ATI Fundamentals CMS Proctored Exam 2026/2027 | 70 Questions & Verified Answers
ATI Fundamentals CMS Proctored Exam
2026/2027 Edition
70 Questions and Verified Answers | 100% Correct | LATEST
Section 1: Safe, Effective Care Environment
Management of Care, Client Rights, Advocacy, Delegation, Legal/Ethical Issues, Safety/Infection Control
(Q1-Q20)
Q1: A nurse is caring for four clients on a medical-surgical unit. Which of the following tasks should the
nurse delegate to an unlicensed assistive personnel (UAP)?
A. Perform an initial admission assessment on a new client
B. Measure and record vital signs on a stable postoperative client [CORRECT]
C. Evaluate the effectiveness of a pain management intervention
D. Instruct a client on wound care discharge instructions
Correct Answer: B
Rationale: Measuring and recording vital signs on a stable client falls within the scope of UAP practice, as it involves routine data
collection that does not require clinical judgment. The RN must perform the initial admission assessment because it requires
clinical reasoning and comprehensive evaluation. Evaluating interventions and providing client education are RN-level
responsibilities that require nursing knowledge and judgment.
Q2: A nurse is preparing to administer a blood transfusion to a client. Which of the following actions should
the nurse take FIRST?
A. Verify the client's identity using two identifiers [CORRECT]
B. Obtain the client's vital signs including temperature
C. Prime the IV tubing with 0.9% sodium chloride
D. Check the blood product expiration date and type
Correct Answer: A
Rationale: The first action in the nursing process is assessment, and the priority safety action before administering any blood
product is verifying client identity using two identifiers (e.g., name and date of birth). This follows the Six Rights of medication
administration and prevents the most dangerous error: administering blood to the wrong client. While checking the expiration date,
priming tubing, and obtaining vital signs are all necessary steps, client identification must always come first to ensure client safety.
Q3: A nurse is caring for a client who is on contact precautions for Clostridioides difficile infection. Which of
the following actions by the nurse demonstrates correct infection control practice?
A. Wear a standard surgical mask when entering the room
B. Use an alcohol-based hand sanitizer after removing gloves
, ATI Fundamentals CMS Proctored Exam 2026/2027 | 70 Questions & Verified Answers
C. Don gown and gloves before entering the client's room [CORRECT]
D. Place the client in a room with negative-pressure airflow
Correct Answer: C
Rationale: Contact precautions require the nurse to don a gown and gloves before entering the client's room to prevent the
transmission of organisms spread by direct or indirect contact. A surgical mask is required for droplet precautions, not contact
precautions. Alcohol-based hand sanitizers are not effective against C. difficile spores; hands must be washed with soap and water.
Negative-pressure airflow is required for airborne precautions, not contact precautions.
Q4: A nurse receives a phone call from a person who identifies themselves as a family member and asks for
information about a client's condition. Which of the following responses by the nurse is appropriate?
A. Provide the information because family members have a right to know
B. Verify the client's code status before sharing any information
C. Inform the caller that client information cannot be disclosed without the client's written consent
[CORRECT]
D. Ask the caller to come to the facility to receive the information in person
Correct Answer: C
Rationale: HIPAA regulations prohibit the disclosure of protected health information to any person without the client's written
authorization, including family members. The nurse must protect client confidentiality regardless of who is calling. Providing
information without consent violates HIPAA, and asking the caller to come in person does not resolve the authorization
requirement. Code status is unrelated to the issue of information disclosure.
Q5: A nurse on a medical-surgical unit is assigned to care for the following clients. Which client should the
nurse assess FIRST?
A. A client who is 1 day postoperative following a cholecystectomy with a heart rate of 96/min
B. A client who has heart failure and reports shortness of breath while lying flat [CORRECT]
C. A client who has type 2 diabetes mellitus and a fasting blood glucose of 180 mg/dL
D. A client who has a stage 2 pressure injury on the coccyx that needs a dressing change
Correct Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) priority framework, the client with heart failure reporting shortness
of breath while lying flat should be assessed first. This client is exhibiting a potential respiratory compromise (breathing), which
takes priority over all other concerns. The postoperative client's heart rate is within normal limits. The diabetic client's glucose is
elevated but not at a critical level requiring immediate intervention. The pressure injury requires care but is not an acute safety
threat.
Q6: A nurse is reviewing the medical record of a client who has an advance directive that includes a Do Not
Resuscitate (DNR) order. The client's family member verbally requests that the nurse perform resuscitation if
the client's heart stops. Which of the following actions should the nurse take?
A. Honor the family member's request because family wishes take priority
B. Follow the advance directive as documented in the client's medical record [CORRECT]
C. Initiate resuscitation until the provider can be contacted
D. Ask another nurse for a second opinion before making a decision
Correct Answer: B
, ATI Fundamentals CMS Proctored Exam 2026/2027 | 70 Questions & Verified Answers
Rationale: The nurse must follow the client's advance directive as documented in the medical record. An advance directive is a
legal document that reflects the client's own wishes regarding treatment and takes precedence over the verbal requests of family
members. Honoring the family's verbal request over the client's documented wishes violates legal and ethical standards. The nurse
does not need a second opinion or provider contact to follow a valid DNR order.
Q7: A nurse is caring for a client who has been placed in wrist restraints. Which of the following actions
should the nurse take?
A. Secure the restraints to the side rails of the bed
B. Remove the restraints every 4 hours to perform range-of-motion exercises
C. Ensure that two fingers can be inserted between the restraint and the client's skin [CORRECT]
D. Tie the restraints using a double knot for added security
Correct Answer: C
Rationale: The nurse should ensure that two fingers can be inserted between the restraint and the client's skin to maintain
adequate circulation and prevent tissue damage. Restraints must be secured to the movable portion of the bed frame, not the side
rails, to prevent injury if side rails are raised or lowered. Restraints should be removed at least every 2 hours (not 4 hours) for
assessment, repositioning, and range-of-motion exercises. A quick-release knot (not a double knot) must be used so restraints can
be removed rapidly in an emergency.
Q8: A nurse is implementing a fire safety plan on the unit. The nurse identifies a fire in a wastebasket. Which
of the following actions should the nurse take in the correct order?
A. Pull the fire alarm, confine the fire, rescue clients, and then extinguish the fire
B. Rescue clients, pull the fire alarm, confine the fire, and then extinguish the fire [CORRECT]
C. Confine the fire, rescue clients, pull the fire alarm, and then extinguish the fire
D. Extinguish the fire, pull the fire alarm, rescue clients, and then confine the fire
Correct Answer: B
Rationale: The correct sequence for responding to a fire follows the RACE mnemonic: Rescue (remove clients from immediate
danger), Alarm (activate the fire alarm), Confine (close doors and windows to contain the fire), and Extinguish (use an appropriate
fire extinguisher to put out the fire). Client safety and life preservation always take the highest priority, making rescue the first
action. Pulling the alarm before rescuing clients delays their evacuation and increases the risk of harm.
Q9: A nurse is caring for a client who requires airborne precautions. Which of the following personal
protective equipment (PPE) items is required when entering the client's room?
A. N95 respirator mask [CORRECT]
B. Surgical face mask
C. Gown and gloves only
D. Face shield and gown
Correct Answer: A
Rationale: Airborne precautions require the use of an N95 respirator mask (or higher-level respiratory protection) because these
precautions are designed to prevent transmission of organisms that spread via small airborne droplet nuclei (e.g., tuberculosis,
measles, varicella). A standard surgical mask does not provide adequate filtration for airborne pathogens. Gown and gloves are
used for contact precautions. A face shield is used when there is a risk of splashing and is not specific to airborne isolation.
ATI Fundamentals CMS Proctored Exam
2026/2027 Edition
70 Questions and Verified Answers | 100% Correct | LATEST
Section 1: Safe, Effective Care Environment
Management of Care, Client Rights, Advocacy, Delegation, Legal/Ethical Issues, Safety/Infection Control
(Q1-Q20)
Q1: A nurse is caring for four clients on a medical-surgical unit. Which of the following tasks should the
nurse delegate to an unlicensed assistive personnel (UAP)?
A. Perform an initial admission assessment on a new client
B. Measure and record vital signs on a stable postoperative client [CORRECT]
C. Evaluate the effectiveness of a pain management intervention
D. Instruct a client on wound care discharge instructions
Correct Answer: B
Rationale: Measuring and recording vital signs on a stable client falls within the scope of UAP practice, as it involves routine data
collection that does not require clinical judgment. The RN must perform the initial admission assessment because it requires
clinical reasoning and comprehensive evaluation. Evaluating interventions and providing client education are RN-level
responsibilities that require nursing knowledge and judgment.
Q2: A nurse is preparing to administer a blood transfusion to a client. Which of the following actions should
the nurse take FIRST?
A. Verify the client's identity using two identifiers [CORRECT]
B. Obtain the client's vital signs including temperature
C. Prime the IV tubing with 0.9% sodium chloride
D. Check the blood product expiration date and type
Correct Answer: A
Rationale: The first action in the nursing process is assessment, and the priority safety action before administering any blood
product is verifying client identity using two identifiers (e.g., name and date of birth). This follows the Six Rights of medication
administration and prevents the most dangerous error: administering blood to the wrong client. While checking the expiration date,
priming tubing, and obtaining vital signs are all necessary steps, client identification must always come first to ensure client safety.
Q3: A nurse is caring for a client who is on contact precautions for Clostridioides difficile infection. Which of
the following actions by the nurse demonstrates correct infection control practice?
A. Wear a standard surgical mask when entering the room
B. Use an alcohol-based hand sanitizer after removing gloves
, ATI Fundamentals CMS Proctored Exam 2026/2027 | 70 Questions & Verified Answers
C. Don gown and gloves before entering the client's room [CORRECT]
D. Place the client in a room with negative-pressure airflow
Correct Answer: C
Rationale: Contact precautions require the nurse to don a gown and gloves before entering the client's room to prevent the
transmission of organisms spread by direct or indirect contact. A surgical mask is required for droplet precautions, not contact
precautions. Alcohol-based hand sanitizers are not effective against C. difficile spores; hands must be washed with soap and water.
Negative-pressure airflow is required for airborne precautions, not contact precautions.
Q4: A nurse receives a phone call from a person who identifies themselves as a family member and asks for
information about a client's condition. Which of the following responses by the nurse is appropriate?
A. Provide the information because family members have a right to know
B. Verify the client's code status before sharing any information
C. Inform the caller that client information cannot be disclosed without the client's written consent
[CORRECT]
D. Ask the caller to come to the facility to receive the information in person
Correct Answer: C
Rationale: HIPAA regulations prohibit the disclosure of protected health information to any person without the client's written
authorization, including family members. The nurse must protect client confidentiality regardless of who is calling. Providing
information without consent violates HIPAA, and asking the caller to come in person does not resolve the authorization
requirement. Code status is unrelated to the issue of information disclosure.
Q5: A nurse on a medical-surgical unit is assigned to care for the following clients. Which client should the
nurse assess FIRST?
A. A client who is 1 day postoperative following a cholecystectomy with a heart rate of 96/min
B. A client who has heart failure and reports shortness of breath while lying flat [CORRECT]
C. A client who has type 2 diabetes mellitus and a fasting blood glucose of 180 mg/dL
D. A client who has a stage 2 pressure injury on the coccyx that needs a dressing change
Correct Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) priority framework, the client with heart failure reporting shortness
of breath while lying flat should be assessed first. This client is exhibiting a potential respiratory compromise (breathing), which
takes priority over all other concerns. The postoperative client's heart rate is within normal limits. The diabetic client's glucose is
elevated but not at a critical level requiring immediate intervention. The pressure injury requires care but is not an acute safety
threat.
Q6: A nurse is reviewing the medical record of a client who has an advance directive that includes a Do Not
Resuscitate (DNR) order. The client's family member verbally requests that the nurse perform resuscitation if
the client's heart stops. Which of the following actions should the nurse take?
A. Honor the family member's request because family wishes take priority
B. Follow the advance directive as documented in the client's medical record [CORRECT]
C. Initiate resuscitation until the provider can be contacted
D. Ask another nurse for a second opinion before making a decision
Correct Answer: B
, ATI Fundamentals CMS Proctored Exam 2026/2027 | 70 Questions & Verified Answers
Rationale: The nurse must follow the client's advance directive as documented in the medical record. An advance directive is a
legal document that reflects the client's own wishes regarding treatment and takes precedence over the verbal requests of family
members. Honoring the family's verbal request over the client's documented wishes violates legal and ethical standards. The nurse
does not need a second opinion or provider contact to follow a valid DNR order.
Q7: A nurse is caring for a client who has been placed in wrist restraints. Which of the following actions
should the nurse take?
A. Secure the restraints to the side rails of the bed
B. Remove the restraints every 4 hours to perform range-of-motion exercises
C. Ensure that two fingers can be inserted between the restraint and the client's skin [CORRECT]
D. Tie the restraints using a double knot for added security
Correct Answer: C
Rationale: The nurse should ensure that two fingers can be inserted between the restraint and the client's skin to maintain
adequate circulation and prevent tissue damage. Restraints must be secured to the movable portion of the bed frame, not the side
rails, to prevent injury if side rails are raised or lowered. Restraints should be removed at least every 2 hours (not 4 hours) for
assessment, repositioning, and range-of-motion exercises. A quick-release knot (not a double knot) must be used so restraints can
be removed rapidly in an emergency.
Q8: A nurse is implementing a fire safety plan on the unit. The nurse identifies a fire in a wastebasket. Which
of the following actions should the nurse take in the correct order?
A. Pull the fire alarm, confine the fire, rescue clients, and then extinguish the fire
B. Rescue clients, pull the fire alarm, confine the fire, and then extinguish the fire [CORRECT]
C. Confine the fire, rescue clients, pull the fire alarm, and then extinguish the fire
D. Extinguish the fire, pull the fire alarm, rescue clients, and then confine the fire
Correct Answer: B
Rationale: The correct sequence for responding to a fire follows the RACE mnemonic: Rescue (remove clients from immediate
danger), Alarm (activate the fire alarm), Confine (close doors and windows to contain the fire), and Extinguish (use an appropriate
fire extinguisher to put out the fire). Client safety and life preservation always take the highest priority, making rescue the first
action. Pulling the alarm before rescuing clients delays their evacuation and increases the risk of harm.
Q9: A nurse is caring for a client who requires airborne precautions. Which of the following personal
protective equipment (PPE) items is required when entering the client's room?
A. N95 respirator mask [CORRECT]
B. Surgical face mask
C. Gown and gloves only
D. Face shield and gown
Correct Answer: A
Rationale: Airborne precautions require the use of an N95 respirator mask (or higher-level respiratory protection) because these
precautions are designed to prevent transmission of organisms that spread via small airborne droplet nuclei (e.g., tuberculosis,
measles, varicella). A standard surgical mask does not provide adequate filtration for airborne pathogens. Gown and gloves are
used for contact precautions. A face shield is used when there is a risk of splashing and is not specific to airborne isolation.
