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ATI RN CMS COMPREHENSIVE
QUESTION BANK PRACTICE EXAM
2026–2027 | QUESTIONS 1–100 | CLINICAL
JUDGMENT & SAFETY | DETAILED
RATIONALES
INTRODUCTION
The ATI RN Content Mastery Series (CMS) Comprehensive assessment is designed to evaluate
nursing students' mastery of broad nursing knowledge and application across major clinical
content areas. ATI's RN comprehensive assessment incorporates the major NCLEX-RN Client
Needs categories and evaluates concepts spanning fundamentals, adult medical-surgical nursing,
maternal-newborn care, mental health, pediatric nursing, pharmacology, nutrition, community
health, and leadership. ATI also emphasizes clinical judgment and application of nursing
knowledge rather than simple recall.
This practice bank is designed for RN students preparing for comprehensive ATI-style
assessment and NCLEX-RN readiness. The questions emphasize prioritization, delegation,
safety, pharmacology, clinical deterioration, patient education, ethical decision-making, and
application of nursing knowledge to realistic clinical situations. Each question contains four
answer choices with one best answer followed by a rationale explaining the clinical reasoning.
Students can use the bank to identify weak areas, practice recognizing the most urgent client
needs, strengthen clinical judgment, and reinforce connections among different nursing
specialties. Repeated practice with scenario-based questions can help students become more
confident when approaching difficult comprehensive-assessment items.
CONTENT AREA OVERVIEW
CONTENT AREA QUESTIONS KEY TOPICS WEIGHT/EMPHASIS
Prioritization, delegation,
Management of Care 1–15 advocacy, coordination, High
legal/ethical care
Safety & Infection Isolation, infection prevention,
16–27 High
Control emergencies, falls, hazards
Health Promotion & Growth, prevention, pregnancy,
28–37 Moderate
Maintenance screening, health teaching
Mental health, therapeutic
Psychosocial
38–48 communication, grief, crisis, Moderate
Integrity
coping
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CONTENT AREA QUESTIONS KEY TOPICS WEIGHT/EMPHASIS
Basic Care & Nutrition, hygiene, mobility,
49–58 Moderate
Comfort elimination, pain, comfort
Medication administration,
Pharmacological &
59–73 adverse effects, IV therapy, High
Parenteral Therapies
calculations
Reduction of Risk Diagnostics, laboratory values,
74–86 High
Potential complications, monitoring
Acute illness, shock,
Physiological respiratory/cardiac,
87–100 High
Adaptation neurological and endocrine
emergencies
ATI states that its RN CMS Comprehensive assessment covers the eight major NCLEX Client
Needs categories and includes content such as Fundamentals, Adult Medical-Surgical, Maternal-
Newborn, Mental Health, Nursing Care of Children, Leadership, Community Health,
Pharmacology, and Nutrition.
QUESTIONS 1–100
MANAGEMENT OF CARE
Q1:
The nurse receives report on four clients. Which client should the nurse assess first?
A) A client with osteoarthritis requesting assistance with bathing
B) A client with pneumonia who has a temperature of 38.1°C
C) A client 4 hours after thyroidectomy who is frequently swallowing and reports neck pressure
D) A client awaiting discharge instructions
C) A client 4 hours after thyroidectomy who is frequently swallowing and reports neck
pressure
Rationale: Frequent swallowing and neck pressure after thyroidectomy can indicate
postoperative bleeding and developing airway compromise, requiring immediate assessment.
Option A represents a routine comfort need. Option B requires monitoring and treatment but is
less immediately threatening than possible airway compromise. Option D can safely be delayed
while an unstable client is assessed.
Q2:
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A nurse is caring for four clients. Which task is appropriate to delegate to an experienced
assistive personnel?
A) Assessing a client with new-onset confusion
B) Evaluating a client's response to IV analgesia
C) Obtaining vital signs for a stable postoperative client
D) Teaching incentive-spirometer use
C) Obtaining vital signs for a stable postoperative client
Rationale: Routine vital signs for a stable client may be delegated when the person is trained
and organizational policy permits. Assessment of new confusion, evaluation of medication
response, and client teaching require nursing judgment and should remain with the nurse.
Q3:
A nurse discovers that a prescribed medication dose appears unusually high. What should the
nurse do?
A) Administer the dose because the provider prescribed it
B) Ask another nurse to give the medication
C) Withhold the medication temporarily and clarify the prescription
D) Reduce the dose independently
C) Withhold the medication temporarily and clarify the prescription
Rationale: The nurse has a responsibility to identify potentially unsafe prescriptions before
administration. Administering a questionable dose or delegating it does not remove the nurse's
responsibility. Independently changing the prescription is outside the nurse's authority.
Q4:
A competent adult refuses a recommended surgical procedure. Which action is appropriate?
A) Ask the family to sign consent instead
B) Respect the refusal and notify the healthcare provider
C) Tell the client treatment will occur regardless
D) Obtain consent from another nurse
B) Respect the refusal and notify the healthcare provider
Rationale: A competent adult has the right to refuse treatment. The nurse should ensure the
client understands relevant information, document the refusal, and notify the provider. Family
members cannot override a competent client's decision.
Q5:
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A client with limited English proficiency is preparing for discharge. Which intervention best
promotes safety?
A) Ask the client's child to interpret
B) Use a qualified healthcare interpreter
C) Speak louder
D) Provide instructions only in English
B) Use a qualified healthcare interpreter
Rationale: A qualified interpreter reduces errors caused by inaccurate translation and supports
informed decision-making. Children and family members should not routinely be used for
complex medical interpretation. Speaking louder does not solve a language barrier.
Q6:
A nurse is assigning care for four clients. Which client should the nurse see first?
A) A client requesting a PRN sleep medication
B) A client with chronic pain rated 6/10
C) A client with new crushing chest pain and diaphoresis
D) A client requesting assistance with meal selection
C) A client with new crushing chest pain and diaphoresis
Rationale: New crushing chest pain with diaphoresis suggests possible acute coronary syndrome
and requires immediate assessment. The other needs are important but are not as immediately
life-threatening.
Q7:
A nurse is reviewing discharge instructions with a client who has heart failure. Which statement
indicates a need for further teaching?
A) “I will weigh myself every morning.”
B) “I will call if I gain weight rapidly.”
C) “I can stop my diuretic when my ankles look normal.”
D) “I will follow my prescribed sodium restriction.”
C) “I can stop my diuretic when my ankles look normal.”
Rationale: Medication should not be stopped without instructions from the healthcare provider.
Daily weights, reporting rapid weight gain, and following prescribed dietary restrictions are
appropriate heart-failure management strategies.
Q8:
ATI RN CMS COMPREHENSIVE
QUESTION BANK PRACTICE EXAM
2026–2027 | QUESTIONS 1–100 | CLINICAL
JUDGMENT & SAFETY | DETAILED
RATIONALES
INTRODUCTION
The ATI RN Content Mastery Series (CMS) Comprehensive assessment is designed to evaluate
nursing students' mastery of broad nursing knowledge and application across major clinical
content areas. ATI's RN comprehensive assessment incorporates the major NCLEX-RN Client
Needs categories and evaluates concepts spanning fundamentals, adult medical-surgical nursing,
maternal-newborn care, mental health, pediatric nursing, pharmacology, nutrition, community
health, and leadership. ATI also emphasizes clinical judgment and application of nursing
knowledge rather than simple recall.
This practice bank is designed for RN students preparing for comprehensive ATI-style
assessment and NCLEX-RN readiness. The questions emphasize prioritization, delegation,
safety, pharmacology, clinical deterioration, patient education, ethical decision-making, and
application of nursing knowledge to realistic clinical situations. Each question contains four
answer choices with one best answer followed by a rationale explaining the clinical reasoning.
Students can use the bank to identify weak areas, practice recognizing the most urgent client
needs, strengthen clinical judgment, and reinforce connections among different nursing
specialties. Repeated practice with scenario-based questions can help students become more
confident when approaching difficult comprehensive-assessment items.
CONTENT AREA OVERVIEW
CONTENT AREA QUESTIONS KEY TOPICS WEIGHT/EMPHASIS
Prioritization, delegation,
Management of Care 1–15 advocacy, coordination, High
legal/ethical care
Safety & Infection Isolation, infection prevention,
16–27 High
Control emergencies, falls, hazards
Health Promotion & Growth, prevention, pregnancy,
28–37 Moderate
Maintenance screening, health teaching
Mental health, therapeutic
Psychosocial
38–48 communication, grief, crisis, Moderate
Integrity
coping
,2|Page
CONTENT AREA QUESTIONS KEY TOPICS WEIGHT/EMPHASIS
Basic Care & Nutrition, hygiene, mobility,
49–58 Moderate
Comfort elimination, pain, comfort
Medication administration,
Pharmacological &
59–73 adverse effects, IV therapy, High
Parenteral Therapies
calculations
Reduction of Risk Diagnostics, laboratory values,
74–86 High
Potential complications, monitoring
Acute illness, shock,
Physiological respiratory/cardiac,
87–100 High
Adaptation neurological and endocrine
emergencies
ATI states that its RN CMS Comprehensive assessment covers the eight major NCLEX Client
Needs categories and includes content such as Fundamentals, Adult Medical-Surgical, Maternal-
Newborn, Mental Health, Nursing Care of Children, Leadership, Community Health,
Pharmacology, and Nutrition.
QUESTIONS 1–100
MANAGEMENT OF CARE
Q1:
The nurse receives report on four clients. Which client should the nurse assess first?
A) A client with osteoarthritis requesting assistance with bathing
B) A client with pneumonia who has a temperature of 38.1°C
C) A client 4 hours after thyroidectomy who is frequently swallowing and reports neck pressure
D) A client awaiting discharge instructions
C) A client 4 hours after thyroidectomy who is frequently swallowing and reports neck
pressure
Rationale: Frequent swallowing and neck pressure after thyroidectomy can indicate
postoperative bleeding and developing airway compromise, requiring immediate assessment.
Option A represents a routine comfort need. Option B requires monitoring and treatment but is
less immediately threatening than possible airway compromise. Option D can safely be delayed
while an unstable client is assessed.
Q2:
,3|Page
A nurse is caring for four clients. Which task is appropriate to delegate to an experienced
assistive personnel?
A) Assessing a client with new-onset confusion
B) Evaluating a client's response to IV analgesia
C) Obtaining vital signs for a stable postoperative client
D) Teaching incentive-spirometer use
C) Obtaining vital signs for a stable postoperative client
Rationale: Routine vital signs for a stable client may be delegated when the person is trained
and organizational policy permits. Assessment of new confusion, evaluation of medication
response, and client teaching require nursing judgment and should remain with the nurse.
Q3:
A nurse discovers that a prescribed medication dose appears unusually high. What should the
nurse do?
A) Administer the dose because the provider prescribed it
B) Ask another nurse to give the medication
C) Withhold the medication temporarily and clarify the prescription
D) Reduce the dose independently
C) Withhold the medication temporarily and clarify the prescription
Rationale: The nurse has a responsibility to identify potentially unsafe prescriptions before
administration. Administering a questionable dose or delegating it does not remove the nurse's
responsibility. Independently changing the prescription is outside the nurse's authority.
Q4:
A competent adult refuses a recommended surgical procedure. Which action is appropriate?
A) Ask the family to sign consent instead
B) Respect the refusal and notify the healthcare provider
C) Tell the client treatment will occur regardless
D) Obtain consent from another nurse
B) Respect the refusal and notify the healthcare provider
Rationale: A competent adult has the right to refuse treatment. The nurse should ensure the
client understands relevant information, document the refusal, and notify the provider. Family
members cannot override a competent client's decision.
Q5:
, 4|Page
A client with limited English proficiency is preparing for discharge. Which intervention best
promotes safety?
A) Ask the client's child to interpret
B) Use a qualified healthcare interpreter
C) Speak louder
D) Provide instructions only in English
B) Use a qualified healthcare interpreter
Rationale: A qualified interpreter reduces errors caused by inaccurate translation and supports
informed decision-making. Children and family members should not routinely be used for
complex medical interpretation. Speaking louder does not solve a language barrier.
Q6:
A nurse is assigning care for four clients. Which client should the nurse see first?
A) A client requesting a PRN sleep medication
B) A client with chronic pain rated 6/10
C) A client with new crushing chest pain and diaphoresis
D) A client requesting assistance with meal selection
C) A client with new crushing chest pain and diaphoresis
Rationale: New crushing chest pain with diaphoresis suggests possible acute coronary syndrome
and requires immediate assessment. The other needs are important but are not as immediately
life-threatening.
Q7:
A nurse is reviewing discharge instructions with a client who has heart failure. Which statement
indicates a need for further teaching?
A) “I will weigh myself every morning.”
B) “I will call if I gain weight rapidly.”
C) “I can stop my diuretic when my ankles look normal.”
D) “I will follow my prescribed sodium restriction.”
C) “I can stop my diuretic when my ankles look normal.”
Rationale: Medication should not be stopped without instructions from the healthcare provider.
Daily weights, reporting rapid weight gain, and following prescribed dietary restrictions are
appropriate heart-failure management strategies.
Q8:
