1
ATI RN Concept-Based Assessment Level 2 Proctored
Exam Comprehensive Nursing Review Official
Practice Exam Actual Exam 2026/2027 with Detailed
Rationales | Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Advanced Clinical Judgment & Priority Setting | Q1 – Q10
Section 2 | Pharmacology & Medication Safety | Q11 – Q20
Section 3 | Physiological Adaptation | Q21 – Q30
Section 4 | Psychosocial Integrity | Q31 – Q40
Section 5 | Safety & Infection Control | Q41 – Q45
Section 6 | Health Promotion & Maintenance | Q46 – Q50
Instructions: Choose the single best answer. Pass: 40 in 90 minutes.
══════════════════════════════════════
SECTION 1: ADVANCED CLINICAL JUDGMENT & PRIORITY SETTING
Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A nurse is caring for four patients on a medical unit. The 68-year-old patient with
COPD has an SpO2 of 88% on 2 L/min oxygen, the 45-year-old patient with a
femur fracture reports severe pain, the 72-year-old patient with heart failure has 2+
pitting edema, and the 50-year-old patient with pneumonia is requesting to
ambulate. The nurse should assess the patient with COPD first because hypoxemia
,2
is life-threatening and takes priority in the ABC framework. The patient with
severe pain is the most tempting alternative, but airway and breathing always
outrank comfort according to Maslow's hierarchy of needs. On the ATI exam,
always identify the most unstable patient using ABC first.
A. Assess the patient with a femur fracture to determine the pain level
B. Ambulate the patient with pneumonia to improve lung expansion
C. Assess the patient with COPD to address the hypoxemia ✓ CORRECT
D. Evaluate the patient with heart failure for fluid overload
Correct Answer: C
Rationale: Hypoxemia is life-threatening and takes priority in the ABC framework,
requiring the nurse to assess the COPD patient with an SpO2 of 88% first.
Assessing the patient with severe pain is a tempting alternative because pain
demands attention, but airway and breathing always outrank comfort according to
Maslow's hierarchy of needs. On the ATI exam, always identify the most unstable
patient using ABC first.
Question 2 of 50
A 62-year-old patient receiving tPA for an ischemic stroke suddenly reports a
severe headache and begins vomiting. The nurse should prepare for which priority
intervention?
A. Administration of an antiemetic to relieve vomiting
B. Immediate provider notification and CT scan ✓ CORRECT
C. Insertion of an orogastric tube to prevent aspiration
D. Bilateral blood pressure measurement to check for orthostasis
,3
Correct Answer: B
Rationale: Severe headache and vomiting after tPA administration suggest
intracranial hemorrhage, requiring immediate provider notification and preparation
for a STAT CT scan. Administering an antiemetic is tempting to manage the
vomiting, but it delays life-saving diagnosis and treatment of a potential bleed.
Remember that tPA carries a high risk for hemorrhage, and sudden neurological
changes require immediate action.
Question 3 of 50
A 55-year-old patient in septic shock has a mean arterial pressure (MAP) of 52
mmHg after receiving a 30 mL/kg normal saline bolus. The nurse should anticipate
a prescription for which medication?
A. Dobutamine to increase cardiac output
B. Epinephrine to stimulate beta and alpha receptors
C. Norepinephrine to restore MAP through vasoconstriction ✓ CORRECT
D. Milrinone to improve myocardial contractility
Correct Answer: C
Rationale: In septic shock, norepinephrine is the first-line vasopressor to maintain
MAP ≥ 65 mmHg when fluid resuscitation fails. Dobutamine is a tempting choice
because it increases cardiac output, but it does not effectively restore MAP through
vasoconstriction in distributive shock. The Surviving Sepsis Campaign guidelines
specifically recommend norepinephrine as the initial vasopressor of choice.
Question 4 of 50
, 4
A charge nurse is assigning tasks to a licensed practical nurse (LPN) and an
unlicensed assistive personnel (UAP). The most appropriate task to assign to the
UAP is:
A. Measuring intake and output for a patient with acute kidney injury
B. Reinforcing discharge teaching for a patient with a new colostomy
C. Assessing a patient's surgical incision site for signs of infection
D. Ambulating a stable patient who is 24 hours post-appendectomy ✓ CORRECT
Correct Answer: D
Rationale: Ambulating a stable postoperative patient falls within the scope of
practice for UAP and is a safe delegation. Measuring intake and output for a
patient with acute kidney injury is tempting to assign to UAP, but the clinical
instability of the patient requires the assessment and judgment of a licensed nurse.
When delegating, match the complexity of the task to the skill level of the
personnel while ensuring the patient is stable.
Question 5 of 50
A 74-year-old patient with heart failure reports new-onset dyspnea and a
productive cough with pink, frothy sputum. The nurse should take which priority
action?
A. Place the patient in a high-Fowler's position ✓ CORRECT
B. Auscultate the patient's lung sounds
C. Notify the rapid response team
D. Check the patient's oxygen saturation
ATI RN Concept-Based Assessment Level 2 Proctored
Exam Comprehensive Nursing Review Official
Practice Exam Actual Exam 2026/2027 with Detailed
Rationales | Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Advanced Clinical Judgment & Priority Setting | Q1 – Q10
Section 2 | Pharmacology & Medication Safety | Q11 – Q20
Section 3 | Physiological Adaptation | Q21 – Q30
Section 4 | Psychosocial Integrity | Q31 – Q40
Section 5 | Safety & Infection Control | Q41 – Q45
Section 6 | Health Promotion & Maintenance | Q46 – Q50
Instructions: Choose the single best answer. Pass: 40 in 90 minutes.
══════════════════════════════════════
SECTION 1: ADVANCED CLINICAL JUDGMENT & PRIORITY SETTING
Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A nurse is caring for four patients on a medical unit. The 68-year-old patient with
COPD has an SpO2 of 88% on 2 L/min oxygen, the 45-year-old patient with a
femur fracture reports severe pain, the 72-year-old patient with heart failure has 2+
pitting edema, and the 50-year-old patient with pneumonia is requesting to
ambulate. The nurse should assess the patient with COPD first because hypoxemia
,2
is life-threatening and takes priority in the ABC framework. The patient with
severe pain is the most tempting alternative, but airway and breathing always
outrank comfort according to Maslow's hierarchy of needs. On the ATI exam,
always identify the most unstable patient using ABC first.
A. Assess the patient with a femur fracture to determine the pain level
B. Ambulate the patient with pneumonia to improve lung expansion
C. Assess the patient with COPD to address the hypoxemia ✓ CORRECT
D. Evaluate the patient with heart failure for fluid overload
Correct Answer: C
Rationale: Hypoxemia is life-threatening and takes priority in the ABC framework,
requiring the nurse to assess the COPD patient with an SpO2 of 88% first.
Assessing the patient with severe pain is a tempting alternative because pain
demands attention, but airway and breathing always outrank comfort according to
Maslow's hierarchy of needs. On the ATI exam, always identify the most unstable
patient using ABC first.
Question 2 of 50
A 62-year-old patient receiving tPA for an ischemic stroke suddenly reports a
severe headache and begins vomiting. The nurse should prepare for which priority
intervention?
A. Administration of an antiemetic to relieve vomiting
B. Immediate provider notification and CT scan ✓ CORRECT
C. Insertion of an orogastric tube to prevent aspiration
D. Bilateral blood pressure measurement to check for orthostasis
,3
Correct Answer: B
Rationale: Severe headache and vomiting after tPA administration suggest
intracranial hemorrhage, requiring immediate provider notification and preparation
for a STAT CT scan. Administering an antiemetic is tempting to manage the
vomiting, but it delays life-saving diagnosis and treatment of a potential bleed.
Remember that tPA carries a high risk for hemorrhage, and sudden neurological
changes require immediate action.
Question 3 of 50
A 55-year-old patient in septic shock has a mean arterial pressure (MAP) of 52
mmHg after receiving a 30 mL/kg normal saline bolus. The nurse should anticipate
a prescription for which medication?
A. Dobutamine to increase cardiac output
B. Epinephrine to stimulate beta and alpha receptors
C. Norepinephrine to restore MAP through vasoconstriction ✓ CORRECT
D. Milrinone to improve myocardial contractility
Correct Answer: C
Rationale: In septic shock, norepinephrine is the first-line vasopressor to maintain
MAP ≥ 65 mmHg when fluid resuscitation fails. Dobutamine is a tempting choice
because it increases cardiac output, but it does not effectively restore MAP through
vasoconstriction in distributive shock. The Surviving Sepsis Campaign guidelines
specifically recommend norepinephrine as the initial vasopressor of choice.
Question 4 of 50
, 4
A charge nurse is assigning tasks to a licensed practical nurse (LPN) and an
unlicensed assistive personnel (UAP). The most appropriate task to assign to the
UAP is:
A. Measuring intake and output for a patient with acute kidney injury
B. Reinforcing discharge teaching for a patient with a new colostomy
C. Assessing a patient's surgical incision site for signs of infection
D. Ambulating a stable patient who is 24 hours post-appendectomy ✓ CORRECT
Correct Answer: D
Rationale: Ambulating a stable postoperative patient falls within the scope of
practice for UAP and is a safe delegation. Measuring intake and output for a
patient with acute kidney injury is tempting to assign to UAP, but the clinical
instability of the patient requires the assessment and judgment of a licensed nurse.
When delegating, match the complexity of the task to the skill level of the
personnel while ensuring the patient is stable.
Question 5 of 50
A 74-year-old patient with heart failure reports new-onset dyspnea and a
productive cough with pink, frothy sputum. The nurse should take which priority
action?
A. Place the patient in a high-Fowler's position ✓ CORRECT
B. Auscultate the patient's lung sounds
C. Notify the rapid response team
D. Check the patient's oxygen saturation
