ATI CMS Fundamentals Exam Actual Exam 2026/2027:
Complete Exam-Style Questions with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
TABLE OF CONTENTS
Section 1 | Foundations of Nursing Practice | Q1 – Q45
Section 2 | Health Promotion & Maintenance | Q46 – Q90
Section 3 | Psychosocial Integrity | Q91 – Q135
Section 4 | Physiological Integrity | Q136 – Q180
Instructions: Choose the single best answer. Pass: Level 2 proficiency in 240 minutes.
══════════════════════════════════════
SECTION 1: FOUNDATIONS OF NURSING PRACTICE Q1 – Q45
══════════════════════════════════════
Question 1 of 180
A 78-year-old client is admitted to a medical-surgical unit after a fall at home. During the
initial head-to-toe assessment, the nurse notes that the client is alert but has difficulty
following multi-step instructions. The client's daughter states her father has been "a bit
confused" since the fall. Which action by the nurse best supports client safety during
the first 24 hours of admission?
A. Apply bilateral soft wrist restraints to prevent the client from pulling out the IV line
B. Place the bed in the lowest position and keep the call light within reach at all times
C. Ask the physician to order a sitter to remain in the room continuously until discharge
D. Move the client to a room near the nurses' station and dim the lights to promote sleep
Correct Answer: B
Rationale: Keeping the bed in the lowest position with the call light accessible is a
foundational safety intervention that preserves autonomy while reducing fall risk.
,Restraints are inappropriate as a first-line measure and require a physician's order with
documented alternatives attempted first. A sitter is resource-intensive and not indicated
for mild confusion, and dimming lights can actually worsen confusion in older adults.
Question 2 of 180
The nurse is caring for a client who received a new diagnosis of type 2 diabetes
mellitus. The client states, "I don't understand why I have to check my blood sugar. I feel
fine." Which response by the nurse demonstrates the best use of therapeutic
communication?
A. "You feel fine now, but uncontrolled blood sugar can damage your kidneys and eyes
over time."
B. "It must be frustrating to have a new routine when you don't feel sick. Can you tell me
more about that?"
C. "Most people with diabetes don't feel symptoms at first, which is why monitoring is
so important."
D. "Your doctor ordered the checks because they are the standard of care for all diabetic
patients."
Correct Answer: B
Rationale: This response validates the client's feelings and uses open-ended
exploration, which is the cornerstone of therapeutic communication. While answer A
provides factual information, it dismisses the client's emotional concern and may create
defensiveness. Answer C is educational but does not address the expressed feeling,
and answer D deflects responsibility to the physician rather than engaging the client.
Question 3 of 180
A nurse on a busy telemetry unit receives a telephone order from a physician for a new
antihypertensive medication. The physician speaks quickly and has a heavy accent.
Which action by the nurse best protects the client from a medication error?
,A. Repeat the order back to the physician using the full drug name, dose, route, and
frequency
B. Write down the order first, then read it back to the physician from the written notes
C. Ask another nurse to listen on the phone extension to confirm the order verbally
D. Request that the physician call back when the unit is less busy to clarify the order
Correct Answer: A
Rationale: Read-back verification using complete drug names and details is the Joint
Commission's recommended practice for telephone orders and directly reduces
transcription errors. Writing the order down before reading it back introduces a delay
where details can be misremembered. A second listener is helpful but not a substitute
for the receiving nurse's direct read-back, and delaying the order could harm the client if
the medication is time-sensitive.
Question 4 of 180
During morning rounds, the nurse finds a postoperative client lying supine with the head
of the bed flat. The client had a total abdominal hysterectomy 8 hours ago and has a
morphine patient-controlled analgesia pump. The nurse notes shallow respirations at 10
breaths per minute. Which intervention is the nurse's priority?
A. Administer the prescribed naloxone per standing protocol
B. Elevate the head of the bed to 45 degrees and encourage deep breathing
C. Stimulate the client verbally and apply a nasal cannula at 2 L/min
D. Document the findings and continue to monitor the respiratory rate every 15 minutes
Correct Answer: B
Rationale: Positioning the client upright is the least invasive, most immediate
intervention to improve respiratory excursion and lung expansion in a postoperative
patient with shallow breathing. Naloxone is reserved for significant respiratory
depression or decreased level of consciousness, which is not described here.
Stimulation and low-flow oxygen are supportive but do not address the mechanical
restriction caused by supine positioning.
, Question 5 of 180
A nursing student is preparing to administer a cleansing enema to an adult client who
has been constipated for 5 days. The client is lying in the left lateral position. Which
instruction by the nurse educator is most accurate regarding safe enema
administration?
A. "Insert the tubing 3 to 4 inches and allow the solution to flow in over 5 minutes."
B. "Insert the tubing 6 to 8 inches and instill the solution as quickly as the client can
tolerate."
C. "Insert the tubing 2 to 3 inches and raise the container no more than 18 inches above
the bed."
D. "Insert the tubing 4 to 6 inches and clamp the tubing if the client reports cramping."
Correct Answer: C
Rationale: For an adult, inserting the tube 2 to 3 inches with the container no higher than
18 inches prevents rectal trauma and excessive pressure on the colon wall. Inserting 6
to 8 inches risks perforation, and rapid instillation causes painful cramping and
premature expulsion. While clamping for cramping is reasonable, the insertion depth in
answer D is slightly deeper than the safest standard.
Question 6 of 180
The nurse is caring for a client who is a practicing Jehovah's Witness and is scheduled
for an elective total knee replacement. The client refuses to sign the consent form
because it includes a standard clause about possible blood transfusion. Which action
by the nurse is most appropriate?
A. Notify the surgeon immediately so the consent can be modified to reflect the client's
wishes
B. Explain that the hospital cannot perform surgery without the standard consent form
as written
C. Ask the client to sign the form but document the refusal of blood products in the
nursing notes
Complete Exam-Style Questions with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
TABLE OF CONTENTS
Section 1 | Foundations of Nursing Practice | Q1 – Q45
Section 2 | Health Promotion & Maintenance | Q46 – Q90
Section 3 | Psychosocial Integrity | Q91 – Q135
Section 4 | Physiological Integrity | Q136 – Q180
Instructions: Choose the single best answer. Pass: Level 2 proficiency in 240 minutes.
══════════════════════════════════════
SECTION 1: FOUNDATIONS OF NURSING PRACTICE Q1 – Q45
══════════════════════════════════════
Question 1 of 180
A 78-year-old client is admitted to a medical-surgical unit after a fall at home. During the
initial head-to-toe assessment, the nurse notes that the client is alert but has difficulty
following multi-step instructions. The client's daughter states her father has been "a bit
confused" since the fall. Which action by the nurse best supports client safety during
the first 24 hours of admission?
A. Apply bilateral soft wrist restraints to prevent the client from pulling out the IV line
B. Place the bed in the lowest position and keep the call light within reach at all times
C. Ask the physician to order a sitter to remain in the room continuously until discharge
D. Move the client to a room near the nurses' station and dim the lights to promote sleep
Correct Answer: B
Rationale: Keeping the bed in the lowest position with the call light accessible is a
foundational safety intervention that preserves autonomy while reducing fall risk.
,Restraints are inappropriate as a first-line measure and require a physician's order with
documented alternatives attempted first. A sitter is resource-intensive and not indicated
for mild confusion, and dimming lights can actually worsen confusion in older adults.
Question 2 of 180
The nurse is caring for a client who received a new diagnosis of type 2 diabetes
mellitus. The client states, "I don't understand why I have to check my blood sugar. I feel
fine." Which response by the nurse demonstrates the best use of therapeutic
communication?
A. "You feel fine now, but uncontrolled blood sugar can damage your kidneys and eyes
over time."
B. "It must be frustrating to have a new routine when you don't feel sick. Can you tell me
more about that?"
C. "Most people with diabetes don't feel symptoms at first, which is why monitoring is
so important."
D. "Your doctor ordered the checks because they are the standard of care for all diabetic
patients."
Correct Answer: B
Rationale: This response validates the client's feelings and uses open-ended
exploration, which is the cornerstone of therapeutic communication. While answer A
provides factual information, it dismisses the client's emotional concern and may create
defensiveness. Answer C is educational but does not address the expressed feeling,
and answer D deflects responsibility to the physician rather than engaging the client.
Question 3 of 180
A nurse on a busy telemetry unit receives a telephone order from a physician for a new
antihypertensive medication. The physician speaks quickly and has a heavy accent.
Which action by the nurse best protects the client from a medication error?
,A. Repeat the order back to the physician using the full drug name, dose, route, and
frequency
B. Write down the order first, then read it back to the physician from the written notes
C. Ask another nurse to listen on the phone extension to confirm the order verbally
D. Request that the physician call back when the unit is less busy to clarify the order
Correct Answer: A
Rationale: Read-back verification using complete drug names and details is the Joint
Commission's recommended practice for telephone orders and directly reduces
transcription errors. Writing the order down before reading it back introduces a delay
where details can be misremembered. A second listener is helpful but not a substitute
for the receiving nurse's direct read-back, and delaying the order could harm the client if
the medication is time-sensitive.
Question 4 of 180
During morning rounds, the nurse finds a postoperative client lying supine with the head
of the bed flat. The client had a total abdominal hysterectomy 8 hours ago and has a
morphine patient-controlled analgesia pump. The nurse notes shallow respirations at 10
breaths per minute. Which intervention is the nurse's priority?
A. Administer the prescribed naloxone per standing protocol
B. Elevate the head of the bed to 45 degrees and encourage deep breathing
C. Stimulate the client verbally and apply a nasal cannula at 2 L/min
D. Document the findings and continue to monitor the respiratory rate every 15 minutes
Correct Answer: B
Rationale: Positioning the client upright is the least invasive, most immediate
intervention to improve respiratory excursion and lung expansion in a postoperative
patient with shallow breathing. Naloxone is reserved for significant respiratory
depression or decreased level of consciousness, which is not described here.
Stimulation and low-flow oxygen are supportive but do not address the mechanical
restriction caused by supine positioning.
, Question 5 of 180
A nursing student is preparing to administer a cleansing enema to an adult client who
has been constipated for 5 days. The client is lying in the left lateral position. Which
instruction by the nurse educator is most accurate regarding safe enema
administration?
A. "Insert the tubing 3 to 4 inches and allow the solution to flow in over 5 minutes."
B. "Insert the tubing 6 to 8 inches and instill the solution as quickly as the client can
tolerate."
C. "Insert the tubing 2 to 3 inches and raise the container no more than 18 inches above
the bed."
D. "Insert the tubing 4 to 6 inches and clamp the tubing if the client reports cramping."
Correct Answer: C
Rationale: For an adult, inserting the tube 2 to 3 inches with the container no higher than
18 inches prevents rectal trauma and excessive pressure on the colon wall. Inserting 6
to 8 inches risks perforation, and rapid instillation causes painful cramping and
premature expulsion. While clamping for cramping is reasonable, the insertion depth in
answer D is slightly deeper than the safest standard.
Question 6 of 180
The nurse is caring for a client who is a practicing Jehovah's Witness and is scheduled
for an elective total knee replacement. The client refuses to sign the consent form
because it includes a standard clause about possible blood transfusion. Which action
by the nurse is most appropriate?
A. Notify the surgeon immediately so the consent can be modified to reflect the client's
wishes
B. Explain that the hospital cannot perform surgery without the standard consent form
as written
C. Ask the client to sign the form but document the refusal of blood products in the
nursing notes
