ATI RN
r
ATI RN CONCEPT BASED ASSESSMENT LEVEL 2 PROCTORED
r r r r r r r
r EXAM 2026 VERIFIED QUESTIONS AND ANSWERS WITH
r r r r r r
r EXPLANATIONS GRADED A+
r r
Studypark
, ATIRNConcept-BasedAssessmentLevel2 Proctored
r r r r r rr
Exam
r
Format: 150 Multiple-Choice Questions
r r r
Domains: Clinical Judgment & Priority Setting, Pharmacology, Physiological
r r r r r r r
r Adaptation, Psychosocial Integrity, Safety & Infection Control, Health Promotion &
r r r r r r r r r
r Maintenance
Domain1: Advanced Clinical Judgment& Priority Setting
r r r r r r r
(Questions 1-30)
r r
1. A patient with a STEMI receives tPA and suddenly develops a severe headache
r r r r r r r r r r r r r
r and vomiting. BP 200/110 mmHg. What is the nurse's immediate action?
r r r r r r r r r r
A. Administer antiemetic r
B. Notify provider and prepare for emergency CT scan
r r r r r r r
C. Lower head of bed r r r
D. Give acetaminophen
r
,Answer: B. These are classic signs of intracranial hemorrhage, a life-threatening
r r r r r r r r r r
r complication of tPA. Rapid imaging and neurosurgical consultation are critical
r r r r r r r r r 1
r .
2. A patient with sepsis has a lactate of 5.2 mmol/L and BP 82/48 mmHg after 30
r r r r r r r r r r r r r r r r
mL/kg crystalloid. What is the next priority?
r r r r r r r
A. Start dopamine r
B. Begin norepinephrine to maintain MAP ≥ 65 mmHg
r r r r r r r
C. Obtain CT scan r r
D. Administer antibiotics r
Answer: B. Fluid-refractory septic shock requires vasopressor
r r r r r r
r support. Norepinephrine is first-line per Surviving Sepsis Guidelines
r r r r r r r 1 r .
3. A patient post-craniotomy has a sudden decrease in LOC and blown pupil. What
r r r r r r r r r r r r r
r is the nurse's first action?
r r r r
A. Obtain CT order r r
B. Raise head of bed 30° and hyperventilate
r r r r r r
C. Give mannitol r
D. Call family r
Answer: B. This indicates increased ICP. The priority is to elevate HOB and
r r r r r r r r r r r r
r hyperventilate to reduce PaCO₂, which causes vasoconstriction and decreases r r r r r r r r
r ICP 1 r .
4. A patient with DKA has K⁺ 2.8 mEq/L after insulin infusion. What is the priority intervention?
r r r r r r r r r r r r r r r r
A. Continue insulin r
B. Give 40 mEq KCl IV per protocol
r r r r r r
C. Start phosphate r
D. Stop fluids r
Answer: B. Hypokalemia must be corrected before insulin administration to
r r r r r r r r r
r prevent fatal dysrhythmias, as insulin drives potassium into cells
r r r r r r r r 1 r .
5. A nurse is caring for a client who is receiving heparin therapy and has an aPTT of
r r r r r r r r r r r r r r r r r
92 seconds (control 30). Which medication should the nurse anticipate?
r r r r r r r r r r
A. Leucovorin
B. Vitamin K r
, C. Deferoxamine
D. Protamine
Answer: D. An aPTT > 3x control requires intervention. Protamine sulfate is the
r r r r r r r r r r r r
r specific antagonist for heparin
r r r 3 r .
6.A patient with a subdural hematoma has ICP 18 mmHg and BP 90/60 mmHg. What
r r r r r r r r r r r r r r r
r is the priority?
r r
A. Give mannitol r
B. Increase BP to maintain cerebral perfusion pressure (CPP ≥ 60 mmHg)
r r r r r r r r r r
C. Lower head of bed r r r
D. Hyperventilate rapidly r
Answer: B. CPP = MAP - ICP. A low MAP reduces CPP, potentially causing brain
r r r r r r r r r r r r r r
r ischemia. Fluids or vasopressors may be needed
r r r r r r 1 r .
7. A nurse is assessing a client who is 1 day postoperative following open ileostomy
r r r r r r r r r r r r r r
placement. Which finding is the priority to report?
r r r r r r r r
A. Liquid fecal drainage from stoma r r r r
B. Absence of bowel sounds r r r
C. Stoma is dark purple in color r r r r r
D. Client reports pain at the surgical site
r r r r r r
Answer: C. A dark purple or black stoma indicates ischemia or necrosis of
r r r r r r r r r r r r
r the bowel, requiring immediate surgical intervention
r r r r r 9 r .
8.A patient with a GI bleed has BP 78/40 mmHg and HR 130 bpm.What is the
r r r r r r r r r r r r r r r r r
priority?
r
A. Insert NG tube r r
B. Start 2 large-bore IVs and give rapid crystalloid
r r r r r r r
C. Obtain type and cross r r r
D. Give pantoprazole r
Answer: B. Hemodynamic instability from hemorrhagic shock requires
r r r r r r r
r immediate fluid resuscitation and blood preparation r r r r r 1 r .
9. A patient with a spinal cord injury at T4 has BP 80/50 mmHg and HR 48 bpm.
r r r r r r r r r r r r r r r r r
What is the likely cause?
r r r r r
r
ATI RN CONCEPT BASED ASSESSMENT LEVEL 2 PROCTORED
r r r r r r r
r EXAM 2026 VERIFIED QUESTIONS AND ANSWERS WITH
r r r r r r
r EXPLANATIONS GRADED A+
r r
Studypark
, ATIRNConcept-BasedAssessmentLevel2 Proctored
r r r r r rr
Exam
r
Format: 150 Multiple-Choice Questions
r r r
Domains: Clinical Judgment & Priority Setting, Pharmacology, Physiological
r r r r r r r
r Adaptation, Psychosocial Integrity, Safety & Infection Control, Health Promotion &
r r r r r r r r r
r Maintenance
Domain1: Advanced Clinical Judgment& Priority Setting
r r r r r r r
(Questions 1-30)
r r
1. A patient with a STEMI receives tPA and suddenly develops a severe headache
r r r r r r r r r r r r r
r and vomiting. BP 200/110 mmHg. What is the nurse's immediate action?
r r r r r r r r r r
A. Administer antiemetic r
B. Notify provider and prepare for emergency CT scan
r r r r r r r
C. Lower head of bed r r r
D. Give acetaminophen
r
,Answer: B. These are classic signs of intracranial hemorrhage, a life-threatening
r r r r r r r r r r
r complication of tPA. Rapid imaging and neurosurgical consultation are critical
r r r r r r r r r 1
r .
2. A patient with sepsis has a lactate of 5.2 mmol/L and BP 82/48 mmHg after 30
r r r r r r r r r r r r r r r r
mL/kg crystalloid. What is the next priority?
r r r r r r r
A. Start dopamine r
B. Begin norepinephrine to maintain MAP ≥ 65 mmHg
r r r r r r r
C. Obtain CT scan r r
D. Administer antibiotics r
Answer: B. Fluid-refractory septic shock requires vasopressor
r r r r r r
r support. Norepinephrine is first-line per Surviving Sepsis Guidelines
r r r r r r r 1 r .
3. A patient post-craniotomy has a sudden decrease in LOC and blown pupil. What
r r r r r r r r r r r r r
r is the nurse's first action?
r r r r
A. Obtain CT order r r
B. Raise head of bed 30° and hyperventilate
r r r r r r
C. Give mannitol r
D. Call family r
Answer: B. This indicates increased ICP. The priority is to elevate HOB and
r r r r r r r r r r r r
r hyperventilate to reduce PaCO₂, which causes vasoconstriction and decreases r r r r r r r r
r ICP 1 r .
4. A patient with DKA has K⁺ 2.8 mEq/L after insulin infusion. What is the priority intervention?
r r r r r r r r r r r r r r r r
A. Continue insulin r
B. Give 40 mEq KCl IV per protocol
r r r r r r
C. Start phosphate r
D. Stop fluids r
Answer: B. Hypokalemia must be corrected before insulin administration to
r r r r r r r r r
r prevent fatal dysrhythmias, as insulin drives potassium into cells
r r r r r r r r 1 r .
5. A nurse is caring for a client who is receiving heparin therapy and has an aPTT of
r r r r r r r r r r r r r r r r r
92 seconds (control 30). Which medication should the nurse anticipate?
r r r r r r r r r r
A. Leucovorin
B. Vitamin K r
, C. Deferoxamine
D. Protamine
Answer: D. An aPTT > 3x control requires intervention. Protamine sulfate is the
r r r r r r r r r r r r
r specific antagonist for heparin
r r r 3 r .
6.A patient with a subdural hematoma has ICP 18 mmHg and BP 90/60 mmHg. What
r r r r r r r r r r r r r r r
r is the priority?
r r
A. Give mannitol r
B. Increase BP to maintain cerebral perfusion pressure (CPP ≥ 60 mmHg)
r r r r r r r r r r
C. Lower head of bed r r r
D. Hyperventilate rapidly r
Answer: B. CPP = MAP - ICP. A low MAP reduces CPP, potentially causing brain
r r r r r r r r r r r r r r
r ischemia. Fluids or vasopressors may be needed
r r r r r r 1 r .
7. A nurse is assessing a client who is 1 day postoperative following open ileostomy
r r r r r r r r r r r r r r
placement. Which finding is the priority to report?
r r r r r r r r
A. Liquid fecal drainage from stoma r r r r
B. Absence of bowel sounds r r r
C. Stoma is dark purple in color r r r r r
D. Client reports pain at the surgical site
r r r r r r
Answer: C. A dark purple or black stoma indicates ischemia or necrosis of
r r r r r r r r r r r r
r the bowel, requiring immediate surgical intervention
r r r r r 9 r .
8.A patient with a GI bleed has BP 78/40 mmHg and HR 130 bpm.What is the
r r r r r r r r r r r r r r r r r
priority?
r
A. Insert NG tube r r
B. Start 2 large-bore IVs and give rapid crystalloid
r r r r r r r
C. Obtain type and cross r r r
D. Give pantoprazole r
Answer: B. Hemodynamic instability from hemorrhagic shock requires
r r r r r r r
r immediate fluid resuscitation and blood preparation r r r r r 1 r .
9. A patient with a spinal cord injury at T4 has BP 80/50 mmHg and HR 48 bpm.
r r r r r r r r r r r r r r r r r
What is the likely cause?
r r r r r
