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Exam Overview
Fundamentals exams are given by your nursing school, not at a public test center. Your program orders the exam from the testing company, and faculty proctor it in a computer lab or through approved remote proctoring. You do not register or pay separately; the cost is usually part of your program fees.
Key Facts About the ATI RN Fundamentals Assessment
| Feature | Details |
|---|---|
| Publisher | Assessment Technologies Institute (ATI), Content Mastery Series |
| Questions | 70: 60 scored and 10 unscored pretest questions |
| Question types | Multiple choice with four options, select all that apply, hot spot, and Next Generation NCLEX clinical judgment items |
| Time | About one minute per question: 70 minutes on classic forms, 90 minutes on forms with scored clinical judgment items |
| Delivery | Computer-based, proctored by your school |
| Results | Percentage score and proficiency level (Level 3, Level 2, Level 1, Below Level 1), shown when you finish |
| Remediation | Focused Review study plan built from your missed topics |
Key Facts About the HESI Fundamentals Exam
| Feature | Details |
|---|---|
| Publisher | Elsevier (HESI specialty exam) |
| Question types | Multiple choice, multiple response, and Next Generation NCLEX items such as case studies, bowtie and trend items |
| Length and time | Set by your school's order; ask your instructor |
| Score | HESI score, usually between 0 and 1500, weighted by question difficulty |
| Benchmarks | 850 is Elsevier's acceptable level; 900 is the recommended level, and many schools expect 900 or higher |
| Results | Shown when you finish, with a conversion score for your gradebook and remediation by topic |
How the Content Is Weighted
Neither company publishes an exact item count by topic for its fundamentals exam. Both report your results by the NCLEX-RN Client Needs categories, and fundamentals exams lean heavily on safety, infection control, basic care and priority setting. This guide's sections and practice tests use the following weights.
Practice Test Blueprint
| Section | Main Client Needs Category | Questions per Test |
|---|---|---|
| 1. Foundations of Professional Nursing Practice | Management of Care | 16 |
| 2. Safety and Infection Prevention and Control | Safety and Infection Prevention and Control | 18 |
| 3. Health Assessment and Health Promotion | Health Promotion and Maintenance | 12 |
| 4. Medication Administration and IV Therapy | Pharmacological and Parenteral Therapies | 14 |
| 5. Basic Care and Comfort | Basic Care and Comfort | 16 |
| 6. Oxygenation, Fluids, Skin Integrity and Surgical Care | Physiological Adaptation; Reduction of Risk Potential | 14 |
| 7. Psychosocial Integrity and Client Education | Psychosocial Integrity | 10 |
How Your School Uses the Score
Each program sets its own rules. Common examples are a set number of course points for each proficiency level, a required Level 2 or a HESI score of 850 or 900, and a required remediation plan and retake for lower scores. Read your course syllabus and testing policy so you know your target before you start studying.
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