ATI RN Concepts Level 2 Comprehensive
Curriculum Review Official Practice Exam
Actual Exam 2026/2027 with Detailed
Rationales | Complete Exam-Style Questions |
Pass Guaranteed – A+ Graded
══════════════════════════════════════
SECTION 1: FUNDAMENTALS OF NURSING & PATIENT-CENTERED CARE Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 78-year-old client with a history of stroke is admitted to the medical-surgical unit with
aspiration pneumonia. During the morning assessment, the nurse notes crackles in the right
lower lobe, oxygen saturation of 90% on 2 L nasal cannula, and the client is coughing up thick
yellow sputum. The nurse plans care for the shift. Which action should the nurse prioritize?
A. Encourage the client to use the incentive spirometer every 2 hours while awake
B. Suction the oropharynx using clean technique every 4 hours
C. Elevate the head of the bed to 45 degrees and encourage deep breathing
D. Administer the PRN antitussive to suppress the cough reflex
Correct Answer: C
Rationale: Elevating the head of the bed to 45 degrees promotes lung expansion and reduces
the risk of further aspiration, while encouraging deep breathing helps mobilize secretions and
improve oxygenation per ATI fundamentals standards. Option A is incorrect because although
incentive spirometry is beneficial, airway positioning and breathing techniques take priority
when oxygen saturation is below 92%. Positioning the client upright is the first-line nursing
intervention to improve ventilation and protect the airway.
Question 2 of 50
A nurse is caring for a postoperative client on day 2 after abdominal surgery who has a
Jackson-Pratt drain in place. The nurse observes that the drain bulb is compressed and
contains 75 mL of sanguineous fluid from the past 4 hours. The client reports mild
tenderness at the insertion site, but the surrounding skin is intact. Which action should the
nurse take next?
,A. Milk the tubing gently toward the bulb to maintain patency
B. Empty the drain, recompress the bulb, and secure the plug
C. Remove the dressing and cleanse the insertion site with alcohol
D. Clamp the tubing for 30 minutes to allow tissue approximation
Correct Answer: B
Rationale: Emptying the drain when it is half full or every 8 hours maintains suction and
prevents retrograde contamination, which is the standard ATI procedure for closed-wound
drainage systems. Option A is incorrect because milking the tubing is only indicated when
there is visible clotting or obstruction, and aggressive manipulation can damage tissue.
Maintaining consistent negative pressure in the bulb is the priority nursing action for effective
wound drainage.
Question 3 of 50
During a routine home health visit, a nurse is assessing a 65-year-old client who lives alone
and manages type 2 diabetes. The client shows the nurse the insulin vials stored on the
kitchen counter near the stove. The client states, "I keep them here so I remember to take my
shot before meals." Which response by the nurse demonstrates the best patient-centered
teaching?
A. "You should store unopened insulin in the freezer so it stays potent longer."
B. "Insulin needs to be kept in the refrigerator, but you can keep the vial you are using at room
temperature."
C. "It is fine to leave insulin on the counter as long as it is not in direct sunlight."
D. "You need to discard that vial and get a new prescription from your provider."
Correct Answer: B
Rationale: Current ATI pharmacology standards state that unopened insulin should be
refrigerated, while the vial in use may be kept at room temperature away from heat and light
for up to 28 days. Option A is incorrect because freezing destroys insulin proteins and
renders the medication ineffective, which is a common patient misconception. Providing
clear, practical storage guidance supports self-management without creating unnecessary
anxiety or expense.
Question 4 of 50
A nurse is preparing to administer a cleansing enema to a 58-year-old client who has
constipation following 3 days of opioid therapy after knee replacement. The client is
positioned in the left lateral Sims position. The nurse has hung the enema bag 18 inches
above the bed and lubricated the tubing. Which next step best demonstrates safe enema
administration?
A. Insert the tubing 6 to 8 inches into the rectum and open the clamp slowly
, B. Ask the client to bear down while inserting the tubing 2 to 4 inches
C. Insert the tubing 3 to 4 inches and allow the solution to flow rapidly
D. Position the client supine and insert the tubing until resistance is met
Correct Answer: A
Rationale: Inserting the tubing 6 to 8 inches for a cleansing enema and regulating the flow
rate prevents rectal mucosal trauma and spasm, aligning with ATI fundamentals for bowel
elimination. Option C is incorrect because rapid infusion causes cramping, distention, and an
immediate urge to evacuate, which reduces the effectiveness of the procedure. Slow,
controlled administration with the client in the left lateral position allows the solution to flow
by gravity along the anatomical curve of the colon.
Question 5 of 50
A nurse on the oncology unit is caring for a client who is neutropenic after chemotherapy.
The client's absolute neutrophil count is 450 cells/mm³. The nurse is reviewing the plan of
care with the unlicensed assistive personnel (UAP). Which instruction should the nurse give
to the UAP?
A. "Take the client's temperature orally every 4 hours and report anything over 99.5°F."
B. "Remove the fresh flowers from the room and do not bring the client any raw fruits."
C. "Help the client ambulate in the hallway twice a day to prevent deconditioning."
D. "Use an axillary thermometer and avoid fresh plants or raw food in the room."
Correct Answer: D
Rationale: For neutropenic clients, an axillary thermometer is preferred to avoid mucosal
trauma and bacteremia risk, and eliminating fresh plants and raw foods reduces exposure to
pathogens per ATI infection control standards. Option B is incorrect because while removing
flowers and raw fruits is appropriate, the instruction to use oral temperature assessment
violates neutropenic precautions. The nurse must ensure the UAP understands both
protective environment measures and the rationale for non-invasive temperature routes.
Question 6 of 50
A nurse is assessing a 42-year-old client who returned from the post-anesthesia care unit 2
hours ago after a thyroidectomy. The client is restless, has a respiratory rate of 28 breaths
per minute, and the nurse hears stridor on auscultation. The surgical dressing is dry and
intact. Which action should the nurse take first?
A. Administer the PRN morphine sulfate to reduce anxiety and respiratory rate
B. Apply a humidified oxygen mask and keep emergency airway equipment at the bedside
C. Remove the surgical dressing to inspect the incision for bleeding
D. Call the provider and request a stat portable chest x-ray
Curriculum Review Official Practice Exam
Actual Exam 2026/2027 with Detailed
Rationales | Complete Exam-Style Questions |
Pass Guaranteed – A+ Graded
══════════════════════════════════════
SECTION 1: FUNDAMENTALS OF NURSING & PATIENT-CENTERED CARE Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 78-year-old client with a history of stroke is admitted to the medical-surgical unit with
aspiration pneumonia. During the morning assessment, the nurse notes crackles in the right
lower lobe, oxygen saturation of 90% on 2 L nasal cannula, and the client is coughing up thick
yellow sputum. The nurse plans care for the shift. Which action should the nurse prioritize?
A. Encourage the client to use the incentive spirometer every 2 hours while awake
B. Suction the oropharynx using clean technique every 4 hours
C. Elevate the head of the bed to 45 degrees and encourage deep breathing
D. Administer the PRN antitussive to suppress the cough reflex
Correct Answer: C
Rationale: Elevating the head of the bed to 45 degrees promotes lung expansion and reduces
the risk of further aspiration, while encouraging deep breathing helps mobilize secretions and
improve oxygenation per ATI fundamentals standards. Option A is incorrect because although
incentive spirometry is beneficial, airway positioning and breathing techniques take priority
when oxygen saturation is below 92%. Positioning the client upright is the first-line nursing
intervention to improve ventilation and protect the airway.
Question 2 of 50
A nurse is caring for a postoperative client on day 2 after abdominal surgery who has a
Jackson-Pratt drain in place. The nurse observes that the drain bulb is compressed and
contains 75 mL of sanguineous fluid from the past 4 hours. The client reports mild
tenderness at the insertion site, but the surrounding skin is intact. Which action should the
nurse take next?
,A. Milk the tubing gently toward the bulb to maintain patency
B. Empty the drain, recompress the bulb, and secure the plug
C. Remove the dressing and cleanse the insertion site with alcohol
D. Clamp the tubing for 30 minutes to allow tissue approximation
Correct Answer: B
Rationale: Emptying the drain when it is half full or every 8 hours maintains suction and
prevents retrograde contamination, which is the standard ATI procedure for closed-wound
drainage systems. Option A is incorrect because milking the tubing is only indicated when
there is visible clotting or obstruction, and aggressive manipulation can damage tissue.
Maintaining consistent negative pressure in the bulb is the priority nursing action for effective
wound drainage.
Question 3 of 50
During a routine home health visit, a nurse is assessing a 65-year-old client who lives alone
and manages type 2 diabetes. The client shows the nurse the insulin vials stored on the
kitchen counter near the stove. The client states, "I keep them here so I remember to take my
shot before meals." Which response by the nurse demonstrates the best patient-centered
teaching?
A. "You should store unopened insulin in the freezer so it stays potent longer."
B. "Insulin needs to be kept in the refrigerator, but you can keep the vial you are using at room
temperature."
C. "It is fine to leave insulin on the counter as long as it is not in direct sunlight."
D. "You need to discard that vial and get a new prescription from your provider."
Correct Answer: B
Rationale: Current ATI pharmacology standards state that unopened insulin should be
refrigerated, while the vial in use may be kept at room temperature away from heat and light
for up to 28 days. Option A is incorrect because freezing destroys insulin proteins and
renders the medication ineffective, which is a common patient misconception. Providing
clear, practical storage guidance supports self-management without creating unnecessary
anxiety or expense.
Question 4 of 50
A nurse is preparing to administer a cleansing enema to a 58-year-old client who has
constipation following 3 days of opioid therapy after knee replacement. The client is
positioned in the left lateral Sims position. The nurse has hung the enema bag 18 inches
above the bed and lubricated the tubing. Which next step best demonstrates safe enema
administration?
A. Insert the tubing 6 to 8 inches into the rectum and open the clamp slowly
, B. Ask the client to bear down while inserting the tubing 2 to 4 inches
C. Insert the tubing 3 to 4 inches and allow the solution to flow rapidly
D. Position the client supine and insert the tubing until resistance is met
Correct Answer: A
Rationale: Inserting the tubing 6 to 8 inches for a cleansing enema and regulating the flow
rate prevents rectal mucosal trauma and spasm, aligning with ATI fundamentals for bowel
elimination. Option C is incorrect because rapid infusion causes cramping, distention, and an
immediate urge to evacuate, which reduces the effectiveness of the procedure. Slow,
controlled administration with the client in the left lateral position allows the solution to flow
by gravity along the anatomical curve of the colon.
Question 5 of 50
A nurse on the oncology unit is caring for a client who is neutropenic after chemotherapy.
The client's absolute neutrophil count is 450 cells/mm³. The nurse is reviewing the plan of
care with the unlicensed assistive personnel (UAP). Which instruction should the nurse give
to the UAP?
A. "Take the client's temperature orally every 4 hours and report anything over 99.5°F."
B. "Remove the fresh flowers from the room and do not bring the client any raw fruits."
C. "Help the client ambulate in the hallway twice a day to prevent deconditioning."
D. "Use an axillary thermometer and avoid fresh plants or raw food in the room."
Correct Answer: D
Rationale: For neutropenic clients, an axillary thermometer is preferred to avoid mucosal
trauma and bacteremia risk, and eliminating fresh plants and raw foods reduces exposure to
pathogens per ATI infection control standards. Option B is incorrect because while removing
flowers and raw fruits is appropriate, the instruction to use oral temperature assessment
violates neutropenic precautions. The nurse must ensure the UAP understands both
protective environment measures and the rationale for non-invasive temperature routes.
Question 6 of 50
A nurse is assessing a 42-year-old client who returned from the post-anesthesia care unit 2
hours ago after a thyroidectomy. The client is restless, has a respiratory rate of 28 breaths
per minute, and the nurse hears stridor on auscultation. The surgical dressing is dry and
intact. Which action should the nurse take first?
A. Administer the PRN morphine sulfate to reduce anxiety and respiratory rate
B. Apply a humidified oxygen mask and keep emergency airway equipment at the bedside
C. Remove the surgical dressing to inspect the incision for bleeding
D. Call the provider and request a stat portable chest x-ray
