ATI RN Concept Based Assessment Level 2 Online Practice
Form B Questions and Answers with Rationales
Question 1: During care for this situation - A neutropenic client develops a low-grade fever - a nurse proposes the
following intervention: Explain that chills occur when the hypothalamic set point rises above the current body
temperature. Which alternative is more appropriate?
A. Treat any fever as clinically important and report it promptly
B. Monitor environmental temperature and use external warming or cooling as needed
C. Assess environmental exposure and ability to maintain safe indoor warmth
D. Stop triggering agents and prepare to administer dantrolene
Answer: A. Treat any fever as clinically important and report it promptly
Rationale: Immunosuppressed clients may mount only a modest temperature rise despite serious infection. Thermoregulation care
distinguishes regulated fever from environmental heat or cold injury and treats dangerous temperature extremes promptly. The
distractors may fit other clinical situations, but they do not best address the cues and priority in this item. The nurse should reassess
the client after intervention and escalate care if the expected response does not occur.
Question 2: Which clinical principle best explains the appropriate response to this situation: A client becomes
angry at staff after learning of a life-limiting diagnosis?
A. Disenfranchised grief can occur when a loss is not fully recognized by others
B. Guilt and counterfactual thinking are common grief responses that benefit from nonjudgmental exploration
C. Anger can be part of grief and is best met with calm therapeutic communication
D. There is no universal schedule for grief tasks, and individual pacing should be respected
Answer: C. Anger can be part of grief and is best met with calm therapeutic communication
Rationale: Anger can be part of grief and is best met with calm therapeutic communication. Grief care is individualized, culturally
responsive, nonjudgmental, and focused on presence, meaning, function, and safety. The distractors may fit other clinical
situations, but they do not best address the cues and priority in this item. The nurse should reassess the client after intervention and
escalate care if the expected response does not occur.
Question 3: Which clinical principle best explains the appropriate response to this situation: A client with
hyperthyroidism reports heat intolerance, weight loss, and palpitations?
A. Excess cortisol promotes protein catabolism, hyperglycemia, and immune suppression
B. Illness increases counterregulatory hormones and can precipitate ketoacidosis even when food intake is reduced
C. Renal dysfunction around contrast exposure can increase the risk associated with metformin accumulation
D. Excess thyroid hormone increases metabolic rate and sympathetic activity
Answer: D. Excess thyroid hormone increases metabolic rate and sympathetic activity
Rationale: Excess thyroid hormone increases metabolic rate and sympathetic activity. Metabolic care focuses on hormone effects,
glucose regulation, energy balance, and recognition of acute endocrine instability. The distractors may fit other clinical situations,
but they do not best address the cues and priority in this item. The nurse should reassess the client after intervention and escalate
care if the expected response does not occur. ATI RN Concept-Based Level 2 Online Practice Form B - Original Practice Bank
Page 1
,Question 4: During care for this situation - A mechanically ventilated client has a pH of 7.52 and carbon dioxide of
27 after a rate increase - a nurse proposes the following intervention: Treat the pain and reassess respiratory rate
and acid-base status. Which alternative is more appropriate?
A. Report probable excessive minute ventilation and anticipate a ventilator adjustment
B. Interpret the near-normal pH as evidence of renal compensation for chronic respiratory acidosis
C. Assess for worsening ventilatory failure and notify the provider promptly
D. Recognize primary metabolic alkalosis and address gastric acid loss
Answer: A. Report probable excessive minute ventilation and anticipate a ventilator adjustment
Rationale: Excess ventilation removes too much carbon dioxide and can cause respiratory alkalosis. Acid-base interpretation begins
with pH, then identifies the primary carbon dioxide or bicarbonate disturbance and any compensation. The distractors may fit other
clinical situations, but they do not best address the cues and priority in this item. The nurse should reassess the client after
intervention and escalate care if the expected response does not occur.
Question 5: During care for this situation - A client taking long-term prednisone asks why the medication should
not be stopped abruptly - a nurse proposes the following intervention: Monitor hydration, nutrition, and signs of
systemic complications. Which alternative is more appropriate?
A. Stop the medication and treat the reaction as possible anaphylaxis
B. Explain that antihistamines block histamine effects such as itching and increased secretions
C. Explain that the dose usually must be tapered to prevent adrenal insufficiency
D. Assess for a disease flare and review triggers such as infection or sun exposure
Answer: C. Explain that the dose usually must be tapered to prevent adrenal insufficiency
Rationale: Chronic glucocorticoid therapy suppresses the hypothalamic-pituitary-adrenal axis. Inflammation is protective when
controlled but can cause tissue injury or systemic complications when excessive or persistent. The distractors may fit other clinical
situations, but they do not best address the cues and priority in this item. The nurse should reassess the client after intervention and
escalate care if the expected response does not occur.
Question 6: Which clinical principle best explains the appropriate response to this situation: A client receiving
large volumes of hypotonic fluid develops headache and confusion?
A. Severe hyponatremia can cause cerebral edema and neurologic deterioration
B. Significant hypokalemia can cause muscle weakness and dangerous cardiac dysrhythmias
C. Excess free water can dilute serum sodium and cause neurologic symptoms
D. Low magnesium increases neuromuscular irritability and dysrhythmia risk
Answer: C. Excess free water can dilute serum sodium and cause neurologic symptoms
Rationale: Excess free water can dilute serum sodium and cause neurologic symptoms. Fluid and electrolyte problems are prioritized
by neurologic, cardiac, respiratory, and perfusion consequences. The distractors may fit other clinical situations, but they do not
best address the cues and priority in this item. The nurse should reassess the client after intervention and escalate care if the
expected response does not occur. ATI RN Concept-Based Level 2 Online Practice Form B - Original Practice Bank Page 2
,Question 7: Which clinical principle best explains the appropriate response to this situation: A client with chronic
kidney disease has hyperkalemia?
A. Long-term weight management is safer and more effective when changes are sustainable and nutritionally adequate
B. Abrupt interruption of high-dextrose parenteral nutrition can cause hypoglycemia
C. Vitamin C improves absorption of non-heme iron
D. Dietary potassium restriction can help control hyperkalemia when kidney excretion is impaired
Answer: D. Dietary potassium restriction can help control hyperkalemia when kidney excretion is impaired
Rationale: Dietary potassium restriction can help control hyperkalemia when kidney excretion is impaired. Nutrition plans should
meet energy and nutrient needs while accounting for swallowing safety, disease restrictions, route of feeding, and client
preferences. The distractors may fit other clinical situations, but they do not best address the cues and priority in this item. The
nurse should reassess the client after intervention and escalate care if the expected response does not occur.
Question 8: During care for this situation - A client with hearing impairment relies on lip reading - a nurse
proposes the following intervention: Use plain language, short steps, and demonstration with teach-back. Which
alternative is more appropriate?
A. Face the client in good light and avoid covering the mouth while speaking
B. Prioritize information needed for immediate safety and self-care, then provide resources for reinforcement
C. Include the caregiver in hands-on teaching and verify return demonstration
D. Treat the pain and return to teaching when the client can focus
Answer: A. Face the client in good light and avoid covering the mouth while speaking
Rationale: Visual access to facial and lip cues improves communication for clients who use lip reading. Effective teaching matches
readiness, literacy, language, sensory needs, learning domain, and the client ability to demonstrate understanding. The distractors
may fit other clinical situations, but they do not best address the cues and priority in this item. The nurse should reassess the client
after intervention and escalate care if the expected response does not occur.
Question 9: A nurse is caring for a client in this situation: An older adult is deconditioned after prolonged bed rest.
Which action should the nurse take?
A. Increase activity gradually while monitoring orthostatic symptoms and tolerance
B. Maintain prescribed hip precautions and avoid positions that risk dislocation
C. Position the chair on the stronger side and use a gait belt when indicated
D. Perform prescribed range-of-motion exercises and maintain functional alignment
Answer: A. Increase activity gradually while monitoring orthostatic symptoms and tolerance
Rationale: Prolonged immobility reduces cardiovascular and muscle conditioning and increases fall risk during remobilization.
Mobility interventions preserve function while preventing falls, contractures, venous stasis, pressure injury, and neurovascular
compromise. The distractors may fit other clinical situations, but they do not best address the cues and priority in this item. The
nurse should reassess the client after intervention and escalate care if the expected response does not occur. ATI RN
Concept-Based Level 2 Online Practice Form B - Original Practice Bank Page 3
, Question 10: A nurse is caring for a client in this situation: A client with diarrhea is receiving broad-spectrum
antibiotics. Which action should the nurse take?
A. Initiate a bowel prevention plan with fluids, activity, and prescribed stool-softening measures
B. Keep the client nothing by mouth and prepare for gastric decompression as prescribed
C. Place emphasis on hydration and evaluate for possible Clostridioides difficile infection
D. Assess for fecal impaction with overflow leakage
Answer: C. Place emphasis on hydration and evaluate for possible Clostridioides difficile infection
Rationale: Antibiotic-associated diarrhea can reflect C difficile and requires prompt infection-focused assessment. Elimination care
balances assessment of urinary or bowel function with prevention of infection, obstruction, skin injury, and fluid loss. The
distractors may fit other clinical situations, but they do not best address the cues and priority in this item. The nurse should reassess
the client after intervention and escalate care if the expected response does not occur.
Question 11: A nurse is caring for a client in this situation: A client receiving oxygen by nasal cannula reports dry
nasal passages. Which action should the nurse take?
A. Anticipate positive-pressure ventilation strategies that recruit alveoli
B. Provide water-based humidification or lubricant according to policy
C. Position upright, support oxygenation, and administer prescribed diuretic therapy promptly
D. Apply oxygen and initiate urgent evaluation for pulmonary embolism
Answer: B. Provide water-based humidification or lubricant according to policy
Rationale: Low-flow oxygen can dry mucous membranes, and petroleum products should be avoided around oxygen. Airway and
breathing problems require rapid assessment of oxygenation, ventilation, work of breathing, and response to therapy. The
distractors may fit other clinical situations, but they do not best address the cues and priority in this item. The nurse should reassess
the client after intervention and escalate care if the expected response does not occur.
Question 12: Which clinical principle best explains the appropriate response to this situation: A client with
influenza is admitted during peak symptoms?
A. Reducing catheter days is one of the most effective measures to prevent catheter-associated infection
B. Gloves do not replace hand hygiene because contamination can occur during removal or through microscopic defects
C. Contact precautions reduce spread from contaminated drainage and surfaces
D. Influenza primarily spreads through respiratory droplets at close range
Answer: D. Influenza primarily spreads through respiratory droplets at close range
Rationale: Influenza primarily spreads through respiratory droplets at close range. Infection care combines early recognition, source
control, appropriate precautions, antimicrobial stewardship, and prevention of device-related infection. The distractors may fit
other clinical situations, but they do not best address the cues and priority in this item. The nurse should reassess the client after
intervention and escalate care if the expected response does not occur. ATI RN Concept-Based Level 2 Online Practice Form B -
Original Practice Bank Page 4
Form B Questions and Answers with Rationales
Question 1: During care for this situation - A neutropenic client develops a low-grade fever - a nurse proposes the
following intervention: Explain that chills occur when the hypothalamic set point rises above the current body
temperature. Which alternative is more appropriate?
A. Treat any fever as clinically important and report it promptly
B. Monitor environmental temperature and use external warming or cooling as needed
C. Assess environmental exposure and ability to maintain safe indoor warmth
D. Stop triggering agents and prepare to administer dantrolene
Answer: A. Treat any fever as clinically important and report it promptly
Rationale: Immunosuppressed clients may mount only a modest temperature rise despite serious infection. Thermoregulation care
distinguishes regulated fever from environmental heat or cold injury and treats dangerous temperature extremes promptly. The
distractors may fit other clinical situations, but they do not best address the cues and priority in this item. The nurse should reassess
the client after intervention and escalate care if the expected response does not occur.
Question 2: Which clinical principle best explains the appropriate response to this situation: A client becomes
angry at staff after learning of a life-limiting diagnosis?
A. Disenfranchised grief can occur when a loss is not fully recognized by others
B. Guilt and counterfactual thinking are common grief responses that benefit from nonjudgmental exploration
C. Anger can be part of grief and is best met with calm therapeutic communication
D. There is no universal schedule for grief tasks, and individual pacing should be respected
Answer: C. Anger can be part of grief and is best met with calm therapeutic communication
Rationale: Anger can be part of grief and is best met with calm therapeutic communication. Grief care is individualized, culturally
responsive, nonjudgmental, and focused on presence, meaning, function, and safety. The distractors may fit other clinical
situations, but they do not best address the cues and priority in this item. The nurse should reassess the client after intervention and
escalate care if the expected response does not occur.
Question 3: Which clinical principle best explains the appropriate response to this situation: A client with
hyperthyroidism reports heat intolerance, weight loss, and palpitations?
A. Excess cortisol promotes protein catabolism, hyperglycemia, and immune suppression
B. Illness increases counterregulatory hormones and can precipitate ketoacidosis even when food intake is reduced
C. Renal dysfunction around contrast exposure can increase the risk associated with metformin accumulation
D. Excess thyroid hormone increases metabolic rate and sympathetic activity
Answer: D. Excess thyroid hormone increases metabolic rate and sympathetic activity
Rationale: Excess thyroid hormone increases metabolic rate and sympathetic activity. Metabolic care focuses on hormone effects,
glucose regulation, energy balance, and recognition of acute endocrine instability. The distractors may fit other clinical situations,
but they do not best address the cues and priority in this item. The nurse should reassess the client after intervention and escalate
care if the expected response does not occur. ATI RN Concept-Based Level 2 Online Practice Form B - Original Practice Bank
Page 1
,Question 4: During care for this situation - A mechanically ventilated client has a pH of 7.52 and carbon dioxide of
27 after a rate increase - a nurse proposes the following intervention: Treat the pain and reassess respiratory rate
and acid-base status. Which alternative is more appropriate?
A. Report probable excessive minute ventilation and anticipate a ventilator adjustment
B. Interpret the near-normal pH as evidence of renal compensation for chronic respiratory acidosis
C. Assess for worsening ventilatory failure and notify the provider promptly
D. Recognize primary metabolic alkalosis and address gastric acid loss
Answer: A. Report probable excessive minute ventilation and anticipate a ventilator adjustment
Rationale: Excess ventilation removes too much carbon dioxide and can cause respiratory alkalosis. Acid-base interpretation begins
with pH, then identifies the primary carbon dioxide or bicarbonate disturbance and any compensation. The distractors may fit other
clinical situations, but they do not best address the cues and priority in this item. The nurse should reassess the client after
intervention and escalate care if the expected response does not occur.
Question 5: During care for this situation - A client taking long-term prednisone asks why the medication should
not be stopped abruptly - a nurse proposes the following intervention: Monitor hydration, nutrition, and signs of
systemic complications. Which alternative is more appropriate?
A. Stop the medication and treat the reaction as possible anaphylaxis
B. Explain that antihistamines block histamine effects such as itching and increased secretions
C. Explain that the dose usually must be tapered to prevent adrenal insufficiency
D. Assess for a disease flare and review triggers such as infection or sun exposure
Answer: C. Explain that the dose usually must be tapered to prevent adrenal insufficiency
Rationale: Chronic glucocorticoid therapy suppresses the hypothalamic-pituitary-adrenal axis. Inflammation is protective when
controlled but can cause tissue injury or systemic complications when excessive or persistent. The distractors may fit other clinical
situations, but they do not best address the cues and priority in this item. The nurse should reassess the client after intervention and
escalate care if the expected response does not occur.
Question 6: Which clinical principle best explains the appropriate response to this situation: A client receiving
large volumes of hypotonic fluid develops headache and confusion?
A. Severe hyponatremia can cause cerebral edema and neurologic deterioration
B. Significant hypokalemia can cause muscle weakness and dangerous cardiac dysrhythmias
C. Excess free water can dilute serum sodium and cause neurologic symptoms
D. Low magnesium increases neuromuscular irritability and dysrhythmia risk
Answer: C. Excess free water can dilute serum sodium and cause neurologic symptoms
Rationale: Excess free water can dilute serum sodium and cause neurologic symptoms. Fluid and electrolyte problems are prioritized
by neurologic, cardiac, respiratory, and perfusion consequences. The distractors may fit other clinical situations, but they do not
best address the cues and priority in this item. The nurse should reassess the client after intervention and escalate care if the
expected response does not occur. ATI RN Concept-Based Level 2 Online Practice Form B - Original Practice Bank Page 2
,Question 7: Which clinical principle best explains the appropriate response to this situation: A client with chronic
kidney disease has hyperkalemia?
A. Long-term weight management is safer and more effective when changes are sustainable and nutritionally adequate
B. Abrupt interruption of high-dextrose parenteral nutrition can cause hypoglycemia
C. Vitamin C improves absorption of non-heme iron
D. Dietary potassium restriction can help control hyperkalemia when kidney excretion is impaired
Answer: D. Dietary potassium restriction can help control hyperkalemia when kidney excretion is impaired
Rationale: Dietary potassium restriction can help control hyperkalemia when kidney excretion is impaired. Nutrition plans should
meet energy and nutrient needs while accounting for swallowing safety, disease restrictions, route of feeding, and client
preferences. The distractors may fit other clinical situations, but they do not best address the cues and priority in this item. The
nurse should reassess the client after intervention and escalate care if the expected response does not occur.
Question 8: During care for this situation - A client with hearing impairment relies on lip reading - a nurse
proposes the following intervention: Use plain language, short steps, and demonstration with teach-back. Which
alternative is more appropriate?
A. Face the client in good light and avoid covering the mouth while speaking
B. Prioritize information needed for immediate safety and self-care, then provide resources for reinforcement
C. Include the caregiver in hands-on teaching and verify return demonstration
D. Treat the pain and return to teaching when the client can focus
Answer: A. Face the client in good light and avoid covering the mouth while speaking
Rationale: Visual access to facial and lip cues improves communication for clients who use lip reading. Effective teaching matches
readiness, literacy, language, sensory needs, learning domain, and the client ability to demonstrate understanding. The distractors
may fit other clinical situations, but they do not best address the cues and priority in this item. The nurse should reassess the client
after intervention and escalate care if the expected response does not occur.
Question 9: A nurse is caring for a client in this situation: An older adult is deconditioned after prolonged bed rest.
Which action should the nurse take?
A. Increase activity gradually while monitoring orthostatic symptoms and tolerance
B. Maintain prescribed hip precautions and avoid positions that risk dislocation
C. Position the chair on the stronger side and use a gait belt when indicated
D. Perform prescribed range-of-motion exercises and maintain functional alignment
Answer: A. Increase activity gradually while monitoring orthostatic symptoms and tolerance
Rationale: Prolonged immobility reduces cardiovascular and muscle conditioning and increases fall risk during remobilization.
Mobility interventions preserve function while preventing falls, contractures, venous stasis, pressure injury, and neurovascular
compromise. The distractors may fit other clinical situations, but they do not best address the cues and priority in this item. The
nurse should reassess the client after intervention and escalate care if the expected response does not occur. ATI RN
Concept-Based Level 2 Online Practice Form B - Original Practice Bank Page 3
, Question 10: A nurse is caring for a client in this situation: A client with diarrhea is receiving broad-spectrum
antibiotics. Which action should the nurse take?
A. Initiate a bowel prevention plan with fluids, activity, and prescribed stool-softening measures
B. Keep the client nothing by mouth and prepare for gastric decompression as prescribed
C. Place emphasis on hydration and evaluate for possible Clostridioides difficile infection
D. Assess for fecal impaction with overflow leakage
Answer: C. Place emphasis on hydration and evaluate for possible Clostridioides difficile infection
Rationale: Antibiotic-associated diarrhea can reflect C difficile and requires prompt infection-focused assessment. Elimination care
balances assessment of urinary or bowel function with prevention of infection, obstruction, skin injury, and fluid loss. The
distractors may fit other clinical situations, but they do not best address the cues and priority in this item. The nurse should reassess
the client after intervention and escalate care if the expected response does not occur.
Question 11: A nurse is caring for a client in this situation: A client receiving oxygen by nasal cannula reports dry
nasal passages. Which action should the nurse take?
A. Anticipate positive-pressure ventilation strategies that recruit alveoli
B. Provide water-based humidification or lubricant according to policy
C. Position upright, support oxygenation, and administer prescribed diuretic therapy promptly
D. Apply oxygen and initiate urgent evaluation for pulmonary embolism
Answer: B. Provide water-based humidification or lubricant according to policy
Rationale: Low-flow oxygen can dry mucous membranes, and petroleum products should be avoided around oxygen. Airway and
breathing problems require rapid assessment of oxygenation, ventilation, work of breathing, and response to therapy. The
distractors may fit other clinical situations, but they do not best address the cues and priority in this item. The nurse should reassess
the client after intervention and escalate care if the expected response does not occur.
Question 12: Which clinical principle best explains the appropriate response to this situation: A client with
influenza is admitted during peak symptoms?
A. Reducing catheter days is one of the most effective measures to prevent catheter-associated infection
B. Gloves do not replace hand hygiene because contamination can occur during removal or through microscopic defects
C. Contact precautions reduce spread from contaminated drainage and surfaces
D. Influenza primarily spreads through respiratory droplets at close range
Answer: D. Influenza primarily spreads through respiratory droplets at close range
Rationale: Influenza primarily spreads through respiratory droplets at close range. Infection care combines early recognition, source
control, appropriate precautions, antimicrobial stewardship, and prevention of device-related infection. The distractors may fit
other clinical situations, but they do not best address the cues and priority in this item. The nurse should reassess the client after
intervention and escalate care if the expected response does not occur. ATI RN Concept-Based Level 2 Online Practice Form B -
Original Practice Bank Page 4
