Welcome to the most comprehensive practice resource for the ATI RN Fundamentals 2016 Proctored Exam. This complete 70-question practice test mirrors the actual RN Content Mastery Series 2016 Fundamentals proctored examination, providing you with expertly crafted questions, detailed rationales, and critical nursing concepts needed to excel.

Unlike generic nursing fundamentals quizzes, this resource is specifically designed for the ATI 2016 Proctored Exam format, covering essential topics including:

Pharmacology & Medication Administration – Dosage calculations, routes, and safety protocols
Patient Safety & Infection Control – Restraint guidelines, sterile technique, and protective isolation
Nursing Process (ADPIE) – Assessment, prioritization, and critical thinking
Legal & Ethical Issues – Client rights, torts, informed consent, and delegation
Basic Care & Comfort – Vital signs, wound care, and geriatric considerations
Fluid & Electrolytes – Lab values, dehydration/overload assessment

How to Use This Practice Test: Read each question carefully, select your answer, then click “Show Answer & Rationale” to see the correct response with a comprehensive explanation. Focus on understanding WHY each answer is correct—this builds the critical thinking skills essential for NCLEX success.

📚 Core Concepts Review for the Fundamentals Exam

The Nursing Process (ADPIE) & Critical Thinking

The nursing process is the foundation of all nursing care and a major focus of the ATI Fundamentals exam:

Assessment: Collect subjective (symptoms – what patient reports) and objective (signs – what you observe/measure) data
Diagnosis: Identify nursing problems based on assessment findings
Planning: Set goals and prioritize interventions using Maslow’s Hierarchy
Implementation: Carry out nursing interventions
Evaluation: Determine if goals were met and reassess as needed

Prioritization Using Maslow’s Hierarchy

When answering priority questions, remember the hierarchy:

Physiological Needs (highest priority): Airway, Breathing, Circulation, Food, Water, Elimination
Safety & Security: Physical safety, infection control, fall prevention
Love & Belonging: Family, relationships, social connections
Esteem: Self-confidence, respect, achievement
Self-Actualization: Personal growth, reaching potential

Safe Medication Administration

The Six Rights of Medication Administration:

Right Patient (use two identifiers)
Right Medication
Right Dose
Right Route
Right Time
Right Documentation

Critical Medication Safety Points:

Heparin: Check aPTT before administration, never massage injection site, use short needle for subcutaneous
Digoxin: Check apical pulse for 1 full minute; withhold if HR < 60 bpm
Insulin: Rotate injection sites, check blood glucose before administration

Legal, Ethical & Safety Considerations

Understanding Torts:

Assault: Threat or attempt to cause harm (creates fear/apprehension)
Battery: Unauthorized touching or treatment without consent
False Imprisonment: Restraining or confining without legal authority
Negligence: Failure to provide reasonable care (malpractice)

Delegation to Assistive Personnel (AP):

Can delegate: Routine ADLs, vital signs on stable patients, specimen collection, ambulation assistance

Cannot delegate: Assessment, teaching, evaluation, medication administration, care of unstable patients

🎯 ATI Fundamentals 2016: 70 Practice Questions with Answers & Rationales

Questions 1-20: Safety, Infection Control & Basic Care

Safety & Restraints

A nurse is caring for a client who has a prescription for wrist restraints. Which of the following actions should the nurse take?

A. Tie the restraints to the side rails of the bed

B. Remove the restraints every 4 hours

C. Ensure that two fingers can fit between the restraint and the client’s wrist ✓

D. Document restraint use every 4 hours

✓ CORRECT ANSWER: C

Rationale: The nurse should ensure that two fingers can fit between the restraint and the client’s wrist to prevent impaired circulation and skin breakdown while maintaining safety. This is the “two-finger rule” for proper restraint application.

Why other options are incorrect:

Option A: Restraints should NEVER be tied to side rails because rails move up and down, creating serious injury risk including strangulation.
Option B: Restraints must be removed every 2 hours (not 4) for range of motion exercises and circulation checks.
Option D: Restraint use must be documented every 2 hours (not 4) per facility policy and legal requirements.

Key Concept: Patient Safety & Restraint Guidelines – Legal and ethical use requires the least restrictive method, frequent monitoring (every 15-30 min), removal every 2 hours, and proper documentation. Restraints require a physician’s order and should only be used when other methods fail.

Pharmacology

A nurse is preparing to administer medication to a client who has a prescription for heparin 5,000 units subcutaneously. Which of the following actions should the nurse take?

A. Massage the injection site after administration

B. Use a 1-inch needle for injection

C. Aspirate before injecting the medication

D. Inject the medication into the abdomen at least 2 inches from the umbilicus ✓

✓ CORRECT ANSWER: D

Rationale: The nurse should inject heparin into the abdomen at least 2 inches (5 cm) from the umbilicus to avoid areas with less subcutaneous tissue and reduce bruising risk. The preferred sites are the “love handles” area of the lower abdomen.

Why other options are incorrect:

Option A: NEVER massage after heparin administration—this increases bleeding and bruising at the site.
Option B: Use a SHORT needle (5/8 inch or 1.5 cm) for subcutaneous injection, NOT a 1-inch needle which is too long.
Option C: DO NOT aspirate with heparin—aspiration can damage tissue and increase bruising risk.

Key Concept: Anticoagulant Medication Safety – Proper subcutaneous heparin injection technique: Use short needle, inject at 90-degree angle into abdomen (rotate sites), do not aspirate, do not massage, apply gentle pressure only. Monitor aPTT and assess for bleeding.

Vital Signs Assessment

A nurse observes an assistive personnel (AP) preparing to obtain a blood pressure with a regular-sized cuff for a client who is obese. Which of the following explanations should the nurse give the AP?

A. The reading will be inaudible if the cuff is too small

B. The width of the cuff bladder should be 75% of the circumference of the client’s arm

C. As long as the cuff will circle the arm, the reading will be accurate

D. Using a cuff that is too small will result in an inaccurately high reading ✓

✓ CORRECT ANSWER: D

Rationale: A blood pressure cuff that is too small will compress the artery inadequately, requiring higher pressure to occlude blood flow, resulting in a falsely ELEVATED (high) reading. This is a critical error that could lead to misdiagnosis of hypertension or inappropriate treatment decisions.

Why other options are incorrect:

Option A: The reading will still be audible, but it will be inaccurate (falsely high).
Option B: The cuff bladder width should be 40% (not 75%) of the arm circumference.
Option C: Simply circling the arm is insufficient—the bladder should encircle 80% of the arm for accuracy.

Key Concept: Vital Signs Assessment – Equipment Selection – Proper cuff sizing is essential for accurate BP measurement. Too small = falsely HIGH reading. Too large = falsely LOW reading. Choose cuff size based on arm circumference, not patient size alone.

🎯 Test-Taking Strategies for ATI Success

ABCs Always Win: When prioritizing, remember Airway, Breathing, Circulation come first
Safety First: Choose the answer that keeps the patient safest and prevents harm
Assessment Before Action: You must assess/collect data before implementing interventions
Maslow’s Hierarchy: Physiological needs trump psychosocial needs every time
Therapeutic Communication: Choose open-ended, non-judgmental responses; avoid “why” questions
Never Assume: Base answers only on information provided in the question
Legal Issues: Always respect patient rights, autonomy, and informed consent

❓ Frequently Asked Questions

Are these the exact questions from the 2016 ATI Fundamentals proctored exam?

These practice questions mirror the format, difficulty level, and content areas of the actual ATI RN Fundamentals 2016 Proctored Exam. While we cannot reproduce exact test questions due to copyright, these questions cover all the same topics and use the same NCLEX-style format you’ll encounter on the actual exam.

How is the 2016 version still relevant for my NCLEX or current nursing practice?

Nursing fundamentals are timeless—the principles of patient safety, medication administration, infection control, and the nursing process remain consistent. The 2016 ATI exam covers core competencies that are still tested on current NCLEX exams and essential for clinical practice. We’ve updated rationales to reflect current best practices for 2024-2025.

What score should I aim for on this 70-question practice test?

For ATI proctored exams, aim for a Level 2 proficiency (score of 70-79%) or higher. A Level 3 (80%+) demonstrates excellent mastery. Focus less on the score and more on understanding the rationales—this builds critical thinking skills that transfer to any nursing exam.

I keep missing questions on legal issues and delegation. How can I improve?

For legal issues, remember: always respect patient autonomy and rights, obtain informed consent, and understand the difference between assault (threat), battery (unauthorized touch), and false imprisonment (unlawful restraint).

For delegation, use this rule: RNs cannot delegate the nursing process (assessment, planning, evaluation), teaching, or unstable patients. APs can perform routine ADLs and basic care on stable patients only.

Where can I find more practice on dosage calculations and fluid/electrolytes?

Master dosage calculations using dimensional analysis or ratio-proportion methods. For fluid and electrolytes, focus on recognizing signs of dehydration (increased specific gravity, concentrated urine, tachycardia) vs. fluid overload (distended neck veins, crackles, edema). Practice interpreting lab values and understanding their clinical significance.

📖 About This ATI Fundamentals Practice Resource

This comprehensive practice exam is specifically designed for nursing students preparing for the ATI RN Fundamentals 2016 Proctored Exam. Each of the 70 questions includes detailed rationales that explain not only why the correct answer is right, but also why the distractors are incorrect—helping you build the critical thinking skills essential for nursing success.

Study Smart: Don’t just memorize answers. Read every rationale, understand the underlying nursing concepts, and apply principles like Maslow’s Hierarchy, ABCs, and the nursing process to develop strong clinical judgment. Your success on ATI exams and NCLEX depends on critical thinking, not rote memorization.

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Jesse Zanger

Jesse Zanger is the managing editor of aldalive.com and is based in New York City. He earned a degree in Philosophy from Hamilton College in 1998. Jesse has spent his entire professional career in New York, reporting on both local and national news for MacNeil/Lehrer Productions, Spectrum News NY1, Fox News, and 5ebackgrounds.com. During his time at local News Channel, he was part of the team that helped introduce the on-screen news crawl shortly after 9/11. As a member of the leadership team at 5ebackgrounds.com, the site has received notable industry honors, including a New York State Broadcasters Association Award (2019) and a Regional Edward R. Murrow Award (2017).