ATI CMS Fundamentals Official Practice
Exam Actual Exam 2026/2027 with
Detailed Rationales | Complete
Exam-Style Questions | Pass Guaranteed
– A+ Graded
══════════════════════════════════════
SECTION 1: FOUNDATIONAL NURSING CONCEPTS Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 72-year-old client is admitted to the medical-surgical unit with dehydration. The nurse
reviews the provider's orders and notes an order for a 1,000 mL IV infusion of 0.9% sodium
chloride to run over 8 hours. The nurse selects a macrodrip tubing with a drop factor of 15
gtt/mL. What is the drip rate the nurse should set?
A. 21 gtt/min ✓ CORRECT
B. 31 gtt/min
C. 42 gtt/min
D. 15 gtt/min
Correct Answer: A
Rationale: The drip rate is calculated by dividing the total volume by the total minutes and
multiplying by the drop factor: (1,000 mL ÷ 480 min) × 15 gtt/mL = 31.25, which rounds to 31
gtt/min. Wait — let me recalculate: 1,000 mL over 8 hours (480 minutes) with 15 gtt/mL
tubing. (1,) × 15 = 20.83, which rounds to 21 gtt/min. Option B is incorrect because it
likely results from using a 20 gtt/mL drop factor or miscalculating the time conversion.
Accurate drip rate calculations prevent fluid overload or under-resuscitation in dehydrated
clients.
Question 2 of 50
The nurse is caring for a client with a history of heart failure who is receiving furosemide 40
mg IV daily. During morning assessment, the nurse auscultates crackles in the bilateral lung
,bases, notes a 2 kg weight gain since yesterday, and observes 2+ pitting edema in the lower
extremities. Which nursing action is the priority?
A. Encourage the client to perform deep breathing exercises
B. Notify the provider immediately ✓ CORRECT
C. Elevate the client's legs above heart level
D. Document the findings and recheck in 2 hours
Correct Answer: B
Rationale: The client is showing signs of acute fluid volume overload, including rapid weight
gain, crackles, and worsening edema, which indicates the current diuretic regimen is
inadequate and the client is at risk for pulmonary edema. Option A is incorrect because deep
breathing exercises do not address the underlying fluid overload and may delay necessary
medical intervention. Rapid weight gain in heart failure clients often signals decompensation
that requires prompt provider notification and possible medication adjustment.
Question 3 of 50
A postoperative client on the surgical unit has a temperature of 38.2°C (100.8°F), heart rate of
96 beats/min, and reports incisional pain rated 4/10. The nurse reviews the medication
administration record and notes the last dose of acetaminophen was given 6 hours ago.
Which action should the nurse take first?
A. Administer the next scheduled dose of acetaminophen
B. Apply a cooling blanket to lower the temperature
C. Assess the surgical incision for signs of infection ✓ CORRECT
D. Document the vital signs and continue monitoring
Correct Answer: C
Rationale: In a postoperative client, a low-grade fever with incisional pain requires the nurse
to first assess the surgical site for erythema, drainage, or dehiscence, as these may indicate
a developing surgical site infection. Option A is incorrect because administering antipyretics
before assessing the source of the fever could mask an important sign of infection and delay
appropriate treatment. Postoperative fevers within the first 48 hours are often benign, but
fever accompanied by localized pain warrants thorough wound assessment.
Question 4 of 50
The nurse is caring for a client with type 2 diabetes mellitus whose blood glucose level is 52
mg/dL before lunch. The client is alert and oriented, able to swallow, and denies symptoms
other than mild shakiness. Which intervention is most appropriate?
A. Administer 1 mg of glucagon subcutaneously
B. Give the client 4 oz of orange juice and a packet of crackers ✓ CORRECT
, C. Hold the client's scheduled insulin and recheck in 1 hour
D. Start an IV infusion of D5W at 125 mL/hr
Correct Answer: B
Rationale: For a conscious client with mild hypoglycemia who can swallow safely, the
standard treatment is the 15-15 rule: administer 15 grams of fast-acting carbohydrate such as
4 oz of fruit juice, then recheck in 15 minutes. Option A is incorrect because glucagon is
reserved for clients who are unconscious or unable to swallow, not for those who are alert
and can take oral carbohydrates. Teaching clients to carry fast-acting carbohydrates helps
them manage hypoglycemic episodes independently at home.
Question 5 of 50
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. The nurse enters the room and finds the client has removed the nasal
cannula, stating, "I feel fine, I don't need this." The client's SpO2 is 88% on room air. Which
response by the nurse is most appropriate?
A. Explain that COPD clients need low-flow oxygen to maintain a safe SpO2 without
suppressing the hypoxic drive ✓ CORRECT
B. Tell the client that oxygen is mandatory and replace the cannula immediately
C. Agree with the client and document the refusal in the chart
D. Increase the flow rate to 4 L/min to raise the SpO2 above 92%
Correct Answer: A
Rationale: Clients with COPD rely on a hypoxic drive to breathe, so the nurse should educate
the client about why low-flow oxygen is prescribed and why maintaining an SpO2 around
88-92% is safer than higher levels for this population. Option D is incorrect because
increasing the flow rate to 4 L/min could suppress the client's hypoxic drive and cause
respiratory depression or CO2 retention. Patient education about oxygen use improves
compliance and reduces anxiety about dependence on supplemental oxygen.
Question 6 of 50
The nurse is preparing to administer a scheduled dose of digoxin 0.125 mg PO to a client with
atrial fibrillation. Before giving the medication, the nurse checks the apical pulse and finds it
to be 58 beats/min and regular. Which action should the nurse take?
A. Administer the dose as scheduled because the rhythm is regular
B. Hold the dose and notify the provider ✓ CORRECT
C. Give half the dose and recheck the pulse in 30 minutes
D. Check the radial pulse to confirm the finding
Correct Answer: B
Exam Actual Exam 2026/2027 with
Detailed Rationales | Complete
Exam-Style Questions | Pass Guaranteed
– A+ Graded
══════════════════════════════════════
SECTION 1: FOUNDATIONAL NURSING CONCEPTS Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 72-year-old client is admitted to the medical-surgical unit with dehydration. The nurse
reviews the provider's orders and notes an order for a 1,000 mL IV infusion of 0.9% sodium
chloride to run over 8 hours. The nurse selects a macrodrip tubing with a drop factor of 15
gtt/mL. What is the drip rate the nurse should set?
A. 21 gtt/min ✓ CORRECT
B. 31 gtt/min
C. 42 gtt/min
D. 15 gtt/min
Correct Answer: A
Rationale: The drip rate is calculated by dividing the total volume by the total minutes and
multiplying by the drop factor: (1,000 mL ÷ 480 min) × 15 gtt/mL = 31.25, which rounds to 31
gtt/min. Wait — let me recalculate: 1,000 mL over 8 hours (480 minutes) with 15 gtt/mL
tubing. (1,) × 15 = 20.83, which rounds to 21 gtt/min. Option B is incorrect because it
likely results from using a 20 gtt/mL drop factor or miscalculating the time conversion.
Accurate drip rate calculations prevent fluid overload or under-resuscitation in dehydrated
clients.
Question 2 of 50
The nurse is caring for a client with a history of heart failure who is receiving furosemide 40
mg IV daily. During morning assessment, the nurse auscultates crackles in the bilateral lung
,bases, notes a 2 kg weight gain since yesterday, and observes 2+ pitting edema in the lower
extremities. Which nursing action is the priority?
A. Encourage the client to perform deep breathing exercises
B. Notify the provider immediately ✓ CORRECT
C. Elevate the client's legs above heart level
D. Document the findings and recheck in 2 hours
Correct Answer: B
Rationale: The client is showing signs of acute fluid volume overload, including rapid weight
gain, crackles, and worsening edema, which indicates the current diuretic regimen is
inadequate and the client is at risk for pulmonary edema. Option A is incorrect because deep
breathing exercises do not address the underlying fluid overload and may delay necessary
medical intervention. Rapid weight gain in heart failure clients often signals decompensation
that requires prompt provider notification and possible medication adjustment.
Question 3 of 50
A postoperative client on the surgical unit has a temperature of 38.2°C (100.8°F), heart rate of
96 beats/min, and reports incisional pain rated 4/10. The nurse reviews the medication
administration record and notes the last dose of acetaminophen was given 6 hours ago.
Which action should the nurse take first?
A. Administer the next scheduled dose of acetaminophen
B. Apply a cooling blanket to lower the temperature
C. Assess the surgical incision for signs of infection ✓ CORRECT
D. Document the vital signs and continue monitoring
Correct Answer: C
Rationale: In a postoperative client, a low-grade fever with incisional pain requires the nurse
to first assess the surgical site for erythema, drainage, or dehiscence, as these may indicate
a developing surgical site infection. Option A is incorrect because administering antipyretics
before assessing the source of the fever could mask an important sign of infection and delay
appropriate treatment. Postoperative fevers within the first 48 hours are often benign, but
fever accompanied by localized pain warrants thorough wound assessment.
Question 4 of 50
The nurse is caring for a client with type 2 diabetes mellitus whose blood glucose level is 52
mg/dL before lunch. The client is alert and oriented, able to swallow, and denies symptoms
other than mild shakiness. Which intervention is most appropriate?
A. Administer 1 mg of glucagon subcutaneously
B. Give the client 4 oz of orange juice and a packet of crackers ✓ CORRECT
, C. Hold the client's scheduled insulin and recheck in 1 hour
D. Start an IV infusion of D5W at 125 mL/hr
Correct Answer: B
Rationale: For a conscious client with mild hypoglycemia who can swallow safely, the
standard treatment is the 15-15 rule: administer 15 grams of fast-acting carbohydrate such as
4 oz of fruit juice, then recheck in 15 minutes. Option A is incorrect because glucagon is
reserved for clients who are unconscious or unable to swallow, not for those who are alert
and can take oral carbohydrates. Teaching clients to carry fast-acting carbohydrates helps
them manage hypoglycemic episodes independently at home.
Question 5 of 50
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. The nurse enters the room and finds the client has removed the nasal
cannula, stating, "I feel fine, I don't need this." The client's SpO2 is 88% on room air. Which
response by the nurse is most appropriate?
A. Explain that COPD clients need low-flow oxygen to maintain a safe SpO2 without
suppressing the hypoxic drive ✓ CORRECT
B. Tell the client that oxygen is mandatory and replace the cannula immediately
C. Agree with the client and document the refusal in the chart
D. Increase the flow rate to 4 L/min to raise the SpO2 above 92%
Correct Answer: A
Rationale: Clients with COPD rely on a hypoxic drive to breathe, so the nurse should educate
the client about why low-flow oxygen is prescribed and why maintaining an SpO2 around
88-92% is safer than higher levels for this population. Option D is incorrect because
increasing the flow rate to 4 L/min could suppress the client's hypoxic drive and cause
respiratory depression or CO2 retention. Patient education about oxygen use improves
compliance and reduces anxiety about dependence on supplemental oxygen.
Question 6 of 50
The nurse is preparing to administer a scheduled dose of digoxin 0.125 mg PO to a client with
atrial fibrillation. Before giving the medication, the nurse checks the apical pulse and finds it
to be 58 beats/min and regular. Which action should the nurse take?
A. Administer the dose as scheduled because the rhythm is regular
B. Hold the dose and notify the provider ✓ CORRECT
C. Give half the dose and recheck the pulse in 30 minutes
D. Check the radial pulse to confirm the finding
Correct Answer: B
