ATI Fundamentals exam 2025/2026 COMPLETE
QUESTIONS WITH CORRECT DETAILED
ANSWERS
DOMAIN 1: NURSING PROCESS & CLINICAL JUDGMENT
1. A nurse is caring for a client and notices a change in their condition. Which step of the nursing
process involves collecting subjective and objective data?
A. Planning
B. Implementation
C. Assessment (correct answer)
D. Evaluation
RATIONALE: Assessment is the FIRST step of the nursing process (ADPIE) and involves
collecting comprehensive subjective data (what the client reports) and objective data (what
the nurse observes/measures). All other steps depend on accurate, thorough assessment
data. Assessment is ongoing throughout the nurse-client relationship, not just at admission.
2. A nurse writes the following statement: "Client will ambulate 50 feet with a walker by end of
shift." This is an example of which part of the nursing process?
A. Assessment
B. Nursing diagnosis
C. Planning (correct answer)
D. Implementation
RATIONALE: Planning involves setting measurable, client-centered goals and expected
outcomes. A well-written outcome is SMART: Specific (ambulate 50 feet), Measurable (50
feet), Achievable, Realistic, and Time-bound (by end of shift). Goals guide interventions
and provide criteria for evaluation. This is the third step of ADPIE.
3. A nurse administers a prescribed medication to a client. This action represents which step of
the nursing process?
A. Assessment
, B. Planning
C. Implementation (correct answer)
D. Evaluation
RATIONALE: Implementation is the fourth step of ADPIE — it involves carrying out the
planned nursing interventions. Administering medications, performing procedures,
providing education, and executing care activities are all implementation activities.
Implementation must follow assessment, diagnosis, and planning to be safe and effective.
4. A nurse reassesses a client after implementing pain interventions and finds the pain decreased
from 8/10 to 3/10. This represents which step of the nursing process?
A. Assessment
B. Planning
C. Implementation
D. Evaluation (correct answer)
RATIONALE: Evaluation is the fifth step of ADPIE — it involves determining whether the
client achieved the expected outcomes of the nursing interventions. Comparing the client's
response (pain 3/10) to the established goal determines the effectiveness of care. If goals are
not met, the nurse reassesses and modifies the plan of care.
5. When prioritizing nursing diagnoses, which nursing diagnosis has the highest priority using
Maslow's Hierarchy of Needs?
A. Ineffective coping related to new diagnosis
B. Ineffective airway clearance related to excessive secretions (correct answer)
C. Disturbed body image related to weight gain
D. Social isolation related to hospitalization
RATIONALE: Maslow's hierarchy prioritizes physiological needs first (survival needs —
air, water, food, shelter). Ineffective airway clearance directly threatens the most basic
physiological need — oxygen. Without a patent airway, all other needs become irrelevant.
Coping, body image, and social isolation are higher-level psychosocial needs addressed
after physiological stability.
6. A nurse is writing a nursing diagnosis for a client who has difficulty breathing related to
COPD. Which nursing diagnosis is correctly written using PES format?
A. COPD related to smoking
, B. Ineffective breathing pattern related to airway obstruction as evidenced by
respiratory rate of 28 breaths/min and use of accessory muscles (correct answer)
C. Dyspnea related to ineffective breathing
D. Respiratory distress as evidenced by COPD
RATIONALE: A correctly written NANDA nursing diagnosis in PES format includes:
Problem (ineffective breathing pattern) + Etiology/related to (airway obstruction — the
cause) + Signs/Symptoms as evidenced by (objective/subjective data supporting the
diagnosis). The etiology should never be a medical diagnosis — it should be a modifiable
factor the nurse can address. The "as evidenced by" provides clinical evidence.
7. A nurse is collecting data on a newly admitted client. The client states, "I have had a headache
for three days." This is an example of:
A. Objective data
B. Subjective data (correct answer)
C. Secondary data
D. Validated data
RATIONALE: Subjective data is information reported by the client (or family/significant
other) that cannot be directly observed or measured by the nurse — symptoms such as
pain, nausea, fatigue, anxiety, and headache. Objective data is observable and measurable
— vital signs, laboratory results, physical assessment findings. Both types of data are
essential for complete assessment.
8. A nurse measures a client's blood pressure as 148/92 mmHg. This is an example of:
A. Subjective data
B. Objective data (correct answer)
C. Primary data
D. Tertiary data
RATIONALE: Objective data is observable, measurable, and verifiable by the nurse or
other healthcare providers. Blood pressure measurements, vital signs, laboratory values,
physical assessment findings (breath sounds, skin color, edema), and diagnostic results are
all objective data. Unlike subjective data, objective findings can be independently
confirmed by other observers.
9. Which statement by a nursing student best demonstrates understanding of the critical thinking
process in nursing?
, A. "I follow the care plan exactly as written regardless of client changes."
B. "I continuously analyze data, question assumptions, and adjust my care based on
the client's response." (correct answer)
C. "Critical thinking means memorizing all nursing protocols."
D. "I ask the charge nurse before making any clinical decisions."
RATIONALE: Critical thinking in nursing involves purposeful, reflective reasoning —
analyzing data objectively, questioning assumptions, considering alternatives, and making
evidence-based clinical judgments. It is an active, ongoing cognitive process that leads to
sound clinical decisions. Following protocols without thought or always deferring to others
represents lack of clinical judgment development.
10. A nurse is caring for a client and identifies a discrepancy between the client's verbal report
and physical assessment findings. What is the most appropriate nursing action?
A. Document only what the client reports
B. Document only the physical findings
C. Document both findings and clarify the discrepancy through further assessment
(correct answer)
D. Report only to the charge nurse without documenting
RATIONALE: Both subjective (client-reported) and objective (nurse-observed) data must
be documented accurately. Discrepancies between the two are clinically significant and
require further investigation — they may indicate denial, altered cognition, cultural pain
expression differences, or other important clinical information. Complete, accurate
documentation supports safe, continuity of care.
DOMAIN 2: VITAL SIGNS
11. A nurse is assessing an adult client's blood pressure. Which value falls within the normal
range?
A. 145/92 mmHg
B. 118/76 mmHg (correct answer)
C. 160/100 mmHg
D. 90/50 mmHg
RATIONALE: Normal adult blood pressure (AHA 2017 guidelines): <120/80 mmHg =
normal; 120-129/<80 = elevated; 130-139/80-89 = Stage 1 hypertension; ≥140/90 = Stage 2
hypertension; <90/60 = hypotension. 118/76 mmHg falls within the normal range. 145/92
and 160/100 indicate hypertension. 90/50 indicates hypotension requiring assessment for
shock or other causes.
QUESTIONS WITH CORRECT DETAILED
ANSWERS
DOMAIN 1: NURSING PROCESS & CLINICAL JUDGMENT
1. A nurse is caring for a client and notices a change in their condition. Which step of the nursing
process involves collecting subjective and objective data?
A. Planning
B. Implementation
C. Assessment (correct answer)
D. Evaluation
RATIONALE: Assessment is the FIRST step of the nursing process (ADPIE) and involves
collecting comprehensive subjective data (what the client reports) and objective data (what
the nurse observes/measures). All other steps depend on accurate, thorough assessment
data. Assessment is ongoing throughout the nurse-client relationship, not just at admission.
2. A nurse writes the following statement: "Client will ambulate 50 feet with a walker by end of
shift." This is an example of which part of the nursing process?
A. Assessment
B. Nursing diagnosis
C. Planning (correct answer)
D. Implementation
RATIONALE: Planning involves setting measurable, client-centered goals and expected
outcomes. A well-written outcome is SMART: Specific (ambulate 50 feet), Measurable (50
feet), Achievable, Realistic, and Time-bound (by end of shift). Goals guide interventions
and provide criteria for evaluation. This is the third step of ADPIE.
3. A nurse administers a prescribed medication to a client. This action represents which step of
the nursing process?
A. Assessment
, B. Planning
C. Implementation (correct answer)
D. Evaluation
RATIONALE: Implementation is the fourth step of ADPIE — it involves carrying out the
planned nursing interventions. Administering medications, performing procedures,
providing education, and executing care activities are all implementation activities.
Implementation must follow assessment, diagnosis, and planning to be safe and effective.
4. A nurse reassesses a client after implementing pain interventions and finds the pain decreased
from 8/10 to 3/10. This represents which step of the nursing process?
A. Assessment
B. Planning
C. Implementation
D. Evaluation (correct answer)
RATIONALE: Evaluation is the fifth step of ADPIE — it involves determining whether the
client achieved the expected outcomes of the nursing interventions. Comparing the client's
response (pain 3/10) to the established goal determines the effectiveness of care. If goals are
not met, the nurse reassesses and modifies the plan of care.
5. When prioritizing nursing diagnoses, which nursing diagnosis has the highest priority using
Maslow's Hierarchy of Needs?
A. Ineffective coping related to new diagnosis
B. Ineffective airway clearance related to excessive secretions (correct answer)
C. Disturbed body image related to weight gain
D. Social isolation related to hospitalization
RATIONALE: Maslow's hierarchy prioritizes physiological needs first (survival needs —
air, water, food, shelter). Ineffective airway clearance directly threatens the most basic
physiological need — oxygen. Without a patent airway, all other needs become irrelevant.
Coping, body image, and social isolation are higher-level psychosocial needs addressed
after physiological stability.
6. A nurse is writing a nursing diagnosis for a client who has difficulty breathing related to
COPD. Which nursing diagnosis is correctly written using PES format?
A. COPD related to smoking
, B. Ineffective breathing pattern related to airway obstruction as evidenced by
respiratory rate of 28 breaths/min and use of accessory muscles (correct answer)
C. Dyspnea related to ineffective breathing
D. Respiratory distress as evidenced by COPD
RATIONALE: A correctly written NANDA nursing diagnosis in PES format includes:
Problem (ineffective breathing pattern) + Etiology/related to (airway obstruction — the
cause) + Signs/Symptoms as evidenced by (objective/subjective data supporting the
diagnosis). The etiology should never be a medical diagnosis — it should be a modifiable
factor the nurse can address. The "as evidenced by" provides clinical evidence.
7. A nurse is collecting data on a newly admitted client. The client states, "I have had a headache
for three days." This is an example of:
A. Objective data
B. Subjective data (correct answer)
C. Secondary data
D. Validated data
RATIONALE: Subjective data is information reported by the client (or family/significant
other) that cannot be directly observed or measured by the nurse — symptoms such as
pain, nausea, fatigue, anxiety, and headache. Objective data is observable and measurable
— vital signs, laboratory results, physical assessment findings. Both types of data are
essential for complete assessment.
8. A nurse measures a client's blood pressure as 148/92 mmHg. This is an example of:
A. Subjective data
B. Objective data (correct answer)
C. Primary data
D. Tertiary data
RATIONALE: Objective data is observable, measurable, and verifiable by the nurse or
other healthcare providers. Blood pressure measurements, vital signs, laboratory values,
physical assessment findings (breath sounds, skin color, edema), and diagnostic results are
all objective data. Unlike subjective data, objective findings can be independently
confirmed by other observers.
9. Which statement by a nursing student best demonstrates understanding of the critical thinking
process in nursing?
, A. "I follow the care plan exactly as written regardless of client changes."
B. "I continuously analyze data, question assumptions, and adjust my care based on
the client's response." (correct answer)
C. "Critical thinking means memorizing all nursing protocols."
D. "I ask the charge nurse before making any clinical decisions."
RATIONALE: Critical thinking in nursing involves purposeful, reflective reasoning —
analyzing data objectively, questioning assumptions, considering alternatives, and making
evidence-based clinical judgments. It is an active, ongoing cognitive process that leads to
sound clinical decisions. Following protocols without thought or always deferring to others
represents lack of clinical judgment development.
10. A nurse is caring for a client and identifies a discrepancy between the client's verbal report
and physical assessment findings. What is the most appropriate nursing action?
A. Document only what the client reports
B. Document only the physical findings
C. Document both findings and clarify the discrepancy through further assessment
(correct answer)
D. Report only to the charge nurse without documenting
RATIONALE: Both subjective (client-reported) and objective (nurse-observed) data must
be documented accurately. Discrepancies between the two are clinically significant and
require further investigation — they may indicate denial, altered cognition, cultural pain
expression differences, or other important clinical information. Complete, accurate
documentation supports safe, continuity of care.
DOMAIN 2: VITAL SIGNS
11. A nurse is assessing an adult client's blood pressure. Which value falls within the normal
range?
A. 145/92 mmHg
B. 118/76 mmHg (correct answer)
C. 160/100 mmHg
D. 90/50 mmHg
RATIONALE: Normal adult blood pressure (AHA 2017 guidelines): <120/80 mmHg =
normal; 120-129/<80 = elevated; 130-139/80-89 = Stage 1 hypertension; ≥140/90 = Stage 2
hypertension; <90/60 = hypotension. 118/76 mmHg falls within the normal range. 145/92
and 160/100 indicate hypertension. 90/50 indicates hypotension requiring assessment for
shock or other causes.
