ATI Fundamentals CMS Proctored Exam
210 Questions and Verified Answers
2026 | 2027 Latest Edition | 100% Correct
Comprehensive Evidence-Based Practice Integration
Aligned with NCLEX-RN Clinical Judgment Framework
Section Topic Questions
1 Safe, Effective Care Environment Q1-Q45 (45)
2 Safety and Infection Control Q46-Q80 (35)
3 Health Promotion and Maintenance Q81-Q110 (30)
4 Psychosocial Integrity Q111-Q135 (25)
5 Basic Care and Comfort Q136-Q165 (30)
6 Pharmacological and Parenteral Therapies Q166-Q190 (25)
7 Reduction of Risk Potential Q191-Q200 (10)
8 Physiological Adaptation Q201-Q210 (10)
Total 210 Questions
Cognitive Level Distribution: 25% Recall | 55% Application | 20% Analysis
Question Style: 80% Scenario-Based | 15% Direct Recall | 5% Calculation
1
,Section 1: Safe, Effective Care Environment (Q1-Q45)
Management of Care, Client Rights, Advocacy, Delegation, Legal/Ethical Issues, & Informed Consent
Q1: A nurse on a medical-surgical unit receives the following change-of-shift report. Which client should the nurse assess
first? Client A was admitted 2 days ago with pneumonia and has a temperature of 38.5°C (101.3°F). Client B had a
cholecystectomy yesterday and reports abdominal pain at 4/10. Client C has heart failure and reports increasing shortness
of breath with an O2 saturation of 88% on room air. Client D is 1 day post-knee replacement and has a heart rate of 98/min.
A. Client A with pneumonia
B. Client B post-cholecystectomy
C. Client C with heart failure **[CORRECT]**
D. Client D post-knee replacement
Correct Answer: C
Rationale: Using the ABC framework, the nurse should prioritize Client C who exhibits airway and breathing compromise with an
oxygen saturation of 88% and increasing dyspnea. This client is the most unstable and requires immediate intervention. The other
clients have findings that, while important, are not immediately life-threatening.
Q2: A charge nurse is making client assignments for the upcoming shift. Which task is most appropriate to delegate to an
unlicensed assistive personnel (UAP)?
A. Ambulating a stable client who had a total knee replacement yesterday **[CORRECT]**
B. Assessing a client's postoperative wound for signs of infection
C. Teaching a client how to perform self-catheterization
D. Evaluating a client's response to a newly administered medication
Correct Answer: A
Rationale: Ambulating a stable postoperative client is a task within the UAP scope of practice as it does not require nursing assessment
or clinical judgment. Assessment, teaching, and evaluation are registered nurse responsibilities that require clinical expertise and
cannot be delegated to unlicensed personnel. The RN retains accountability for the outcomes of all delegated tasks.
Q3: A preoperative nurse is preparing a client for surgery. The client signed the consent form 3 hours ago but now tells the
nurse, "I changed my mind. I don't want this surgery." What is the nurse's best action?
A. Explain the surgical procedure in detail to change the client's mind
B. Tell the client that it is too late to cancel because consent was already signed
C. Notify the surgeon to proceed because the client already gave informed consent
D. Stop all preoperative preparations and notify the surgeon of the client's decision **[CORRECT]**
Correct Answer: D
Rationale: A client has the right to withdraw consent at any time, even after signing a consent form. The nurse must immediately stop
preoperative preparations and notify the surgeon of the client's decision. The nurse cannot override the client's autonomous decision or
proceed with surgery against the client's wishes, as doing so would constitute battery.
Q4: A client with end-stage chronic obstructive pulmonary disease (COPD) has a do-not-resuscitate (DNR) order in place.
The client's family member demands that the nurse "do everything" if the client stops breathing. What is the nurse's best
response?
A. Tell the family that the DNR order must be followed regardless of their wishes
B. Explain that the DNR reflects the client's wishes and facilitate a meeting with the provider and family
**[CORRECT]**
C. Immediately remove the DNR order to accommodate the family's request
2
, D. Ask the family to leave the room and proceed with the plan of care
Correct Answer: B
Rationale: The nurse should serve as a client advocate by upholding the client's autonomous decision while facilitating communication
between the family and the healthcare team. The DNR order reflects the competent client's wishes, and the nurse should support the
client's self-determination. Removing the DNR without the client's consent would violate the client's rights.
Q5: A nurse is caring for a client who is receiving a blood transfusion. After 15 minutes, the client reports itching and a
raised rash on the chest. What is the priority nursing action?
A. Administer diphenhydramine as prescribed
B. Stop the transfusion and maintain IV access with normal saline **[CORRECT]**
C. Slow the transfusion rate and reassess in 15 minutes
D. Document the finding and continue to monitor the client
Correct Answer: B
Rationale: The client is exhibiting signs of an allergic transfusion reaction, which is a potentially life-threatening situation requiring
immediate intervention. The nurse must stop the transfusion first and maintain IV patency with normal saline before implementing
further orders. Following the acute intervention, the nurse should notify the provider and document the event and incident report.
Q6: A nurse is providing discharge teaching to a client with heart failure. Which statement by the client indicates that the
teaching has been effective?
A. "I should limit my fluid intake to no more than 2 liters per day." **[CORRECT]**
B. "I will weigh myself once a week and call my doctor if I gain 5 pounds."
C. "I will take my diuretic in the morning and at bedtime to keep my weight down."
D. "I can drink as much fluid as I want as long as I take my medications."
Correct Answer: A
Rationale: Fluid restriction is a standard recommendation for clients with heart failure to prevent fluid volume overload. The client's
statement about limiting fluids to no more than 2 liters per day indicates understanding of the teaching. Daily weight monitoring, not
weekly, is recommended for early detection of fluid retention, and diuretics should generally be taken in the morning to avoid nocturia.
Q7: A nurse is caring for a client who has been placed in wrist restraints due to agitation and attempts to pull out an
endotracheal tube. Which action by the nurse demonstrates adherence to the least restrictive intervention principle?
A. Applying the restraints tightly to prevent any movement of the hands
B. Requesting an order for chemical restraints instead of physical restraints
C. Assessing the client every 2 hours and removing restraints when the client is calm **[CORRECT]**
D. Leaving the restraints in place continuously until the client is extubated
Correct Answer: C
Rationale: The least restrictive intervention principle requires that restraints be used only when necessary and removed as soon as the
client's behavior indicates they are no longer needed. Restraints must be released at least every 2 hours for assessment, and the nurse
should explore alternatives before and during restraint use. Continuous restraint use without periodic reassessment violates client rights
and regulatory standards.
Q8: A nurse witnesses a colleague fail to perform hand hygiene before performing a wound dressing change. The nurse's
colleague says, "I'm in a hurry and the client's wound isn't infected." What is the nurse's most appropriate action?
A. Report the colleague immediately to the charge nurse and submit an incident report
B. Remind the colleague to perform hand hygiene before the procedure and address it privately
**[CORRECT]**
C. Ignore the behavior because the colleague is experienced and knows best
3
, D. Complete the wound dressing change for the colleague to ensure patient safety
Correct Answer: B
Rationale: The nurse should first address the issue directly and professionally with the colleague, as this promotes a culture of safety
and gives the colleague an opportunity to correct the behavior. If the behavior continues, the nurse should then follow the chain of
command. Hand hygiene is a critical infection control measure regardless of the wound's infection status.
Q9: A nurse is reviewing the medical record of a client and notices that the provider has documented a NANDA nursing
diagnosis of "Risk for Falls." The nurse understands that this type of diagnosis differs from an actual diagnosis in which
way?
A. It requires a collaborative intervention from multiple healthcare providers
B. It describes human responses to health conditions or life processes
C. It indicates a vulnerability to developing an undesirable response to a condition **[CORRECT]**
D. It is developed only by the attending physician and not the nursing staff
Correct Answer: C
Rationale: A risk nursing diagnosis identifies a vulnerability or potential for the client to develop an undesirable response, whereas an
actual diagnosis describes a human response that is already present. Both actual and risk diagnoses are within the nurse's independent
scope of practice. A wellness diagnosis describes a readiness to enhance health, not a risk for an adverse condition.
Q10: A nurse is caring for four clients. Which client should the nurse prioritize using Maslow's hierarchy of needs?
A. A client who reports feeling lonely and isolated since admission
B. A client who has not had a bowel movement in 3 days
C. A client with a blood pressure of 82/50 mm Hg and cool, clammy skin **[CORRECT]**
D. A client who is anxious about an upcoming diagnostic procedure
Correct Answer: C
Rationale: According to Maslow's hierarchy of needs, physiological needs take priority over safety, love/belonging, and
self-actualization needs. A blood pressure of 82/50 mm Hg with cool, clammy skin indicates hypovolemic shock, a life-threatening
physiological emergency requiring immediate intervention. The other clients have important but less urgent psychosocial and
lower-acuity physiological needs.
Q11: A nurse is preparing to administer medications to a client and discovers that the client's identity bracelet is missing.
What should the nurse do first?
A. Ask the client's roommate to confirm the client's identity
B. Administer the medications using the client's name from the chart
C. Verify the client's identity using at least two identifiers and obtain a new identification bracelet
**[CORRECT]**
D. Skip the medication administration until a new bracelet can be made
Correct Answer: C
Rationale: The nurse must use at least two client identifiers, such as the client's name and date of birth, to verify identity before
administering any medication. The nurse should then obtain a replacement identification bracelet. Skipping medications or
administering them without proper identification verification creates a significant patient safety risk and violates The Joint
Commission's National Patient Safety Goals.
Q12: A nurse is assigning tasks to a licensed practical nurse (LPN). Which of the following tasks should the nurse instruct
the LPN to report immediately to the RN?
A. A client's blood pressure is 118/76 mm Hg
B. A client requests a PRN pain medication at the scheduled time
4
210 Questions and Verified Answers
2026 | 2027 Latest Edition | 100% Correct
Comprehensive Evidence-Based Practice Integration
Aligned with NCLEX-RN Clinical Judgment Framework
Section Topic Questions
1 Safe, Effective Care Environment Q1-Q45 (45)
2 Safety and Infection Control Q46-Q80 (35)
3 Health Promotion and Maintenance Q81-Q110 (30)
4 Psychosocial Integrity Q111-Q135 (25)
5 Basic Care and Comfort Q136-Q165 (30)
6 Pharmacological and Parenteral Therapies Q166-Q190 (25)
7 Reduction of Risk Potential Q191-Q200 (10)
8 Physiological Adaptation Q201-Q210 (10)
Total 210 Questions
Cognitive Level Distribution: 25% Recall | 55% Application | 20% Analysis
Question Style: 80% Scenario-Based | 15% Direct Recall | 5% Calculation
1
,Section 1: Safe, Effective Care Environment (Q1-Q45)
Management of Care, Client Rights, Advocacy, Delegation, Legal/Ethical Issues, & Informed Consent
Q1: A nurse on a medical-surgical unit receives the following change-of-shift report. Which client should the nurse assess
first? Client A was admitted 2 days ago with pneumonia and has a temperature of 38.5°C (101.3°F). Client B had a
cholecystectomy yesterday and reports abdominal pain at 4/10. Client C has heart failure and reports increasing shortness
of breath with an O2 saturation of 88% on room air. Client D is 1 day post-knee replacement and has a heart rate of 98/min.
A. Client A with pneumonia
B. Client B post-cholecystectomy
C. Client C with heart failure **[CORRECT]**
D. Client D post-knee replacement
Correct Answer: C
Rationale: Using the ABC framework, the nurse should prioritize Client C who exhibits airway and breathing compromise with an
oxygen saturation of 88% and increasing dyspnea. This client is the most unstable and requires immediate intervention. The other
clients have findings that, while important, are not immediately life-threatening.
Q2: A charge nurse is making client assignments for the upcoming shift. Which task is most appropriate to delegate to an
unlicensed assistive personnel (UAP)?
A. Ambulating a stable client who had a total knee replacement yesterday **[CORRECT]**
B. Assessing a client's postoperative wound for signs of infection
C. Teaching a client how to perform self-catheterization
D. Evaluating a client's response to a newly administered medication
Correct Answer: A
Rationale: Ambulating a stable postoperative client is a task within the UAP scope of practice as it does not require nursing assessment
or clinical judgment. Assessment, teaching, and evaluation are registered nurse responsibilities that require clinical expertise and
cannot be delegated to unlicensed personnel. The RN retains accountability for the outcomes of all delegated tasks.
Q3: A preoperative nurse is preparing a client for surgery. The client signed the consent form 3 hours ago but now tells the
nurse, "I changed my mind. I don't want this surgery." What is the nurse's best action?
A. Explain the surgical procedure in detail to change the client's mind
B. Tell the client that it is too late to cancel because consent was already signed
C. Notify the surgeon to proceed because the client already gave informed consent
D. Stop all preoperative preparations and notify the surgeon of the client's decision **[CORRECT]**
Correct Answer: D
Rationale: A client has the right to withdraw consent at any time, even after signing a consent form. The nurse must immediately stop
preoperative preparations and notify the surgeon of the client's decision. The nurse cannot override the client's autonomous decision or
proceed with surgery against the client's wishes, as doing so would constitute battery.
Q4: A client with end-stage chronic obstructive pulmonary disease (COPD) has a do-not-resuscitate (DNR) order in place.
The client's family member demands that the nurse "do everything" if the client stops breathing. What is the nurse's best
response?
A. Tell the family that the DNR order must be followed regardless of their wishes
B. Explain that the DNR reflects the client's wishes and facilitate a meeting with the provider and family
**[CORRECT]**
C. Immediately remove the DNR order to accommodate the family's request
2
, D. Ask the family to leave the room and proceed with the plan of care
Correct Answer: B
Rationale: The nurse should serve as a client advocate by upholding the client's autonomous decision while facilitating communication
between the family and the healthcare team. The DNR order reflects the competent client's wishes, and the nurse should support the
client's self-determination. Removing the DNR without the client's consent would violate the client's rights.
Q5: A nurse is caring for a client who is receiving a blood transfusion. After 15 minutes, the client reports itching and a
raised rash on the chest. What is the priority nursing action?
A. Administer diphenhydramine as prescribed
B. Stop the transfusion and maintain IV access with normal saline **[CORRECT]**
C. Slow the transfusion rate and reassess in 15 minutes
D. Document the finding and continue to monitor the client
Correct Answer: B
Rationale: The client is exhibiting signs of an allergic transfusion reaction, which is a potentially life-threatening situation requiring
immediate intervention. The nurse must stop the transfusion first and maintain IV patency with normal saline before implementing
further orders. Following the acute intervention, the nurse should notify the provider and document the event and incident report.
Q6: A nurse is providing discharge teaching to a client with heart failure. Which statement by the client indicates that the
teaching has been effective?
A. "I should limit my fluid intake to no more than 2 liters per day." **[CORRECT]**
B. "I will weigh myself once a week and call my doctor if I gain 5 pounds."
C. "I will take my diuretic in the morning and at bedtime to keep my weight down."
D. "I can drink as much fluid as I want as long as I take my medications."
Correct Answer: A
Rationale: Fluid restriction is a standard recommendation for clients with heart failure to prevent fluid volume overload. The client's
statement about limiting fluids to no more than 2 liters per day indicates understanding of the teaching. Daily weight monitoring, not
weekly, is recommended for early detection of fluid retention, and diuretics should generally be taken in the morning to avoid nocturia.
Q7: A nurse is caring for a client who has been placed in wrist restraints due to agitation and attempts to pull out an
endotracheal tube. Which action by the nurse demonstrates adherence to the least restrictive intervention principle?
A. Applying the restraints tightly to prevent any movement of the hands
B. Requesting an order for chemical restraints instead of physical restraints
C. Assessing the client every 2 hours and removing restraints when the client is calm **[CORRECT]**
D. Leaving the restraints in place continuously until the client is extubated
Correct Answer: C
Rationale: The least restrictive intervention principle requires that restraints be used only when necessary and removed as soon as the
client's behavior indicates they are no longer needed. Restraints must be released at least every 2 hours for assessment, and the nurse
should explore alternatives before and during restraint use. Continuous restraint use without periodic reassessment violates client rights
and regulatory standards.
Q8: A nurse witnesses a colleague fail to perform hand hygiene before performing a wound dressing change. The nurse's
colleague says, "I'm in a hurry and the client's wound isn't infected." What is the nurse's most appropriate action?
A. Report the colleague immediately to the charge nurse and submit an incident report
B. Remind the colleague to perform hand hygiene before the procedure and address it privately
**[CORRECT]**
C. Ignore the behavior because the colleague is experienced and knows best
3
, D. Complete the wound dressing change for the colleague to ensure patient safety
Correct Answer: B
Rationale: The nurse should first address the issue directly and professionally with the colleague, as this promotes a culture of safety
and gives the colleague an opportunity to correct the behavior. If the behavior continues, the nurse should then follow the chain of
command. Hand hygiene is a critical infection control measure regardless of the wound's infection status.
Q9: A nurse is reviewing the medical record of a client and notices that the provider has documented a NANDA nursing
diagnosis of "Risk for Falls." The nurse understands that this type of diagnosis differs from an actual diagnosis in which
way?
A. It requires a collaborative intervention from multiple healthcare providers
B. It describes human responses to health conditions or life processes
C. It indicates a vulnerability to developing an undesirable response to a condition **[CORRECT]**
D. It is developed only by the attending physician and not the nursing staff
Correct Answer: C
Rationale: A risk nursing diagnosis identifies a vulnerability or potential for the client to develop an undesirable response, whereas an
actual diagnosis describes a human response that is already present. Both actual and risk diagnoses are within the nurse's independent
scope of practice. A wellness diagnosis describes a readiness to enhance health, not a risk for an adverse condition.
Q10: A nurse is caring for four clients. Which client should the nurse prioritize using Maslow's hierarchy of needs?
A. A client who reports feeling lonely and isolated since admission
B. A client who has not had a bowel movement in 3 days
C. A client with a blood pressure of 82/50 mm Hg and cool, clammy skin **[CORRECT]**
D. A client who is anxious about an upcoming diagnostic procedure
Correct Answer: C
Rationale: According to Maslow's hierarchy of needs, physiological needs take priority over safety, love/belonging, and
self-actualization needs. A blood pressure of 82/50 mm Hg with cool, clammy skin indicates hypovolemic shock, a life-threatening
physiological emergency requiring immediate intervention. The other clients have important but less urgent psychosocial and
lower-acuity physiological needs.
Q11: A nurse is preparing to administer medications to a client and discovers that the client's identity bracelet is missing.
What should the nurse do first?
A. Ask the client's roommate to confirm the client's identity
B. Administer the medications using the client's name from the chart
C. Verify the client's identity using at least two identifiers and obtain a new identification bracelet
**[CORRECT]**
D. Skip the medication administration until a new bracelet can be made
Correct Answer: C
Rationale: The nurse must use at least two client identifiers, such as the client's name and date of birth, to verify identity before
administering any medication. The nurse should then obtain a replacement identification bracelet. Skipping medications or
administering them without proper identification verification creates a significant patient safety risk and violates The Joint
Commission's National Patient Safety Goals.
Q12: A nurse is assigning tasks to a licensed practical nurse (LPN). Which of the following tasks should the nurse instruct
the LPN to report immediately to the RN?
A. A client's blood pressure is 118/76 mm Hg
B. A client requests a PRN pain medication at the scheduled time
4
