1
ATI MED-SURG CMS PROCTORED EXAM 2026-
27 LATEST UPDATED VERSION
Introduction
The ATI Med-Surg CMS Proctored Exam evaluates a nurse’s ability to provide safe, evidence-based care for adult
patients across the medical-surgical continuum while complying with CMS quality standards. Candidates are
expected to:
• Apply critical thinking and clinical judgment
• Prioritize patient safety and quality care
• Integrate CMS core measures (falls, HAI prevention, pain management, medication safety)
• Manage complex multi-system patient scenarios
• Use interprofessional collaboration and ethical reasoning
This exam mirrors the proctored ATI format, emphasizing decision-making under time pressure.
Exam Structure
• Total Questions: 100
• Format: Multiple Choice (A–D)
• Domains Covered:
1. Cardiac & Vascular – 15 questions
2. Respiratory – 12 questions
3. Renal & GU – 8 questions
4. Endocrine & Metabolic – 10 questions
5. Gastrointestinal – 10 questions
6. Neurological – 10 questions
7. Hematology & Oncology – 10 questions
8. Musculoskeletal & Skin – 5 questions
9. Pain, Safety & CMS Quality Measures – 20 questions
• Rationale: Each question includes why the correct answer is right and why others are wrong, promoting
deep understanding.
,2
Questions 1–30
1.
A patient with acute myocardial infarction reports chest pain
rated 8/10. Which is the nurse’s priority action?
A. Administer prescribed nitroglycerin and reassess
B. Document the pain
C. Offer a snack
D. Call family
Answer: A
Rationale:
Chest pain in MI is life-threatening. Administering prescribed
nitroglycerin addresses myocardial ischemia.
• B is incorrect: Documentation alone does not treat the
patient.
• C is incorrect: Food intake is irrelevant during acute MI.
• D is incorrect: Family notification is secondary to patient
stabilization.
2.
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A patient with heart failure has 3+ pitting edema and shortness
of breath. Which intervention is priority?
A. Encourage ambulation
B. Assess lung sounds and oxygen saturation
C. Provide a high-sodium snack
D. Document findings
Answer: B
Rationale:
Edema and dyspnea may indicate fluid overload → risk of
pulmonary edema. Assessment guides immediate
interventions.
• A is incorrect: Ambulation may worsen pulmonary
congestion.
• C is incorrect: Sodium increases fluid retention.
• D is incorrect: Documentation is secondary.
3.
A patient post-CABG has a temperature of 101°F and incision
redness. Which CMS measure is relevant?
A. Pain assessment
B. Hospital-acquired infection prevention (SSI measure)
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C. Fall risk
D. Medication reconciliation
Answer: B
Rationale:
Postoperative wound infection is a core CMS quality metric (SSI
prevention). Early detection is crucial.
• A is incorrect: Pain assessment alone does not address
infection.
• C & D are not directly related to SSI.
4.
A COPD patient requires oxygen. Which action aligns with safety
standards?
A. Set oxygen to 2 L/min per order and monitor saturation
B. Remove oxygen intermittently
C. Place oxygen near open flames
D. Increase to 6 L/min without order
Answer: A
Rationale:
CMS safety mandates following orders and monitoring. Oxygen
is a high-risk therapy.
• B, C, D are unsafe and violate protocols.
ATI MED-SURG CMS PROCTORED EXAM 2026-
27 LATEST UPDATED VERSION
Introduction
The ATI Med-Surg CMS Proctored Exam evaluates a nurse’s ability to provide safe, evidence-based care for adult
patients across the medical-surgical continuum while complying with CMS quality standards. Candidates are
expected to:
• Apply critical thinking and clinical judgment
• Prioritize patient safety and quality care
• Integrate CMS core measures (falls, HAI prevention, pain management, medication safety)
• Manage complex multi-system patient scenarios
• Use interprofessional collaboration and ethical reasoning
This exam mirrors the proctored ATI format, emphasizing decision-making under time pressure.
Exam Structure
• Total Questions: 100
• Format: Multiple Choice (A–D)
• Domains Covered:
1. Cardiac & Vascular – 15 questions
2. Respiratory – 12 questions
3. Renal & GU – 8 questions
4. Endocrine & Metabolic – 10 questions
5. Gastrointestinal – 10 questions
6. Neurological – 10 questions
7. Hematology & Oncology – 10 questions
8. Musculoskeletal & Skin – 5 questions
9. Pain, Safety & CMS Quality Measures – 20 questions
• Rationale: Each question includes why the correct answer is right and why others are wrong, promoting
deep understanding.
,2
Questions 1–30
1.
A patient with acute myocardial infarction reports chest pain
rated 8/10. Which is the nurse’s priority action?
A. Administer prescribed nitroglycerin and reassess
B. Document the pain
C. Offer a snack
D. Call family
Answer: A
Rationale:
Chest pain in MI is life-threatening. Administering prescribed
nitroglycerin addresses myocardial ischemia.
• B is incorrect: Documentation alone does not treat the
patient.
• C is incorrect: Food intake is irrelevant during acute MI.
• D is incorrect: Family notification is secondary to patient
stabilization.
2.
,3
A patient with heart failure has 3+ pitting edema and shortness
of breath. Which intervention is priority?
A. Encourage ambulation
B. Assess lung sounds and oxygen saturation
C. Provide a high-sodium snack
D. Document findings
Answer: B
Rationale:
Edema and dyspnea may indicate fluid overload → risk of
pulmonary edema. Assessment guides immediate
interventions.
• A is incorrect: Ambulation may worsen pulmonary
congestion.
• C is incorrect: Sodium increases fluid retention.
• D is incorrect: Documentation is secondary.
3.
A patient post-CABG has a temperature of 101°F and incision
redness. Which CMS measure is relevant?
A. Pain assessment
B. Hospital-acquired infection prevention (SSI measure)
, 4
C. Fall risk
D. Medication reconciliation
Answer: B
Rationale:
Postoperative wound infection is a core CMS quality metric (SSI
prevention). Early detection is crucial.
• A is incorrect: Pain assessment alone does not address
infection.
• C & D are not directly related to SSI.
4.
A COPD patient requires oxygen. Which action aligns with safety
standards?
A. Set oxygen to 2 L/min per order and monitor saturation
B. Remove oxygen intermittently
C. Place oxygen near open flames
D. Increase to 6 L/min without order
Answer: A
Rationale:
CMS safety mandates following orders and monitoring. Oxygen
is a high-risk therapy.
• B, C, D are unsafe and violate protocols.
