ATI RN Concept Based Assessment Level 3 Online Practice
Form B Questions and Answers with Rationales
Question 1: Current findings are as follows: an adult presents after sexual assault, is anxious, avoids eye contact,
and asks to stop several times during the initial examination. Which nursing action should occur first?
A. Validate the disclosure, assess immediate safety and lethality risk, offer resources, and support the client's choices without
coercion
B. Explain each step, obtain consent before every part of care, allow the client to pause or decline procedures, and offer forensic
and advocacy options
C. Ensure the child's immediate safety, document objective findings, and follow mandatory reporting requirements without
independently investigating the alleged perpetrator
D. Help create a detailed individualized safety plan that includes emergency contacts, secure documents and medications, safe
communication, and a destination unknown to the partner
Answer: B. Explain each step, obtain consent before every part of care, allow the client to pause or decline procedures,
and offer forensic and advocacy options
Rationale: Explain each step, obtain consent before every part of care, allow the client to pause or decline procedures, and offer
forensic and advocacy options is the priority because forensic evidence collection should never override the competent client's right
to accept or refuse components of care. This step addresses the most immediate threat associated with Sexual assault
trauma-informed care. The other actions may be appropriate for different presentations or after stabilization, but they do not
address the highest-priority need here. After intervening, the nurse should reassess the client maintains control over consent,
receives desired medical and forensic care, and reports feeling informed and respected.
Question 2: The client record shows the following presentation: six weeks after delivery a parent reports persistent
sadness, guilt, loss of interest, poor bonding, insomnia even when the infant sleeps, and thoughts that the family
would be better without them. Which clinical problem best explains this pattern?
A. Antidepressant activation early in treatment
B. Postpartum depression
C. Persistent depressive disorder
D. Electroconvulsive therapy care
Answer: B. Postpartum depression
Rationale: This pattern is most consistent with Postpartum depression. Postpartum depression causes sustained depressive symptoms
that impair function and bonding and can include suicidal thoughts. The alternative choices usually produce a different cluster of
findings, time course, or risk factors. Early recognition allows the nurse to assess suicide and infant-safety risk immediately and
arrange prompt perinatal mental-health treatment and practical support. ATI RN Concept-Based Assessment Level 3 - Original
Online Practice Form B Page 1
,Question 3: The nurse is caring for a client with the following presentation: a competent client states a clear
treatment preference that differs from what several family members want and an advance directive supports the
client's choice. Which action is most appropriate to take next?
A. Reposition the client, reduce unnecessary fluids when consistent with goals, and give prescribed anticholinergic medication if
secretions are distressing to the family or client
B. Provide privacy and respectful time for culturally appropriate practices when they do not conflict with legal or safety
requirements
C. Start or intensify the prescribed stimulant-based bowel regimen and assess hydration, mobility, and other contributing factors
D. Advocate for the competent client's informed preference and notify the provider or ethics resource if conflict continues
Answer: D. Advocate for the competent client's informed preference and notify the provider or ethics resource if
conflict continues
Rationale: Advocate for the competent client's informed preference and notify the provider or ethics resource if conflict continues is
the priority because the nurse's role includes protecting autonomy and helping resolve conflict without substituting family wishes
for the client's decision. This step addresses the most immediate threat associated with Advance directive conflict. The other
actions may be appropriate for different presentations or after stabilization, but they do not address the highest-priority need here.
After intervening, the nurse should reassess the treatment plan reflects the client's stated goals and family questions are addressed
without overriding the client's autonomy.
Question 4: A nurse reassesses a client being treated for Postpartum hemorrhage from uterine atony. Which
finding is the best indicator of improvement?
A. glucose values remain within individualized pregnancy targets with appropriate fetal growth and no maternal metabolic
decompensation
B. a firm contracted uterus with reduced bleeding, improving blood pressure, and adequate urine output
C. controlled blood pressure with no seizure, stable neurologic findings, and reassuring maternal-fetal status while delivery
planning proceeds
D. improved fetal heart rate while pressure is relieved and rapid completion of definitive delivery
Answer: B. a firm contracted uterus with reduced bleeding, improving blood pressure, and adequate urine output
Rationale: The most useful evaluation finding is a firm contracted uterus with reduced bleeding, improving blood pressure, and
adequate urine output. This outcome directly reflects the physiologic or psychosocial problem being treated in Postpartum
hemorrhage from uterine atony. The other findings can be clinically important, but they are less specific for judging the response to
this plan. The nurse should trend this outcome together with the client's symptoms and overall condition. ATI RN Concept-Based
Assessment Level 3 - Original Online Practice Form B Page 2
Question 5: Which client statement reflects appropriate understanding of home care for Vascular dementia?
A. I will change the daily routine frequently so the person does not become dependent on structure.
B. I will follow the plan for blood pressure, diabetes, smoking cessation, and other vascular risks to reduce further brain injury.
C. I will argue with the person until they admit that a false memory is incorrect.
D. I will give over-the-counter sedating medicines for confusion without checking with the prescriber.
Answer: B. I will follow the plan for blood pressure, diabetes, smoking cessation, and other vascular risks to reduce
further brain injury.
Rationale: The statement "I will follow the plan for blood pressure, diabetes, smoking cessation, and other vascular risks to reduce
further brain injury." reflects correct understanding of Vascular dementia. This instruction matters: risk-factor control and rapid
response to new neurologic symptoms help reduce recurrent brain injury. The incorrect statements could delay needed care, create
avoidable risk, or conflict with the treatment plan. The nurse should use teach-back and confirm when the client should contact the
health care team or seek urgent evaluation.
,Question 6: Current findings are as follows: an older adult has left lower-quadrant abdominal pain, fever, nausea,
and localized tenderness without generalized peritoneal rigidity. Which nursing action should occur first?
A. Administer prescribed anti-inflammatory therapy and monitor closely for evidence of pericardial effusion or tamponade
B. Provide bowel rest or diet modification as ordered, administer prescribed therapy, and monitor for perforation, abscess, or
sepsis
C. Keep the client NPO as ordered, provide analgesia and fluids, and prepare for definitive evaluation and management of
gallbladder inflammation
D. Monitor blood pressure, fluid status, urine output, and renal function while limiting sodium and fluids as prescribed
Answer: B. Provide bowel rest or diet modification as ordered, administer prescribed therapy, and monitor for
perforation, abscess, or sepsis
Rationale: Provide bowel rest or diet modification as ordered, administer prescribed therapy, and monitor for perforation, abscess, or
sepsis is the priority because acute management limits bowel stress and treats complications while the abdomen is monitored for
worsening peritoneal findings. This step addresses the most immediate threat associated with Acute diverticulitis. The other actions
may be appropriate for different presentations or after stabilization, but they do not address the highest-priority need here. After
intervening, the nurse should reassess resolution of fever and focal tenderness with toleration of diet and no signs of perforation.
ATI RN Concept-Based Assessment Level 3 - Original Online Practice Form B Page 3
Question 7: A nurse reassesses a client being treated for Emergency contraception counseling. Which finding is the
best indicator of improvement?
A. more complete risk assessment and client-reported comfort discussing sexual health without unnecessary assumptions
B. less dryness, pain, and urinary discomfort with improved sexual comfort and no treatment complications
C. use of an effective contraceptive method without preventable thrombotic or cerebrovascular complications
D. timely use of an appropriate emergency-contraception method with a follow-up plan for ongoing contraception and
pregnancy testing if indicated
Answer: D. timely use of an appropriate emergency-contraception method with a follow-up plan for ongoing
contraception and pregnancy testing if indicated
Rationale: The most useful evaluation finding is timely use of an appropriate emergency-contraception method with a follow-up plan
for ongoing contraception and pregnancy testing if indicated. This outcome directly reflects the physiologic or psychosocial
problem being treated in Emergency contraception counseling. The other findings can be clinically important, but they are less
specific for judging the response to this plan. The nurse should trend this outcome together with the client's symptoms and overall
condition.
, Question 8: The nurse receives this report: a client has blood pressure of 228/132 mm Hg with acute confusion,
blurred vision, pulmonary crackles, and rising creatinine. Which intervention is the highest priority?
A. Assess hemodynamic stability and prepare for urgent rate control or synchronized cardioversion if instability progresses
B. Begin closely titrated intravenous blood-pressure reduction as prescribed with continuous assessment of neurologic, cardiac,
and renal perfusion
C. Treat the event as a vascular emergency, keep the limb protected, and notify the vascular team immediately for reperfusion
planning
D. Control the source of loss, establish large-bore vascular access, and begin prescribed isotonic fluid and blood-product
resuscitation
Answer: B. Begin closely titrated intravenous blood-pressure reduction as prescribed with continuous assessment of
neurologic, cardiac, and renal perfusion
Rationale: Begin closely titrated intravenous blood-pressure reduction as prescribed with continuous assessment of neurologic,
cardiac, and renal perfusion is the priority because blood pressure must be lowered in a controlled manner because overly rapid
reduction can compromise autoregulated organ perfusion. This step addresses the most immediate threat associated with
Hypertensive emergency. The other actions may be appropriate for different presentations or after stabilization, but they do not
address the highest-priority need here. After intervening, the nurse should reassess gradual blood pressure reduction with
improving organ dysfunction and no evidence of cerebral, coronary, or renal hypoperfusion. ATI RN Concept-Based Assessment
Level 3 - Original Online Practice Form B Page 4
Question 9: The nurse is caring for a client with the following presentation: a client reports drinking increasing
amounts every evening to 'turn off my brain' after work and now has morning tremor and missed responsibilities.
Which action is most appropriate to take next?
A. Focus first on safety and immediate concrete needs, provide simple information in small amounts, and identify available
support persons
B. Provide early trauma-informed assessment, practical support, and evidence-based psychotherapy while monitoring for
persistent or worsening symptoms
C. Assess functional impact and support cognitive-behavioral strategies, regular activity, sleep structure, and prescribed
medication when indicated
D. Assess quantity, withdrawal risk, safety, and readiness for treatment while offering evidence-based substance-use resources
and alternative coping strategies
Answer: D. Assess quantity, withdrawal risk, safety, and readiness for treatment while offering evidence-based
substance-use resources and alternative coping strategies
Rationale: Assess quantity, withdrawal risk, safety, and readiness for treatment while offering evidence-based substance-use
resources and alternative coping strategies is the priority because assessment must include withdrawal severity because abrupt
cessation after heavy sustained use can be medically dangerous. This step addresses the most immediate threat associated with
Alcohol used as a stress-coping strategy. The other actions may be appropriate for different presentations or after stabilization, but
they do not address the highest-priority need here. After intervening, the nurse should reassess safer alcohol use or abstinence
according to the treatment plan with no withdrawal complication and improved daily function.
Form B Questions and Answers with Rationales
Question 1: Current findings are as follows: an adult presents after sexual assault, is anxious, avoids eye contact,
and asks to stop several times during the initial examination. Which nursing action should occur first?
A. Validate the disclosure, assess immediate safety and lethality risk, offer resources, and support the client's choices without
coercion
B. Explain each step, obtain consent before every part of care, allow the client to pause or decline procedures, and offer forensic
and advocacy options
C. Ensure the child's immediate safety, document objective findings, and follow mandatory reporting requirements without
independently investigating the alleged perpetrator
D. Help create a detailed individualized safety plan that includes emergency contacts, secure documents and medications, safe
communication, and a destination unknown to the partner
Answer: B. Explain each step, obtain consent before every part of care, allow the client to pause or decline procedures,
and offer forensic and advocacy options
Rationale: Explain each step, obtain consent before every part of care, allow the client to pause or decline procedures, and offer
forensic and advocacy options is the priority because forensic evidence collection should never override the competent client's right
to accept or refuse components of care. This step addresses the most immediate threat associated with Sexual assault
trauma-informed care. The other actions may be appropriate for different presentations or after stabilization, but they do not
address the highest-priority need here. After intervening, the nurse should reassess the client maintains control over consent,
receives desired medical and forensic care, and reports feeling informed and respected.
Question 2: The client record shows the following presentation: six weeks after delivery a parent reports persistent
sadness, guilt, loss of interest, poor bonding, insomnia even when the infant sleeps, and thoughts that the family
would be better without them. Which clinical problem best explains this pattern?
A. Antidepressant activation early in treatment
B. Postpartum depression
C. Persistent depressive disorder
D. Electroconvulsive therapy care
Answer: B. Postpartum depression
Rationale: This pattern is most consistent with Postpartum depression. Postpartum depression causes sustained depressive symptoms
that impair function and bonding and can include suicidal thoughts. The alternative choices usually produce a different cluster of
findings, time course, or risk factors. Early recognition allows the nurse to assess suicide and infant-safety risk immediately and
arrange prompt perinatal mental-health treatment and practical support. ATI RN Concept-Based Assessment Level 3 - Original
Online Practice Form B Page 1
,Question 3: The nurse is caring for a client with the following presentation: a competent client states a clear
treatment preference that differs from what several family members want and an advance directive supports the
client's choice. Which action is most appropriate to take next?
A. Reposition the client, reduce unnecessary fluids when consistent with goals, and give prescribed anticholinergic medication if
secretions are distressing to the family or client
B. Provide privacy and respectful time for culturally appropriate practices when they do not conflict with legal or safety
requirements
C. Start or intensify the prescribed stimulant-based bowel regimen and assess hydration, mobility, and other contributing factors
D. Advocate for the competent client's informed preference and notify the provider or ethics resource if conflict continues
Answer: D. Advocate for the competent client's informed preference and notify the provider or ethics resource if
conflict continues
Rationale: Advocate for the competent client's informed preference and notify the provider or ethics resource if conflict continues is
the priority because the nurse's role includes protecting autonomy and helping resolve conflict without substituting family wishes
for the client's decision. This step addresses the most immediate threat associated with Advance directive conflict. The other
actions may be appropriate for different presentations or after stabilization, but they do not address the highest-priority need here.
After intervening, the nurse should reassess the treatment plan reflects the client's stated goals and family questions are addressed
without overriding the client's autonomy.
Question 4: A nurse reassesses a client being treated for Postpartum hemorrhage from uterine atony. Which
finding is the best indicator of improvement?
A. glucose values remain within individualized pregnancy targets with appropriate fetal growth and no maternal metabolic
decompensation
B. a firm contracted uterus with reduced bleeding, improving blood pressure, and adequate urine output
C. controlled blood pressure with no seizure, stable neurologic findings, and reassuring maternal-fetal status while delivery
planning proceeds
D. improved fetal heart rate while pressure is relieved and rapid completion of definitive delivery
Answer: B. a firm contracted uterus with reduced bleeding, improving blood pressure, and adequate urine output
Rationale: The most useful evaluation finding is a firm contracted uterus with reduced bleeding, improving blood pressure, and
adequate urine output. This outcome directly reflects the physiologic or psychosocial problem being treated in Postpartum
hemorrhage from uterine atony. The other findings can be clinically important, but they are less specific for judging the response to
this plan. The nurse should trend this outcome together with the client's symptoms and overall condition. ATI RN Concept-Based
Assessment Level 3 - Original Online Practice Form B Page 2
Question 5: Which client statement reflects appropriate understanding of home care for Vascular dementia?
A. I will change the daily routine frequently so the person does not become dependent on structure.
B. I will follow the plan for blood pressure, diabetes, smoking cessation, and other vascular risks to reduce further brain injury.
C. I will argue with the person until they admit that a false memory is incorrect.
D. I will give over-the-counter sedating medicines for confusion without checking with the prescriber.
Answer: B. I will follow the plan for blood pressure, diabetes, smoking cessation, and other vascular risks to reduce
further brain injury.
Rationale: The statement "I will follow the plan for blood pressure, diabetes, smoking cessation, and other vascular risks to reduce
further brain injury." reflects correct understanding of Vascular dementia. This instruction matters: risk-factor control and rapid
response to new neurologic symptoms help reduce recurrent brain injury. The incorrect statements could delay needed care, create
avoidable risk, or conflict with the treatment plan. The nurse should use teach-back and confirm when the client should contact the
health care team or seek urgent evaluation.
,Question 6: Current findings are as follows: an older adult has left lower-quadrant abdominal pain, fever, nausea,
and localized tenderness without generalized peritoneal rigidity. Which nursing action should occur first?
A. Administer prescribed anti-inflammatory therapy and monitor closely for evidence of pericardial effusion or tamponade
B. Provide bowel rest or diet modification as ordered, administer prescribed therapy, and monitor for perforation, abscess, or
sepsis
C. Keep the client NPO as ordered, provide analgesia and fluids, and prepare for definitive evaluation and management of
gallbladder inflammation
D. Monitor blood pressure, fluid status, urine output, and renal function while limiting sodium and fluids as prescribed
Answer: B. Provide bowel rest or diet modification as ordered, administer prescribed therapy, and monitor for
perforation, abscess, or sepsis
Rationale: Provide bowel rest or diet modification as ordered, administer prescribed therapy, and monitor for perforation, abscess, or
sepsis is the priority because acute management limits bowel stress and treats complications while the abdomen is monitored for
worsening peritoneal findings. This step addresses the most immediate threat associated with Acute diverticulitis. The other actions
may be appropriate for different presentations or after stabilization, but they do not address the highest-priority need here. After
intervening, the nurse should reassess resolution of fever and focal tenderness with toleration of diet and no signs of perforation.
ATI RN Concept-Based Assessment Level 3 - Original Online Practice Form B Page 3
Question 7: A nurse reassesses a client being treated for Emergency contraception counseling. Which finding is the
best indicator of improvement?
A. more complete risk assessment and client-reported comfort discussing sexual health without unnecessary assumptions
B. less dryness, pain, and urinary discomfort with improved sexual comfort and no treatment complications
C. use of an effective contraceptive method without preventable thrombotic or cerebrovascular complications
D. timely use of an appropriate emergency-contraception method with a follow-up plan for ongoing contraception and
pregnancy testing if indicated
Answer: D. timely use of an appropriate emergency-contraception method with a follow-up plan for ongoing
contraception and pregnancy testing if indicated
Rationale: The most useful evaluation finding is timely use of an appropriate emergency-contraception method with a follow-up plan
for ongoing contraception and pregnancy testing if indicated. This outcome directly reflects the physiologic or psychosocial
problem being treated in Emergency contraception counseling. The other findings can be clinically important, but they are less
specific for judging the response to this plan. The nurse should trend this outcome together with the client's symptoms and overall
condition.
, Question 8: The nurse receives this report: a client has blood pressure of 228/132 mm Hg with acute confusion,
blurred vision, pulmonary crackles, and rising creatinine. Which intervention is the highest priority?
A. Assess hemodynamic stability and prepare for urgent rate control or synchronized cardioversion if instability progresses
B. Begin closely titrated intravenous blood-pressure reduction as prescribed with continuous assessment of neurologic, cardiac,
and renal perfusion
C. Treat the event as a vascular emergency, keep the limb protected, and notify the vascular team immediately for reperfusion
planning
D. Control the source of loss, establish large-bore vascular access, and begin prescribed isotonic fluid and blood-product
resuscitation
Answer: B. Begin closely titrated intravenous blood-pressure reduction as prescribed with continuous assessment of
neurologic, cardiac, and renal perfusion
Rationale: Begin closely titrated intravenous blood-pressure reduction as prescribed with continuous assessment of neurologic,
cardiac, and renal perfusion is the priority because blood pressure must be lowered in a controlled manner because overly rapid
reduction can compromise autoregulated organ perfusion. This step addresses the most immediate threat associated with
Hypertensive emergency. The other actions may be appropriate for different presentations or after stabilization, but they do not
address the highest-priority need here. After intervening, the nurse should reassess gradual blood pressure reduction with
improving organ dysfunction and no evidence of cerebral, coronary, or renal hypoperfusion. ATI RN Concept-Based Assessment
Level 3 - Original Online Practice Form B Page 4
Question 9: The nurse is caring for a client with the following presentation: a client reports drinking increasing
amounts every evening to 'turn off my brain' after work and now has morning tremor and missed responsibilities.
Which action is most appropriate to take next?
A. Focus first on safety and immediate concrete needs, provide simple information in small amounts, and identify available
support persons
B. Provide early trauma-informed assessment, practical support, and evidence-based psychotherapy while monitoring for
persistent or worsening symptoms
C. Assess functional impact and support cognitive-behavioral strategies, regular activity, sleep structure, and prescribed
medication when indicated
D. Assess quantity, withdrawal risk, safety, and readiness for treatment while offering evidence-based substance-use resources
and alternative coping strategies
Answer: D. Assess quantity, withdrawal risk, safety, and readiness for treatment while offering evidence-based
substance-use resources and alternative coping strategies
Rationale: Assess quantity, withdrawal risk, safety, and readiness for treatment while offering evidence-based substance-use
resources and alternative coping strategies is the priority because assessment must include withdrawal severity because abrupt
cessation after heavy sustained use can be medically dangerous. This step addresses the most immediate threat associated with
Alcohol used as a stress-coping strategy. The other actions may be appropriate for different presentations or after stabilization, but
they do not address the highest-priority need here. After intervening, the nurse should reassess safer alcohol use or abstinence
according to the treatment plan with no withdrawal complication and improved daily function.
