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

The ATI Med-Surg 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 90 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 Med-Surg exam

ATI’s Adult Medical Surgical review module opens with the foundations of care, works through the body systems, and ends with perioperative care. ATI’s Targeted Medical Surgical practice tests break the subject into the same pieces: cardiovascular; fluid, electrolyte and acid-base; gastrointestinal; immune; endocrine; neurosensory and musculoskeletal; perioperative; renal and urinary; and respiratory. It is the biggest of the nine exams.

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

• The unstable patient. Most hard items ask who to see first or what to do first: the chest pain that is an MI, the confusion that is sepsis, the new weakness that is a stroke, the sudden shortness of breath after surgery that is a pulmonary embolism.
• Labs that change the plan. Hyperkalemia and its ECG changes, the glucose and potassium of DKA, and the creatinine and urine output of AKI.
• Post-op complications. Respiratory, vascular and wound problems, and what each looks like in the first hours and days.
• Fluids and electrolytes inside every system. Heart failure, kidney disease and GI losses all show up as fluid overload or deficit first.

A study plan for the ATI Med-Surg 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 med-surg. 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.