ATI FUNDAMENTALS RETAKE EXAM
2026/2027
75 Questions | Complete Exam-Style Questions with Detailed Rationales | 100%
Verified
Introduction
This ATI Fundamentals Retake Exam format for 2026/2027 reflects the standardized competency
assessment used to evaluate proficiency in foundational nursing principles for pre-licensure RN
students preparing for NCLEX-RN licensure. The official examination consists of exactly 75
multiple-choice questions (MCQ) covering critical domains: basic care and comfort, safety and
infection control, health promotion and maintenance, pharmacological and parenteral therapies,
management of care, physiological adaptation, legal/ethical considerations, and scenario-based
application. The exam measures knowledge essential for safe, effective, and entry-level practice,
aligned with current NCSBN Clinical Judgment Measurement Model (CJMM), NCSBN NCLEX-
RN test plan, ATI Testing blueprints, and institutional nursing program learning outcomes.
Exam Structure
• Exact official question count: 75 multiple-choice questions (MCQ) per commonly cited ATI
Fundamentals Retake specifications
• All questions presented in MCQ format with four options (A, B, C, D), single-best-answer
unless specified as SATA or NGN format
• Item types: Standard MCQ, Select-All-That-Apply (SATA), NGN bow-tie items, trend
recognition, and prioritization scenarios
• Total testing time: 105 minutes (computer-based, proctored format via ATI Testing platform)
• Passing score: Level 2 or higher (approximately 75-80%, or 56-60/75 correct) for NCLEX-
RN readiness prediction
Examination Overview
Domain Questions Key Topics Weight
Basic Care & Comfort 13 ADLs, Hygiene, Positioning, Pain 17%
Management, Nutrition/Fluids,
Elimination, Sleep/Rest, Comfort Measures
Safety & Infection 16 Standard/Transmission-Based Precautions, 21%
Control Hand Hygiene, Fall Prevention, Medication
Safety, Equipment Use, Emergency
Response
Health Promotion & 11 Health Screening, Immunizations, Lifestyle 15%
Maintenance Education, Developmental Stages, Self-Care
Strategies, Preventive Care
Pharmacological & 13 Rights of Medication Administration, 17%
Parenteral Therapies Routes, Dose Calculations, Side
Effects/Adverse Reactions, IV Therapy,
High-Alert Medications
Management of Care 12 Delegation, Supervision, Prioritization, 16%
Legal/Ethical Issues, Documentation,
Interprofessional Collaboration, Advocacy
Physiological Adaptation 10 Vital Signs Interpretation, Fluid/Electrolyte 14%
& Clinical Judgment Basics, NGN Trend/Bow-Tie Items, Clinical
Prioritization, Early Warning Signs
Comprehensive Foundational Nursing
TOTAL 75 100%
Competency
Page 1
,Examination Questions
Domain: Safety & Infection Control
1. A nurse is preparing to care for a client placed on contact precautions for a
multidrug-resistant wound infection. Which action should the nurse take first?
A. Apply a gown and gloves before entering the client's room
B. Perform hand hygiene with alcohol-based sanitizer
C. Place a surgical mask on the client during transport
D. Use a dedicated blood pressure cuff and stethoscope for the client
Correct Answer: A
Rationale: For contact precautions, the nurse must don a gown and gloves before entering the
client's environment to prevent transmission of pathogens. While dedicated equipment (D) is
appropriate, it occurs after donning PPE. Hand hygiene (B) is performed before and after PPE
use but does not replace barrier protection. Masks (C) are not required for contact precautions
unless droplet/airborne precautions are also indicated. Following CDC transmission-based
precaution protocols is foundational to infection control.
[SATA] 2. Select All That Apply: Which actions by the nurse demonstrate adherence
to the "Five Rights" of medication administration?
A. Verifying the client's identity using two identifiers before administration
B. Checking the medication label against the MAR three times
C. Administering the medication via the prescribed route at the correct time
D. Documenting administration immediately after giving the medication
Correct Answer: A, B, C, D
Rationale: The Five Rights of medication administration are: right patient, right drug, right
dose, right route, and right time. Verifying identity (A) ensures right patient. Triple-checking
the label (B) ensures right drug/dose. Administering via prescribed route/time (C) ensures right
route/time. Documentation after administration (D) completes the legal and safety record. All
actions align with ISMP safety standards and reduce preventable medication errors.
3. A nurse is caring for a client with tuberculosis admitted to the medical unit.
Which type of transmission-based precautions should the nurse implement?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Standard precautions only
Correct Answer: C
Rationale: Tuberculosis is transmitted via airborne particles that remain suspended in the air
and travel over long distances. Airborne precautions require a negative-pressure isolation room
and N95 respirator or PAPR for the nurse. Contact precautions (A) are for direct/indirect
contact transmission (e.g., MRSA, C. difficile). Droplet precautions (B) are for large-particle
transmission within 3-6 feet (e.g., influenza, meningococcal). Standard precautions (D) apply to
all clients but are insufficient alone for TB.
4. A nurse enters a client's room and notes that the IV insertion site has redness,
warmth, swelling, and a palpable venous cord. The nurse should recognize these
findings as indicating which complication?
A. Infiltration
B. Phlebitis
C. Extravasation
D. Hematoma
Page 2
, Correct Answer: B
Rationale: Phlebitis is inflammation of a vein indicated by redness, warmth, swelling, and a
palpable cord along the vein. It is the most common IV complication. Infiltration (A) presents
with coolness, pallor, and swelling without redness or warmth. Extravasation (C) is similar to
infiltration but involves a vesicant agent causing tissue damage. Hematoma (D) presents with
ecchymosis and blood pooling at the site. The nurse should discontinue the IV and restart at a
new site.
5. A nurse is performing hand hygiene using soap and water. How long should the
nurse scrub their hands?
A. 5 seconds
B. 15 seconds
C. 20 seconds
D. 60 seconds
Correct Answer: C
Rationale: CDC guidelines recommend scrubbing hands with soap and water for at least 20
seconds to effectively remove microorganisms. This includes all surfaces of the hands and
fingers. Alcohol-based hand rubs should be applied for at least 20 seconds until dry. Five
seconds (A) is insufficient for adequate microbial reduction. Fifteen seconds (B) is commonly
used but the evidence-based minimum is 20 seconds. Sixty seconds (D) is unnecessary for
routine hand hygiene.
6. A client with a history of falls is admitted to the unit. Which intervention is the
nurse's priority to ensure client safety?
A. Place the client on a low bed with the call light within reach
B. Apply bilateral soft wrist restraints per provider order
C. Keep all four side rails raised at all times
D. Administer a sedative to reduce agitation and movement
Correct Answer: A
Rationale: Placing the client on a low bed with the call light within reach is the least restrictive
and most effective fall prevention intervention. Restraints (B) are a last resort requiring
continuous reassessment and can increase agitation, injury risk, and complications. Keeping all
four side rails raised (C) is considered a restraint and requires an order and monitoring.
Sedation (D) impairs mobility and balance, paradoxically increasing fall risk. Evidence-based
fall prevention emphasizes environmental safety, not restriction.
7. A nurse is caring for a client who has a new chest tube connected to a water-seal
drainage system. The nurse notices continuous bubbling in the water-seal chamber.
Which action should the nurse take first?
A. Clamp the chest tube near the insertion site
B. Check the drainage system for disconnection or an air leak
C. Document the finding and continue monitoring
D. Increase the suction to 40 cm H2O
Correct Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
drainage system. The nurse must first identify the source by checking all connections from the
client to the drainage unit. Clamping (A) is contraindicated as it can cause tension
pneumothorax and is only used briefly during tube change. Documenting without action (C)
delays needed intervention. Increasing suction (D) is inappropriate; the nurse must identify and
correct the leak first.
8. A nurse receives a medication order from a provider via telephone. What is the
nurse's best action?
Page 3
2026/2027
75 Questions | Complete Exam-Style Questions with Detailed Rationales | 100%
Verified
Introduction
This ATI Fundamentals Retake Exam format for 2026/2027 reflects the standardized competency
assessment used to evaluate proficiency in foundational nursing principles for pre-licensure RN
students preparing for NCLEX-RN licensure. The official examination consists of exactly 75
multiple-choice questions (MCQ) covering critical domains: basic care and comfort, safety and
infection control, health promotion and maintenance, pharmacological and parenteral therapies,
management of care, physiological adaptation, legal/ethical considerations, and scenario-based
application. The exam measures knowledge essential for safe, effective, and entry-level practice,
aligned with current NCSBN Clinical Judgment Measurement Model (CJMM), NCSBN NCLEX-
RN test plan, ATI Testing blueprints, and institutional nursing program learning outcomes.
Exam Structure
• Exact official question count: 75 multiple-choice questions (MCQ) per commonly cited ATI
Fundamentals Retake specifications
• All questions presented in MCQ format with four options (A, B, C, D), single-best-answer
unless specified as SATA or NGN format
• Item types: Standard MCQ, Select-All-That-Apply (SATA), NGN bow-tie items, trend
recognition, and prioritization scenarios
• Total testing time: 105 minutes (computer-based, proctored format via ATI Testing platform)
• Passing score: Level 2 or higher (approximately 75-80%, or 56-60/75 correct) for NCLEX-
RN readiness prediction
Examination Overview
Domain Questions Key Topics Weight
Basic Care & Comfort 13 ADLs, Hygiene, Positioning, Pain 17%
Management, Nutrition/Fluids,
Elimination, Sleep/Rest, Comfort Measures
Safety & Infection 16 Standard/Transmission-Based Precautions, 21%
Control Hand Hygiene, Fall Prevention, Medication
Safety, Equipment Use, Emergency
Response
Health Promotion & 11 Health Screening, Immunizations, Lifestyle 15%
Maintenance Education, Developmental Stages, Self-Care
Strategies, Preventive Care
Pharmacological & 13 Rights of Medication Administration, 17%
Parenteral Therapies Routes, Dose Calculations, Side
Effects/Adverse Reactions, IV Therapy,
High-Alert Medications
Management of Care 12 Delegation, Supervision, Prioritization, 16%
Legal/Ethical Issues, Documentation,
Interprofessional Collaboration, Advocacy
Physiological Adaptation 10 Vital Signs Interpretation, Fluid/Electrolyte 14%
& Clinical Judgment Basics, NGN Trend/Bow-Tie Items, Clinical
Prioritization, Early Warning Signs
Comprehensive Foundational Nursing
TOTAL 75 100%
Competency
Page 1
,Examination Questions
Domain: Safety & Infection Control
1. A nurse is preparing to care for a client placed on contact precautions for a
multidrug-resistant wound infection. Which action should the nurse take first?
A. Apply a gown and gloves before entering the client's room
B. Perform hand hygiene with alcohol-based sanitizer
C. Place a surgical mask on the client during transport
D. Use a dedicated blood pressure cuff and stethoscope for the client
Correct Answer: A
Rationale: For contact precautions, the nurse must don a gown and gloves before entering the
client's environment to prevent transmission of pathogens. While dedicated equipment (D) is
appropriate, it occurs after donning PPE. Hand hygiene (B) is performed before and after PPE
use but does not replace barrier protection. Masks (C) are not required for contact precautions
unless droplet/airborne precautions are also indicated. Following CDC transmission-based
precaution protocols is foundational to infection control.
[SATA] 2. Select All That Apply: Which actions by the nurse demonstrate adherence
to the "Five Rights" of medication administration?
A. Verifying the client's identity using two identifiers before administration
B. Checking the medication label against the MAR three times
C. Administering the medication via the prescribed route at the correct time
D. Documenting administration immediately after giving the medication
Correct Answer: A, B, C, D
Rationale: The Five Rights of medication administration are: right patient, right drug, right
dose, right route, and right time. Verifying identity (A) ensures right patient. Triple-checking
the label (B) ensures right drug/dose. Administering via prescribed route/time (C) ensures right
route/time. Documentation after administration (D) completes the legal and safety record. All
actions align with ISMP safety standards and reduce preventable medication errors.
3. A nurse is caring for a client with tuberculosis admitted to the medical unit.
Which type of transmission-based precautions should the nurse implement?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Standard precautions only
Correct Answer: C
Rationale: Tuberculosis is transmitted via airborne particles that remain suspended in the air
and travel over long distances. Airborne precautions require a negative-pressure isolation room
and N95 respirator or PAPR for the nurse. Contact precautions (A) are for direct/indirect
contact transmission (e.g., MRSA, C. difficile). Droplet precautions (B) are for large-particle
transmission within 3-6 feet (e.g., influenza, meningococcal). Standard precautions (D) apply to
all clients but are insufficient alone for TB.
4. A nurse enters a client's room and notes that the IV insertion site has redness,
warmth, swelling, and a palpable venous cord. The nurse should recognize these
findings as indicating which complication?
A. Infiltration
B. Phlebitis
C. Extravasation
D. Hematoma
Page 2
, Correct Answer: B
Rationale: Phlebitis is inflammation of a vein indicated by redness, warmth, swelling, and a
palpable cord along the vein. It is the most common IV complication. Infiltration (A) presents
with coolness, pallor, and swelling without redness or warmth. Extravasation (C) is similar to
infiltration but involves a vesicant agent causing tissue damage. Hematoma (D) presents with
ecchymosis and blood pooling at the site. The nurse should discontinue the IV and restart at a
new site.
5. A nurse is performing hand hygiene using soap and water. How long should the
nurse scrub their hands?
A. 5 seconds
B. 15 seconds
C. 20 seconds
D. 60 seconds
Correct Answer: C
Rationale: CDC guidelines recommend scrubbing hands with soap and water for at least 20
seconds to effectively remove microorganisms. This includes all surfaces of the hands and
fingers. Alcohol-based hand rubs should be applied for at least 20 seconds until dry. Five
seconds (A) is insufficient for adequate microbial reduction. Fifteen seconds (B) is commonly
used but the evidence-based minimum is 20 seconds. Sixty seconds (D) is unnecessary for
routine hand hygiene.
6. A client with a history of falls is admitted to the unit. Which intervention is the
nurse's priority to ensure client safety?
A. Place the client on a low bed with the call light within reach
B. Apply bilateral soft wrist restraints per provider order
C. Keep all four side rails raised at all times
D. Administer a sedative to reduce agitation and movement
Correct Answer: A
Rationale: Placing the client on a low bed with the call light within reach is the least restrictive
and most effective fall prevention intervention. Restraints (B) are a last resort requiring
continuous reassessment and can increase agitation, injury risk, and complications. Keeping all
four side rails raised (C) is considered a restraint and requires an order and monitoring.
Sedation (D) impairs mobility and balance, paradoxically increasing fall risk. Evidence-based
fall prevention emphasizes environmental safety, not restriction.
7. A nurse is caring for a client who has a new chest tube connected to a water-seal
drainage system. The nurse notices continuous bubbling in the water-seal chamber.
Which action should the nurse take first?
A. Clamp the chest tube near the insertion site
B. Check the drainage system for disconnection or an air leak
C. Document the finding and continue monitoring
D. Increase the suction to 40 cm H2O
Correct Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
drainage system. The nurse must first identify the source by checking all connections from the
client to the drainage unit. Clamping (A) is contraindicated as it can cause tension
pneumothorax and is only used briefly during tube change. Documenting without action (C)
delays needed intervention. Increasing suction (D) is inappropriate; the nurse must identify and
correct the leak first.
8. A nurse receives a medication order from a provider via telephone. What is the
nurse's best action?
Page 3
