ATI Fundamentals Proctored Exam (CMS): What’s on It and How to Study

The ATI Fundamentals proctored exam is one of ATI’s nine RN Content Mastery Series (CMS) exams, usually given near the end of the course. ATI’s 2019 guide lists 60 scored questions plus 10 unscored ones, at one minute each. You get a proficiency level, not a pass or fail, and Level 2 is a common target. Prepare by finding your gaps with a practice test, fixing those, then mixing.

What is on the ATI Fundamentals exam

ATI’s description of the Fundamentals practice test lists four groups: the foundations of practice (health care delivery, communication, professional standards, the lifespan, health assessment); basic nursing care (medication administration and error prevention, safety, infection control, wound care); psychosocial support (family, culture, spirituality, end of life); and physiologic support (oxygenation, circulation, fluids and electrolytes, nutrition, elimination, the senses).

Here is the same subject laid out as NurseSavvy topics. Every topic has a cheat sheet, learning cards and original practice questions:

Where students lose points

• Which precautions. Airborne, droplet and contact look alike on a question until you tie each to the organisms it covers.
• Safety first. Fall prevention, patient identification and medication error prevention are the answers to a large share of Fundamentals items.
• Assessment order and normal findings. Abdominal assessment changes the usual order; blood pressure technique errors are classic distractors.
• Skin and mobility. Pressure injuries and immobility complications.

A study plan for the ATI Fundamentals CMS

Pick the weeks you have left. The plan splits the subject into even weeks and keeps the last one for mixed practice.

How to study for it, in order

1. Measure first. Take Practice A with rationales off, the way the proctored exam feels. ATI itself says practice scores are not built to predict the proctored score, so treat it as a map of what you missed, not a forecast.
2. Fix the misses, not the whole book. Work the Focused Review it builds and write out the key points for each missed topic (many schools assign “three critical points” or ATI’s Active Learning Templates). Then take Practice B with rationales on.
3. Relearn by system, then mix. Learn each weak area with short recall sessions (on NurseSavvy, the topic’s cards and cheat sheet), then answer mixed questions so you practice choosing the area, not just answering inside it.
4. Spend the last days on priority and safety. These exams are written in the NCLEX style: what do you do first, which finding do you report, what does the teaching need to correct. Our priority-question guide covers the reasoning.
5. Stop the night before. Sleep is the last study session.

What score do you need?

ATI reports a proficiency level, not a pass or fail. Level 2 means ATI is fairly certain you meet the NCLEX-RN standard in fundamentals. It is the level ATI’s own research counts as proficient and a common school target, though some schools ask for Level 3. ATI does not publish the percent each level needs; it varies by exam and version, so ignore the numbers on forums. The full picture is in ATI proficiency levels explained.

How much it counts is your school’s call. At the schools whose policies we read, the ATI part of a course grade was 10% or less, often with points for the practice tests and Focused Review as well as the proctored level.

New to ATI’s exams? Start with what the Content Mastery Series is. Looking for free practice? Read what is actually free.

ATI, Content Mastery Series and Comprehensive Predictor are trademarks of Assessment Technologies Institute, LLC. HESI is a registered trademark of Elsevier. Kaplan is a trademark of Kaplan, Inc. NCLEX is a registered trademark of the National Council of State Boards of Nursing. NurseSavvy is not affiliated with or endorsed by these companies, and every NurseSavvy practice question is original.