ATI Fundamentals CMS Proctored Exam
70 Questions and Verified Answers | 100% Correct | LATEST
2026/2027 Edition
Section 1: Safe, Effective Care Environment (Management of Care and
Safety/Infection Control)
Q1: A nurse is caring for a client who refuses a blood transfusion based on religious beliefs. The
client's spouse insists the nurse proceed with the transfusion. Which of the following actions
should the nurse take?
A. Obtain the blood and administer it as the spouse requests
B. Respect the client's refusal and document the refusal in the medical record [CORRECT]
C. Ask the healthcare provider to override the client's decision
D. Contact the hospital ethics committee before taking any action
Correct Answer: B
The correct answer is B. Respect the client's refusal and document the refusal in the medical record.
The principle of patient autonomy and informed consent guarantees a competent adult the right to
refuse any treatment, including life-saving interventions. The nurse must honor the client's decision
regardless of the spouse's wishes. Option A violates client autonomy and could constitute battery.
Option C is inappropriate because the provider cannot override a competent client's informed refusal.
Option D delays necessary documentation and is not required when the client is competent and the
refusal is clear.
Q2: A nurse on a medical-surgical unit is delegating tasks to an assistive personnel (AP). Which
of the following tasks should the nurse delegate to the AP?
A. Assessing a client's wound for signs of infection
B. Measuring and recording a client's intake and output [CORRECT]
C. Evaluating a client's response to pain medication
D. Teaching a client about discharge instructions
Correct Answer: B
The correct answer is B. Measuring and recording a client's intake and output. The Five Rights of
Delegation indicate that the right task must be within the delegate's scope of practice. Measuring I&O;
is a standardized, non-complex task appropriate for AP. Assessment (Option A), evaluation (Option C),
and teaching (Option D) are nursing functions that require RN-level education and clinical judgment
and cannot be delegated to AP.
Q3: A nurse is preparing to administer medications to four clients. Which of the following
actions follows the Six Rights of medication administration?
A. Administering a medication that was prescribed for a client with a similar name
B. Giving the medication at the prescribed time within a 30-minute window [CORRECT]
C. Adjusting the dose based on the nurse's clinical judgment
D. Leaving the medication at the bedside for the client to take later
ATI Fundamentals CMS Proctored Exam 2026/2027 | Page 1
, Correct Answer: B
The correct answer is B. Giving the medication at the prescribed time within a 30-minute window. The
Six Rights include Right patient, Right drug, Right dose, Right route, Right time, and Right
documentation. Administering within the accepted time window (typically 30 minutes before or after
the scheduled time) upholds the Right Time. Option A violates Right Patient. Option C violates Right
Dose. Option D violates Right Route and Right Patient because the nurse cannot verify the client
actually takes the medication.
Q4: A nurse is caring for a client who has a new diagnosis of terminal cancer. The client states,
"I want to make sure nobody keeps me alive on machines." Which of the following documents
should the nurse recommend the client complete?
A. Informed consent form
B. Living will [CORRECT]
C. HIPAA authorization
D. Incident report
Correct Answer: B
The correct answer is B. Living will. A living will is a type of advance directive that specifies a client's
wishes regarding end-of-life care, including the refusal of life-sustaining treatments such as
mechanical ventilation. This directly addresses the client's concern about being kept alive on
machines. Informed consent (Option A) is for specific procedures, not end-of-life preferences. HIPAA
authorization (Option C) governs release of health information. An incident report (Option D) is used
for documenting unusual events.
Q5: A nurse is caring for a client who is on contact precautions for methicillin-resistant
Staphylococcus aureus (MRSA). Which of the following actions should the nurse take when
removing personal protective equipment (PPE)?
A. Remove the gown first, then gloves, then mask
B. Remove gloves first, then gown, then perform hand hygiene
C. Remove the mask first, then the gown, then gloves
D. Remove gloves and gown together, then perform hand hygiene [CORRECT]
Correct Answer: D
The correct answer is D. Remove gloves and gown together, then perform hand hygiene. For contact
precautions, the gown and gloves are the most contaminated items. The recommended doffing
sequence is to remove gloves and gown together by grasping the gown at the front and pulling it
forward and down, rolling it inside-out over the gloves. Hand hygiene must be performed immediately
after removal. Option A is incorrect because the mask is not the most contaminated item for contact
precautions. Options B and C describe incorrect sequences that increase the risk of self-contamination.
Q6: A nurse receives a change-of-shift report on four clients. Which of the following clients
should the nurse assess first?
A. A client who is 1 day postoperative following a laparoscopic cholecystectomy with mild
incisional pain
B. A client who has a scheduled chest x-ray at 1000
C. A client who reports new-onset shortness of breath and SpO2 of 88% on room air
[CORRECT]
D. A client who is awaiting discharge teaching for heart failure management
Correct Answer: C
ATI Fundamentals CMS Proctored Exam 2026/2027 | Page 2
, The correct answer is C. A client who reports new-onset shortness of breath and SpO2 of 88% on room
air. Using the ABC (Airway, Breathing, Circulation) prioritization framework, this client has a
compromised breathing status requiring immediate assessment and intervention. The SpO2 of 88% is
below the normal range of 95-100% and indicates potential hypoxemia. Option A is stable postoperative
pain. Option B is a routine scheduled procedure. Option D is an educational need that is not urgent.
Q7: A nurse is reviewing a client's medical record and notes a DNR (Do Not Resuscitate) order.
Which of the following is an appropriate action by the nurse?
A. Remove all monitoring equipment from the client's room
B. Ensure the DNR order is documented in the client's medical record and communicate it
to the care team [CORRECT]
C. Decline to perform any care for the client
D. Ask the family to revoke the DNR order
Correct Answer: B
The correct answer is B. Ensure the DNR order is documented in the client's medical record and
communicate it to the care team. A DNR order means that CPR will not be performed in the event of
cardiac or respiratory arrest, but it does not mean the nurse stops all care. The nurse must verify the
order is in the chart and ensure all team members are aware. Option A is incorrect because monitoring
can continue. Option C is incorrect because the client still receives all other nursing care. Option D is
inappropriate because the nurse should not influence the client's or family's decision about a DNR.
Q8: A nurse is caring for a client diagnosed with Clostridioides difficile infection. Which of the
following infection control precautions is most appropriate?
A. Airborne precautions with N95 respirator
B. Contact precautions with soap and water hand hygiene [CORRECT]
C. Droplet precautions with surgical mask within 3 feet
D. Standard precautions only with alcohol-based hand sanitizer
Correct Answer: B
The correct answer is B. Contact precautions with soap and water hand hygiene. C. difficile is
transmitted via the fecal-oral route through contact with spores that can survive on surfaces. Contact
precautions (gown and gloves) are required. Critically, alcohol-based hand rub does not kill C. difficile
spores; the nurse must use soap and water for hand hygiene. Option A is for tuberculosis, measles, and
varicella. Option C is for influenza and pertussis. Option D is insufficient because alcohol-based
sanitizer is ineffective against C. difficile spores.
Q9: A nurse is caring for multiple clients on a busy medical unit. Which of the following tasks
can be safely delegated to a licensed practical nurse (LPN)?
A. Developing the initial nursing care plan for a newly admitted client
B. Administering a scheduled oral medication to a stable client [CORRECT]
C. Performing the initial admission assessment on a new client
D. Evaluating the effectiveness of a client's pain management regimen
Correct Answer: B
The correct answer is B. Administering a scheduled oral medication to a stable client. LPNs can
administer medications under the supervision of an RN for stable clients with predictable outcomes.
This falls within the LPN scope of practice. Developing care plans (Option A), performing initial
assessments (Option C), and evaluating care effectiveness (Option D) are all RN-level responsibilities
that require advanced clinical judgment and critical thinking that exceed the LPN scope.
ATI Fundamentals CMS Proctored Exam 2026/2027 | Page 3
70 Questions and Verified Answers | 100% Correct | LATEST
2026/2027 Edition
Section 1: Safe, Effective Care Environment (Management of Care and
Safety/Infection Control)
Q1: A nurse is caring for a client who refuses a blood transfusion based on religious beliefs. The
client's spouse insists the nurse proceed with the transfusion. Which of the following actions
should the nurse take?
A. Obtain the blood and administer it as the spouse requests
B. Respect the client's refusal and document the refusal in the medical record [CORRECT]
C. Ask the healthcare provider to override the client's decision
D. Contact the hospital ethics committee before taking any action
Correct Answer: B
The correct answer is B. Respect the client's refusal and document the refusal in the medical record.
The principle of patient autonomy and informed consent guarantees a competent adult the right to
refuse any treatment, including life-saving interventions. The nurse must honor the client's decision
regardless of the spouse's wishes. Option A violates client autonomy and could constitute battery.
Option C is inappropriate because the provider cannot override a competent client's informed refusal.
Option D delays necessary documentation and is not required when the client is competent and the
refusal is clear.
Q2: A nurse on a medical-surgical unit is delegating tasks to an assistive personnel (AP). Which
of the following tasks should the nurse delegate to the AP?
A. Assessing a client's wound for signs of infection
B. Measuring and recording a client's intake and output [CORRECT]
C. Evaluating a client's response to pain medication
D. Teaching a client about discharge instructions
Correct Answer: B
The correct answer is B. Measuring and recording a client's intake and output. The Five Rights of
Delegation indicate that the right task must be within the delegate's scope of practice. Measuring I&O;
is a standardized, non-complex task appropriate for AP. Assessment (Option A), evaluation (Option C),
and teaching (Option D) are nursing functions that require RN-level education and clinical judgment
and cannot be delegated to AP.
Q3: A nurse is preparing to administer medications to four clients. Which of the following
actions follows the Six Rights of medication administration?
A. Administering a medication that was prescribed for a client with a similar name
B. Giving the medication at the prescribed time within a 30-minute window [CORRECT]
C. Adjusting the dose based on the nurse's clinical judgment
D. Leaving the medication at the bedside for the client to take later
ATI Fundamentals CMS Proctored Exam 2026/2027 | Page 1
, Correct Answer: B
The correct answer is B. Giving the medication at the prescribed time within a 30-minute window. The
Six Rights include Right patient, Right drug, Right dose, Right route, Right time, and Right
documentation. Administering within the accepted time window (typically 30 minutes before or after
the scheduled time) upholds the Right Time. Option A violates Right Patient. Option C violates Right
Dose. Option D violates Right Route and Right Patient because the nurse cannot verify the client
actually takes the medication.
Q4: A nurse is caring for a client who has a new diagnosis of terminal cancer. The client states,
"I want to make sure nobody keeps me alive on machines." Which of the following documents
should the nurse recommend the client complete?
A. Informed consent form
B. Living will [CORRECT]
C. HIPAA authorization
D. Incident report
Correct Answer: B
The correct answer is B. Living will. A living will is a type of advance directive that specifies a client's
wishes regarding end-of-life care, including the refusal of life-sustaining treatments such as
mechanical ventilation. This directly addresses the client's concern about being kept alive on
machines. Informed consent (Option A) is for specific procedures, not end-of-life preferences. HIPAA
authorization (Option C) governs release of health information. An incident report (Option D) is used
for documenting unusual events.
Q5: A nurse is caring for a client who is on contact precautions for methicillin-resistant
Staphylococcus aureus (MRSA). Which of the following actions should the nurse take when
removing personal protective equipment (PPE)?
A. Remove the gown first, then gloves, then mask
B. Remove gloves first, then gown, then perform hand hygiene
C. Remove the mask first, then the gown, then gloves
D. Remove gloves and gown together, then perform hand hygiene [CORRECT]
Correct Answer: D
The correct answer is D. Remove gloves and gown together, then perform hand hygiene. For contact
precautions, the gown and gloves are the most contaminated items. The recommended doffing
sequence is to remove gloves and gown together by grasping the gown at the front and pulling it
forward and down, rolling it inside-out over the gloves. Hand hygiene must be performed immediately
after removal. Option A is incorrect because the mask is not the most contaminated item for contact
precautions. Options B and C describe incorrect sequences that increase the risk of self-contamination.
Q6: A nurse receives a change-of-shift report on four clients. Which of the following clients
should the nurse assess first?
A. A client who is 1 day postoperative following a laparoscopic cholecystectomy with mild
incisional pain
B. A client who has a scheduled chest x-ray at 1000
C. A client who reports new-onset shortness of breath and SpO2 of 88% on room air
[CORRECT]
D. A client who is awaiting discharge teaching for heart failure management
Correct Answer: C
ATI Fundamentals CMS Proctored Exam 2026/2027 | Page 2
, The correct answer is C. A client who reports new-onset shortness of breath and SpO2 of 88% on room
air. Using the ABC (Airway, Breathing, Circulation) prioritization framework, this client has a
compromised breathing status requiring immediate assessment and intervention. The SpO2 of 88% is
below the normal range of 95-100% and indicates potential hypoxemia. Option A is stable postoperative
pain. Option B is a routine scheduled procedure. Option D is an educational need that is not urgent.
Q7: A nurse is reviewing a client's medical record and notes a DNR (Do Not Resuscitate) order.
Which of the following is an appropriate action by the nurse?
A. Remove all monitoring equipment from the client's room
B. Ensure the DNR order is documented in the client's medical record and communicate it
to the care team [CORRECT]
C. Decline to perform any care for the client
D. Ask the family to revoke the DNR order
Correct Answer: B
The correct answer is B. Ensure the DNR order is documented in the client's medical record and
communicate it to the care team. A DNR order means that CPR will not be performed in the event of
cardiac or respiratory arrest, but it does not mean the nurse stops all care. The nurse must verify the
order is in the chart and ensure all team members are aware. Option A is incorrect because monitoring
can continue. Option C is incorrect because the client still receives all other nursing care. Option D is
inappropriate because the nurse should not influence the client's or family's decision about a DNR.
Q8: A nurse is caring for a client diagnosed with Clostridioides difficile infection. Which of the
following infection control precautions is most appropriate?
A. Airborne precautions with N95 respirator
B. Contact precautions with soap and water hand hygiene [CORRECT]
C. Droplet precautions with surgical mask within 3 feet
D. Standard precautions only with alcohol-based hand sanitizer
Correct Answer: B
The correct answer is B. Contact precautions with soap and water hand hygiene. C. difficile is
transmitted via the fecal-oral route through contact with spores that can survive on surfaces. Contact
precautions (gown and gloves) are required. Critically, alcohol-based hand rub does not kill C. difficile
spores; the nurse must use soap and water for hand hygiene. Option A is for tuberculosis, measles, and
varicella. Option C is for influenza and pertussis. Option D is insufficient because alcohol-based
sanitizer is ineffective against C. difficile spores.
Q9: A nurse is caring for multiple clients on a busy medical unit. Which of the following tasks
can be safely delegated to a licensed practical nurse (LPN)?
A. Developing the initial nursing care plan for a newly admitted client
B. Administering a scheduled oral medication to a stable client [CORRECT]
C. Performing the initial admission assessment on a new client
D. Evaluating the effectiveness of a client's pain management regimen
Correct Answer: B
The correct answer is B. Administering a scheduled oral medication to a stable client. LPNs can
administer medications under the supervision of an RN for stable clients with predictable outcomes.
This falls within the LPN scope of practice. Developing care plans (Option A), performing initial
assessments (Option C), and evaluating care effectiveness (Option D) are all RN-level responsibilities
that require advanced clinical judgment and critical thinking that exceed the LPN scope.
ATI Fundamentals CMS Proctored Exam 2026/2027 | Page 3
