2026/2027 ATI CRITICAL
CARE PROCTORED EXAM:
ULTIMATE MASTERY GUIDE
Comprehensive Preparation Guide, Expert
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Rationales & Visual Study Aids
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Edition Year: 2026
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THE CANDIDATE'S TOOLKIT
(FRONT MATTER)
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Topic Index & Strategic Module
BreakdownM
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Success on the ATI Critical Care Proctored Exam requires more than rote memorization; it
demands a nuanced understanding of physiological interdependence. The exam blueprint is not
merely a list of topics but a structural framework that assesses a candidate's ability to prioritize
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care in high-acuity environments. This guide organizes the vast curriculum into five strategic
modules, reflecting the weighted domains of the exam, including Management of Care (approx.
20%) and Pharmacological & Parenteral Therapies (approx. 15%).
The following module breakdown outlines the core competencies targeted in this guide:
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Module Core Competencies & Key Blueprint Weight
Themes
1. Cardiovascular Hemodynamic Monitoring: High Yield
Hemodynamics & Shock CVP, PAOP, SVR, MAP,
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Module Core Competencies & Key Blueprint Weight
Themes
Cardiac Index interpretation.
Shock States: Differentiating
Cardiogenic, Hypovolemic,
Septic, and Neurogenic
profiles. Dysrhythmias: Lethal
rhythms, AV blocks, and ACLS
protocols. ACS Management:
MI localization and
post-intervention care
(CABG/PCI).
2. Respiratory Critical Care Mechanical Ventilation: High Yield
Modes (AC, SIMV, PSV),
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Weaning, and Troubleshooting
Alarms. Gas Exchange:
Advanced ABG interpretation,
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ARDS pathology, and
Pulmonary Embolism
management. Airway
Management: Artificial
airways, suctioning protocols,
and chest tube management.
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3. Neurocritical Care ICP Dynamics: Monroe-Kellie Moderate Yield
hypothesis, CPP calculation,
and herniation syndromes.
Trauma & Stroke: TBI
management (GCS), Spinal
Cord Injury (Autonomic
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Dysreflexia), and Ischemic vs.
Hemorrhagic Stroke
interventions. Sensory: Brain
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death testing and sedation
assessment.
4. Renal, Endocrine & Renal Failure: AKI phases, Moderate Yield
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Metabolic RIFLE criteria, and CRRT vs.
Hemodialysis nuances.
Endocrine Crises: DKA vs.
HHS differentiation, Adrenal
Crisis, and Thyroid
Storm/Myxedema Coma.
Electrolytes: Life-threatening
imbalances (Hyperkalemia,
Hyponatremia).
5. Trauma, Burn & GI Trauma Resuscitation: Moderate Yield
Emergencies Primary/Secondary Survey
(ABCDE), Massive Transfusion.
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Module Core Competencies & Key Blueprint Weight
Themes
Burns: Fluid resuscitation
(Parkland), inhalation injury,
and wound care.
GI/Multi-System: GI Bleeding,
Pancreatitis, Organ Donation,
and Triage ethics.
High-Yield Formula Sheet: The "Math of Survival"
In the critical care environment, rapid calculation is often the difference between stability and
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decompensation. The following formulas are essential for the exam and clinical practice.
Candidates must not only memorize the equation but understand the physiological implications
of the variables.
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1. Mean Arterial Pressure (MAP)
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The MAP is the average pressure in a patient’s arteries during one cardiac cycle. It is
considered a better indicator of perfusion to vital organs than systolic blood pressure alone
because diastole lasts twice as long as systole.
● Formula:
● Clinical Significance: A MAP of at least 60-65 mm Hg is required to maintain adequate
tissue perfusion to the coronary arteries, kidneys, and brain. In sepsis, the Surviving
Sepsis Campaign targets a MAP \ge 65 mm Hg.
● Exam Application: You will likely be given a BP (e.g., 90/40) and asked if perfusion is
adequate.
○ Calculation: [(2 \times 40) + 90] / 3 = = 56.6 mm Hg.