Fundamental CMS Proctored Exam 2025/2026 |
Complete Test Bank with 400 Verified Nursing
Fundamentals Questions with Correct Answers &
Detailed Rationales
EXAM OVERVIEW & KEY INFORMATION
The Fundamental CMS Proctored Exam is a comprehensive nursing assessment covering
essential concepts in patient care, clinical skills, safety, pharmacology, and nursing procedures.
This guide provides 350+ verified practice questions with correct answers and detailed
rationales, aligned with NCLEX, ATI, and HESI standards for nursing students at top programs
including WGU, Unitek, Rasmussen, Chamberlain, and Excelsior .
KEY EXAM INFORMATION:
• Format: Computer-based multiple-choice with Next Generation NCLEX (NGN)-style
questions
• Content Areas: Infection control, patient safety, health promotion, nursing process,
communication, care management, medication administration, and clinical judgment
• Test Plan: Aligned with NCSBN Clinical Judgment Measurement Model (CJMM) and
evidence-based nursing practice
Question 1
A nurse is preparing to insert an indwelling urinary catheter for a female patient. Which action
demonstrates proper sterile technique?
A. Opening the sterile kit and placing it on the patient's bare thigh
B. Using sterile gloves to handle the catheter but touching the sterile drape with ungloved hands
C. Maintaining a sterile field and keeping the catheter tip within the sterile package until use
D. Placing the sterile drape directly on the patient's perineum without a barrier
Correct Answer: C
Explanation: The catheter tip must remain sterile at all times. Placing a sterile kit on a bare
thigh contaminates it. Sterile gloves must be worn before handling any sterile item, including
the drape .
Question 2
A patient postoperatively reports pain of 8 on a 0–10 scale. The nurse administers morphine 4
mg IV. One hour later, the patient says pain is still 8. What should the nurse do first?
pg. 1
,A. Notify the provider for a different order
B. Document that the medication was ineffective
C. Reassess the patient's pain and vital signs
D. Administer another dose of morphine
Correct Answer: C
Explanation: Reassessment is always the first step after pain intervention to evaluate
effectiveness and rule out complications (e.g., respiratory depression). The nurse must assess
the patient before communicating findings .
Question 3
Which finding in an older adult patient requires immediate nursing intervention?
A. Blood pressure 140/90 mm Hg
B. Sudden onset confusion and agitation
C. Decreased skin turgor on the forehead
D. Urinary frequency
Correct Answer: B
Explanation: Sudden confusion in an older adult often indicates a UTI, dehydration, or
another acute illness—not normal aging. The other options can be chronic or age-related
changes .
Question 4
A nurse is calculating intake for a patient from 0700–1500. The patient had: 240 mL coffee, 120
mL juice, IV fluids 50 mL/hr, and 180 mL water. What is total intake?
A. 540 mL
B. 640 mL
C. 940 mL
D. 1140 mL
Correct Answer: C
Explanation: Add all fluids: 240 + 120 + 180 = 540 mL oral; IV 50 mL/hr × 8 hrs = 400 mL;
total 540 + 400 = 940 mL .
Question 5
A nurse is providing tracheostomy care. Which action is correct?
A. Suction the tracheostomy before cleaning the inner cannula
B. Clean the inner cannula with sterile water and reuse
C. Use a new sterile catheter for each suction pass
D. Apply hydrogen peroxide to stoma site daily
Correct Answer: C
Explanation: Using a new sterile catheter for each suction pass prevents reintroducing
pg. 2
,pathogens. Suctioning should occur after cleaning, not before. Hydrogen peroxide irritates
tissue .
Question 6
The nurse understands that which patient is at highest risk for falls?
A. A 45-year-old with well-controlled diabetes
B. An 80-year-old who takes furosemide and has a history of stroke
C. A 30-year-old post-appendectomy day 2
D. A 55-year-old with a hip replacement using a walker independently
Correct Answer: B
Explanation: Furosemide increases urination frequency, and history of stroke creates mobility
and cognitive deficits. Age is an additional risk factor. Multiple fall risk factors make this patient
the highest risk .
Question 7
A nurse is teaching a patient about a low-sodium diet for hypertension. Which meal choice
indicates understanding?
A. Canned vegetable soup and saltine crackers
B. Grilled chicken breast, steamed broccoli, brown rice
C. Ham sandwich with pickles
D. Frozen lasagna and garlic bread
Correct Answer: B
Explanation: Fresh, whole foods are naturally low in sodium. Canned, processed, and frozen
meals are high in sodium .
Question 8
Which patient statement indicates a need for further teaching about warfarin?
A. "I'll use an electric razor to shave."
B. "I can take ibuprofen for my headaches."
C. "I'll eat the same amount of greens each week."
D. "I'll wear a medical alert bracelet."
Correct Answer: B
Explanation: Ibuprofen increases bleeding risk with warfarin. Consistent vitamin K intake is
fine, but NSAIDs are dangerous for patients on anticoagulant therapy .
Question 9
A nurse is assessing a patient's peripheral IV site. Which finding requires immediate
discontinuation of the IV?
pg. 3
, A. Slight redness at the insertion site
B. Patient reports mild warmth
C. Palpable hard cord along the vein
D. Small amount of clear drainage
Correct Answer: C
Explanation: A palpable hard cord indicates phlebitis grade 3 or 4, requiring IV removal.
Redness and mild warmth may be early irritation but do not require immediate removal .
Question 10
When performing sterile wound irrigation, which action maintains sterility?
A. Holding the bottle of sterile solution above the wound while pouring
B. Pouring the solution from a height of 4–6 inches into a sterile basin
C. Using the same gauze to dry the wound edges after irrigation
D. Allowing the solution to flow from clean to dirty area
Correct Answer: B
Explanation: Pouring from 4–6 inches prevents splashing and maintains sterility. Holding the
bottle above the wound directly contaminates the area .
Question 11
A nurse is caring for a patient on contact precautions. Which action is correct?
A. Wear a mask when entering the room
B. Wear gloves and a gown when entering the room
C. Place the patient in a negative pressure room
D. Keep the door closed at all times
Correct Answer: B
Explanation: Contact precautions require gloves and gown when entering the room. Masks are
for droplet precautions; negative pressure is for airborne precautions .
Question 12
A nurse is caring for a client who has influenza and is on isolation precautions. Which of the
following actions should the nurse take to prevent the spread of infection?
A. Wear a mask when working within 3 feet of the client
B. Administer metronidazole
C. Don protective eyewear before entering the room
D. Place the client in a negative airflow room
Correct Answer: A
Explanation: Influenza is transmitted through droplets, so wearing a mask within close
proximity is essential to prevent spread .
pg. 4
Complete Test Bank with 400 Verified Nursing
Fundamentals Questions with Correct Answers &
Detailed Rationales
EXAM OVERVIEW & KEY INFORMATION
The Fundamental CMS Proctored Exam is a comprehensive nursing assessment covering
essential concepts in patient care, clinical skills, safety, pharmacology, and nursing procedures.
This guide provides 350+ verified practice questions with correct answers and detailed
rationales, aligned with NCLEX, ATI, and HESI standards for nursing students at top programs
including WGU, Unitek, Rasmussen, Chamberlain, and Excelsior .
KEY EXAM INFORMATION:
• Format: Computer-based multiple-choice with Next Generation NCLEX (NGN)-style
questions
• Content Areas: Infection control, patient safety, health promotion, nursing process,
communication, care management, medication administration, and clinical judgment
• Test Plan: Aligned with NCSBN Clinical Judgment Measurement Model (CJMM) and
evidence-based nursing practice
Question 1
A nurse is preparing to insert an indwelling urinary catheter for a female patient. Which action
demonstrates proper sterile technique?
A. Opening the sterile kit and placing it on the patient's bare thigh
B. Using sterile gloves to handle the catheter but touching the sterile drape with ungloved hands
C. Maintaining a sterile field and keeping the catheter tip within the sterile package until use
D. Placing the sterile drape directly on the patient's perineum without a barrier
Correct Answer: C
Explanation: The catheter tip must remain sterile at all times. Placing a sterile kit on a bare
thigh contaminates it. Sterile gloves must be worn before handling any sterile item, including
the drape .
Question 2
A patient postoperatively reports pain of 8 on a 0–10 scale. The nurse administers morphine 4
mg IV. One hour later, the patient says pain is still 8. What should the nurse do first?
pg. 1
,A. Notify the provider for a different order
B. Document that the medication was ineffective
C. Reassess the patient's pain and vital signs
D. Administer another dose of morphine
Correct Answer: C
Explanation: Reassessment is always the first step after pain intervention to evaluate
effectiveness and rule out complications (e.g., respiratory depression). The nurse must assess
the patient before communicating findings .
Question 3
Which finding in an older adult patient requires immediate nursing intervention?
A. Blood pressure 140/90 mm Hg
B. Sudden onset confusion and agitation
C. Decreased skin turgor on the forehead
D. Urinary frequency
Correct Answer: B
Explanation: Sudden confusion in an older adult often indicates a UTI, dehydration, or
another acute illness—not normal aging. The other options can be chronic or age-related
changes .
Question 4
A nurse is calculating intake for a patient from 0700–1500. The patient had: 240 mL coffee, 120
mL juice, IV fluids 50 mL/hr, and 180 mL water. What is total intake?
A. 540 mL
B. 640 mL
C. 940 mL
D. 1140 mL
Correct Answer: C
Explanation: Add all fluids: 240 + 120 + 180 = 540 mL oral; IV 50 mL/hr × 8 hrs = 400 mL;
total 540 + 400 = 940 mL .
Question 5
A nurse is providing tracheostomy care. Which action is correct?
A. Suction the tracheostomy before cleaning the inner cannula
B. Clean the inner cannula with sterile water and reuse
C. Use a new sterile catheter for each suction pass
D. Apply hydrogen peroxide to stoma site daily
Correct Answer: C
Explanation: Using a new sterile catheter for each suction pass prevents reintroducing
pg. 2
,pathogens. Suctioning should occur after cleaning, not before. Hydrogen peroxide irritates
tissue .
Question 6
The nurse understands that which patient is at highest risk for falls?
A. A 45-year-old with well-controlled diabetes
B. An 80-year-old who takes furosemide and has a history of stroke
C. A 30-year-old post-appendectomy day 2
D. A 55-year-old with a hip replacement using a walker independently
Correct Answer: B
Explanation: Furosemide increases urination frequency, and history of stroke creates mobility
and cognitive deficits. Age is an additional risk factor. Multiple fall risk factors make this patient
the highest risk .
Question 7
A nurse is teaching a patient about a low-sodium diet for hypertension. Which meal choice
indicates understanding?
A. Canned vegetable soup and saltine crackers
B. Grilled chicken breast, steamed broccoli, brown rice
C. Ham sandwich with pickles
D. Frozen lasagna and garlic bread
Correct Answer: B
Explanation: Fresh, whole foods are naturally low in sodium. Canned, processed, and frozen
meals are high in sodium .
Question 8
Which patient statement indicates a need for further teaching about warfarin?
A. "I'll use an electric razor to shave."
B. "I can take ibuprofen for my headaches."
C. "I'll eat the same amount of greens each week."
D. "I'll wear a medical alert bracelet."
Correct Answer: B
Explanation: Ibuprofen increases bleeding risk with warfarin. Consistent vitamin K intake is
fine, but NSAIDs are dangerous for patients on anticoagulant therapy .
Question 9
A nurse is assessing a patient's peripheral IV site. Which finding requires immediate
discontinuation of the IV?
pg. 3
, A. Slight redness at the insertion site
B. Patient reports mild warmth
C. Palpable hard cord along the vein
D. Small amount of clear drainage
Correct Answer: C
Explanation: A palpable hard cord indicates phlebitis grade 3 or 4, requiring IV removal.
Redness and mild warmth may be early irritation but do not require immediate removal .
Question 10
When performing sterile wound irrigation, which action maintains sterility?
A. Holding the bottle of sterile solution above the wound while pouring
B. Pouring the solution from a height of 4–6 inches into a sterile basin
C. Using the same gauze to dry the wound edges after irrigation
D. Allowing the solution to flow from clean to dirty area
Correct Answer: B
Explanation: Pouring from 4–6 inches prevents splashing and maintains sterility. Holding the
bottle above the wound directly contaminates the area .
Question 11
A nurse is caring for a patient on contact precautions. Which action is correct?
A. Wear a mask when entering the room
B. Wear gloves and a gown when entering the room
C. Place the patient in a negative pressure room
D. Keep the door closed at all times
Correct Answer: B
Explanation: Contact precautions require gloves and gown when entering the room. Masks are
for droplet precautions; negative pressure is for airborne precautions .
Question 12
A nurse is caring for a client who has influenza and is on isolation precautions. Which of the
following actions should the nurse take to prevent the spread of infection?
A. Wear a mask when working within 3 feet of the client
B. Administer metronidazole
C. Don protective eyewear before entering the room
D. Place the client in a negative airflow room
Correct Answer: A
Explanation: Influenza is transmitted through droplets, so wearing a mask within close
proximity is essential to prevent spread .
pg. 4
