ATI: CMS FUNDAMENTAL EXAM 2026/2027 QUESTIONS AND
ANSWERS REAL EXAM |LATEST VERSION | QU, Exams of Nursing
Comprehensive Assessment
2026-2027 • 100 Questions • 100% VERIFIED
Introduction
This comprehensive 100-question assessment examination question bank is specifically designed to
evaluate clinical competencies, foundational nursing principles, and evidence-based clinical judgment
for nursing candidates. Aligned with the official ATI CMS Fundamentals curriculum, testing blueprints,
and NCLEX-RN standards, this examination spans eight essential domains: Nursing Process and Clinical
Judgment, Safety and Infection Control, Basic Care and Comfort, Health Promotion and Maintenance,
Psychosocial Integrity, Pharmacological Therapies, Reduction of Risk Potential, and Physiological
Adaptation. Mastery of these core concepts is vital for academic progression, NCLEX readiness, client
safety vigilance, and nursing clinical execution across diverse acute, long-term, and community
healthcare environments.
Question 1
A nurse is caring for a client who is 4 hours postoperative following an open cholecystectomy and
reports severe abdominal pain rating an 8 on a 0-to-10 visual numeric scale. Which action should the
nurse execute FIRST in accordance with the nursing process?
A. Administer the maximum prescribed dose of intravenous hydromorphone immediately
B. Reposition the client into a high-Fowler position and apply a warm abdominal compress
C. Contact the surgical provider to request an increase in the analgesic dosage
D. Conduct a focused physical assessment of the client's surgical site, vital signs, and pain
characteristics before selecting an intervention
Correct Answer: D. Conduct a focused physical assessment of the client's surgical site, vital
signs, and pain characteristics before selecting an intervention
Rationale: According to the nursing process and clinical judgment frameworks, assessment is always the
priority first step before implementing any clinical intervention. The nurse must collect comprehensive
objective and subjective data—including location, quality, onset, aggravating factors, wound status, and
baseline vital signs—to ensure that the pain is not secondary to acute postoperative complications such
as internal hemorrhage, evisceration, or infection.
,Question 2
A nurse receives report on four clients in the acute medical-surgical unit. Based on Maslow's Hierarchy
of Needs and the Airway-Breathing-Circulation (ABC) priority framework, which client requires the
nurse's immediate assessment?
A. A client scheduled for discharge in 2 hours who requires home wound dressing instructions
B. A client with chronic osteomyelitis who requests a scheduled dose of oral antibiotic therapy
C. A client with diabetic neuropathy who reports burning numbness in bilateral lower extremities
D. A client with acute laryngeal edema following extubation who exhibits high-pitched inspiratory
stridor and intercostal retractions
Correct Answer: D. A client with acute laryngeal edema following extubation who exhibits
high-pitched inspiratory stridor and intercostal retractions
Rationale: Using the ABC priority framework, airway compromise represents the most immediate, life-
threatening physiological risk. Inspiratory stridor and intercostal retractions indicate severe upper
airway narrowing and imminent respiratory arrest, demanding immediate clinical evaluation and airway
stabilization. The other clients represent stable circulatory, comfort, or educational needs that can be
addressed subsequently.
Question 3
A registered nurse (RN) is planning client care assignments for the shift. Which clinical task is
appropriate for the RN to delegate to an Assistive Personnel (AP)?
A. Measuring and recording routine vital signs and empty drainage volume from a closed suction
Jackson-Pratt bulb for a stable client
B. Conducting the initial admission health history and comprehensive skin assessment
C. Administering a scheduled oral dose of acetaminophen to an alert postoperative client
D. Providing discharge education regarding insulin self-administration techniques
Correct Answer: A. Measuring and recording routine vital signs and empty drainage volume
from a closed suction Jackson-Pratt bulb for a stable client
Rationale: The scope of delegation for Assistive Personnel (AP) encompasses routine, non-invasive,
standardized tasks performed on stable clients that do not require clinical assessment, nursing judgment,
decision-making, or complex evaluation. Measuring routine vital signs and recording drainage volumes
are within AP competency. Admission assessments, client teaching, and medication administration
require licensed nursing judgment and cannot be delegated to AP.
,Question 4
An RN is delegating tasks to a Licensed Vocational Nurse (LVN). Which assignment is within the
professional scope and competency of the LVN?
A. Inserting an indwelling urinary catheter and performing a sterile wound dressing change on an
established pressure injury
B. Conducting the initial post-operative assessment immediately following transfer from the PACU
C. Administering an intravenous push dose of furosemide during acute pulmonary edema
D. Developing the initial comprehensive nursing care plan for a newly admitted client with heart
failure
Correct Answer: A. Inserting an indwelling urinary catheter and performing a sterile wound
dressing change on an established pressure injury
Rationale: Licensed Vocational Nurses (LVNs) are educated and licensed to perform technical,
predictable clinical nursing procedures for stable clients with predictable outcomes, including sterile
catheterization, dressing changes on established wounds, and administering scheduled
oral/subcutaneous medications. Formulating initial nursing care plans, performing initial
admission/PACU assessments, and administering high-risk IV push medications remain the non-
delegable responsibility of the RN.
Question 5
A nurse is executing a clinical handoff report using the SBAR (Situation, Background, Assessment,
Recommendation) standardized communication model. Which statement correctly exemplifies the
'Assessment' component of SBAR?
A. 'This is Nurse Miller calling about Mr. Davis in Room 412 who is having acute dizziness.'
B. 'The client's blood pressure has decreased to 86/52 mmHg, heart rate is 118 bpm, and skin is cool
and clammy, suggesting hypovolemic shock.'
C. 'Mr. Davis is a 64-year-old male admitted yesterday for a bleeding duodenal ulcer.'
D. 'I recommend initiating an intravenous bolus of 500 mL normal saline and obtaining a stat
complete blood count.'
Correct Answer: B. 'The client's blood pressure has decreased to 86/52 mmHg, heart rate is
118 bpm, and skin is cool and clammy, suggesting hypovolemic shock.'
Rationale: In SBAR communication: 1) Situation defines the immediate clinical problem; 2) Background
outlines relevant admission history and clinical context; 3) Assessment provides the nurse's analysis of
current vital signs, physical findings, and clinical judgment of the underlying problem (e.g., hypotension,
tachycardia, diaphoresis indicating hypovolemia); 4) Recommendation states the specific clinical action
or provider order requested.
, Question 6
A nurse is witnessing an adult client sign an informed consent form for an elective laparoscopic repair.
What is the specific legal and professional role of the nurse in this scenario?
A. Guaranteeing that the surgical procedure will achieve complete curative success
B. Determining whether the client's family members agree with the planned surgical intervention
C. Verifying that the client is competent, acting voluntarily, and that the signature on the document
is authentic
D. Explaining the surgical risks, potential complications, and alternative therapeutic options to the
client
Correct Answer: C. Verifying that the client is competent, acting voluntarily, and that the
signature on the document is authentic
Rationale: The nurse's legal responsibility when witnessing informed consent is strictly limited to three
elements: 1) Confirming that the client is mentally competent and alert; 2) Verifying that consent is given
voluntarily without coercion; 3) Witnessing the authentic signature of the client on the form. The primary
provider performing the procedure carries the non-delegable duty to explain the diagnosis, procedure,
material risks, expected benefits, and alternatives.
Question 7
A hospitalized client has a legal Durable Power of Attorney for Healthcare (Healthcare Proxy)
designated in their advance directives. Under which clinical condition does the healthcare proxy acquire
legal authority to make medical decisions?
A. Immediately upon admission to any acute healthcare facility regardless of client orientation
B. Whenever family members disagree with the client's current treatment choices
C. Only when the attending physician determines and documents that the client lacks decisional
capacity to make informed choices
D. Exclusively when the client enters hospice care during the active dying phase
Correct Answer: C. Only when the attending physician determines and documents that the
client lacks decisional capacity to make informed choices
Rationale: A Durable Power of Attorney for Healthcare (Healthcare Proxy) designates a surrogate
decision-maker whose legal authority is dormant as long as the client retains cognitive and decisional
capacity. The proxy's authority is activated ONLY when the client is deemed incapacitated or unable to
communicate their own healthcare decisions, as verified and documented by qualified medical personnel.
ANSWERS REAL EXAM |LATEST VERSION | QU, Exams of Nursing
Comprehensive Assessment
2026-2027 • 100 Questions • 100% VERIFIED
Introduction
This comprehensive 100-question assessment examination question bank is specifically designed to
evaluate clinical competencies, foundational nursing principles, and evidence-based clinical judgment
for nursing candidates. Aligned with the official ATI CMS Fundamentals curriculum, testing blueprints,
and NCLEX-RN standards, this examination spans eight essential domains: Nursing Process and Clinical
Judgment, Safety and Infection Control, Basic Care and Comfort, Health Promotion and Maintenance,
Psychosocial Integrity, Pharmacological Therapies, Reduction of Risk Potential, and Physiological
Adaptation. Mastery of these core concepts is vital for academic progression, NCLEX readiness, client
safety vigilance, and nursing clinical execution across diverse acute, long-term, and community
healthcare environments.
Question 1
A nurse is caring for a client who is 4 hours postoperative following an open cholecystectomy and
reports severe abdominal pain rating an 8 on a 0-to-10 visual numeric scale. Which action should the
nurse execute FIRST in accordance with the nursing process?
A. Administer the maximum prescribed dose of intravenous hydromorphone immediately
B. Reposition the client into a high-Fowler position and apply a warm abdominal compress
C. Contact the surgical provider to request an increase in the analgesic dosage
D. Conduct a focused physical assessment of the client's surgical site, vital signs, and pain
characteristics before selecting an intervention
Correct Answer: D. Conduct a focused physical assessment of the client's surgical site, vital
signs, and pain characteristics before selecting an intervention
Rationale: According to the nursing process and clinical judgment frameworks, assessment is always the
priority first step before implementing any clinical intervention. The nurse must collect comprehensive
objective and subjective data—including location, quality, onset, aggravating factors, wound status, and
baseline vital signs—to ensure that the pain is not secondary to acute postoperative complications such
as internal hemorrhage, evisceration, or infection.
,Question 2
A nurse receives report on four clients in the acute medical-surgical unit. Based on Maslow's Hierarchy
of Needs and the Airway-Breathing-Circulation (ABC) priority framework, which client requires the
nurse's immediate assessment?
A. A client scheduled for discharge in 2 hours who requires home wound dressing instructions
B. A client with chronic osteomyelitis who requests a scheduled dose of oral antibiotic therapy
C. A client with diabetic neuropathy who reports burning numbness in bilateral lower extremities
D. A client with acute laryngeal edema following extubation who exhibits high-pitched inspiratory
stridor and intercostal retractions
Correct Answer: D. A client with acute laryngeal edema following extubation who exhibits
high-pitched inspiratory stridor and intercostal retractions
Rationale: Using the ABC priority framework, airway compromise represents the most immediate, life-
threatening physiological risk. Inspiratory stridor and intercostal retractions indicate severe upper
airway narrowing and imminent respiratory arrest, demanding immediate clinical evaluation and airway
stabilization. The other clients represent stable circulatory, comfort, or educational needs that can be
addressed subsequently.
Question 3
A registered nurse (RN) is planning client care assignments for the shift. Which clinical task is
appropriate for the RN to delegate to an Assistive Personnel (AP)?
A. Measuring and recording routine vital signs and empty drainage volume from a closed suction
Jackson-Pratt bulb for a stable client
B. Conducting the initial admission health history and comprehensive skin assessment
C. Administering a scheduled oral dose of acetaminophen to an alert postoperative client
D. Providing discharge education regarding insulin self-administration techniques
Correct Answer: A. Measuring and recording routine vital signs and empty drainage volume
from a closed suction Jackson-Pratt bulb for a stable client
Rationale: The scope of delegation for Assistive Personnel (AP) encompasses routine, non-invasive,
standardized tasks performed on stable clients that do not require clinical assessment, nursing judgment,
decision-making, or complex evaluation. Measuring routine vital signs and recording drainage volumes
are within AP competency. Admission assessments, client teaching, and medication administration
require licensed nursing judgment and cannot be delegated to AP.
,Question 4
An RN is delegating tasks to a Licensed Vocational Nurse (LVN). Which assignment is within the
professional scope and competency of the LVN?
A. Inserting an indwelling urinary catheter and performing a sterile wound dressing change on an
established pressure injury
B. Conducting the initial post-operative assessment immediately following transfer from the PACU
C. Administering an intravenous push dose of furosemide during acute pulmonary edema
D. Developing the initial comprehensive nursing care plan for a newly admitted client with heart
failure
Correct Answer: A. Inserting an indwelling urinary catheter and performing a sterile wound
dressing change on an established pressure injury
Rationale: Licensed Vocational Nurses (LVNs) are educated and licensed to perform technical,
predictable clinical nursing procedures for stable clients with predictable outcomes, including sterile
catheterization, dressing changes on established wounds, and administering scheduled
oral/subcutaneous medications. Formulating initial nursing care plans, performing initial
admission/PACU assessments, and administering high-risk IV push medications remain the non-
delegable responsibility of the RN.
Question 5
A nurse is executing a clinical handoff report using the SBAR (Situation, Background, Assessment,
Recommendation) standardized communication model. Which statement correctly exemplifies the
'Assessment' component of SBAR?
A. 'This is Nurse Miller calling about Mr. Davis in Room 412 who is having acute dizziness.'
B. 'The client's blood pressure has decreased to 86/52 mmHg, heart rate is 118 bpm, and skin is cool
and clammy, suggesting hypovolemic shock.'
C. 'Mr. Davis is a 64-year-old male admitted yesterday for a bleeding duodenal ulcer.'
D. 'I recommend initiating an intravenous bolus of 500 mL normal saline and obtaining a stat
complete blood count.'
Correct Answer: B. 'The client's blood pressure has decreased to 86/52 mmHg, heart rate is
118 bpm, and skin is cool and clammy, suggesting hypovolemic shock.'
Rationale: In SBAR communication: 1) Situation defines the immediate clinical problem; 2) Background
outlines relevant admission history and clinical context; 3) Assessment provides the nurse's analysis of
current vital signs, physical findings, and clinical judgment of the underlying problem (e.g., hypotension,
tachycardia, diaphoresis indicating hypovolemia); 4) Recommendation states the specific clinical action
or provider order requested.
, Question 6
A nurse is witnessing an adult client sign an informed consent form for an elective laparoscopic repair.
What is the specific legal and professional role of the nurse in this scenario?
A. Guaranteeing that the surgical procedure will achieve complete curative success
B. Determining whether the client's family members agree with the planned surgical intervention
C. Verifying that the client is competent, acting voluntarily, and that the signature on the document
is authentic
D. Explaining the surgical risks, potential complications, and alternative therapeutic options to the
client
Correct Answer: C. Verifying that the client is competent, acting voluntarily, and that the
signature on the document is authentic
Rationale: The nurse's legal responsibility when witnessing informed consent is strictly limited to three
elements: 1) Confirming that the client is mentally competent and alert; 2) Verifying that consent is given
voluntarily without coercion; 3) Witnessing the authentic signature of the client on the form. The primary
provider performing the procedure carries the non-delegable duty to explain the diagnosis, procedure,
material risks, expected benefits, and alternatives.
Question 7
A hospitalized client has a legal Durable Power of Attorney for Healthcare (Healthcare Proxy)
designated in their advance directives. Under which clinical condition does the healthcare proxy acquire
legal authority to make medical decisions?
A. Immediately upon admission to any acute healthcare facility regardless of client orientation
B. Whenever family members disagree with the client's current treatment choices
C. Only when the attending physician determines and documents that the client lacks decisional
capacity to make informed choices
D. Exclusively when the client enters hospice care during the active dying phase
Correct Answer: C. Only when the attending physician determines and documents that the
client lacks decisional capacity to make informed choices
Rationale: A Durable Power of Attorney for Healthcare (Healthcare Proxy) designates a surrogate
decision-maker whose legal authority is dormant as long as the client retains cognitive and decisional
capacity. The proxy's authority is activated ONLY when the client is deemed incapacitated or unable to
communicate their own healthcare decisions, as verified and documented by qualified medical personnel.
