ATI Fundamentals CMS Actual Proctored Exam
2024/2025 – 100% Verified Correct Answers
Instructions
This document contains 80 unique multiple-choice questions designed for the ATI Fun-
damentals CMS Proctored Exam 2024/2025, covering essential concepts such as safety,
infection control, communication, and the nursing process, aligned with ATI Funda-
mentals content. Each question includes a verified correct answer and a comprehensive
rationale to support learning. Select the best answer for each question.
Question 1: A nurse is preparing to administer medication via a nasogastric tube. Which action
should the nurse take first?
A. Crush the medication into a fine powder
B. Verify tube placement
C. Flush the tube with water
D. Position the client supine
Answer: B. Verify tube placement
Rationale: Verifying nasogastric tube placement (e.g., via pH testing of aspirate or
X-ray confirmation) is the priority to ensure the tube is in the stomach, preventing
aspiration. Crushing medication, flushing, or positioning follows confirmation.
Question 2: A client with a new colostomy refuses to look at the stoma. Which nursing response
is most therapeutic?
A. ”You’ll get used to it over time.”
B. ”Can you share what concerns you about looking at it?”
C. ”It’s important to accept your new stoma.”
D. ”Let me show you how to care for it.”
Answer: B. ”Can you share what concerns you about looking at it?”
Rationale: Using therapeutic communication, the nurse explores the client’s feel-
ings, promoting trust and addressing emotional barriers. Directive responses or
minimization may dismiss the client’s concerns.
Question 3: A nurse is assisting a client with ambulation using a walker. Which instruction is
correct?
A. Step forward with the stronger leg first
B. Hold the walker with one hand only
C. Move the walker after taking two steps
D. Lean backward while walking
Answer: A. Step forward with the stronger leg first
1
, Rationale: When using a walker, the client steps forward with the stronger leg first,
followed by the weaker leg, while moving the walker forward for stability. Holding
with both hands and avoiding leaning backward ensures safety.
Question 4: Which precaution is most appropriate for a client with MRSA in a private room?
A. Standard precautions
B. Contact precautions
C. Droplet precautions
D. Airborne precautions
Answer: B. Contact precautions
Rationale: MRSA is transmitted via direct contact or contaminated surfaces, re-
quiring contact precautions (gloves, gown, dedicated equipment). Standard pre-
cautions are insufficient, and droplet or airborne precautions are not indicated.
Question 5: A nurse is calculating a client’s intake and output. The client consumed 8 oz of
juice, 240 mL of water, and 6 oz of broth. What is the total intake in mL?
A. 420 mL
B. 540 mL
C. 660 mL
D. 780 mL
Answer: B. 540 mL
Rationale: To calculate: 8 oz juice = 240 mL (1 oz = 30 mL), 240 mL water, 6 oz
broth = 180 mL. Total: 240 + 240 + 180 = 540 mL.
Question 6: A nurse is preparing to perform a sterile dressing change. Which action violates
sterile technique?
A. Wearing sterile gloves
B. Opening the sterile field away from the body
C. Touching the outer 1-inch border of the sterile field
D. Using sterile saline to moisten gauze
Answer: C. Touching the outer 1-inch border of the sterile field
Rationale: The outer 1-inch border of a sterile field is considered non-sterile. Touch-
ing it contaminates the sterile field. Other actions maintain sterility.
Question 7: A client reports pain rated 6/10. Which action should the nurse take first?
A. Administer a prescribed analgesic
B. Assess the pain’s location and quality
C. Teach non-pharmacological pain relief
D. Document the pain level
Answer: B. Assess the pain’s location and quality
Rationale: The nursing process prioritizes assessment to understand the pain’s char-
acteristics before intervening. This guides appropriate pain management, followed
by administration, teaching, or documentation.
Question 8: A nurse is teaching a client about pressure injury prevention. Which instruction is
most effective?
A. Reposition every 4 hours
B. Use a donut-shaped cushion
C. Keep skin clean and dry
D. Limit fluid intake
2
, Answer: C. Keep skin clean and dry
Rationale: Keeping skin clean and dry prevents moisture-related skin breakdown, a
key factor in pressure injury prevention. Repositioning should occur every 2 hours,
donut cushions increase risk, and fluid intake supports skin integrity.
Question 9: A client with a new tracheostomy requires suctioning. Which action ensures safety?
A. Suction for 20 seconds each pass
B. Use a catheter with a diameter larger than the tube
C. Apply suction while inserting the catheter
D. Pre-oxygenate the client
Answer: D. Pre-oxygenate the client
Rationale: Pre-oxygenation prevents hypoxia during tracheostomy suctioning. Suc-
tioning should last 10–15 seconds, the catheter should be smaller than half the
tube’s diameter, and suction is applied only on withdrawal.
Question 10: A nurse is delegating tasks to an assistive personnel (AP). Which task is appropriate
to delegate?
A. Assessing a client’s pain level
B. Obtaining a client’s vital signs
C. Developing a client’s care plan
D. Administering oral medications
Answer: B. Obtaining a client’s vital signs
Rationale: Obtaining vital signs is within the AP’s scope of practice. Assessment,
care planning, and medication administration are nursing responsibilities requiring
clinical judgment.
Question 11: A client with dysphagia is at risk for aspiration. Which position is safest during
meals?
A. Supine
B. Semi-Fowler’s
C. High Fowler’s
D. Prone
Answer: C. High Fowler’s
Rationale: High Fowler’s position (upright, 90 degrees) minimizes aspiration risk
by aligning the esophagus for safer swallowing. Other positions increase aspiration
risk.
Question 12: A nurse is preparing to insert an indwelling urinary catheter. Which action is most
important?
A. Use clean gloves for insertion
B. Maintain a sterile field
C. Lubricate the catheter tip after insertion
D. Inflate the balloon before insertion
Answer: B. Maintain a sterile field
Rationale: Catheter insertion is a sterile procedure to prevent infection. Sterile
gloves, a sterile field, and lubricating the catheter tip before insertion are required.
Balloon inflation occurs after insertion.
Question 13: A client with a history of falls is being discharged. Which safety instruction should
the nurse include?
3
2024/2025 – 100% Verified Correct Answers
Instructions
This document contains 80 unique multiple-choice questions designed for the ATI Fun-
damentals CMS Proctored Exam 2024/2025, covering essential concepts such as safety,
infection control, communication, and the nursing process, aligned with ATI Funda-
mentals content. Each question includes a verified correct answer and a comprehensive
rationale to support learning. Select the best answer for each question.
Question 1: A nurse is preparing to administer medication via a nasogastric tube. Which action
should the nurse take first?
A. Crush the medication into a fine powder
B. Verify tube placement
C. Flush the tube with water
D. Position the client supine
Answer: B. Verify tube placement
Rationale: Verifying nasogastric tube placement (e.g., via pH testing of aspirate or
X-ray confirmation) is the priority to ensure the tube is in the stomach, preventing
aspiration. Crushing medication, flushing, or positioning follows confirmation.
Question 2: A client with a new colostomy refuses to look at the stoma. Which nursing response
is most therapeutic?
A. ”You’ll get used to it over time.”
B. ”Can you share what concerns you about looking at it?”
C. ”It’s important to accept your new stoma.”
D. ”Let me show you how to care for it.”
Answer: B. ”Can you share what concerns you about looking at it?”
Rationale: Using therapeutic communication, the nurse explores the client’s feel-
ings, promoting trust and addressing emotional barriers. Directive responses or
minimization may dismiss the client’s concerns.
Question 3: A nurse is assisting a client with ambulation using a walker. Which instruction is
correct?
A. Step forward with the stronger leg first
B. Hold the walker with one hand only
C. Move the walker after taking two steps
D. Lean backward while walking
Answer: A. Step forward with the stronger leg first
1
, Rationale: When using a walker, the client steps forward with the stronger leg first,
followed by the weaker leg, while moving the walker forward for stability. Holding
with both hands and avoiding leaning backward ensures safety.
Question 4: Which precaution is most appropriate for a client with MRSA in a private room?
A. Standard precautions
B. Contact precautions
C. Droplet precautions
D. Airborne precautions
Answer: B. Contact precautions
Rationale: MRSA is transmitted via direct contact or contaminated surfaces, re-
quiring contact precautions (gloves, gown, dedicated equipment). Standard pre-
cautions are insufficient, and droplet or airborne precautions are not indicated.
Question 5: A nurse is calculating a client’s intake and output. The client consumed 8 oz of
juice, 240 mL of water, and 6 oz of broth. What is the total intake in mL?
A. 420 mL
B. 540 mL
C. 660 mL
D. 780 mL
Answer: B. 540 mL
Rationale: To calculate: 8 oz juice = 240 mL (1 oz = 30 mL), 240 mL water, 6 oz
broth = 180 mL. Total: 240 + 240 + 180 = 540 mL.
Question 6: A nurse is preparing to perform a sterile dressing change. Which action violates
sterile technique?
A. Wearing sterile gloves
B. Opening the sterile field away from the body
C. Touching the outer 1-inch border of the sterile field
D. Using sterile saline to moisten gauze
Answer: C. Touching the outer 1-inch border of the sterile field
Rationale: The outer 1-inch border of a sterile field is considered non-sterile. Touch-
ing it contaminates the sterile field. Other actions maintain sterility.
Question 7: A client reports pain rated 6/10. Which action should the nurse take first?
A. Administer a prescribed analgesic
B. Assess the pain’s location and quality
C. Teach non-pharmacological pain relief
D. Document the pain level
Answer: B. Assess the pain’s location and quality
Rationale: The nursing process prioritizes assessment to understand the pain’s char-
acteristics before intervening. This guides appropriate pain management, followed
by administration, teaching, or documentation.
Question 8: A nurse is teaching a client about pressure injury prevention. Which instruction is
most effective?
A. Reposition every 4 hours
B. Use a donut-shaped cushion
C. Keep skin clean and dry
D. Limit fluid intake
2
, Answer: C. Keep skin clean and dry
Rationale: Keeping skin clean and dry prevents moisture-related skin breakdown, a
key factor in pressure injury prevention. Repositioning should occur every 2 hours,
donut cushions increase risk, and fluid intake supports skin integrity.
Question 9: A client with a new tracheostomy requires suctioning. Which action ensures safety?
A. Suction for 20 seconds each pass
B. Use a catheter with a diameter larger than the tube
C. Apply suction while inserting the catheter
D. Pre-oxygenate the client
Answer: D. Pre-oxygenate the client
Rationale: Pre-oxygenation prevents hypoxia during tracheostomy suctioning. Suc-
tioning should last 10–15 seconds, the catheter should be smaller than half the
tube’s diameter, and suction is applied only on withdrawal.
Question 10: A nurse is delegating tasks to an assistive personnel (AP). Which task is appropriate
to delegate?
A. Assessing a client’s pain level
B. Obtaining a client’s vital signs
C. Developing a client’s care plan
D. Administering oral medications
Answer: B. Obtaining a client’s vital signs
Rationale: Obtaining vital signs is within the AP’s scope of practice. Assessment,
care planning, and medication administration are nursing responsibilities requiring
clinical judgment.
Question 11: A client with dysphagia is at risk for aspiration. Which position is safest during
meals?
A. Supine
B. Semi-Fowler’s
C. High Fowler’s
D. Prone
Answer: C. High Fowler’s
Rationale: High Fowler’s position (upright, 90 degrees) minimizes aspiration risk
by aligning the esophagus for safer swallowing. Other positions increase aspiration
risk.
Question 12: A nurse is preparing to insert an indwelling urinary catheter. Which action is most
important?
A. Use clean gloves for insertion
B. Maintain a sterile field
C. Lubricate the catheter tip after insertion
D. Inflate the balloon before insertion
Answer: B. Maintain a sterile field
Rationale: Catheter insertion is a sterile procedure to prevent infection. Sterile
gloves, a sterile field, and lubricating the catheter tip before insertion are required.
Balloon inflation occurs after insertion.
Question 13: A client with a history of falls is being discharged. Which safety instruction should
the nurse include?
3
