ATI RN FUNDAMENTALS RETAKE
DRILL EXAM 2026 — 85
COMPREHENSIVE PRACTICE
QUESTIONS & RATIONALES :
QUESTIONS AND
RATIONALES/GRADED A+
UPDATE 100% CORRECT
📌 SECTION 1: NURSING PROCESS & CLINICAL
JUDGMENT (ADPIE)
Question 1
A nurse is caring for a client who reports severe abdominal pain and rates it “8 out of
10” on the pain scale. The nurse reviews the client’s chart, notes vital signs, and
auscultates bowel sounds. Which phase of the nursing process is the nurse primarily
engaged in?
• A) Planning
• B) Implementation
• C) Assessment
• D) Diagnosis
Rationale: Assessment is the first step of the ADPIE nursing process and involves
systematically collecting data (subjective and objective) about the client’s health
status. In this scenario, the nurse is gathering pain rating and physical assessment
data, which clearly falls under Assessment.
,Question 2
After reviewing a client’s assessment findings, a nurse identifies the following
problem: Ineffective Airway Clearance related to excessive mucus production. This step
in the nursing process is known as:
• A) Assessment
• B) Nursing Diagnosis
• C) Evaluation
• D) Planning
Rationale: Formulating a nursing diagnosis is the second step of ADPIE. The nurse
clusters assessment data, identifies patterns, and states an actual or potential client
problem requiring nursing intervention.
Question 3
A nurse writes the following outcome for a client with Impaired Physical Mobility:
“Client will ambulate 50 feet in the hallway twice daily by postoperative day 2.” Which
phase of the nursing process does this represent?
• A) Implementation
• B) Assessment
• C) Evaluation
• D) Planning
Rationale: The planning phase involves establishing client goals and desired
outcomes that are measurable, realistic, and time-bound. The statement given is a
clear outcome statement, which is created during the planning phase.
Question 4
A nurse has been providing complete bed care to an immobile client, including
repositioning every 2 hours. At the end of the shift, the nurse observes the client’s
sacral skin is intact without redness. The nurse is currently performing which step of
the nursing process?
• A) Diagnosis
• B) Planning
• C) Implementation
• D) Evaluation
,Rationale: Evaluation occurs after interventions are implemented. The nurse assesses
the client’s response to nursing actions (repositioning) and determines whether the
desired outcome (intact skin) was achieved.
Question 5
A client with newly diagnosed Type 2 diabetes mellitus asks, “Why do I need to check
my feet every day?” The nurse explains the rationale and demonstrates proper foot
inspection. This nursing action occurs during which phase of the nursing process?
• A) Assessment
• B) Diagnosis
• C) Planning
• D) Implementation
Rationale: Implementation is the phase in which the nurse executes the nursing
interventions planned. Teaching the client a skill (daily foot inspection) and providing
the rationale qualifies as implementation.
Question 6
A nurse is utilizing the Situation, Background, Assessment, Recommendation
(SBAR) technique to communicate about a client whose blood pressure has dropped
sharply. Which component of SBAR would the nurse use to state the client’s current
vital signs?
• A) Situation
• B) Background
• C) Assessment
• D) Recommendation
Rationale: In SBAR, the “Assessment” component includes the nurse’s current clinical
findings, such as vital signs, physical assessment data, and analysis of the problem.
Stating that the blood pressure has “dropped from 120/80 to 90/60” is the
Assessment portion.
Question 7
A graduate nurse asks the preceptor, “How do I know whether I should delegate a
task to the nursing assistant?” Which response by the preceptor best reflects
appropriate delegation principles?
, • A) “Delegate any tasks you are too busy to complete.”
• B) “Use the five rights of delegation: right task, right circumstances, right
person, right direction, and right supervision.”
• C) “Only delegate tasks that are not within the RN’s scope of practice.”
• D) “Delegation is not allowed in acute care settings.”
Rationale: The five rights of delegation provide a framework for safe delegation:
right task, right circumstances, right person, right direction/communication, and right
supervision/evaluation. Delegation never transfers accountability from the RN.
Question 8
A charge nurse is observing a newly licensed nurse provide care for a client on
contact precautions. Which action requires the charge nurse to intervene?
• A) Wearing a gown and gloves before entering the room
• B) Placing a “Contact Precautions” sign on the client’s door
• C) Removing gloves after touching the client and before leaving the
room, without performing hand hygiene afterward
• D) Using the client’s designated blood pressure cuff and stethoscope
Rationale: Hand hygiene must always be performed immediately after removing
gloves because gloves can have micro-tears that allow contamination. Failing to
perform hand hygiene after glove removal is a breach of infection control standards.
Question 9
A nurse is planning care for a client who has a new diagnosis of hypertension. The
nurse knows that which of the following is the priority action?
• A) Schedule a follow-up appointment with the primary care provider
• B) Assess the client’s blood pressure and vital signs
• C) Provide education on the DASH diet
• D) Discuss the side effects of antihypertensive medications
Rationale: Using the ABCs (Airway, Breathing, Circulation) and Maslow’s hierarchy,
assessment of the client’s vital signs — especially blood pressure — is the priority
before any teaching or follow-up planning can occur.
Question 10
DRILL EXAM 2026 — 85
COMPREHENSIVE PRACTICE
QUESTIONS & RATIONALES :
QUESTIONS AND
RATIONALES/GRADED A+
UPDATE 100% CORRECT
📌 SECTION 1: NURSING PROCESS & CLINICAL
JUDGMENT (ADPIE)
Question 1
A nurse is caring for a client who reports severe abdominal pain and rates it “8 out of
10” on the pain scale. The nurse reviews the client’s chart, notes vital signs, and
auscultates bowel sounds. Which phase of the nursing process is the nurse primarily
engaged in?
• A) Planning
• B) Implementation
• C) Assessment
• D) Diagnosis
Rationale: Assessment is the first step of the ADPIE nursing process and involves
systematically collecting data (subjective and objective) about the client’s health
status. In this scenario, the nurse is gathering pain rating and physical assessment
data, which clearly falls under Assessment.
,Question 2
After reviewing a client’s assessment findings, a nurse identifies the following
problem: Ineffective Airway Clearance related to excessive mucus production. This step
in the nursing process is known as:
• A) Assessment
• B) Nursing Diagnosis
• C) Evaluation
• D) Planning
Rationale: Formulating a nursing diagnosis is the second step of ADPIE. The nurse
clusters assessment data, identifies patterns, and states an actual or potential client
problem requiring nursing intervention.
Question 3
A nurse writes the following outcome for a client with Impaired Physical Mobility:
“Client will ambulate 50 feet in the hallway twice daily by postoperative day 2.” Which
phase of the nursing process does this represent?
• A) Implementation
• B) Assessment
• C) Evaluation
• D) Planning
Rationale: The planning phase involves establishing client goals and desired
outcomes that are measurable, realistic, and time-bound. The statement given is a
clear outcome statement, which is created during the planning phase.
Question 4
A nurse has been providing complete bed care to an immobile client, including
repositioning every 2 hours. At the end of the shift, the nurse observes the client’s
sacral skin is intact without redness. The nurse is currently performing which step of
the nursing process?
• A) Diagnosis
• B) Planning
• C) Implementation
• D) Evaluation
,Rationale: Evaluation occurs after interventions are implemented. The nurse assesses
the client’s response to nursing actions (repositioning) and determines whether the
desired outcome (intact skin) was achieved.
Question 5
A client with newly diagnosed Type 2 diabetes mellitus asks, “Why do I need to check
my feet every day?” The nurse explains the rationale and demonstrates proper foot
inspection. This nursing action occurs during which phase of the nursing process?
• A) Assessment
• B) Diagnosis
• C) Planning
• D) Implementation
Rationale: Implementation is the phase in which the nurse executes the nursing
interventions planned. Teaching the client a skill (daily foot inspection) and providing
the rationale qualifies as implementation.
Question 6
A nurse is utilizing the Situation, Background, Assessment, Recommendation
(SBAR) technique to communicate about a client whose blood pressure has dropped
sharply. Which component of SBAR would the nurse use to state the client’s current
vital signs?
• A) Situation
• B) Background
• C) Assessment
• D) Recommendation
Rationale: In SBAR, the “Assessment” component includes the nurse’s current clinical
findings, such as vital signs, physical assessment data, and analysis of the problem.
Stating that the blood pressure has “dropped from 120/80 to 90/60” is the
Assessment portion.
Question 7
A graduate nurse asks the preceptor, “How do I know whether I should delegate a
task to the nursing assistant?” Which response by the preceptor best reflects
appropriate delegation principles?
, • A) “Delegate any tasks you are too busy to complete.”
• B) “Use the five rights of delegation: right task, right circumstances, right
person, right direction, and right supervision.”
• C) “Only delegate tasks that are not within the RN’s scope of practice.”
• D) “Delegation is not allowed in acute care settings.”
Rationale: The five rights of delegation provide a framework for safe delegation:
right task, right circumstances, right person, right direction/communication, and right
supervision/evaluation. Delegation never transfers accountability from the RN.
Question 8
A charge nurse is observing a newly licensed nurse provide care for a client on
contact precautions. Which action requires the charge nurse to intervene?
• A) Wearing a gown and gloves before entering the room
• B) Placing a “Contact Precautions” sign on the client’s door
• C) Removing gloves after touching the client and before leaving the
room, without performing hand hygiene afterward
• D) Using the client’s designated blood pressure cuff and stethoscope
Rationale: Hand hygiene must always be performed immediately after removing
gloves because gloves can have micro-tears that allow contamination. Failing to
perform hand hygiene after glove removal is a breach of infection control standards.
Question 9
A nurse is planning care for a client who has a new diagnosis of hypertension. The
nurse knows that which of the following is the priority action?
• A) Schedule a follow-up appointment with the primary care provider
• B) Assess the client’s blood pressure and vital signs
• C) Provide education on the DASH diet
• D) Discuss the side effects of antihypertensive medications
Rationale: Using the ABCs (Airway, Breathing, Circulation) and Maslow’s hierarchy,
assessment of the client’s vital signs — especially blood pressure — is the priority
before any teaching or follow-up planning can occur.
Question 10
