ATI CMS Fundamentals Actual Exam –
Assessment Technologies Institute (ATI) –
2026/2027 Academic Year – Verified
Questions and Answers
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT –
MANAGEMENT OF CARE (Questions 1-35)
1. Q: A charge nurse is assigning tasks on a medical-surgical unit. Which task
should be assigned to the Licensed Practical Nurse (LPN)?
A) Conduct the initial admission assessment for a client with pneumonia.
B) Evaluate the effectiveness of a new diuretic medication.
C) Administer a scheduled subcutaneous insulin injection to a client with stable
diabetes.
D) Create the plan of care for a client recently diagnosed with heart failure.
Answer: C
Rationale: LPNs function under the supervision of an RN and can perform tasks that
are routine and stable, such as administering scheduled medications and reinforcing
teaching. The RN is responsible for assessment (A), evaluation (B), and the initial plan
of care (D). This aligns with the "five rights" of delegation – specifically the right task,
which should be routine and have a predictable outcome .
2. Q: Which of the following actions is most appropriate for the registered
nurse (RN) to delegate to an assistive personnel (AP)?
A) Reinforcing teaching about a low-sodium diet.
B) Assessing the lung sounds of a client with shortness of breath.
C) Obtaining a routine capillary blood glucose level.
D) Evaluating the pain level after medication administration.
Answer: C
Rationale: APs are trained to perform routine, non-invasive tasks like vital signs,
intake/output, and point-of-care testing (like blood glucose) for stable patients. Tasks
,requiring assessment (B, D), evaluation, or teaching (A) must be performed by licensed
nurses (RN/LPN) .
3. Q: A nurse is prioritizing care for four clients at the start of the shift. Which
client should the nurse assess first?
A) A client post-operative day 2 who is requesting pain medication.
B) A client with a new diagnosis of diabetes needing education on insulin.
C) A client with a tracheostomy who has copious, thick secretions and is attempting
to cough.
D) A client scheduled for discharge in two hours who needs help packing.
Answer: C
Rationale: Using the ABCs (Airway, Breathing, Circulation), the client with a
tracheostomy and thick secretions is at immediate risk for airway obstruction. This
takes priority over comfort (A), teaching (B), and discharge planning (D). Physiological
needs (breathing) are the highest priority per Maslow's Hierarchy of Needs .
4. Q: A nurse manager is providing education to staff about delegation. Which
statement by a staff nurse indicates a correct understanding of the "five rights"
of delegation?
A) "I must ensure the task is within my own scope of practice."
B) "I can delegate any task as long as I supervise the AP."
C) "The right task is one that is routine and has a predictable outcome."
D) "I am ultimately responsible for the task once it is delegated."
Answer: C
Rationale: The "right task" must be one that is routine, non-invasive, and has a
predictable, stable outcome. The RN retains ultimate accountability for the task and
patient (D), making options A and B incomplete or incorrect .
5. Q: A nurse is giving a change-of-shift report about a client admitted earlier
that day with pneumonia. Which piece of information is the priority for the
nurse to provide?
,A) Admitting diagnosis.
B) Client's preferred name.
C) Current body temperature.
D) Diagnostic results from two days ago.
Answer: C
Rationale: When using the airway, breathing, circulation (ABC) approach to client care,
the nurse should determine that the priority information to provide is the current status
of the client's vital signs, specifically the temperature which indicates infection status .
6. Q: A nurse is caring for a client who has major fecal incontinence and reports
irritation in the perianal area. Which action should the nurse take first?
A) Apply a fecal collection system.
B) Notify the healthcare provider.
C) Cleanse and dry the area.
D) Check the client's perineum.
Answer: D
Rationale: The nursing process prioritizes assessment before intervention. The priority
nursing action is for the nurse to collect more data by assessing the area of irritation
before implementing any treatments .
7. Q: A charge nurse has four clients. Which client should the nurse assign to
the most experienced RN?
A) A client who is 1 day post-operative from an appendectomy.
B) A client with a new colostomy requiring stoma teaching.
C) A client with a blood glucose level of 50 mg/dL.
D) A client who is requesting to use the bedside commode.
Answer: C
Rationale: A blood glucose level of 50 mg/dL indicates severe hypoglycemia, which is a
life-threatening emergency requiring immediate intervention. This takes priority over
requests for medication, discharge, or toileting and requires an experienced nurse's
assessment and intervention skills .
, 8. Q: A client is refusing a life-saving blood transfusion based on religious
beliefs. What should the nurse do?
A) Administer the blood transfusion to save the client's life.
B) Call the provider to override the client's decision.
C) Respect the client's decision, provide information about consequences, and notify
the provider.
D) Ask the client's family to convince them to accept the transfusion.
Answer: C
Rationale: Clients have the right to refuse treatment. The nurse must respect the
patient's decision, provide appropriate information about risks and benefits, and
advocate for the patient's rights and preferences .
9. Q: A nurse makes an error that could potentially harm a patient. What is the
nurse's professional responsibility?
A) Document the error as a near miss.
B) Protect the patient, report the error according to policy, and participate in actions
to prevent recurrence.
C) Notify the patient's family immediately.
D) Keep the error confidential to avoid liability.
Answer: B
Rationale: The nurse's responsibility is to protect the patient, report the error according
to policy, and participate in actions to prevent recurrence. Reporting errors helps
protect patients, correct problems, and prevent similar events from happening again .
10. Q: What is the primary goal of patient safety?
A) To reduce healthcare costs.
B) To prevent avoidable harm to patients.
C) To increase patient satisfaction scores.
D) To minimize documentation requirements.
Answer: B
Rationale: The primary goal of patient safety is to prevent avoidable harm to patients.
All safety measures, protocols, and interventions are designed with this as the ultimate
objective .
Assessment Technologies Institute (ATI) –
2026/2027 Academic Year – Verified
Questions and Answers
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT –
MANAGEMENT OF CARE (Questions 1-35)
1. Q: A charge nurse is assigning tasks on a medical-surgical unit. Which task
should be assigned to the Licensed Practical Nurse (LPN)?
A) Conduct the initial admission assessment for a client with pneumonia.
B) Evaluate the effectiveness of a new diuretic medication.
C) Administer a scheduled subcutaneous insulin injection to a client with stable
diabetes.
D) Create the plan of care for a client recently diagnosed with heart failure.
Answer: C
Rationale: LPNs function under the supervision of an RN and can perform tasks that
are routine and stable, such as administering scheduled medications and reinforcing
teaching. The RN is responsible for assessment (A), evaluation (B), and the initial plan
of care (D). This aligns with the "five rights" of delegation – specifically the right task,
which should be routine and have a predictable outcome .
2. Q: Which of the following actions is most appropriate for the registered
nurse (RN) to delegate to an assistive personnel (AP)?
A) Reinforcing teaching about a low-sodium diet.
B) Assessing the lung sounds of a client with shortness of breath.
C) Obtaining a routine capillary blood glucose level.
D) Evaluating the pain level after medication administration.
Answer: C
Rationale: APs are trained to perform routine, non-invasive tasks like vital signs,
intake/output, and point-of-care testing (like blood glucose) for stable patients. Tasks
,requiring assessment (B, D), evaluation, or teaching (A) must be performed by licensed
nurses (RN/LPN) .
3. Q: A nurse is prioritizing care for four clients at the start of the shift. Which
client should the nurse assess first?
A) A client post-operative day 2 who is requesting pain medication.
B) A client with a new diagnosis of diabetes needing education on insulin.
C) A client with a tracheostomy who has copious, thick secretions and is attempting
to cough.
D) A client scheduled for discharge in two hours who needs help packing.
Answer: C
Rationale: Using the ABCs (Airway, Breathing, Circulation), the client with a
tracheostomy and thick secretions is at immediate risk for airway obstruction. This
takes priority over comfort (A), teaching (B), and discharge planning (D). Physiological
needs (breathing) are the highest priority per Maslow's Hierarchy of Needs .
4. Q: A nurse manager is providing education to staff about delegation. Which
statement by a staff nurse indicates a correct understanding of the "five rights"
of delegation?
A) "I must ensure the task is within my own scope of practice."
B) "I can delegate any task as long as I supervise the AP."
C) "The right task is one that is routine and has a predictable outcome."
D) "I am ultimately responsible for the task once it is delegated."
Answer: C
Rationale: The "right task" must be one that is routine, non-invasive, and has a
predictable, stable outcome. The RN retains ultimate accountability for the task and
patient (D), making options A and B incomplete or incorrect .
5. Q: A nurse is giving a change-of-shift report about a client admitted earlier
that day with pneumonia. Which piece of information is the priority for the
nurse to provide?
,A) Admitting diagnosis.
B) Client's preferred name.
C) Current body temperature.
D) Diagnostic results from two days ago.
Answer: C
Rationale: When using the airway, breathing, circulation (ABC) approach to client care,
the nurse should determine that the priority information to provide is the current status
of the client's vital signs, specifically the temperature which indicates infection status .
6. Q: A nurse is caring for a client who has major fecal incontinence and reports
irritation in the perianal area. Which action should the nurse take first?
A) Apply a fecal collection system.
B) Notify the healthcare provider.
C) Cleanse and dry the area.
D) Check the client's perineum.
Answer: D
Rationale: The nursing process prioritizes assessment before intervention. The priority
nursing action is for the nurse to collect more data by assessing the area of irritation
before implementing any treatments .
7. Q: A charge nurse has four clients. Which client should the nurse assign to
the most experienced RN?
A) A client who is 1 day post-operative from an appendectomy.
B) A client with a new colostomy requiring stoma teaching.
C) A client with a blood glucose level of 50 mg/dL.
D) A client who is requesting to use the bedside commode.
Answer: C
Rationale: A blood glucose level of 50 mg/dL indicates severe hypoglycemia, which is a
life-threatening emergency requiring immediate intervention. This takes priority over
requests for medication, discharge, or toileting and requires an experienced nurse's
assessment and intervention skills .
, 8. Q: A client is refusing a life-saving blood transfusion based on religious
beliefs. What should the nurse do?
A) Administer the blood transfusion to save the client's life.
B) Call the provider to override the client's decision.
C) Respect the client's decision, provide information about consequences, and notify
the provider.
D) Ask the client's family to convince them to accept the transfusion.
Answer: C
Rationale: Clients have the right to refuse treatment. The nurse must respect the
patient's decision, provide appropriate information about risks and benefits, and
advocate for the patient's rights and preferences .
9. Q: A nurse makes an error that could potentially harm a patient. What is the
nurse's professional responsibility?
A) Document the error as a near miss.
B) Protect the patient, report the error according to policy, and participate in actions
to prevent recurrence.
C) Notify the patient's family immediately.
D) Keep the error confidential to avoid liability.
Answer: B
Rationale: The nurse's responsibility is to protect the patient, report the error according
to policy, and participate in actions to prevent recurrence. Reporting errors helps
protect patients, correct problems, and prevent similar events from happening again .
10. Q: What is the primary goal of patient safety?
A) To reduce healthcare costs.
B) To prevent avoidable harm to patients.
C) To increase patient satisfaction scores.
D) To minimize documentation requirements.
Answer: B
Rationale: The primary goal of patient safety is to prevent avoidable harm to patients.
All safety measures, protocols, and interventions are designed with this as the ultimate
objective .
