psychosocial
III 15 1 20
Integrity
,2|Page
NGN
Traditional Total
Domain Topics Covered Case
Q&A Items
Studies
Physiological
IV Integrity: Basic 25 2 35
Care
Physiological
Integrity:
V 20 1 25
Pharmacological
Therapies
Physiological
VI Integrity: 20 2 30
Reduction of Risk
Physiological
Integrity:
VII 20 2 30
Physiological
Adaptation
Total 140 12 200
PART I: Safe & Effective Care Environment
Traditional Questions 1-20 | NGN Case Studies 1-2
,3|Page
Traditional Questions
1. A nurse is preparing to administer a blood transfusion to a
patient. Which of the following actions is the priority before
initiating the transfusion?
A) Obtain the patient's vital signs
B) Verify the blood product with another nurse
C) Prime the tubing with 0.9% normal saline
D) Ensure the patient has signed a consent form
Answer: B) Verify the blood product with another nurse
Rationale: The priority action before a blood transfusion is verification
of the blood product with another licensed nurse using a two-nurse
verification process. This includes checking the patient's identification,
blood type, Rh factor, expiration date, and unit number. Vital signs
(option A) are important as a baseline but are not the priority. Priming
tubing (option C) should be done with normal saline but is not the
priority. Consent (option D) should already be obtained before the blood
is brought to the bedside.
2. A nurse is caring for a patient who has a new diagnosis of
Clostridium difficile. Which of the following precautions should the
nurse implement?
A) Airborne precautions
B) Droplet precautions
C) Contact precautions
D) Protective environment
, 4|Page
Answer: C) Contact precautions
Rationale: C. difficile is transmitted via the fecal-oral route and spores
that persist on surfaces. Contact precautions include a private room,
gown and gloves for all staff entering the room, and dedicated
equipment. Hand hygiene must be performed with soap and water
(alcohol-based hand sanitizer is ineffective against C. diff spores).
Airborne precautions are for tuberculosis, measles, varicella. Droplet
precautions are for influenza, meningitis. Protective environment is for
immunocompromised patients.
3. A nurse is preparing to insert a nasogastric tube. Which of the
following actions is appropriate to verify placement before initiating
feedings?
A) Auscultate for air insufflation
B) Aspirate gastric contents and check pH
C) Obtain a chest x-ray
D) Assess for coughing or gagging
Answer: C) Obtain a chest x-ray
Rationale: For initial placement of a nasogastric tube, a chest x-ray is
the gold standard for confirming proper placement in the stomach (not
the lungs or esophagus). After initial placement confirmation, aspirating
gastric contents and checking pH (option B) is appropriate for ongoing
verification. Auscultation (option A) is unreliable and may give false
reassurance. Coughing or gagging (option D) indicates airway irritation
but does not confirm placement.
Comprehensive Test Bank ATI Fundamentals
Proctored Exam with NGN Next Generation NCLEX-
Style Questions | High-Yield Practice | Detailed
Rationales 2026-2027 Edition | Graded A+.
Structure & Organization
This test bank is organized according to the ATI Fundamentals
Proctored Exam content outline, incorporating Next Generation NCLEX
(NGN) item types including case studies, bow-tie questions, and
enhanced hot spots.
NGN
Traditional Total
Domain Topics Covered Case
Q&A Items
Studies
Safe & Effective
I 20 2 30
Care Environment
Health Promotion
II 20 2 30
& Maintenance
Psychosocial
III 15 1 20
Integrity
,2|Page
NGN
Traditional Total
Domain Topics Covered Case
Q&A Items
Studies
Physiological
IV Integrity: Basic 25 2 35
Care
Physiological
Integrity:
V 20 1 25
Pharmacological
Therapies
Physiological
VI Integrity: 20 2 30
Reduction of Risk
Physiological
Integrity:
VII 20 2 30
Physiological
Adaptation
Total 140 12 200
PART I: Safe & Effective Care Environment
Traditional Questions 1-20 | NGN Case Studies 1-2
,3|Page
Traditional Questions
1. A nurse is preparing to administer a blood transfusion to a
patient. Which of the following actions is the priority before
initiating the transfusion?
A) Obtain the patient's vital signs
B) Verify the blood product with another nurse
C) Prime the tubing with 0.9% normal saline
D) Ensure the patient has signed a consent form
Answer: B) Verify the blood product with another nurse
Rationale: The priority action before a blood transfusion is verification
of the blood product with another licensed nurse using a two-nurse
verification process. This includes checking the patient's identification,
blood type, Rh factor, expiration date, and unit number. Vital signs
(option A) are important as a baseline but are not the priority. Priming
tubing (option C) should be done with normal saline but is not the
priority. Consent (option D) should already be obtained before the blood
is brought to the bedside.
2. A nurse is caring for a patient who has a new diagnosis of
Clostridium difficile. Which of the following precautions should the
nurse implement?
A) Airborne precautions
B) Droplet precautions
C) Contact precautions
D) Protective environment
, 4|Page
Answer: C) Contact precautions
Rationale: C. difficile is transmitted via the fecal-oral route and spores
that persist on surfaces. Contact precautions include a private room,
gown and gloves for all staff entering the room, and dedicated
equipment. Hand hygiene must be performed with soap and water
(alcohol-based hand sanitizer is ineffective against C. diff spores).
Airborne precautions are for tuberculosis, measles, varicella. Droplet
precautions are for influenza, meningitis. Protective environment is for
immunocompromised patients.
3. A nurse is preparing to insert a nasogastric tube. Which of the
following actions is appropriate to verify placement before initiating
feedings?
A) Auscultate for air insufflation
B) Aspirate gastric contents and check pH
C) Obtain a chest x-ray
D) Assess for coughing or gagging
Answer: C) Obtain a chest x-ray
Rationale: For initial placement of a nasogastric tube, a chest x-ray is
the gold standard for confirming proper placement in the stomach (not
the lungs or esophagus). After initial placement confirmation, aspirating
gastric contents and checking pH (option B) is appropriate for ongoing
verification. Auscultation (option A) is unreliable and may give false
reassurance. Coughing or gagging (option D) indicates airway irritation
but does not confirm placement.
