ATI RN CONCEPT-BASED ASSESSMENT LEVEL 3
PROCTORED ACTUAL EXAM PREP 2026 ALL QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT FEEDBACK |NEW AND
REVISED |INSTANT DOWNLOAD!!
1. A client with heart failure has 2+ pitting edema in the lower extremities.
Which intervention should the nurse implement first?
A) Administer a diuretic as prescribed
B) Elevate the head of the bed
C) Encourage ambulation
D) Restrict fluid intake
Correct answer: A) Administer a diuretic as prescribed
Rationale: Administering a prescribed diuretic addresses fluid overload, which is the priority in
managing heart failure with edema. While elevating the head of the bed may help with breathing
and fluid restriction may be part of the plan, pharmacological intervention to remove excess fluid
is the most direct and immediate action to address the edema.
,2. Which lab value indicates effective anticoagulant therapy with warfarin?
A) INR 1.0
B) INR 2.5
C) PT 10 seconds
D) Platelets 250,000/mm³
Correct answer: B) INR 2.5
Rationale: The therapeutic INR range for most indications (atrial fibrillation, DVT, pulmonary
embolism) is 2–3. An INR of 2.5 falls within this therapeutic window, indicating effective
anticoagulation. INR 1.0 is subtherapeutic. PT without INR standardization is not reliable for
monitoring warfarin.
3. A client is prescribed furosemide. Which electrolyte imbalance is most
concerning for a patient on furosemide?
A) Hypernatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypophosphatemia
Correct answer: B) Hypokalemia
Rationale: Furosemide is a loop diuretic that inhibits the Na/K/2Cl cotransporter in the thick
ascending limb of Henle, leading to increased potassium excretion. Hypokalemia is the most
concerning electrolyte imbalance because it can predispose to cardiac arrhythmias.
,4. A nurse is assessing a client with peripheral arterial disease (PAD). Which
finding is most consistent with this diagnosis?
A) Diminished or absent pulses in the lower extremities
B) Bilateral pitting edema
C) Warm erythematous skin
D) Distended jugular veins
Correct Answer: A) Diminished or absent pulses in the lower extremities
Rationale: Peripheral arterial disease is characterized by diminished or absent pulses due to
atherosclerotic narrowing of the arteries. Edema, warmth, and erythema are more consistent with
venous insufficiency or inflammation. Jugular venous distention suggests right-sided heart
failure.
5. A client with chronic obstructive pulmonary disease (COPD) presents with
worsening dyspnea and a productive cough with thick, green sputum. Which
intervention should the nurse prioritize?
A) Administer prescribed bronchodilators
B) Encourage oral fluid intake
C) Position the client in high-Fowler’s position
D) Obtain a sputum culture
Correct Answer: A) Administer prescribed bronchodilators
Rationale: The priority intervention in a COPD exacerbation is to improve airway patency and
gas exchange. Administering prescribed bronchodilators (e.g., albuterol, ipratropium) helps
relieve bronchospasm and is the first-line treatment. While fluid intake, positioning, and sputum
culture are important, they are not the initial priority.
, 6. A client is admitted with acute respiratory distress syndrome (ARDS).
Which arterial blood gas (ABG) finding is most consistent with this diagnosis?
A) Hypoxemia refractory to oxygen therapy
B) Respiratory alkalosis
C) Hypercapnia with metabolic alkalosis
D) Normal PaO₂ with elevated PaCO₂
Correct Answer: A) Hypoxemia refractory to oxygen therapy
Rationale: ARDS is characterized by severe, refractory hypoxemia (PaO₂/FiO₂ ratio < 300) due
to alveolar-capillary membrane damage and pulmonary edema. The hypoxemia does not improve
significantly with oxygen administration alone.
7. A client with diabetic ketoacidosis (DKA) has a serum potassium of 5.8
mEq/L. Which intervention should the nurse anticipate?
A) Administer insulin as prescribed
B) Administer potassium supplements
C) Restrict all fluids
D) Administer sodium bicarbonate
Correct Answer: A) Administer insulin as prescribed
Rationale: In DKA, total body potassium is depleted despite an initially elevated serum
potassium due to acidosis shifting potassium out of cells. Insulin therapy will drive potassium
back into cells, lowering serum levels. Potassium supplements may be needed once levels drop.
Sodium bicarbonate is not routinely recommended.
PROCTORED ACTUAL EXAM PREP 2026 ALL QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT FEEDBACK |NEW AND
REVISED |INSTANT DOWNLOAD!!
1. A client with heart failure has 2+ pitting edema in the lower extremities.
Which intervention should the nurse implement first?
A) Administer a diuretic as prescribed
B) Elevate the head of the bed
C) Encourage ambulation
D) Restrict fluid intake
Correct answer: A) Administer a diuretic as prescribed
Rationale: Administering a prescribed diuretic addresses fluid overload, which is the priority in
managing heart failure with edema. While elevating the head of the bed may help with breathing
and fluid restriction may be part of the plan, pharmacological intervention to remove excess fluid
is the most direct and immediate action to address the edema.
,2. Which lab value indicates effective anticoagulant therapy with warfarin?
A) INR 1.0
B) INR 2.5
C) PT 10 seconds
D) Platelets 250,000/mm³
Correct answer: B) INR 2.5
Rationale: The therapeutic INR range for most indications (atrial fibrillation, DVT, pulmonary
embolism) is 2–3. An INR of 2.5 falls within this therapeutic window, indicating effective
anticoagulation. INR 1.0 is subtherapeutic. PT without INR standardization is not reliable for
monitoring warfarin.
3. A client is prescribed furosemide. Which electrolyte imbalance is most
concerning for a patient on furosemide?
A) Hypernatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypophosphatemia
Correct answer: B) Hypokalemia
Rationale: Furosemide is a loop diuretic that inhibits the Na/K/2Cl cotransporter in the thick
ascending limb of Henle, leading to increased potassium excretion. Hypokalemia is the most
concerning electrolyte imbalance because it can predispose to cardiac arrhythmias.
,4. A nurse is assessing a client with peripheral arterial disease (PAD). Which
finding is most consistent with this diagnosis?
A) Diminished or absent pulses in the lower extremities
B) Bilateral pitting edema
C) Warm erythematous skin
D) Distended jugular veins
Correct Answer: A) Diminished or absent pulses in the lower extremities
Rationale: Peripheral arterial disease is characterized by diminished or absent pulses due to
atherosclerotic narrowing of the arteries. Edema, warmth, and erythema are more consistent with
venous insufficiency or inflammation. Jugular venous distention suggests right-sided heart
failure.
5. A client with chronic obstructive pulmonary disease (COPD) presents with
worsening dyspnea and a productive cough with thick, green sputum. Which
intervention should the nurse prioritize?
A) Administer prescribed bronchodilators
B) Encourage oral fluid intake
C) Position the client in high-Fowler’s position
D) Obtain a sputum culture
Correct Answer: A) Administer prescribed bronchodilators
Rationale: The priority intervention in a COPD exacerbation is to improve airway patency and
gas exchange. Administering prescribed bronchodilators (e.g., albuterol, ipratropium) helps
relieve bronchospasm and is the first-line treatment. While fluid intake, positioning, and sputum
culture are important, they are not the initial priority.
, 6. A client is admitted with acute respiratory distress syndrome (ARDS).
Which arterial blood gas (ABG) finding is most consistent with this diagnosis?
A) Hypoxemia refractory to oxygen therapy
B) Respiratory alkalosis
C) Hypercapnia with metabolic alkalosis
D) Normal PaO₂ with elevated PaCO₂
Correct Answer: A) Hypoxemia refractory to oxygen therapy
Rationale: ARDS is characterized by severe, refractory hypoxemia (PaO₂/FiO₂ ratio < 300) due
to alveolar-capillary membrane damage and pulmonary edema. The hypoxemia does not improve
significantly with oxygen administration alone.
7. A client with diabetic ketoacidosis (DKA) has a serum potassium of 5.8
mEq/L. Which intervention should the nurse anticipate?
A) Administer insulin as prescribed
B) Administer potassium supplements
C) Restrict all fluids
D) Administer sodium bicarbonate
Correct Answer: A) Administer insulin as prescribed
Rationale: In DKA, total body potassium is depleted despite an initially elevated serum
potassium due to acidosis shifting potassium out of cells. Insulin therapy will drive potassium
back into cells, lowering serum levels. Potassium supplements may be needed once levels drop.
Sodium bicarbonate is not routinely recommended.
