ATI RN Concept-Based Assessment Level 2 Proctored Exam 2026/2027
Actual Exam with Detailed Rationales | Complete Exam-Style Questions |
100% Verified Pass Guaranteed – A+ Graded
Total Questions: 50 | Time: 90 min | Pass: 80%
TABLE OF CONTENTS
Section 1 | Acid-Base Balance & Fluid/Electrolytes | Q1 – Q10
Section 2 | Immunity, Infection & Inflammation | Q11 – Q20
Section 3 | Perfusion, Gas Exchange & Clotting | Q21 – Q30
Section 4 | Cognition, Sensory Perception & Intracranial Regulation | Q31 – Q40
Section 5 | Thermoregulation, Metabolism & Cellular Regulation | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
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SECTION 1: ACID-BASE BALANCE & FLUID/ELECTROLYTES Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 68-year-old male is admitted to the emergency department with pneumonia. His
arterial blood gas results show pH 7.32, PaCO2 48 mmHg, and HCO3 26 mEq/L. The
nurse recognizes this acid-base imbalance as which of the following?
A. Metabolic acidosis with partial compensation
B. Metabolic alkalosis with full compensation
C. Respiratory acidosis without compensation
D. Respiratory acidosis with partial compensation ✓ CORRECT
Correct Answer: D
Rationale: The pH is low (acidosis) and the PaCO2 is elevated, indicating a respiratory
acidosis. The HCO3 is slightly elevated but not enough to bring the pH back to normal,
indicating only partial metabolic compensation. Option C is incorrect because the
elevated HCO3 shows the kidneys are attempting to compensate, so it is not "without
compensation."
,Question 2 of 50
A 52-year-old female with a history of heart failure is receiving IV furosemide 40 mg
twice daily. On the third day of therapy, she reports muscle weakness and palpitations.
Her laboratory results show potassium 2.8 mEq/L, sodium 138 mEq/L, and chloride 102
mEq/L. Which nursing intervention is the priority?
A. Administer a potassium-sparing diuretic
B. Obtain a 12-lead ECG immediately ✓ CORRECT
C. Increase oral fluid intake to 3 liters daily
D. Discontinue the furosemide and notify the provider
Correct Answer: B
Rationale: A potassium level of 2.8 mEq/L places the patient at high risk for
life-threatening cardiac dysrhythmias, so obtaining an ECG to assess for arrhythmias is
the priority. Option D is tempting because discontinuing the diuretic is important, but the
immediate threat is cardiac instability, which must be assessed first.
Question 3 of 50
A 34-year-old male with diabetic ketoacidosis has the following arterial blood gas: pH
7.25, PaCO2 22 mmHg, HCO3 12 mEq/L. The nurse is reviewing the expected
compensatory response and recognizes which finding as consistent with appropriate
compensation?
A. Expected PaCO2 of 28 mmHg based on Winter's formula
B. Expected PaCO2 of 18 mmHg based on Winter's formula ✓ CORRECT
C. Expected PaCO2 of 35 mmHg based on Winter's formula
D. Expected PaCO2 of 40 mmHg based on Winter's formula
Correct Answer: B
Rationale: Winter's formula for metabolic acidosis states that expected PaCO2 = 1.5 ×
HCO3 + 8 ± 2, so 1.5(12) + 8 = 26, with a range of 24–28 mmHg; however, the patient's
, PaCO2 of 22 mmHg indicates hyperventilation beyond expected compensation. Option
A represents the upper limit of expected compensation, but the actual value of 22
suggests the patient is overcompensating or has a concurrent respiratory alkalosis.
Question 4 of 50
A 45-year-old female post-op day 2 after gastric bypass surgery reports dizziness and
tingling in her fingers. Her vital signs are stable, and her arterial blood gas shows pH
7.48, PaCO2 38 mmHg, and HCO3 30 mEq/L. Which clinical finding would the nurse
expect to assess next?
A. Positive Chvostek sign ✓ CORRECT
B. Kussmaul respirations
C. Deep, rapid breathing pattern
D. Fruity odor on the breath
Correct Answer: A
Rationale: The ABG indicates metabolic alkalosis (elevated pH and HCO3 with normal
PaCO2), which is common after gastric surgery due to vomiting or nasogastric suction;
metabolic alkalosis causes hypocalcemia, leading to a positive Chvostek sign. Option B
is incorrect because Kussmaul respirations are a compensatory mechanism for
metabolic acidosis, not alkalosis.
Question 5 of 50
A 72-year-old male with end-stage renal disease missed two dialysis sessions due to
transportation issues. He presents with lethargy, nausea, and a potassium level of 6.8
mEq/L. The nurse prepares to administer calcium gluconate. The nurse understands
that the primary purpose of this medication in this situation is to:
A. Shift potassium back into the intracellular space
B. Promote potassium excretion through the kidneys
C. Stabilize the cardiac cell membrane ✓ CORRECT
Actual Exam with Detailed Rationales | Complete Exam-Style Questions |
100% Verified Pass Guaranteed – A+ Graded
Total Questions: 50 | Time: 90 min | Pass: 80%
TABLE OF CONTENTS
Section 1 | Acid-Base Balance & Fluid/Electrolytes | Q1 – Q10
Section 2 | Immunity, Infection & Inflammation | Q11 – Q20
Section 3 | Perfusion, Gas Exchange & Clotting | Q21 – Q30
Section 4 | Cognition, Sensory Perception & Intracranial Regulation | Q31 – Q40
Section 5 | Thermoregulation, Metabolism & Cellular Regulation | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: ACID-BASE BALANCE & FLUID/ELECTROLYTES Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 68-year-old male is admitted to the emergency department with pneumonia. His
arterial blood gas results show pH 7.32, PaCO2 48 mmHg, and HCO3 26 mEq/L. The
nurse recognizes this acid-base imbalance as which of the following?
A. Metabolic acidosis with partial compensation
B. Metabolic alkalosis with full compensation
C. Respiratory acidosis without compensation
D. Respiratory acidosis with partial compensation ✓ CORRECT
Correct Answer: D
Rationale: The pH is low (acidosis) and the PaCO2 is elevated, indicating a respiratory
acidosis. The HCO3 is slightly elevated but not enough to bring the pH back to normal,
indicating only partial metabolic compensation. Option C is incorrect because the
elevated HCO3 shows the kidneys are attempting to compensate, so it is not "without
compensation."
,Question 2 of 50
A 52-year-old female with a history of heart failure is receiving IV furosemide 40 mg
twice daily. On the third day of therapy, she reports muscle weakness and palpitations.
Her laboratory results show potassium 2.8 mEq/L, sodium 138 mEq/L, and chloride 102
mEq/L. Which nursing intervention is the priority?
A. Administer a potassium-sparing diuretic
B. Obtain a 12-lead ECG immediately ✓ CORRECT
C. Increase oral fluid intake to 3 liters daily
D. Discontinue the furosemide and notify the provider
Correct Answer: B
Rationale: A potassium level of 2.8 mEq/L places the patient at high risk for
life-threatening cardiac dysrhythmias, so obtaining an ECG to assess for arrhythmias is
the priority. Option D is tempting because discontinuing the diuretic is important, but the
immediate threat is cardiac instability, which must be assessed first.
Question 3 of 50
A 34-year-old male with diabetic ketoacidosis has the following arterial blood gas: pH
7.25, PaCO2 22 mmHg, HCO3 12 mEq/L. The nurse is reviewing the expected
compensatory response and recognizes which finding as consistent with appropriate
compensation?
A. Expected PaCO2 of 28 mmHg based on Winter's formula
B. Expected PaCO2 of 18 mmHg based on Winter's formula ✓ CORRECT
C. Expected PaCO2 of 35 mmHg based on Winter's formula
D. Expected PaCO2 of 40 mmHg based on Winter's formula
Correct Answer: B
Rationale: Winter's formula for metabolic acidosis states that expected PaCO2 = 1.5 ×
HCO3 + 8 ± 2, so 1.5(12) + 8 = 26, with a range of 24–28 mmHg; however, the patient's
, PaCO2 of 22 mmHg indicates hyperventilation beyond expected compensation. Option
A represents the upper limit of expected compensation, but the actual value of 22
suggests the patient is overcompensating or has a concurrent respiratory alkalosis.
Question 4 of 50
A 45-year-old female post-op day 2 after gastric bypass surgery reports dizziness and
tingling in her fingers. Her vital signs are stable, and her arterial blood gas shows pH
7.48, PaCO2 38 mmHg, and HCO3 30 mEq/L. Which clinical finding would the nurse
expect to assess next?
A. Positive Chvostek sign ✓ CORRECT
B. Kussmaul respirations
C. Deep, rapid breathing pattern
D. Fruity odor on the breath
Correct Answer: A
Rationale: The ABG indicates metabolic alkalosis (elevated pH and HCO3 with normal
PaCO2), which is common after gastric surgery due to vomiting or nasogastric suction;
metabolic alkalosis causes hypocalcemia, leading to a positive Chvostek sign. Option B
is incorrect because Kussmaul respirations are a compensatory mechanism for
metabolic acidosis, not alkalosis.
Question 5 of 50
A 72-year-old male with end-stage renal disease missed two dialysis sessions due to
transportation issues. He presents with lethargy, nausea, and a potassium level of 6.8
mEq/L. The nurse prepares to administer calcium gluconate. The nurse understands
that the primary purpose of this medication in this situation is to:
A. Shift potassium back into the intracellular space
B. Promote potassium excretion through the kidneys
C. Stabilize the cardiac cell membrane ✓ CORRECT
