ATI RN Fundamentals Exam
ACTUAL EXAM 2026/2027 | ATI RN
Fundamentals Proctored | Verified
Q&A | Pass Guaranteed - A+ Graded
Section 1: Safe & Effective Care Environment (18 Questions)
Q1. A nurse on a medical-surgical unit is caring for four clients. Which client should the nurse assess
first?
A. A client 2 hours post-op appendectomy with a temperature of 99.2°F and pain 3/10
B. A client with pneumonia who has an oxygen saturation of 91% on 2 L nasal cannula and is restless
C. A client with heart failure who has 2+ pitting edema and reports feeling tired
D. A client with diabetes who has a blood glucose of 168 mg/dL and is asymptomatic
Correct Answer: B
Rationale: The ABCs (Airway, Breathing, Circulation) framework is the highest priority in nursing. A client
with pneumonia and oxygen saturation of 91% (normal >95%) with restlessness is demonstrating
hypoxemia and potential respiratory decompensation. Restlessness is an early sign of hypoxia in adults,
preceding cyanosis. This client requires immediate assessment, oxygen titration, and possible escalation
of care. The other clients have stable or less acute presentations that can be addressed after the priority
airway/breathing issue is managed. (ATI Strategy: ABCs – airway and breathing always come first)
Q2. A nurse is delegating tasks to unlicensed assistive personnel (UAP) on a busy unit. Which task is
appropriate to delegate to the UAP?
A. Assessing a postoperative client's surgical incision for signs of infection
B. Feeding a client with dysphagia who requires thickened liquids and close monitoring
C. Obtaining vital signs on a stable client admitted 2 days ago for hypertension
D. Teaching a newly diagnosed diabetic client how to perform blood glucose monitoring
,Correct Answer: C
Rationale: The five rights of delegation guide safe task assignment: right task, right circumstance, right
person, right direction/communication, and right supervision. Obtaining vital signs on a stable client is
within the UAP scope of practice, as it is a routine, non-invasive task with predictable outcomes. The RN
retains responsibility for assessment, evaluation, and teaching—activities that require clinical judgment
and critical thinking. The RN must verify that the UAP has been trained in proper technique and provide
clear parameters for reporting abnormal findings. (ATI Strategy: Delegation – UAP performs routine
tasks; RN performs assessment, teaching, evaluation)
Q3. A client with a history of violent behavior is admitted to the psychiatric unit. The provider orders
wrist restraints. Which nursing action is the priority before applying restraints?
A. Administer a PRN sedative to calm the client
B. Attempt less restrictive interventions and document their failure
C. Call security to hold the client down during application
D. Explain to the client that restraints are for their own safety
Correct Answer: B
Rationale: The Joint Commission and CMS mandate that restraints are used only as a last resort after
less restrictive interventions have been attempted and documented as ineffective. These interventions
include verbal de-escalation, offering PRN medications, environmental modifications (quiet space,
reduced stimuli), and one-to-one observation. The nurse must document the specific behaviors posing
imminent danger, interventions attempted, and the client's response. Restraint application requires a
physician's order (renewed every 24 hours), continuous monitoring (every 15 minutes for physical
restraints), and immediate release when the client no longer poses a danger. (ATI Strategy: Least
restrictive intervention – restraints are last resort after documentation of failed alternatives)
Q4. A nurse discovers a medication error: a client received another client's dose of metoprolol. The
client is asymptomatic with stable vital signs. What is the nurse's priority action?
A. Complete an incident report and submit it to risk management
B. Notify the provider and monitor the client closely for adverse effects
C. Document the error in the client's medical record with full details
D. Tell the client what happened and apologize for the mistake
Correct Answer: B
Rationale: Client safety is the immediate priority following any medication error. The nurse must first
assess the client, notify the provider, and initiate appropriate monitoring or interventions based on the
,drug's pharmacology (metoprolol is a beta-blocker that can cause bradycardia and hypotension). The
incident report is completed for quality improvement and should be objective, factual, and free of
blame or opinions. Documentation in the medical record should include the client's response and
interventions implemented, but should not reference the incident report (which is not part of the
medical record). Disclosure to the client is important but follows immediate safety measures and
provider notification. (ATI Strategy: Safety priority – assess and protect the client first; documentation
follows)
Q5. A client is brought to the emergency department unconscious after a motor vehicle accident. The
family is not present. Which action is most appropriate regarding informed consent for emergency
surgery?
A. Wait for the family to arrive before proceeding with surgery
B. Proceed with surgery under implied consent for emergency treatment to save life or limb
C. Ask the police officer present to sign the consent form
D. Have two nurses sign as witnesses to the implied consent
Correct Answer: B
Rationale: Implied consent applies in life-threatening emergencies when the client is unable to consent
and no legally authorized representative is available. The law presumes that a reasonable person would
consent to emergency treatment necessary to prevent death or serious harm. The provider must
document the emergency nature of the situation, attempts to contact family, and the medical necessity
of the intervention. Waiting for family arrival could result in death or permanent disability. Police
officers and nurses cannot provide consent on behalf of an incapacitated client unless they hold durable
power of attorney for healthcare. (ATI Strategy: Legal/ethical – implied consent in emergencies when
delay would cause harm)
Q6. A nurse is caring for a client who has a living will stating "no heroic measures" and is now in
respiratory arrest. The family demands that the nurse initiate CPR. What is the nurse's most appropriate
action?
A. Initiate CPR immediately because the family has the right to override the living will
B. Honor the living will and do not initiate CPR; notify the provider and hospital ethics committee
C. Initiate CPR while contacting the provider for clarification
D. Ask the family to provide a new advance directive before making a decision
Correct Answer: B
Rationale: A properly executed living will is a legally binding advance directive that expresses the client's
wishes regarding end-of-life care. The nurse must honor the client's documented preferences even
, when family members disagree. The appropriate response is to not initiate CPR, notify the provider
immediately, and contact the hospital ethics committee or social services to support the family through
the grieving process. The family cannot override a valid advance directive unless they hold durable
power of attorney for healthcare and the document explicitly grants them that authority. Initiating CPR
against the living will constitutes battery (unauthorized touching). (ATI Strategy: Advance directives –
honor client's documented wishes; family cannot override without DPOA-HC)
Q7. A nurse is reviewing a new admission's medication list and notes the client takes warfarin at home.
Which laboratory value is the priority to review before administering the evening dose?
A. Complete blood count
B. International normalized ratio (INR)
C. Comprehensive metabolic panel
D. Lipid panel
Correct Answer: B
Rationale: Warfarin is an oral anticoagulant with a narrow therapeutic index; the INR measures its
anticoagulant effect and guides dosing. The therapeutic range for most indications is 2.0–3.0 (2.5–3.5
for mechanical heart valves). Administering warfarin without knowing the INR risks either inadequate
anticoagulation (thrombosis) or excessive anticoagulation (bleeding). The nurse must hold the dose and
notify the provider if the INR is supratherapeutic (>4.0 without bleeding, >3.0 with bleeding) or
subtherapeutic (<1.5). Baseline and periodic CBC are also important to monitor for occult bleeding, but
INR is the immediate priority for dose determination. (ATI Strategy: High-alert medication – verify
therapeutic lab value before administration)
Q8. A nurse is supervising a licensed practical nurse (LPN) who is caring for four clients. Which client
assignment is most appropriate for the LPN?
A. A client 1 hour post-op from a total hip replacement with a PCA pump and epidural catheter
B. A client with a new colostomy requiring initial pouching technique teaching
C. A client 3 days post-MI with stable vital signs who needs assistance with ADLs
D. A client newly diagnosed with type 2 diabetes requiring insulin administration and blood glucose
teaching
Correct Answer: C
Rationale: The LPN scope of practice includes care for stable clients with predictable outcomes,
assistance with activities of daily living (ADLs), medication administration (excluding IV push and certain
high-alert medications), and data collection. A client 3 days post-myocardial infarction with stable vital
signs is appropriate for LPN care under RN supervision. The RN retains responsibility for unstable clients
ACTUAL EXAM 2026/2027 | ATI RN
Fundamentals Proctored | Verified
Q&A | Pass Guaranteed - A+ Graded
Section 1: Safe & Effective Care Environment (18 Questions)
Q1. A nurse on a medical-surgical unit is caring for four clients. Which client should the nurse assess
first?
A. A client 2 hours post-op appendectomy with a temperature of 99.2°F and pain 3/10
B. A client with pneumonia who has an oxygen saturation of 91% on 2 L nasal cannula and is restless
C. A client with heart failure who has 2+ pitting edema and reports feeling tired
D. A client with diabetes who has a blood glucose of 168 mg/dL and is asymptomatic
Correct Answer: B
Rationale: The ABCs (Airway, Breathing, Circulation) framework is the highest priority in nursing. A client
with pneumonia and oxygen saturation of 91% (normal >95%) with restlessness is demonstrating
hypoxemia and potential respiratory decompensation. Restlessness is an early sign of hypoxia in adults,
preceding cyanosis. This client requires immediate assessment, oxygen titration, and possible escalation
of care. The other clients have stable or less acute presentations that can be addressed after the priority
airway/breathing issue is managed. (ATI Strategy: ABCs – airway and breathing always come first)
Q2. A nurse is delegating tasks to unlicensed assistive personnel (UAP) on a busy unit. Which task is
appropriate to delegate to the UAP?
A. Assessing a postoperative client's surgical incision for signs of infection
B. Feeding a client with dysphagia who requires thickened liquids and close monitoring
C. Obtaining vital signs on a stable client admitted 2 days ago for hypertension
D. Teaching a newly diagnosed diabetic client how to perform blood glucose monitoring
,Correct Answer: C
Rationale: The five rights of delegation guide safe task assignment: right task, right circumstance, right
person, right direction/communication, and right supervision. Obtaining vital signs on a stable client is
within the UAP scope of practice, as it is a routine, non-invasive task with predictable outcomes. The RN
retains responsibility for assessment, evaluation, and teaching—activities that require clinical judgment
and critical thinking. The RN must verify that the UAP has been trained in proper technique and provide
clear parameters for reporting abnormal findings. (ATI Strategy: Delegation – UAP performs routine
tasks; RN performs assessment, teaching, evaluation)
Q3. A client with a history of violent behavior is admitted to the psychiatric unit. The provider orders
wrist restraints. Which nursing action is the priority before applying restraints?
A. Administer a PRN sedative to calm the client
B. Attempt less restrictive interventions and document their failure
C. Call security to hold the client down during application
D. Explain to the client that restraints are for their own safety
Correct Answer: B
Rationale: The Joint Commission and CMS mandate that restraints are used only as a last resort after
less restrictive interventions have been attempted and documented as ineffective. These interventions
include verbal de-escalation, offering PRN medications, environmental modifications (quiet space,
reduced stimuli), and one-to-one observation. The nurse must document the specific behaviors posing
imminent danger, interventions attempted, and the client's response. Restraint application requires a
physician's order (renewed every 24 hours), continuous monitoring (every 15 minutes for physical
restraints), and immediate release when the client no longer poses a danger. (ATI Strategy: Least
restrictive intervention – restraints are last resort after documentation of failed alternatives)
Q4. A nurse discovers a medication error: a client received another client's dose of metoprolol. The
client is asymptomatic with stable vital signs. What is the nurse's priority action?
A. Complete an incident report and submit it to risk management
B. Notify the provider and monitor the client closely for adverse effects
C. Document the error in the client's medical record with full details
D. Tell the client what happened and apologize for the mistake
Correct Answer: B
Rationale: Client safety is the immediate priority following any medication error. The nurse must first
assess the client, notify the provider, and initiate appropriate monitoring or interventions based on the
,drug's pharmacology (metoprolol is a beta-blocker that can cause bradycardia and hypotension). The
incident report is completed for quality improvement and should be objective, factual, and free of
blame or opinions. Documentation in the medical record should include the client's response and
interventions implemented, but should not reference the incident report (which is not part of the
medical record). Disclosure to the client is important but follows immediate safety measures and
provider notification. (ATI Strategy: Safety priority – assess and protect the client first; documentation
follows)
Q5. A client is brought to the emergency department unconscious after a motor vehicle accident. The
family is not present. Which action is most appropriate regarding informed consent for emergency
surgery?
A. Wait for the family to arrive before proceeding with surgery
B. Proceed with surgery under implied consent for emergency treatment to save life or limb
C. Ask the police officer present to sign the consent form
D. Have two nurses sign as witnesses to the implied consent
Correct Answer: B
Rationale: Implied consent applies in life-threatening emergencies when the client is unable to consent
and no legally authorized representative is available. The law presumes that a reasonable person would
consent to emergency treatment necessary to prevent death or serious harm. The provider must
document the emergency nature of the situation, attempts to contact family, and the medical necessity
of the intervention. Waiting for family arrival could result in death or permanent disability. Police
officers and nurses cannot provide consent on behalf of an incapacitated client unless they hold durable
power of attorney for healthcare. (ATI Strategy: Legal/ethical – implied consent in emergencies when
delay would cause harm)
Q6. A nurse is caring for a client who has a living will stating "no heroic measures" and is now in
respiratory arrest. The family demands that the nurse initiate CPR. What is the nurse's most appropriate
action?
A. Initiate CPR immediately because the family has the right to override the living will
B. Honor the living will and do not initiate CPR; notify the provider and hospital ethics committee
C. Initiate CPR while contacting the provider for clarification
D. Ask the family to provide a new advance directive before making a decision
Correct Answer: B
Rationale: A properly executed living will is a legally binding advance directive that expresses the client's
wishes regarding end-of-life care. The nurse must honor the client's documented preferences even
, when family members disagree. The appropriate response is to not initiate CPR, notify the provider
immediately, and contact the hospital ethics committee or social services to support the family through
the grieving process. The family cannot override a valid advance directive unless they hold durable
power of attorney for healthcare and the document explicitly grants them that authority. Initiating CPR
against the living will constitutes battery (unauthorized touching). (ATI Strategy: Advance directives –
honor client's documented wishes; family cannot override without DPOA-HC)
Q7. A nurse is reviewing a new admission's medication list and notes the client takes warfarin at home.
Which laboratory value is the priority to review before administering the evening dose?
A. Complete blood count
B. International normalized ratio (INR)
C. Comprehensive metabolic panel
D. Lipid panel
Correct Answer: B
Rationale: Warfarin is an oral anticoagulant with a narrow therapeutic index; the INR measures its
anticoagulant effect and guides dosing. The therapeutic range for most indications is 2.0–3.0 (2.5–3.5
for mechanical heart valves). Administering warfarin without knowing the INR risks either inadequate
anticoagulation (thrombosis) or excessive anticoagulation (bleeding). The nurse must hold the dose and
notify the provider if the INR is supratherapeutic (>4.0 without bleeding, >3.0 with bleeding) or
subtherapeutic (<1.5). Baseline and periodic CBC are also important to monitor for occult bleeding, but
INR is the immediate priority for dose determination. (ATI Strategy: High-alert medication – verify
therapeutic lab value before administration)
Q8. A nurse is supervising a licensed practical nurse (LPN) who is caring for four clients. Which client
assignment is most appropriate for the LPN?
A. A client 1 hour post-op from a total hip replacement with a PCA pump and epidural catheter
B. A client with a new colostomy requiring initial pouching technique teaching
C. A client 3 days post-MI with stable vital signs who needs assistance with ADLs
D. A client newly diagnosed with type 2 diabetes requiring insulin administration and blood glucose
teaching
Correct Answer: C
Rationale: The LPN scope of practice includes care for stable clients with predictable outcomes,
assistance with activities of daily living (ADLs), medication administration (excluding IV push and certain
high-alert medications), and data collection. A client 3 days post-myocardial infarction with stable vital
signs is appropriate for LPN care under RN supervision. The RN retains responsibility for unstable clients
