ATI RN Concept-Based Assessment Level 2 Proctored Examination Actual
Exam 2026/2027: Complete Exam-Style Questions with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+ Graded
Time Allotment: 3 hours, 30 minutes
Total Questions: 75
Question Formats: Multiple-Choice Questions (MCQ), Select-All-That-Apply (SATA), and
Case-Based Scenarios
Passing Standard: Application, Analysis, and Clinical Judgment Proficiency
SECTION I: CLINICAL JUDGMENT & PATIENT SAFETY
1. A nurse is caring for a client who sustained a full-thickness burn covering 35% of total
body surface area 18 hours ago. The client has a triple-lumen central venous catheter,
and the provider has ordered lactated Ringer's solution per the Parkland formula. The
client's urine output over the past hour was 18 mL. Which action should the nurse take
first?
A. Increase the infusion rate of the lactated Ringer's solution by 25%
B. Notify the provider and request an order for a diuretic
C. Assess the client's breath sounds and level of consciousness
,D. Evaluate the patency of the urinary catheter and confirm accurate measurement
Correct Answer: D
Rationale: During the emergent/resuscitative phase of burn injury (first 24 hours), urine
output is the primary indicator of adequate fluid resuscitation, with a target of 0.5–1
mL/kg/hr for adults. Before altering fluid rates or notifying the provider, the nurse must
first verify data accuracy by ensuring the catheter is patent and the measurement is
correct. This reflects the clinical judgment sequence of data verification before
intervention.
2. A nurse in the emergency department is triaging four clients. Which client should the
nurse assess first?
A. A 24-year-old with a sprained ankle and moderate swelling who reports pain as 6/10
B. A 56-year-old with chest discomfort rated 4/10, blood pressure 148/92 mm Hg, and
diaphoresis
C. A 38-year-old with a lacerated forearm requiring 12 sutures, bleeding controlled with
pressure
D. A 72-year-old with a suspected fractured hip, leg externally rotated, pain 8/10, vital
signs stable
Correct Answer: B
Rationale: Using the Emergency Severity Index (ESI) and ABC prioritization, the
56-year-old with chest discomfort, hypertension, and diaphoresis presents with
potential acute coronary syndrome. Diaphoresis and chest discomfort are high-risk
indicators requiring immediate ECG and cardiac workup. While the fractured hip and
,laceration require intervention, they are not immediately life-threatening. The sprained
ankle is the lowest priority.
3. A nurse is caring for a client receiving mechanical ventilation. The high-pressure
alarm is sounding. Which actions should the nurse take? Select all that apply.
A. Auscultate bilateral breath sounds
B. Check the tubing for condensation or kinks
C. Increase the fraction of inspired oxygen (FiO₂) by 10%
D. Assess the client for synchronous breathing with the ventilator
E. Perform oral suctioning using aseptic technique
F. Verify that the endotracheal tube is properly secured and at the correct depth
Correct Answer: A, B, D, E, F
Rationale: High-pressure alarms indicate increased resistance to airflow, commonly
caused by secretions requiring suctioning (E), bronchospasm or pneumothorax
requiring auscultation (A), patient-ventilator asynchrony (D), kinked tubing (B), or biting
on the tube/displacement requiring verification of tube position (F). Increasing FiO₂ (C)
addresses hypoxemia, not high pressure, and would not resolve the alarm.
4. A client with a history of heart failure presents to the clinic with a 3-pound weight gain
in 2 days, increased dyspnea on exertion, and bilateral ankle edema. The client is
currently taking furosemide 40 mg PO daily, lisinopril 10 mg PO daily, and carvedilol 6.25
mg PO twice daily. Which instruction should the nurse provide?
, A. "Hold your carvedilol today and contact your provider if your heart rate drops below
60."
B. "Take an additional dose of furosemide today and restrict your fluids to 1 liter daily."
C. "Weigh yourself weekly and call if you gain more than 5 pounds in one week."
D. "Your symptoms indicate worsening heart failure; I will contact your provider to
discuss medication adjustments."
Correct Answer: D
Rationale: A 3-pound weight gain in 2 days with worsening edema and dyspnea
indicates acute decompensated heart failure. The nurse should not independently
adjust diuretics (B) or instruct the client to hold beta-blockers (A), as these require
provider orders. While daily weights are important, option C minimizes the current acute
symptoms. The nurse must communicate the clinical deterioration to the provider for
potential medication adjustments and possible additional interventions.
5. A nurse is reviewing morning laboratory results for four clients. Which finding
requires immediate follow-up by the nurse?
A. Client with chronic kidney disease: potassium 5.1 mEq/L
B. Client with acute pancreatitis: calcium 8.9 mg/dL
C. Client with diabetic ketoacidosis: pH 7.28, bicarbonate 18 mEq/L
D. Client with leukemia undergoing chemotherapy: absolute neutrophil count 450
cells/mm³
Correct Answer: D
Exam 2026/2027: Complete Exam-Style Questions with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+ Graded
Time Allotment: 3 hours, 30 minutes
Total Questions: 75
Question Formats: Multiple-Choice Questions (MCQ), Select-All-That-Apply (SATA), and
Case-Based Scenarios
Passing Standard: Application, Analysis, and Clinical Judgment Proficiency
SECTION I: CLINICAL JUDGMENT & PATIENT SAFETY
1. A nurse is caring for a client who sustained a full-thickness burn covering 35% of total
body surface area 18 hours ago. The client has a triple-lumen central venous catheter,
and the provider has ordered lactated Ringer's solution per the Parkland formula. The
client's urine output over the past hour was 18 mL. Which action should the nurse take
first?
A. Increase the infusion rate of the lactated Ringer's solution by 25%
B. Notify the provider and request an order for a diuretic
C. Assess the client's breath sounds and level of consciousness
,D. Evaluate the patency of the urinary catheter and confirm accurate measurement
Correct Answer: D
Rationale: During the emergent/resuscitative phase of burn injury (first 24 hours), urine
output is the primary indicator of adequate fluid resuscitation, with a target of 0.5–1
mL/kg/hr for adults. Before altering fluid rates or notifying the provider, the nurse must
first verify data accuracy by ensuring the catheter is patent and the measurement is
correct. This reflects the clinical judgment sequence of data verification before
intervention.
2. A nurse in the emergency department is triaging four clients. Which client should the
nurse assess first?
A. A 24-year-old with a sprained ankle and moderate swelling who reports pain as 6/10
B. A 56-year-old with chest discomfort rated 4/10, blood pressure 148/92 mm Hg, and
diaphoresis
C. A 38-year-old with a lacerated forearm requiring 12 sutures, bleeding controlled with
pressure
D. A 72-year-old with a suspected fractured hip, leg externally rotated, pain 8/10, vital
signs stable
Correct Answer: B
Rationale: Using the Emergency Severity Index (ESI) and ABC prioritization, the
56-year-old with chest discomfort, hypertension, and diaphoresis presents with
potential acute coronary syndrome. Diaphoresis and chest discomfort are high-risk
indicators requiring immediate ECG and cardiac workup. While the fractured hip and
,laceration require intervention, they are not immediately life-threatening. The sprained
ankle is the lowest priority.
3. A nurse is caring for a client receiving mechanical ventilation. The high-pressure
alarm is sounding. Which actions should the nurse take? Select all that apply.
A. Auscultate bilateral breath sounds
B. Check the tubing for condensation or kinks
C. Increase the fraction of inspired oxygen (FiO₂) by 10%
D. Assess the client for synchronous breathing with the ventilator
E. Perform oral suctioning using aseptic technique
F. Verify that the endotracheal tube is properly secured and at the correct depth
Correct Answer: A, B, D, E, F
Rationale: High-pressure alarms indicate increased resistance to airflow, commonly
caused by secretions requiring suctioning (E), bronchospasm or pneumothorax
requiring auscultation (A), patient-ventilator asynchrony (D), kinked tubing (B), or biting
on the tube/displacement requiring verification of tube position (F). Increasing FiO₂ (C)
addresses hypoxemia, not high pressure, and would not resolve the alarm.
4. A client with a history of heart failure presents to the clinic with a 3-pound weight gain
in 2 days, increased dyspnea on exertion, and bilateral ankle edema. The client is
currently taking furosemide 40 mg PO daily, lisinopril 10 mg PO daily, and carvedilol 6.25
mg PO twice daily. Which instruction should the nurse provide?
, A. "Hold your carvedilol today and contact your provider if your heart rate drops below
60."
B. "Take an additional dose of furosemide today and restrict your fluids to 1 liter daily."
C. "Weigh yourself weekly and call if you gain more than 5 pounds in one week."
D. "Your symptoms indicate worsening heart failure; I will contact your provider to
discuss medication adjustments."
Correct Answer: D
Rationale: A 3-pound weight gain in 2 days with worsening edema and dyspnea
indicates acute decompensated heart failure. The nurse should not independently
adjust diuretics (B) or instruct the client to hold beta-blockers (A), as these require
provider orders. While daily weights are important, option C minimizes the current acute
symptoms. The nurse must communicate the clinical deterioration to the provider for
potential medication adjustments and possible additional interventions.
5. A nurse is reviewing morning laboratory results for four clients. Which finding
requires immediate follow-up by the nurse?
A. Client with chronic kidney disease: potassium 5.1 mEq/L
B. Client with acute pancreatitis: calcium 8.9 mg/dL
C. Client with diabetic ketoacidosis: pH 7.28, bicarbonate 18 mEq/L
D. Client with leukemia undergoing chemotherapy: absolute neutrophil count 450
cells/mm³
Correct Answer: D
