ATI CMS Fundamentals Proctored Exam
2025 | Verified Questions & Expert
Rationales | Scored A+
Section 1: Infection Control and Safety (Questions 1-20)
A nurse is preparing to insert an indwelling urinary catheter for a patient with urinary
retention. Which action best demonstrates adherence to standard precautions?
a) Wearing clean gloves only
b) Performing hand hygiene and donning sterile gloves
c) Using alcohol-based hand rub after the procedure
d) Applying a surgical mask during insertion
Correct Answer: b) Performing hand hygiene and donning sterile gloves
1. Rationale: Standard precautions require hand hygiene before invasive procedures and
sterile technique for catheterization to prevent CAUTI (QSEN: Safety; ATI CMS: Asepsis).
Clean gloves (a) are insufficient for sterile fields; post-procedure rub (c) is secondary;
mask (d) is droplet precaution, not core for this. NCLEX Reasoning: Prioritize
transmission-based precautions based on procedure risk (application level).
A patient with suspected C. difficile infection is placed on contact precautions. The
nurse should educate the patient on which hygiene practice?
a) Using alcohol-based hand sanitizer after toileting
b) Washing hands with soap and water after toileting
c) Applying hand lotion frequently
d) Sharing the call bell with roommates
Correct Answer: b) Washing hands with soap and water after toileting
2. Rationale: C. difficile spores are resistant to alcohol; soap disrupts the spore wall (CDC
2025 Guidelines; ATI CMS: Isolation). Sanitizer ineffective (a); lotion dries skin (c); sharing
spreads spores (d). NCLEX Reasoning: Select interventions based on pathogen-specific
precautions (analysis level).
,During a code blue, the nurse assists with chest compressions. Post-event, what is the
priority action to prevent infection transmission?
a) Change scrubs immediately
b) Perform hand hygiene and don fresh gloves if needed
c) Wipe stethoscope with alcohol
d) Document the event
Correct Answer: b) Perform hand hygiene and don fresh gloves if needed
3. Rationale: Aerosol-generating procedures like CPR require immediate hand hygiene to
prevent respiratory pathogen spread (AHA BLS 2025; QSEN: Safety). Scrub change
secondary (a); stethoscope cleaning later (c); documentation last (d). NCLEX
Reasoning: ABCs extend to safety—hygiene first in chain of infection (prioritization).
A nurse is caring for a patient with MRSA in an isolation room. Which personal protective
equipment (PPE) is essential when entering?
a) Gown and gloves
b) N95 mask and face shield
c) Surgical cap
d) Shoe covers
Correct Answer: a) Gown and gloves
4. Rationale: Contact precautions for MRSA mandate gown/gloves to prevent skin/fomite
transmission (CDC HICPAC 2025; ATI CMS: PPE). N95 for airborne (b); cap/shoes not
routine (c,d). NCLEX Reasoning: Match precautions to mode of transmission (contact vs.
airborne).
The nurse identifies a needlestick injury during IV insertion. What is the immediate
action?
a) Squeeze the site to promote bleeding
b) Wash with soap and water, then report
c) Apply pressure without washing
d) Ignore if asymptomatic
Correct Answer: b) Wash with soap and water, then report
5. Rationale: OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030) requires
immediate washing and reporting for post-exposure prophylaxis (PEP) within 72 hours.
Squeezing risks spread (a); pressure secondary (c); ignore delays care (d). NCLEX
Reasoning: Follow protocol steps—immediate mitigation first (synthesis).
, A patient with active tuberculosis is admitted. The nurse should initiate which
precaution first?
a) Droplet
b) Airborne with negative pressure room
c) Contact
d) Standard only
Correct Answer: b) Airborne with negative pressure room
6. Rationale: TB requires airborne precautions, including N95 and AIIR (CDC TB
Guidelines 2025; ATI CMS: Isolation). Droplet for close contact (a); contact for skin (c);
standard insufficient (d). NCLEX Reasoning: Isolate based on droplet nuclei transmission
(application).
During hand hygiene audit, the nurse observes a colleague using sanitizer before clean
gloves. What is the correct feedback?
a) "Sanitizer is sufficient for gloves."
b) "Hand hygiene should be before donning gloves."
c) "Gloves replace hand hygiene."
d) "No feedback needed."
Correct Answer: b) "Hand hygiene should be before donning gloves."
7. Rationale: WHO/CDC guidelines: Clean hands before gloves to prevent contamination
(QSEN: Teamwork). Sanitizer ok but timing key (a); gloves no substitute (c); feedback
promotes safety (d). NCLEX Reasoning: Educate for compliance (teaching moment).
A nurse is disinfecting a blood spill. Which agent is most effective?
a) Bleach solution (1:10)
b) Alcohol wipes
c) Hydrogen peroxide
d) Soap and water
Correct Answer: a) Bleach solution (1:10)
8. Rationale: EPA-registered disinfectants like 1:10 bleach for bloodborne pathogens
(OSHA 1910.1030; ATI CMS: Cleaning). Alcohol ineffective on non-enveloped viruses (b);
peroxide partial (c); soap insufficient (d). NCLEX Reasoning: Select sporicidal agent for
blood (knowledge application).
The nurse is implementing a fall prevention program. Which intervention is highest
priority for a high-risk patient?
2025 | Verified Questions & Expert
Rationales | Scored A+
Section 1: Infection Control and Safety (Questions 1-20)
A nurse is preparing to insert an indwelling urinary catheter for a patient with urinary
retention. Which action best demonstrates adherence to standard precautions?
a) Wearing clean gloves only
b) Performing hand hygiene and donning sterile gloves
c) Using alcohol-based hand rub after the procedure
d) Applying a surgical mask during insertion
Correct Answer: b) Performing hand hygiene and donning sterile gloves
1. Rationale: Standard precautions require hand hygiene before invasive procedures and
sterile technique for catheterization to prevent CAUTI (QSEN: Safety; ATI CMS: Asepsis).
Clean gloves (a) are insufficient for sterile fields; post-procedure rub (c) is secondary;
mask (d) is droplet precaution, not core for this. NCLEX Reasoning: Prioritize
transmission-based precautions based on procedure risk (application level).
A patient with suspected C. difficile infection is placed on contact precautions. The
nurse should educate the patient on which hygiene practice?
a) Using alcohol-based hand sanitizer after toileting
b) Washing hands with soap and water after toileting
c) Applying hand lotion frequently
d) Sharing the call bell with roommates
Correct Answer: b) Washing hands with soap and water after toileting
2. Rationale: C. difficile spores are resistant to alcohol; soap disrupts the spore wall (CDC
2025 Guidelines; ATI CMS: Isolation). Sanitizer ineffective (a); lotion dries skin (c); sharing
spreads spores (d). NCLEX Reasoning: Select interventions based on pathogen-specific
precautions (analysis level).
,During a code blue, the nurse assists with chest compressions. Post-event, what is the
priority action to prevent infection transmission?
a) Change scrubs immediately
b) Perform hand hygiene and don fresh gloves if needed
c) Wipe stethoscope with alcohol
d) Document the event
Correct Answer: b) Perform hand hygiene and don fresh gloves if needed
3. Rationale: Aerosol-generating procedures like CPR require immediate hand hygiene to
prevent respiratory pathogen spread (AHA BLS 2025; QSEN: Safety). Scrub change
secondary (a); stethoscope cleaning later (c); documentation last (d). NCLEX
Reasoning: ABCs extend to safety—hygiene first in chain of infection (prioritization).
A nurse is caring for a patient with MRSA in an isolation room. Which personal protective
equipment (PPE) is essential when entering?
a) Gown and gloves
b) N95 mask and face shield
c) Surgical cap
d) Shoe covers
Correct Answer: a) Gown and gloves
4. Rationale: Contact precautions for MRSA mandate gown/gloves to prevent skin/fomite
transmission (CDC HICPAC 2025; ATI CMS: PPE). N95 for airborne (b); cap/shoes not
routine (c,d). NCLEX Reasoning: Match precautions to mode of transmission (contact vs.
airborne).
The nurse identifies a needlestick injury during IV insertion. What is the immediate
action?
a) Squeeze the site to promote bleeding
b) Wash with soap and water, then report
c) Apply pressure without washing
d) Ignore if asymptomatic
Correct Answer: b) Wash with soap and water, then report
5. Rationale: OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030) requires
immediate washing and reporting for post-exposure prophylaxis (PEP) within 72 hours.
Squeezing risks spread (a); pressure secondary (c); ignore delays care (d). NCLEX
Reasoning: Follow protocol steps—immediate mitigation first (synthesis).
, A patient with active tuberculosis is admitted. The nurse should initiate which
precaution first?
a) Droplet
b) Airborne with negative pressure room
c) Contact
d) Standard only
Correct Answer: b) Airborne with negative pressure room
6. Rationale: TB requires airborne precautions, including N95 and AIIR (CDC TB
Guidelines 2025; ATI CMS: Isolation). Droplet for close contact (a); contact for skin (c);
standard insufficient (d). NCLEX Reasoning: Isolate based on droplet nuclei transmission
(application).
During hand hygiene audit, the nurse observes a colleague using sanitizer before clean
gloves. What is the correct feedback?
a) "Sanitizer is sufficient for gloves."
b) "Hand hygiene should be before donning gloves."
c) "Gloves replace hand hygiene."
d) "No feedback needed."
Correct Answer: b) "Hand hygiene should be before donning gloves."
7. Rationale: WHO/CDC guidelines: Clean hands before gloves to prevent contamination
(QSEN: Teamwork). Sanitizer ok but timing key (a); gloves no substitute (c); feedback
promotes safety (d). NCLEX Reasoning: Educate for compliance (teaching moment).
A nurse is disinfecting a blood spill. Which agent is most effective?
a) Bleach solution (1:10)
b) Alcohol wipes
c) Hydrogen peroxide
d) Soap and water
Correct Answer: a) Bleach solution (1:10)
8. Rationale: EPA-registered disinfectants like 1:10 bleach for bloodborne pathogens
(OSHA 1910.1030; ATI CMS: Cleaning). Alcohol ineffective on non-enveloped viruses (b);
peroxide partial (c); soap insufficient (d). NCLEX Reasoning: Select sporicidal agent for
blood (knowledge application).
The nurse is implementing a fall prevention program. Which intervention is highest
priority for a high-risk patient?
