ATI FUNDAMENTALS CMS PROCTORED
EXAM 2026/2027 STUDY GUIDE | 200
VERIFIED PRACTICE QUESTIONS &
ANSWERS | CONTENT MASTERY SERIES
EXAM PREP
ATI FUNDAMENTALS CMS PROCTORED EXAM 2026/2027 STUDY GUIDE
200 VERIFIED PRACTICE QUESTIONS & ANSWERS | CONTENT MASTERY SERIES
EXAM PREP
DOCUMENT OVERVIEW
• This comprehensive study guide contains 200 verified practice questions and
detailed rationales covering all major content areas of the ATI Fundamentals CMS
Proctored Exam, including safety, infection control, basic care and comfort,
pharmacology, psychosocial integrity, and physiological adaptation.
• Study this material by completing 20-30 questions daily, reviewing rationales for
both correct and incorrect answers, identifying weak areas for focused review, and
practicing until you achieve consistent mastery across all exam domains.
1. A patient is admitted to the unit with severe hypertension and a history of
stroke. The nurse is assessing the patient's neurological status. Which of the
following findings would MOST LIKELY indicate increased intracranial
pressure?
A) Increased alertness and rapid speech
B) Pinpoint pupils and slow respiratory rate
C) Dilated pupils on one side and decreasing level of consciousness
D) Increased heart rate with normal blood pressure
E) Constricted pupils bilaterally with increased urine output
C) Dilated pupils on one side and decreasing level of consciousness
,Rationale: Unilateral dilated pupil (blown pupil) with a decreasing level of
consciousness is a classic sign of increased intracranial pressure and possible
herniation. This indicates compression of the oculomotor nerve (CN III) on the
affected side. Pinpoint pupils suggest pontine hemorrhage. Increased alertness is
not consistent with increased ICP. Equal dilated pupils suggest bilateral problem.
This is a critical finding requiring immediate intervention.
2. A nursing student is learning about the chain of infection. Which of the
following represents a break in the chain that would prevent transmission of
pathogens?
A) The causative agent remains dormant in the host
B) The susceptible host avoids contact with other individuals
C) Hand hygiene is performed between patient contacts
D) The portal of entry is blocked by intact skin
E) The infectious agent is contained within a single cell
C) Hand hygiene is performed between patient contacts
Rationale: Hand hygiene breaks the chain of infection by eliminating the
transmission route (vehicle/contact transmission). This is one of the most effective
and evidence-based interventions to prevent pathogen transmission. Options A and
E relate to characteristics of pathogens, not breaking the chain. Option B is
isolation, not a universal break in the chain. Option D describes a natural barrier
but is not an intervention. Hand hygiene is a modifiable, controllable action by
healthcare workers.
3. A patient on bed rest for 3 days is being prepared for ambulation. The nurse
recognizes the patient may experience orthostatic hypotension. Which
intervention would be MOST appropriate to prevent this complication?
A) Have the patient sit upright for 30 minutes before standing
,B) Apply high compression stockings and have the patient perform leg exercises
C) Administer an IV fluid bolus and then assist with ambulation
D) Have the patient stand quickly to promote cardiovascular adjustment
E) Apply a fall prevention device and allow patient to stand unassisted
B) Apply high compression stockings and have the patient perform leg
exercises
Rationale: Compression stockings promote venous return and leg exercises
maintain muscle tone and circulation during bed rest. These interventions help
prevent blood pooling in the lower extremities that occurs with prolonged
immobility. While sitting before standing is helpful, it's not as comprehensive as
combining compression stockings with activity. IV fluids and standing quickly are
not appropriate interventions. Unassisted standing after bed rest increases fall risk.
4. A patient with diabetes mellitus type 2 is receiving education about foot
care. Which statement by the patient indicates a need for further teaching?
A) "I will inspect my feet daily using a mirror to see the bottom of my feet"
B) "I will soak my feet in warm water for 30 minutes to soften the skin"
C) "I will wear comfortable shoes that fit properly"
D) "I will see a podiatrist regularly for nail care"
E) "I will dry my feet completely, especially between the toes"
B) "I will soak my feet in warm water for 30 minutes to soften the skin"
Rationale: Prolonged soaking of feet in warm water maceration of the skin and
increases the risk of infection and tissue breakdown in diabetic patients with
neuropathy. Diabetics should limit foot soaks to 5-10 minutes. All other statements
reflect appropriate foot care measures. Daily inspection, proper footwear,
professional nail care, and thorough drying are all essential components of diabetic
foot care education.
, 5. A nurse is administering a subcutaneous injection to an elderly patient.
After needle insertion, the nurse observes blood return in the syringe. Which
action should the nurse take?
A) Inject slowly to dilute the blood and push the solution in
B) Withdraw the needle, discard the syringe, and prepare a new injection
C) Continue with injection since subcutaneous tissue has good blood supply
D) Apply pressure and massage the area after injection
E) Inject half the dose and relocate the needle for the remaining dose
B) Withdraw the needle, discard the syringe, and prepare a new injection
Rationale: Blood return in the syringe indicates the needle has entered a blood
vessel, not the subcutaneous tissue. Injecting into a blood vessel can cause
systemic absorption and adverse effects depending on the medication. The safest
action is to remove the needle and select a new site. Continuing with injection into
a vessel is unsafe. Massage could cause hematoma formation. Splitting the dose
between locations doesn't address the initial problem of needle placement in a
vessel.
6. A patient is receiving continuous tube feeding through a nasogastric tube.
The nurse notes the patient's abdomen is distended and the patient reports
nausea. What is the priority nursing action?
A) Increase the rate of the feeding
B) Check the placement of the tube and the residual volume
C) Discontinue the feeding immediately and call the physician
D) Reposition the patient and elevate the head of the bed
E) Irrigate the tube with 30 mL of normal saline
B) Check the placement of the tube and the residual volume
EXAM 2026/2027 STUDY GUIDE | 200
VERIFIED PRACTICE QUESTIONS &
ANSWERS | CONTENT MASTERY SERIES
EXAM PREP
ATI FUNDAMENTALS CMS PROCTORED EXAM 2026/2027 STUDY GUIDE
200 VERIFIED PRACTICE QUESTIONS & ANSWERS | CONTENT MASTERY SERIES
EXAM PREP
DOCUMENT OVERVIEW
• This comprehensive study guide contains 200 verified practice questions and
detailed rationales covering all major content areas of the ATI Fundamentals CMS
Proctored Exam, including safety, infection control, basic care and comfort,
pharmacology, psychosocial integrity, and physiological adaptation.
• Study this material by completing 20-30 questions daily, reviewing rationales for
both correct and incorrect answers, identifying weak areas for focused review, and
practicing until you achieve consistent mastery across all exam domains.
1. A patient is admitted to the unit with severe hypertension and a history of
stroke. The nurse is assessing the patient's neurological status. Which of the
following findings would MOST LIKELY indicate increased intracranial
pressure?
A) Increased alertness and rapid speech
B) Pinpoint pupils and slow respiratory rate
C) Dilated pupils on one side and decreasing level of consciousness
D) Increased heart rate with normal blood pressure
E) Constricted pupils bilaterally with increased urine output
C) Dilated pupils on one side and decreasing level of consciousness
,Rationale: Unilateral dilated pupil (blown pupil) with a decreasing level of
consciousness is a classic sign of increased intracranial pressure and possible
herniation. This indicates compression of the oculomotor nerve (CN III) on the
affected side. Pinpoint pupils suggest pontine hemorrhage. Increased alertness is
not consistent with increased ICP. Equal dilated pupils suggest bilateral problem.
This is a critical finding requiring immediate intervention.
2. A nursing student is learning about the chain of infection. Which of the
following represents a break in the chain that would prevent transmission of
pathogens?
A) The causative agent remains dormant in the host
B) The susceptible host avoids contact with other individuals
C) Hand hygiene is performed between patient contacts
D) The portal of entry is blocked by intact skin
E) The infectious agent is contained within a single cell
C) Hand hygiene is performed between patient contacts
Rationale: Hand hygiene breaks the chain of infection by eliminating the
transmission route (vehicle/contact transmission). This is one of the most effective
and evidence-based interventions to prevent pathogen transmission. Options A and
E relate to characteristics of pathogens, not breaking the chain. Option B is
isolation, not a universal break in the chain. Option D describes a natural barrier
but is not an intervention. Hand hygiene is a modifiable, controllable action by
healthcare workers.
3. A patient on bed rest for 3 days is being prepared for ambulation. The nurse
recognizes the patient may experience orthostatic hypotension. Which
intervention would be MOST appropriate to prevent this complication?
A) Have the patient sit upright for 30 minutes before standing
,B) Apply high compression stockings and have the patient perform leg exercises
C) Administer an IV fluid bolus and then assist with ambulation
D) Have the patient stand quickly to promote cardiovascular adjustment
E) Apply a fall prevention device and allow patient to stand unassisted
B) Apply high compression stockings and have the patient perform leg
exercises
Rationale: Compression stockings promote venous return and leg exercises
maintain muscle tone and circulation during bed rest. These interventions help
prevent blood pooling in the lower extremities that occurs with prolonged
immobility. While sitting before standing is helpful, it's not as comprehensive as
combining compression stockings with activity. IV fluids and standing quickly are
not appropriate interventions. Unassisted standing after bed rest increases fall risk.
4. A patient with diabetes mellitus type 2 is receiving education about foot
care. Which statement by the patient indicates a need for further teaching?
A) "I will inspect my feet daily using a mirror to see the bottom of my feet"
B) "I will soak my feet in warm water for 30 minutes to soften the skin"
C) "I will wear comfortable shoes that fit properly"
D) "I will see a podiatrist regularly for nail care"
E) "I will dry my feet completely, especially between the toes"
B) "I will soak my feet in warm water for 30 minutes to soften the skin"
Rationale: Prolonged soaking of feet in warm water maceration of the skin and
increases the risk of infection and tissue breakdown in diabetic patients with
neuropathy. Diabetics should limit foot soaks to 5-10 minutes. All other statements
reflect appropriate foot care measures. Daily inspection, proper footwear,
professional nail care, and thorough drying are all essential components of diabetic
foot care education.
, 5. A nurse is administering a subcutaneous injection to an elderly patient.
After needle insertion, the nurse observes blood return in the syringe. Which
action should the nurse take?
A) Inject slowly to dilute the blood and push the solution in
B) Withdraw the needle, discard the syringe, and prepare a new injection
C) Continue with injection since subcutaneous tissue has good blood supply
D) Apply pressure and massage the area after injection
E) Inject half the dose and relocate the needle for the remaining dose
B) Withdraw the needle, discard the syringe, and prepare a new injection
Rationale: Blood return in the syringe indicates the needle has entered a blood
vessel, not the subcutaneous tissue. Injecting into a blood vessel can cause
systemic absorption and adverse effects depending on the medication. The safest
action is to remove the needle and select a new site. Continuing with injection into
a vessel is unsafe. Massage could cause hematoma formation. Splitting the dose
between locations doesn't address the initial problem of needle placement in a
vessel.
6. A patient is receiving continuous tube feeding through a nasogastric tube.
The nurse notes the patient's abdomen is distended and the patient reports
nausea. What is the priority nursing action?
A) Increase the rate of the feeding
B) Check the placement of the tube and the residual volume
C) Discontinue the feeding immediately and call the physician
D) Reposition the patient and elevate the head of the bed
E) Irrigate the tube with 30 mL of normal saline
B) Check the placement of the tube and the residual volume
