ATI RN FUNDAMENTALS PROCTORED EXAM
2026/2027
Assessment Technologies Institute
Comprehensive Foundational Nursing Competency Assessment
70 NGN-Style Questions | Complete Exam-Style Questions
with Detailed Rationales | 100% Verified | Graded A+
Total Questions 70 NGN-Style Questions
Testing Time 90 Minutes (Computer-Based, Proctored)
Passing Score 70–75% (49–53/70 correct)
ATI Level 1 49–56 correct
ATI Level 2 57–63 correct
ATI Level 3 64–70 correct
NGN Item Types Case Study, Bowtie, Trend, Highlight,
Matrix, SATA, Ordered Response, Standard MC
Aligned with NCSBN Clinical Judgment Measurement Model (CJMM)
and Next Generation NCLEX (NGN) Standards
,Domain 1: Basic Care & Comfort (Questions 1–8)
1. [Standard MC] A nurse is assisting a client with left-sided weakness to dress. Which
approach demonstrates the best technique for promoting client independence?
A. Dress the client's left side first, then the right side
B. Dress the client's right side first, then the left side
C. Allow the client to dress independently without assistance
D. Dress both sides simultaneously while the client observes
Correct Answer: B
Rationale: When assisting a client with unilateral weakness, the nurse should dress the weaker
(affected) side first and undress the stronger (unaffected) side first. This approach minimizes
stress on the affected extremity, prevents joint trauma, and promotes the client's participation.
Dressing the affected side first allows the client to use the unaffected arm to guide the garment
over the weak extremity, maximizing independence and safety.
2. [Standard MC] A nurse is transferring a client from bed to wheelchair using a stand-pivot
technique. Which action by the nurse is correct?
A. Place the wheelchair on the client's affected side
B. Place the wheelchair on the client's unaffected side
C. Position the wheelchair facing the foot of the bed
D. Lock the wheelchair brakes only after the client is seated
Correct Answer: B
Rationale: When transferring a client using a stand-pivot technique, the wheelchair should be
positioned on the client's unaffected (stronger) side. This allows the client to pivot toward the
stronger side, using the weight-bearing capacity of the unaffected extremity for stability. The
wheelchair brakes must be locked before the transfer begins, and the client should be wearing
nonskid footwear to prevent slipping.
3. [Standard MC] A nurse is assessing a client's pain using the PQRST mnemonic. Which
component does the 'R' represent?
A. Region of the pain
B. Radiation of the pain
C. Relief measures for the pain
D. Rate of the pain
Correct Answer: B
Rationale: The PQRST pain assessment mnemonic stands for: Provocation/Palliation (what
makes it better or worse), Quality (description of the pain), Region/Radiation (where the pain is
and whether it spreads), Severity (intensity on a scale), and Timing (when it occurs and
duration). The 'R' specifically represents Radiation—determining whether the pain travels to
other areas of the body, which helps differentiate between localized and referred pain patterns
and guides diagnostic reasoning.
4. [SATA] A nurse is caring for a client who requires intermittent enteral feeding via a
nasogastric tube. Which action should the nurse take before each feeding?
(Select All That Apply)
A. Verify tube placement by checking gastric pH
B. Elevate the head of the bed to at least 30 degrees
C. Flush the tube with 30 mL of water
D. Aspirate and measure residual volume
E. Administer the feeding at room temperature only
F. Clamp the tube for 30 minutes before feeding
Correct Answer: A, B, C, D
Rationale: Before administering enteral feedings, the nurse must verify tube placement (gastric
pH of 1–4 confirms gastric positioning, reducing aspiration risk), elevate the head of bed to at
least 30–45 degrees to prevent aspiration, flush the tube with water to ensure patency, and check
, residual volume to assess gastric emptying. Feeding should be at room temperature to prevent
cramping, but this is a preparation step rather than a mandatory pre-feeding action. Clamping
before feeding is not a standard practice.
5. [Standard MC] A nurse is teaching a client about the use of a cane for ambulation. Which
instruction is correct?
A. Hold the cane on the same side as the affected leg
B. Hold the cane on the opposite side from the affected leg
C. Move the cane and affected leg simultaneously forward
D. Advance the unaffected leg first, then the cane and affected leg together
Correct Answer: B
Rationale: A cane should be held on the unaffected (stronger) side, opposite the affected leg, to
provide a wider base of support and reduce stress on the affected joint. The correct gait sequence
is: advance the cane first, then step forward with the affected leg (cane and affected leg move
together), and finally bring the unaffected leg forward past the cane and affected leg. This three-
point gait pattern maintains balance and reduces weight-bearing on the affected extremity.
6. [SATA] A nurse is promoting sleep for an older adult client in an acute care setting.
Which non-pharmacologic interventions should the nurse implement?
(Select All That Apply)
A. Maintain a quiet, dimly lit environment at night
B. Encourage the client to ambulate in the hallway during the day
C. Administer a sedative-hypnotic medication at bedtime
D. Provide a back massage at bedtime
E. Schedule vital signs checks every 2 hours throughout the night
F. Offer a warm beverage such as warm milk before sleep
Correct Answer: A, B, D, F
Rationale: Non-pharmacologic sleep promotion strategies include maintaining a quiet, dimly lit
nighttime environment to support circadian rhythms, encouraging daytime activity to promote
natural fatigue, providing a back massage for relaxation, and offering warm milk (which
contains tryptophan, a precursor to serotonin and melatonin). Administering sedative-hypnotics
is a pharmacologic intervention, and frequent vital signs checks during the night disrupt sleep
architecture. Sleep hygiene should prioritize minimizing nighttime interruptions.
7. [Standard MC] A nurse is caring for a client on bed rest. Which intervention best prevents
the complication of plantar flexion contractures?
A. Place a footboard at the foot of the bed
B. Encourage the client to perform ankle circles
C. Position the client in high Fowler's position
D. Apply compression stockings bilaterally
Correct Answer: A
Rationale: Plantar flexion contractures (footdrop) occur when the foot is allowed to remain in
plantar flexion for prolonged periods. A footboard or a firm surface placed perpendicular to the
mattress maintains the foot in dorsiflexion, preventing shortening of the gastrocnemius muscle
and Achilles tendon. While ankle circles promote circulation, they do not maintain the foot in
proper alignment. Compression stockings address venous return rather than joint positioning.
8. [Standard MC] A nurse is assisting a client with a bed bath. Which action demonstrates
proper technique?
A. Wash from the most contaminated area to the least contaminated area
B. Wash the client's eyes from the outer canthus to the inner canthus
C. Change the bath water after washing the perineal area
D. Use hot water to promote vasodilation and comfort
Correct Answer: C
2026/2027
Assessment Technologies Institute
Comprehensive Foundational Nursing Competency Assessment
70 NGN-Style Questions | Complete Exam-Style Questions
with Detailed Rationales | 100% Verified | Graded A+
Total Questions 70 NGN-Style Questions
Testing Time 90 Minutes (Computer-Based, Proctored)
Passing Score 70–75% (49–53/70 correct)
ATI Level 1 49–56 correct
ATI Level 2 57–63 correct
ATI Level 3 64–70 correct
NGN Item Types Case Study, Bowtie, Trend, Highlight,
Matrix, SATA, Ordered Response, Standard MC
Aligned with NCSBN Clinical Judgment Measurement Model (CJMM)
and Next Generation NCLEX (NGN) Standards
,Domain 1: Basic Care & Comfort (Questions 1–8)
1. [Standard MC] A nurse is assisting a client with left-sided weakness to dress. Which
approach demonstrates the best technique for promoting client independence?
A. Dress the client's left side first, then the right side
B. Dress the client's right side first, then the left side
C. Allow the client to dress independently without assistance
D. Dress both sides simultaneously while the client observes
Correct Answer: B
Rationale: When assisting a client with unilateral weakness, the nurse should dress the weaker
(affected) side first and undress the stronger (unaffected) side first. This approach minimizes
stress on the affected extremity, prevents joint trauma, and promotes the client's participation.
Dressing the affected side first allows the client to use the unaffected arm to guide the garment
over the weak extremity, maximizing independence and safety.
2. [Standard MC] A nurse is transferring a client from bed to wheelchair using a stand-pivot
technique. Which action by the nurse is correct?
A. Place the wheelchair on the client's affected side
B. Place the wheelchair on the client's unaffected side
C. Position the wheelchair facing the foot of the bed
D. Lock the wheelchair brakes only after the client is seated
Correct Answer: B
Rationale: When transferring a client using a stand-pivot technique, the wheelchair should be
positioned on the client's unaffected (stronger) side. This allows the client to pivot toward the
stronger side, using the weight-bearing capacity of the unaffected extremity for stability. The
wheelchair brakes must be locked before the transfer begins, and the client should be wearing
nonskid footwear to prevent slipping.
3. [Standard MC] A nurse is assessing a client's pain using the PQRST mnemonic. Which
component does the 'R' represent?
A. Region of the pain
B. Radiation of the pain
C. Relief measures for the pain
D. Rate of the pain
Correct Answer: B
Rationale: The PQRST pain assessment mnemonic stands for: Provocation/Palliation (what
makes it better or worse), Quality (description of the pain), Region/Radiation (where the pain is
and whether it spreads), Severity (intensity on a scale), and Timing (when it occurs and
duration). The 'R' specifically represents Radiation—determining whether the pain travels to
other areas of the body, which helps differentiate between localized and referred pain patterns
and guides diagnostic reasoning.
4. [SATA] A nurse is caring for a client who requires intermittent enteral feeding via a
nasogastric tube. Which action should the nurse take before each feeding?
(Select All That Apply)
A. Verify tube placement by checking gastric pH
B. Elevate the head of the bed to at least 30 degrees
C. Flush the tube with 30 mL of water
D. Aspirate and measure residual volume
E. Administer the feeding at room temperature only
F. Clamp the tube for 30 minutes before feeding
Correct Answer: A, B, C, D
Rationale: Before administering enteral feedings, the nurse must verify tube placement (gastric
pH of 1–4 confirms gastric positioning, reducing aspiration risk), elevate the head of bed to at
least 30–45 degrees to prevent aspiration, flush the tube with water to ensure patency, and check
, residual volume to assess gastric emptying. Feeding should be at room temperature to prevent
cramping, but this is a preparation step rather than a mandatory pre-feeding action. Clamping
before feeding is not a standard practice.
5. [Standard MC] A nurse is teaching a client about the use of a cane for ambulation. Which
instruction is correct?
A. Hold the cane on the same side as the affected leg
B. Hold the cane on the opposite side from the affected leg
C. Move the cane and affected leg simultaneously forward
D. Advance the unaffected leg first, then the cane and affected leg together
Correct Answer: B
Rationale: A cane should be held on the unaffected (stronger) side, opposite the affected leg, to
provide a wider base of support and reduce stress on the affected joint. The correct gait sequence
is: advance the cane first, then step forward with the affected leg (cane and affected leg move
together), and finally bring the unaffected leg forward past the cane and affected leg. This three-
point gait pattern maintains balance and reduces weight-bearing on the affected extremity.
6. [SATA] A nurse is promoting sleep for an older adult client in an acute care setting.
Which non-pharmacologic interventions should the nurse implement?
(Select All That Apply)
A. Maintain a quiet, dimly lit environment at night
B. Encourage the client to ambulate in the hallway during the day
C. Administer a sedative-hypnotic medication at bedtime
D. Provide a back massage at bedtime
E. Schedule vital signs checks every 2 hours throughout the night
F. Offer a warm beverage such as warm milk before sleep
Correct Answer: A, B, D, F
Rationale: Non-pharmacologic sleep promotion strategies include maintaining a quiet, dimly lit
nighttime environment to support circadian rhythms, encouraging daytime activity to promote
natural fatigue, providing a back massage for relaxation, and offering warm milk (which
contains tryptophan, a precursor to serotonin and melatonin). Administering sedative-hypnotics
is a pharmacologic intervention, and frequent vital signs checks during the night disrupt sleep
architecture. Sleep hygiene should prioritize minimizing nighttime interruptions.
7. [Standard MC] A nurse is caring for a client on bed rest. Which intervention best prevents
the complication of plantar flexion contractures?
A. Place a footboard at the foot of the bed
B. Encourage the client to perform ankle circles
C. Position the client in high Fowler's position
D. Apply compression stockings bilaterally
Correct Answer: A
Rationale: Plantar flexion contractures (footdrop) occur when the foot is allowed to remain in
plantar flexion for prolonged periods. A footboard or a firm surface placed perpendicular to the
mattress maintains the foot in dorsiflexion, preventing shortening of the gastrocnemius muscle
and Achilles tendon. While ankle circles promote circulation, they do not maintain the foot in
proper alignment. Compression stockings address venous return rather than joint positioning.
8. [Standard MC] A nurse is assisting a client with a bed bath. Which action demonstrates
proper technique?
A. Wash from the most contaminated area to the least contaminated area
B. Wash the client's eyes from the outer canthus to the inner canthus
C. Change the bath water after washing the perineal area
D. Use hot water to promote vasodilation and comfort
Correct Answer: C
