ATI CMS Fundamentals 1 — Practice Test 2026/2027
ATI CMS FUNDAMENTALS 1 PRACTICE TEST 1
2026/2027 | 40 Questions | Exam Prep
Instructions: Select the best answer for each question. SATA items require selecting all correct responses.
Ordered items require placing steps in sequence. Answers and rationales follow each question.
Section I: Nursing Process & Clinical Judgment / CJMM (Q1–5)
1. A nurse is caring for a patient admitted with dehydration. After reviewing the intake and
output record, the nurse notes that the patient's urine output for the past 8 hours is 150 mL.
Which step of the nursing process does this action represent?
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
Correct Answer: A. Assessment
Rationale: Reviewing intake and output data to gather information about the patient's fluid status is an
assessment activity. The nursing process begins with assessment—the systematic collection of data to
identify the patient's health status and needs. Assessment includes both objective data (vital signs, lab
values, I&O) and subjective data (patient reports). Diagnosis involves analyzing assessment data to
identify actual or potential health problems. Planning involves developing goals and interventions.
Evaluation involves comparing patient outcomes with established goals to determine the effectiveness of
care.
2. A nurse enters a patient's room and observes the patient grimacing, clutching the
abdomen, and diaphoretic. The patient states, 'I feel like something is tearing inside me.'
Which action demonstrates recognizing cues in the NCSBN Clinical Judgment Measurement
Model (CJMM)?
A. Administering prescribed PRN pain medication immediately
B. Noting the patient's facial expression, vital signs, and verbal report as significant clinical data
C. Calling the healthcare provider to report possible bowel perforation
D. Documenting the findings in the patient's medical record
Correct Answer: B. Noting the patient's facial expression, vital signs, and verbal report as
significant clinical data
Rationale: Recognizing cues is the first cognitive step in the CJMM, where the nurse identifies relevant
clinical data that may indicate a potential problem. The nurse observes the grimacing, diaphoresis,
abdominal clutching, and verbal report of 'tearing' sensation—these are all significant cues that require
further analysis. While administering pain medication (A), calling the provider (C), and documenting (D)
are all appropriate nursing actions, they belong to later phases of clinical judgment (taking action or
evaluating outcomes). The key is to first identify and interpret the clinical significance of the cues before
deciding on the next steps.
3. A nurse is using the nursing process to care for a patient recovering from total knee
arthroplasty. Place the following steps in the correct order (1 = first, 5 = last). [Ordered
Response]
1. Evaluate the patient's pain level and ability to participate in physical therapy
2. Develop a nursing care plan with measurable goals for mobility and pain management
3. Analyze the patient's assessment data to identify nursing diagnoses
4. Implement interventions including pain medication administration and assisted ambulation
5. Assess the patient's surgical site, pain level, vital signs, and range of motion
Correct Answer: 5 → 3 → 2 → 4 → 1
1
, ATI CMS Fundamentals 1 — Practice Test 2026/2027
Rationale: The nursing process follows five sequential steps: Assessment (5) is first—the nurse gathers
data about the surgical site, pain, vital signs, and mobility. Diagnosis (3) follows—the nurse analyzes
assessment data to identify nursing diagnoses such as 'Acute Pain' and 'Impaired Physical Mobility.'
Planning (2) involves developing measurable goals and selecting appropriate interventions.
Implementation (4) is the execution of the planned interventions. Evaluation (1) is the final step, where the
nurse measures the patient's response to interventions and compares outcomes to the established goals,
revising the plan as needed. The nursing process is continuous and cyclical.
4. A nurse on a medical-surgical unit receives report on four patients. Which patient should
the nurse assess FIRST based on priority-setting principles?
A. A patient with type 2 diabetes who has a blood glucose of 210 mg/dL and is awaiting breakfast
B. A patient 2 days post-cholecystectomy who reports incisional pain of 4/10 and has not yet ambulated
C. A patient with heart failure who reports increasing dyspnea over the past 2 hours and has new
bilateral ankle edema
D. A patient with a urinary tract infection who has a temperature of 100.4°F (38°C) and complains of
burning with urination
Correct Answer: C. A patient with heart failure who reports increasing dyspnea over the past
2 hours and has new bilateral ankle edema
Rationale: The nurse should use the ABC (Airway, Breathing, Circulation) framework and Maslow's
hierarchy of needs to prioritize. The patient with heart failure (C) is showing signs of fluid volume excess—
increasing dyspnea and new bilateral edema—which indicates potential respiratory compromise and
requires immediate assessment and intervention. This is a potentially life-threatening change in status. The
patient with elevated blood glucose (A) is stable but needs medication; the post-cholecystectomy patient (B)
has expected postoperative pain; and the UTI patient (D) has low-grade fever. While all require nursing
care, the patient with worsening heart failure takes priority because respiratory status supersedes other
needs.
5. A nurse is generating solutions for a patient with a nursing diagnosis of Risk for Impaired
Skin Integrity related to immobility. Which intervention is most appropriate to include in the
plan of care?
A. Apply a heating pad to bony prominences every 4 hours
B. Reposition the patient every 2 hours and use a pressure redistribution mattress
C. Massage reddened bony areas to improve circulation
D. Keep the head of the bed at 45 degrees continuously
Correct Answer: B. Reposition the patient every 2 hours and use a pressure redistribution
mattress
Rationale: Generating solutions involves selecting evidence-based interventions to address the identified
problem. Repositioning the patient at least every 2 hours relieves pressure on bony prominences, and a
pressure redistribution mattress reduces interface pressure—both are standard pressure injury prevention
measures per NPUAP/EPUAP guidelines. Applying heating pads (A) to bony prominences increases
metabolic demand and risk of burns. Massaging reddened areas (C) is contraindicated because it can
damage fragile capillaries and deepen tissue injury. Keeping the head of the bed at 45 degrees (D)
continuously increases shearing forces on the sacrum; the HOB should be at the lowest degree of elevation
consistent with the patient's medical condition, ideally ≤30 degrees for pressure injury prevention.
Section II: Safety & Infection Control (Q6–11)
6. A nurse is preparing to enter the room of a patient on contact precautions for
Clostridioides difficile infection. Which sequence for donning personal protective equipment
(PPE) is correct?
A. Gown first, then gloves, then mask, then eye protection
B. Hand hygiene, then gown, then mask, then gloves
C. Hand hygiene, then gloves, then gown, then mask
2
ATI CMS FUNDAMENTALS 1 PRACTICE TEST 1
2026/2027 | 40 Questions | Exam Prep
Instructions: Select the best answer for each question. SATA items require selecting all correct responses.
Ordered items require placing steps in sequence. Answers and rationales follow each question.
Section I: Nursing Process & Clinical Judgment / CJMM (Q1–5)
1. A nurse is caring for a patient admitted with dehydration. After reviewing the intake and
output record, the nurse notes that the patient's urine output for the past 8 hours is 150 mL.
Which step of the nursing process does this action represent?
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
Correct Answer: A. Assessment
Rationale: Reviewing intake and output data to gather information about the patient's fluid status is an
assessment activity. The nursing process begins with assessment—the systematic collection of data to
identify the patient's health status and needs. Assessment includes both objective data (vital signs, lab
values, I&O) and subjective data (patient reports). Diagnosis involves analyzing assessment data to
identify actual or potential health problems. Planning involves developing goals and interventions.
Evaluation involves comparing patient outcomes with established goals to determine the effectiveness of
care.
2. A nurse enters a patient's room and observes the patient grimacing, clutching the
abdomen, and diaphoretic. The patient states, 'I feel like something is tearing inside me.'
Which action demonstrates recognizing cues in the NCSBN Clinical Judgment Measurement
Model (CJMM)?
A. Administering prescribed PRN pain medication immediately
B. Noting the patient's facial expression, vital signs, and verbal report as significant clinical data
C. Calling the healthcare provider to report possible bowel perforation
D. Documenting the findings in the patient's medical record
Correct Answer: B. Noting the patient's facial expression, vital signs, and verbal report as
significant clinical data
Rationale: Recognizing cues is the first cognitive step in the CJMM, where the nurse identifies relevant
clinical data that may indicate a potential problem. The nurse observes the grimacing, diaphoresis,
abdominal clutching, and verbal report of 'tearing' sensation—these are all significant cues that require
further analysis. While administering pain medication (A), calling the provider (C), and documenting (D)
are all appropriate nursing actions, they belong to later phases of clinical judgment (taking action or
evaluating outcomes). The key is to first identify and interpret the clinical significance of the cues before
deciding on the next steps.
3. A nurse is using the nursing process to care for a patient recovering from total knee
arthroplasty. Place the following steps in the correct order (1 = first, 5 = last). [Ordered
Response]
1. Evaluate the patient's pain level and ability to participate in physical therapy
2. Develop a nursing care plan with measurable goals for mobility and pain management
3. Analyze the patient's assessment data to identify nursing diagnoses
4. Implement interventions including pain medication administration and assisted ambulation
5. Assess the patient's surgical site, pain level, vital signs, and range of motion
Correct Answer: 5 → 3 → 2 → 4 → 1
1
, ATI CMS Fundamentals 1 — Practice Test 2026/2027
Rationale: The nursing process follows five sequential steps: Assessment (5) is first—the nurse gathers
data about the surgical site, pain, vital signs, and mobility. Diagnosis (3) follows—the nurse analyzes
assessment data to identify nursing diagnoses such as 'Acute Pain' and 'Impaired Physical Mobility.'
Planning (2) involves developing measurable goals and selecting appropriate interventions.
Implementation (4) is the execution of the planned interventions. Evaluation (1) is the final step, where the
nurse measures the patient's response to interventions and compares outcomes to the established goals,
revising the plan as needed. The nursing process is continuous and cyclical.
4. A nurse on a medical-surgical unit receives report on four patients. Which patient should
the nurse assess FIRST based on priority-setting principles?
A. A patient with type 2 diabetes who has a blood glucose of 210 mg/dL and is awaiting breakfast
B. A patient 2 days post-cholecystectomy who reports incisional pain of 4/10 and has not yet ambulated
C. A patient with heart failure who reports increasing dyspnea over the past 2 hours and has new
bilateral ankle edema
D. A patient with a urinary tract infection who has a temperature of 100.4°F (38°C) and complains of
burning with urination
Correct Answer: C. A patient with heart failure who reports increasing dyspnea over the past
2 hours and has new bilateral ankle edema
Rationale: The nurse should use the ABC (Airway, Breathing, Circulation) framework and Maslow's
hierarchy of needs to prioritize. The patient with heart failure (C) is showing signs of fluid volume excess—
increasing dyspnea and new bilateral edema—which indicates potential respiratory compromise and
requires immediate assessment and intervention. This is a potentially life-threatening change in status. The
patient with elevated blood glucose (A) is stable but needs medication; the post-cholecystectomy patient (B)
has expected postoperative pain; and the UTI patient (D) has low-grade fever. While all require nursing
care, the patient with worsening heart failure takes priority because respiratory status supersedes other
needs.
5. A nurse is generating solutions for a patient with a nursing diagnosis of Risk for Impaired
Skin Integrity related to immobility. Which intervention is most appropriate to include in the
plan of care?
A. Apply a heating pad to bony prominences every 4 hours
B. Reposition the patient every 2 hours and use a pressure redistribution mattress
C. Massage reddened bony areas to improve circulation
D. Keep the head of the bed at 45 degrees continuously
Correct Answer: B. Reposition the patient every 2 hours and use a pressure redistribution
mattress
Rationale: Generating solutions involves selecting evidence-based interventions to address the identified
problem. Repositioning the patient at least every 2 hours relieves pressure on bony prominences, and a
pressure redistribution mattress reduces interface pressure—both are standard pressure injury prevention
measures per NPUAP/EPUAP guidelines. Applying heating pads (A) to bony prominences increases
metabolic demand and risk of burns. Massaging reddened areas (C) is contraindicated because it can
damage fragile capillaries and deepen tissue injury. Keeping the head of the bed at 45 degrees (D)
continuously increases shearing forces on the sacrum; the HOB should be at the lowest degree of elevation
consistent with the patient's medical condition, ideally ≤30 degrees for pressure injury prevention.
Section II: Safety & Infection Control (Q6–11)
6. A nurse is preparing to enter the room of a patient on contact precautions for
Clostridioides difficile infection. Which sequence for donning personal protective equipment
(PPE) is correct?
A. Gown first, then gloves, then mask, then eye protection
B. Hand hygiene, then gown, then mask, then gloves
C. Hand hygiene, then gloves, then gown, then mask
2
