ATI RN CONCEPT-BASED ASSESSMENT LEVEL 2
PROCTORED EXAM 2026-2028
250 VERIFIED QUESTIONS AND ANSWERS WITH DETAILED
RATIONALES
QUESTION 1
A nurse manager is reviewing the staffing plan for a medical-surgical unit. The unit has
24 patients with the following acuity: 6 patients require total care, 10 patients require
moderate assistance, and 8 patients are self-care. The nurse-to-patient ratio is 1:6 for
total care, 1:8 for moderate, and 1:12 for self-care. How many registered nurses (RNs)
are needed for the shift?
A) 3
B) 4
C) 5
D) 6
Correct Answer: C) 5.
Rationale: Total care patients: = 1 RN; moderate: = 1.25 → 2 RNs; self-care: 8
/ 12 = 0.67 → 1 RN. Total = 1+2+1 = 4, but rounding up for safety and considering break
coverage, 5 RNs are needed. Staffing should match patient acuity .
QUESTION 2
A charge nurse is assigning tasks to the healthcare team. Which task should be
delegated to a licensed practical nurse (LPN)?
A) Administering a blood transfusion to a stable patient
B) Performing the initial assessment of a newly admitted patient with chest pain
C) Reinforcing teaching about wound care to a patient with a new colostomy
D) Evaluating the effectiveness of pain medication for a patient with chronic pain
,Correct Answer: C) Reinforcing teaching about wound care to a patient with a new
colostomy.
Rationale: Reinforcing teaching is within LPN scope, provided the RN has initiated the
plan. Administering blood requires RN-level monitoring. Initial assessment and evaluation
are RN responsibilities due to complexity and judgment requirements .
QUESTION 3
A nurse is caring for four patients. Which patient should the nurse assess first?
A) A patient with a history of diabetes who has a blood glucose of 180 mg/dL and is
asymptomatic
B) A patient with pneumonia who has a sudden onset of pleuritic chest pain and
dyspnea
C) A patient with a urinary tract infection who has a temperature of 38.5°C (101.3°F) and
chills
D) A patient with a fractured femur who reports pain of 6 on a 0-10 scale after receiving
analgesia
Correct Answer: B) A patient with pneumonia who has a sudden onset of pleuritic
chest pain and dyspnea.
Rationale: Sudden pleuritic chest pain and dyspnea in a patient with pneumonia suggests
possible pulmonary embolism or pneumothorax, which are life-threatening. Option B
requires immediate assessment .
QUESTION 4
A nurse is preparing to discharge a patient with a new diagnosis of heart failure. Which
instruction is most critical to include in the discharge teaching?
,A) Weigh yourself daily and report a weight gain of more than 2 pounds in 24 hours
B) Limit your intake of high-fiber foods to prevent bloating
C) Take your diuretic only when you feel short of breath
D) Avoid using the incentive spirometer after surgery
Correct Answer: A) Weigh yourself daily and report a weight gain of more than 2
pounds in 24 hours.
Rationale: Daily weight monitoring is essential for early detection of fluid retention. A gain
of >2 lbs in 24 hours indicates worsening heart failure and requires prompt intervention.
Diuretics should be taken as prescribed, not PRN .
QUESTION 5
A patient with a STEMI receives tPA and suddenly develops a severe headache and
vomiting. BP 200/110 mmHg. What is the nurse's immediate action?
A) Administer antiemetic
B) Notify provider and prepare for emergency CT scan
C) Lower head of bed
D) Give acetaminophen
Correct Answer: B) Notify provider and prepare for emergency CT scan.
Rationale: Sudden severe headache and hypertension after tPA administration are classic
signs of intracranial hemorrhage—a life-threatening complication. Rapid imaging and
neurosurgical consult are critical. Administering an antiemetic or acetaminophen delays
definitive treatment .
, QUESTION 6
A nurse is caring for a patient who refuses a blood transfusion due to religious beliefs.
The nurse's best response is:
A) "Your family wants you to have the transfusion."
B) "The doctor will be angry if you refuse."
C) "Tell me more about your concerns regarding the transfusion."
D) "We will give you the transfusion anyway to save your life."
Correct Answer: C) "Tell me more about your concerns regarding the transfusion."
Rationale: The nurse should respect the patient's autonomy and explore their concerns.
Religious beliefs must be honored. The nurse should not coerce or manipulate the patient .
QUESTION 7
A nurse discovers that a colleague has been diverting opioids from the medication
supply. What is the nurse's priority action?
A) Confront the colleague privately
B) Report the suspicion to the nurse manager
C) Ignore the behavior unless there is direct evidence
D) Submit an anonymous report to the state board of nursing
Correct Answer: B) Report the suspicion to the nurse manager.
Rationale: The nurse has a legal and ethical duty to report suspected impairment to
protect patient safety. The manager will follow facility policy. Confrontation may escalate
the situation .
PROCTORED EXAM 2026-2028
250 VERIFIED QUESTIONS AND ANSWERS WITH DETAILED
RATIONALES
QUESTION 1
A nurse manager is reviewing the staffing plan for a medical-surgical unit. The unit has
24 patients with the following acuity: 6 patients require total care, 10 patients require
moderate assistance, and 8 patients are self-care. The nurse-to-patient ratio is 1:6 for
total care, 1:8 for moderate, and 1:12 for self-care. How many registered nurses (RNs)
are needed for the shift?
A) 3
B) 4
C) 5
D) 6
Correct Answer: C) 5.
Rationale: Total care patients: = 1 RN; moderate: = 1.25 → 2 RNs; self-care: 8
/ 12 = 0.67 → 1 RN. Total = 1+2+1 = 4, but rounding up for safety and considering break
coverage, 5 RNs are needed. Staffing should match patient acuity .
QUESTION 2
A charge nurse is assigning tasks to the healthcare team. Which task should be
delegated to a licensed practical nurse (LPN)?
A) Administering a blood transfusion to a stable patient
B) Performing the initial assessment of a newly admitted patient with chest pain
C) Reinforcing teaching about wound care to a patient with a new colostomy
D) Evaluating the effectiveness of pain medication for a patient with chronic pain
,Correct Answer: C) Reinforcing teaching about wound care to a patient with a new
colostomy.
Rationale: Reinforcing teaching is within LPN scope, provided the RN has initiated the
plan. Administering blood requires RN-level monitoring. Initial assessment and evaluation
are RN responsibilities due to complexity and judgment requirements .
QUESTION 3
A nurse is caring for four patients. Which patient should the nurse assess first?
A) A patient with a history of diabetes who has a blood glucose of 180 mg/dL and is
asymptomatic
B) A patient with pneumonia who has a sudden onset of pleuritic chest pain and
dyspnea
C) A patient with a urinary tract infection who has a temperature of 38.5°C (101.3°F) and
chills
D) A patient with a fractured femur who reports pain of 6 on a 0-10 scale after receiving
analgesia
Correct Answer: B) A patient with pneumonia who has a sudden onset of pleuritic
chest pain and dyspnea.
Rationale: Sudden pleuritic chest pain and dyspnea in a patient with pneumonia suggests
possible pulmonary embolism or pneumothorax, which are life-threatening. Option B
requires immediate assessment .
QUESTION 4
A nurse is preparing to discharge a patient with a new diagnosis of heart failure. Which
instruction is most critical to include in the discharge teaching?
,A) Weigh yourself daily and report a weight gain of more than 2 pounds in 24 hours
B) Limit your intake of high-fiber foods to prevent bloating
C) Take your diuretic only when you feel short of breath
D) Avoid using the incentive spirometer after surgery
Correct Answer: A) Weigh yourself daily and report a weight gain of more than 2
pounds in 24 hours.
Rationale: Daily weight monitoring is essential for early detection of fluid retention. A gain
of >2 lbs in 24 hours indicates worsening heart failure and requires prompt intervention.
Diuretics should be taken as prescribed, not PRN .
QUESTION 5
A patient with a STEMI receives tPA and suddenly develops a severe headache and
vomiting. BP 200/110 mmHg. What is the nurse's immediate action?
A) Administer antiemetic
B) Notify provider and prepare for emergency CT scan
C) Lower head of bed
D) Give acetaminophen
Correct Answer: B) Notify provider and prepare for emergency CT scan.
Rationale: Sudden severe headache and hypertension after tPA administration are classic
signs of intracranial hemorrhage—a life-threatening complication. Rapid imaging and
neurosurgical consult are critical. Administering an antiemetic or acetaminophen delays
definitive treatment .
, QUESTION 6
A nurse is caring for a patient who refuses a blood transfusion due to religious beliefs.
The nurse's best response is:
A) "Your family wants you to have the transfusion."
B) "The doctor will be angry if you refuse."
C) "Tell me more about your concerns regarding the transfusion."
D) "We will give you the transfusion anyway to save your life."
Correct Answer: C) "Tell me more about your concerns regarding the transfusion."
Rationale: The nurse should respect the patient's autonomy and explore their concerns.
Religious beliefs must be honored. The nurse should not coerce or manipulate the patient .
QUESTION 7
A nurse discovers that a colleague has been diverting opioids from the medication
supply. What is the nurse's priority action?
A) Confront the colleague privately
B) Report the suspicion to the nurse manager
C) Ignore the behavior unless there is direct evidence
D) Submit an anonymous report to the state board of nursing
Correct Answer: B) Report the suspicion to the nurse manager.
Rationale: The nurse has a legal and ethical duty to report suspected impairment to
protect patient safety. The manager will follow facility policy. Confrontation may escalate
the situation .
