ATI RN Concept-Based Assessment Level 2 Proctored Exam
Questions and Answers | Verified Answers with Detailed
Rationales (2026/2027 Edition)
ATI RN Concept-Based Assessment Level 2
Proctored Examination
2026/2027 Edition
SECTION 1: Management of Care
(8 questions)
Question 1
A nurse is delegating tasks on a busy medical-surgical unit. Which task is most
appropriate to assign to a licensed practical nurse (LPN)?
A. Performing the initial admission assessment on a newly admitted patient with chest
pain
B. Reinforcing discharge teaching for a patient with newly diagnosed type 2 diabetes
C. Developing the plan of care for a patient with acute heart failure
D. Administering IV push morphine to a patient post-operatively
Correct Answer: B
Rationale: Reinforcing discharge teaching is within the LPN scope of practice under the
supervision of an RN. The LPN can reinforce previously taught content but cannot
perform the initial teaching. Option A is incorrect because the initial admission
assessment is an RN responsibility that requires clinical judgment and comprehensive
data analysis. Option C is incorrect because developing the plan of care requires
RN-level critical thinking, diagnosis, and outcome identification. Option D is incorrect
because administering IV push medications, especially opioids, is typically outside LPN
scope in most states and requires RN-level assessment of sedation and respiratory
status. According to the Nurse Practice Act and ATI delegation principles, the RN retains
,responsibility for initial assessments, care planning, and evaluation, while the LPN
performs delegated tasks for stable patients with predictable outcomes.
Question 2
A charge nurse is making patient assignments for the shift. Which patient should be
assigned to the most experienced registered nurse?
A. A 45-year-old patient admitted 2 days ago for elective knee replacement, ambulating
independently
B. A 62-year-old patient with new-onset atrial fibrillation, heart rate 140 bpm, BP 88/52
mmHg
C. A 30-year-old patient post-appendectomy, day 1, pain controlled, tolerating clear
liquids
D. A 55-year-old patient with community-acquired pneumonia, SpO2 94% on 2 L nasal
cannula
Correct Answer: B
Rationale: The most experienced RN should be assigned to the most unstable patient.
The patient with new-onset atrial fibrillation, tachycardia, and hypotension (BP 88/52
mmHg) is hemodynamically unstable and requires continuous monitoring, potential
cardioversion, and rapid clinical decision-making. Option A is incorrect because the
post-operative knee replacement patient is stable with predictable outcomes. Option C
is incorrect because the post-appendectomy patient is progressing normally with
controlled pain. Option D is incorrect because the pneumonia patient, while requiring
oxygen, is stable with adequate oxygen saturation. ATI and NCLEX prioritization
principles emphasize assigning the most experienced nurse to the most acutely ill or
unstable patient to ensure safe outcomes and appropriate clinical judgment.
Question 3
A nurse is using the SBAR format to communicate with a provider about a change in a
patient's condition. Which statement by the nurse represents the "Background"
component of SBAR?
A. "The patient's blood pressure has dropped from 142/88 to 92/58 over the past hour."
B. "The patient was admitted yesterday for community-acquired pneumonia and has a
history of COPD."
,C. "I am requesting a stat chest X-ray and provider evaluation."
D. "I believe the patient may be developing septic shock based on the vital sign
changes."
Correct Answer: B
Rationale: The Background component of SBAR includes relevant patient history,
admitting diagnosis, and pertinent clinical context. Stating the admission diagnosis and
history of COPD provides the provider with essential background information. Option A
represents the Assessment component (current clinical data and vital signs). Option C
represents the Recommendation component (specific request for action). Option D
represents the Situation component (concise statement of the problem). SBAR
(Situation, Background, Assessment, Recommendation) is the Joint
Commission-recommended communication framework for handoffs and provider
notifications to ensure clear, structured, and effective communication that reduces
medical errors.
Question 4
A patient with terminal cancer expresses a desire to stop all treatment and go home to
die peacefully. The patient's adult children insist that "everything possible" be done.
Which action by the nurse demonstrates the role of client advocate?
A. Persuading the patient to continue treatment for the family's sake
B. Contacting the ethics committee to override the patient's decision
C. Ensuring the patient understands all options and supporting the patient's
autonomous decision
D. Telling the family that the nurse agrees with their position
Correct Answer: C
Rationale: Client advocacy involves protecting the patient's rights, autonomy, and
self-determination. Supporting the patient's informed, autonomous decision to refuse
treatment aligns with the ANA Code of Ethics and patient rights. Option A violates
patient autonomy and is non-therapeutic. Option B is incorrect because the ethics
committee provides consultation but cannot override a competent patient's decision.
, Option D breaches professional boundaries and fails to advocate for the patient. A living
will or advance directive, if present, is legally binding, and the nurse must ensure the
patient's wishes are communicated to the healthcare team and respected.
Question 5
A nurse witnesses a colleague arriving to work with slurred speech, unsteady gait, and
the odor of alcohol on their breath. What is the nurse's priority action?
A. Confront the colleague privately and tell them to go home
B. Report the observations to the nurse manager immediately
C. Ignore the behavior unless the colleague makes a medication error
D. Document the behavior in the patient's medical record
Correct Answer: B
Rationale: The nurse has a legal and ethical obligation to report suspected impairment
to the nurse manager or supervisor immediately to protect patient safety. Option A is
inappropriate because the nurse lacks authority to send a colleague home and may
enable continued impairment. Option C is dangerous because patient harm could occur
before an error is made. Option D is incorrect because the colleague's behavior should
not be documented in a patient's medical record; it should be reported through
appropriate channels per facility policy and state board of nursing requirements. The
ANA Code of Ethics mandates that nurses report impairment to protect patients and
support the colleague in obtaining help.
Question 6
A patient is preparing to leave the hospital against medical advice (AMA). Which action
should the nurse take first?
A. Have the patient sign the AMA form and document the refusal of care
B. Notify the provider immediately of the patient's intent to leave
C. Explain the risks of leaving AMA and attempt to address the patient's concerns
D. Call security to prevent the patient from leaving the facility
Correct Answer: C
Rationale: The nurse's first action is to explore the patient's reasons for wanting to leave
and explain the potential risks, as many patients who request AMA discharge have
Questions and Answers | Verified Answers with Detailed
Rationales (2026/2027 Edition)
ATI RN Concept-Based Assessment Level 2
Proctored Examination
2026/2027 Edition
SECTION 1: Management of Care
(8 questions)
Question 1
A nurse is delegating tasks on a busy medical-surgical unit. Which task is most
appropriate to assign to a licensed practical nurse (LPN)?
A. Performing the initial admission assessment on a newly admitted patient with chest
pain
B. Reinforcing discharge teaching for a patient with newly diagnosed type 2 diabetes
C. Developing the plan of care for a patient with acute heart failure
D. Administering IV push morphine to a patient post-operatively
Correct Answer: B
Rationale: Reinforcing discharge teaching is within the LPN scope of practice under the
supervision of an RN. The LPN can reinforce previously taught content but cannot
perform the initial teaching. Option A is incorrect because the initial admission
assessment is an RN responsibility that requires clinical judgment and comprehensive
data analysis. Option C is incorrect because developing the plan of care requires
RN-level critical thinking, diagnosis, and outcome identification. Option D is incorrect
because administering IV push medications, especially opioids, is typically outside LPN
scope in most states and requires RN-level assessment of sedation and respiratory
status. According to the Nurse Practice Act and ATI delegation principles, the RN retains
,responsibility for initial assessments, care planning, and evaluation, while the LPN
performs delegated tasks for stable patients with predictable outcomes.
Question 2
A charge nurse is making patient assignments for the shift. Which patient should be
assigned to the most experienced registered nurse?
A. A 45-year-old patient admitted 2 days ago for elective knee replacement, ambulating
independently
B. A 62-year-old patient with new-onset atrial fibrillation, heart rate 140 bpm, BP 88/52
mmHg
C. A 30-year-old patient post-appendectomy, day 1, pain controlled, tolerating clear
liquids
D. A 55-year-old patient with community-acquired pneumonia, SpO2 94% on 2 L nasal
cannula
Correct Answer: B
Rationale: The most experienced RN should be assigned to the most unstable patient.
The patient with new-onset atrial fibrillation, tachycardia, and hypotension (BP 88/52
mmHg) is hemodynamically unstable and requires continuous monitoring, potential
cardioversion, and rapid clinical decision-making. Option A is incorrect because the
post-operative knee replacement patient is stable with predictable outcomes. Option C
is incorrect because the post-appendectomy patient is progressing normally with
controlled pain. Option D is incorrect because the pneumonia patient, while requiring
oxygen, is stable with adequate oxygen saturation. ATI and NCLEX prioritization
principles emphasize assigning the most experienced nurse to the most acutely ill or
unstable patient to ensure safe outcomes and appropriate clinical judgment.
Question 3
A nurse is using the SBAR format to communicate with a provider about a change in a
patient's condition. Which statement by the nurse represents the "Background"
component of SBAR?
A. "The patient's blood pressure has dropped from 142/88 to 92/58 over the past hour."
B. "The patient was admitted yesterday for community-acquired pneumonia and has a
history of COPD."
,C. "I am requesting a stat chest X-ray and provider evaluation."
D. "I believe the patient may be developing septic shock based on the vital sign
changes."
Correct Answer: B
Rationale: The Background component of SBAR includes relevant patient history,
admitting diagnosis, and pertinent clinical context. Stating the admission diagnosis and
history of COPD provides the provider with essential background information. Option A
represents the Assessment component (current clinical data and vital signs). Option C
represents the Recommendation component (specific request for action). Option D
represents the Situation component (concise statement of the problem). SBAR
(Situation, Background, Assessment, Recommendation) is the Joint
Commission-recommended communication framework for handoffs and provider
notifications to ensure clear, structured, and effective communication that reduces
medical errors.
Question 4
A patient with terminal cancer expresses a desire to stop all treatment and go home to
die peacefully. The patient's adult children insist that "everything possible" be done.
Which action by the nurse demonstrates the role of client advocate?
A. Persuading the patient to continue treatment for the family's sake
B. Contacting the ethics committee to override the patient's decision
C. Ensuring the patient understands all options and supporting the patient's
autonomous decision
D. Telling the family that the nurse agrees with their position
Correct Answer: C
Rationale: Client advocacy involves protecting the patient's rights, autonomy, and
self-determination. Supporting the patient's informed, autonomous decision to refuse
treatment aligns with the ANA Code of Ethics and patient rights. Option A violates
patient autonomy and is non-therapeutic. Option B is incorrect because the ethics
committee provides consultation but cannot override a competent patient's decision.
, Option D breaches professional boundaries and fails to advocate for the patient. A living
will or advance directive, if present, is legally binding, and the nurse must ensure the
patient's wishes are communicated to the healthcare team and respected.
Question 5
A nurse witnesses a colleague arriving to work with slurred speech, unsteady gait, and
the odor of alcohol on their breath. What is the nurse's priority action?
A. Confront the colleague privately and tell them to go home
B. Report the observations to the nurse manager immediately
C. Ignore the behavior unless the colleague makes a medication error
D. Document the behavior in the patient's medical record
Correct Answer: B
Rationale: The nurse has a legal and ethical obligation to report suspected impairment
to the nurse manager or supervisor immediately to protect patient safety. Option A is
inappropriate because the nurse lacks authority to send a colleague home and may
enable continued impairment. Option C is dangerous because patient harm could occur
before an error is made. Option D is incorrect because the colleague's behavior should
not be documented in a patient's medical record; it should be reported through
appropriate channels per facility policy and state board of nursing requirements. The
ANA Code of Ethics mandates that nurses report impairment to protect patients and
support the colleague in obtaining help.
Question 6
A patient is preparing to leave the hospital against medical advice (AMA). Which action
should the nurse take first?
A. Have the patient sign the AMA form and document the refusal of care
B. Notify the provider immediately of the patient's intent to leave
C. Explain the risks of leaving AMA and attempt to address the patient's concerns
D. Call security to prevent the patient from leaving the facility
Correct Answer: C
Rationale: The nurse's first action is to explore the patient's reasons for wanting to leave
and explain the potential risks, as many patients who request AMA discharge have
