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ATI CMS Fundamentals Proctored Exam
Actual Exam 2026/2027 – Complete
Exam-Style Questions with Detailed
Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
[SECTION 1: Nursing Process & Critical Thinking — Questions 1-10]
Q1. A nurse receives change-of-shift report for four assigned clients. Which client should the
nurse assess first?
A. A client who reports pain of 4/10 following a laparoscopic cholecystectomy.
B. A client 2 days post-op with a temp of 100.4°F (38°C) who has a red, warm incision.
C. A client with type 2 diabetes who has a blood glucose of 180 mg/dL before breakfast.
D. A client with hypertension requesting a sleeping pill.
Correct Answer: B
Rationale: The nurse should use the ABCs and the concept of stability vs. instability to prioritize
care. The client with an elevated temperature and a red, warm incision 2 days post-op is showing
signs of a potential surgical site infection, which is an acute, unstable condition requiring
immediate assessment to prevent sepsis. The client with pain (A) is stable but requires
intervention; the client with diabetes (C) has glucose that is slightly elevated but not critical; and
the client requesting a sleeping pill (D) has a non-urgent need.
Q2. The nurse is documenting the care provided to a client. Which statement reflects the correct
format for a narrative note?
A. "Client seems to be in a lot of pain, gave medication."
B. "Client verbalized pain level 8/10, administered hydrocodone 5 mg PO at 1400."
C. "Hydrocodone given for pain, client feeling better now."
D. "Pain medication administered as ordered; client sleeping."
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Correct Answer: B
Rationale: Documentation should be objective, specific, and timed to ensure continuity of care
and legal accuracy. Option B includes the client's subjective report (verbalized pain), the
objective intervention (specific drug and dose given), and the time, adhering to the principle of
"chart what you do and do what you chart." Options A, C, and D are vague, lack specific times or
doses, or use subjective terms like "seems."
Q3. A nurse is formulating a nursing diagnosis for a client who is postoperative and reluctant to
cough and deep breathe due to incisional pain. Which nursing diagnosis is the priority?
A. Acute Pain related to surgical incision.
B. Ineffective Airway Clearance related to pain and decreased cough effort.
C. Risk for Infection related to surgical procedure.
D. Impaired Physical Mobility related to surgery.
Correct Answer: A
Rationale: According to Maslow's hierarchy, physiologic needs are the highest priority. While
airway clearance is critical, the underlying cause of the ineffective cough (and potential airway
complication) is pain. Treating the "Acute Pain" (A) will enable the client to participate in
coughing and deep breathing, thereby resolving the "Ineffective Airway Clearance." Therefore,
treating the pain is the first step to preventing respiratory complications.
Q4. A nurse is preparing to insert an indwelling urinary catheter. Which action by the nurse
demonstrates the implementation phase of the nursing process?
A. Assessing the patient's urine output and bladder distention.
B. Determining that the patient requires catheterization due to urinary retention.
C. Gathering the catheterization kit and performing hand hygiene.
D. Evaluating the amount of urine drained 1 hour after insertion.
Correct Answer: C
,3
Rationale: The implementation phase involves carrying out the planned interventions. Gathering
supplies and performing the procedure (C) are active interventions. Assessment is the data
collection phase (A), determining the need is part of the diagnosis/planning phase (B), and
evaluation is the final phase (D).
Q5. A client is scheduled for surgery at 1300. The provider inserts a signed consent form into the
chart at 1245 without witnessing the client sign it. What is the nurse's priority action?
A. Proceed to the operating room as the provider has signed.
B. Have the client sign a new consent form immediately with the nurse as a witness.
C. Call the risk management department.
D. Document that the provider consented the client verbally.
Correct Answer: B
Rationale: Informed consent must be obtained by the provider, but the nurse's role is to witness
the client's signature and verify understanding. If the client's signature is not witnessed by the
nurse (or if the signature is missing), the consent is invalid for the nurse's records. Obtaining a
new signature ensures the client is actively agreeing and that legal documentation is complete.
The provider's signature alone does not confirm the client's immediate informed consent if not
properly witnessed.
Q6. A nurse is caring for a client with a diagnosis of "Imbalanced Nutrition: Less than Body
Requirements." Which evaluation outcome indicates the plan of care was effective?
A. The client eats 50% of each meal.
B. The client has gained 2 lbs since admission.
C. The client states they do not like the hospital food.
D. The client's albumin level remains low.
Correct Answer: B
Rationale: Evaluation involves judging the effectiveness of nursing interventions based on
established goals. Weight gain (B) is an objective, measurable indicator that nutrition is being
absorbed and retained, indicating improvement. Eating 50% (A) might be insufficient depending
, 4
on caloric needs. Distaste for food (C) is a subjective barrier, and a low albumin level (D)
indicates malnutrition is still present or takes time to correct, not necessarily the effectiveness of
recent care.
Q7. A nurse is delegating tasks to an assistive personnel (AP). Which task is most appropriate for
the nurse to delegate?
A. Administering a tap water enema to a client with constipation.
B. Performing the initial admission assessment on a new client.
C. Teaching a client how to use a walker.
D. Measuring vital signs on a stable postoperative client.
Correct Answer: D
Rationale: The "Five Rights of Delegation" include the right task. Measuring vital signs on a
stable client (D) is a standardized, repetitive task that falls within the scope of practice for AP.
Administering an enema (A) requires assessment and sterile technique often reserved for
nursing, admission assessment (B) requires critical thinking and nursing judgment, and teaching
(C) is a complex cognitive task that cannot be delegated.
Q8. A nurse is using critical thinking skills when caring for a client. Which action demonstrates
the "evaluation" component of the nursing process?
A. Reassessing the client's pain 30 minutes after administering analgesic.
B. Setting a goal that the client will report pain less than 3/10.
C. Identifying that the client is at risk for falls.
D. Raising the side rails to prevent falls.
Correct Answer: A
Rationale: Evaluation is the step where the nurse determines if the interventions achieved the
desired outcomes. Reassessing pain after medication (A) directly measures the effectiveness of
the intervention. Setting a goal (B) is part of planning, identifying risks (C) is diagnosis/nursing
judgment, and raising side rails (D) is implementation.
ATI CMS Fundamentals Proctored Exam
Actual Exam 2026/2027 – Complete
Exam-Style Questions with Detailed
Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
[SECTION 1: Nursing Process & Critical Thinking — Questions 1-10]
Q1. A nurse receives change-of-shift report for four assigned clients. Which client should the
nurse assess first?
A. A client who reports pain of 4/10 following a laparoscopic cholecystectomy.
B. A client 2 days post-op with a temp of 100.4°F (38°C) who has a red, warm incision.
C. A client with type 2 diabetes who has a blood glucose of 180 mg/dL before breakfast.
D. A client with hypertension requesting a sleeping pill.
Correct Answer: B
Rationale: The nurse should use the ABCs and the concept of stability vs. instability to prioritize
care. The client with an elevated temperature and a red, warm incision 2 days post-op is showing
signs of a potential surgical site infection, which is an acute, unstable condition requiring
immediate assessment to prevent sepsis. The client with pain (A) is stable but requires
intervention; the client with diabetes (C) has glucose that is slightly elevated but not critical; and
the client requesting a sleeping pill (D) has a non-urgent need.
Q2. The nurse is documenting the care provided to a client. Which statement reflects the correct
format for a narrative note?
A. "Client seems to be in a lot of pain, gave medication."
B. "Client verbalized pain level 8/10, administered hydrocodone 5 mg PO at 1400."
C. "Hydrocodone given for pain, client feeling better now."
D. "Pain medication administered as ordered; client sleeping."
,2
Correct Answer: B
Rationale: Documentation should be objective, specific, and timed to ensure continuity of care
and legal accuracy. Option B includes the client's subjective report (verbalized pain), the
objective intervention (specific drug and dose given), and the time, adhering to the principle of
"chart what you do and do what you chart." Options A, C, and D are vague, lack specific times or
doses, or use subjective terms like "seems."
Q3. A nurse is formulating a nursing diagnosis for a client who is postoperative and reluctant to
cough and deep breathe due to incisional pain. Which nursing diagnosis is the priority?
A. Acute Pain related to surgical incision.
B. Ineffective Airway Clearance related to pain and decreased cough effort.
C. Risk for Infection related to surgical procedure.
D. Impaired Physical Mobility related to surgery.
Correct Answer: A
Rationale: According to Maslow's hierarchy, physiologic needs are the highest priority. While
airway clearance is critical, the underlying cause of the ineffective cough (and potential airway
complication) is pain. Treating the "Acute Pain" (A) will enable the client to participate in
coughing and deep breathing, thereby resolving the "Ineffective Airway Clearance." Therefore,
treating the pain is the first step to preventing respiratory complications.
Q4. A nurse is preparing to insert an indwelling urinary catheter. Which action by the nurse
demonstrates the implementation phase of the nursing process?
A. Assessing the patient's urine output and bladder distention.
B. Determining that the patient requires catheterization due to urinary retention.
C. Gathering the catheterization kit and performing hand hygiene.
D. Evaluating the amount of urine drained 1 hour after insertion.
Correct Answer: C
,3
Rationale: The implementation phase involves carrying out the planned interventions. Gathering
supplies and performing the procedure (C) are active interventions. Assessment is the data
collection phase (A), determining the need is part of the diagnosis/planning phase (B), and
evaluation is the final phase (D).
Q5. A client is scheduled for surgery at 1300. The provider inserts a signed consent form into the
chart at 1245 without witnessing the client sign it. What is the nurse's priority action?
A. Proceed to the operating room as the provider has signed.
B. Have the client sign a new consent form immediately with the nurse as a witness.
C. Call the risk management department.
D. Document that the provider consented the client verbally.
Correct Answer: B
Rationale: Informed consent must be obtained by the provider, but the nurse's role is to witness
the client's signature and verify understanding. If the client's signature is not witnessed by the
nurse (or if the signature is missing), the consent is invalid for the nurse's records. Obtaining a
new signature ensures the client is actively agreeing and that legal documentation is complete.
The provider's signature alone does not confirm the client's immediate informed consent if not
properly witnessed.
Q6. A nurse is caring for a client with a diagnosis of "Imbalanced Nutrition: Less than Body
Requirements." Which evaluation outcome indicates the plan of care was effective?
A. The client eats 50% of each meal.
B. The client has gained 2 lbs since admission.
C. The client states they do not like the hospital food.
D. The client's albumin level remains low.
Correct Answer: B
Rationale: Evaluation involves judging the effectiveness of nursing interventions based on
established goals. Weight gain (B) is an objective, measurable indicator that nutrition is being
absorbed and retained, indicating improvement. Eating 50% (A) might be insufficient depending
, 4
on caloric needs. Distaste for food (C) is a subjective barrier, and a low albumin level (D)
indicates malnutrition is still present or takes time to correct, not necessarily the effectiveness of
recent care.
Q7. A nurse is delegating tasks to an assistive personnel (AP). Which task is most appropriate for
the nurse to delegate?
A. Administering a tap water enema to a client with constipation.
B. Performing the initial admission assessment on a new client.
C. Teaching a client how to use a walker.
D. Measuring vital signs on a stable postoperative client.
Correct Answer: D
Rationale: The "Five Rights of Delegation" include the right task. Measuring vital signs on a
stable client (D) is a standardized, repetitive task that falls within the scope of practice for AP.
Administering an enema (A) requires assessment and sterile technique often reserved for
nursing, admission assessment (B) requires critical thinking and nursing judgment, and teaching
(C) is a complex cognitive task that cannot be delegated.
Q8. A nurse is using critical thinking skills when caring for a client. Which action demonstrates
the "evaluation" component of the nursing process?
A. Reassessing the client's pain 30 minutes after administering analgesic.
B. Setting a goal that the client will report pain less than 3/10.
C. Identifying that the client is at risk for falls.
D. Raising the side rails to prevent falls.
Correct Answer: A
Rationale: Evaluation is the step where the nurse determines if the interventions achieved the
desired outcomes. Reassessing pain after medication (A) directly measures the effectiveness of
the intervention. Setting a goal (B) is part of planning, identifying risks (C) is diagnosis/nursing
judgment, and raising side rails (D) is implementation.
