P R O C TO R E D E X A M I N AT I O N 150 QUESTIONS
ATI RN Concept-
Based Assessment
Level 3
Comprehensive 150-question examination covering patient-
centered care, evidence-based practice, safety and
infection control, clinical decision-making, healthcare
systems, delegation, medical-surgical nursing, mental
health, maternal-newborn and pediatric nursing, and
integrated NGN-style clinical judgment scenarios aligned
All 150 Questions with Correct Answers and Detailed Rationales
with 2026-2027 ATI competencies.
100% Verified | A+ Graded Content
20 26 - 20 27 AT I C O N C E P T- B A S E D A S S E S S M E N T C O M P E T E N C I E S
,Section 1: Patient-Centered Care (Comfort, End-of-Life, Diversity,
Communication, Health Promotion) [Q1-Q20]
Q1: A nurse is caring for a client who is receiving palliative care for end-stage pancreatic cancer. The client
reports severe pain rated 9 on a 0-10 scale. Which of the following is the priority nursing action?
A. Administer the prescribed morphine as ordered [CORRECT]
B. Encourage the client to use guided imagery techniques
C. Reposition the client for comfort
D. Notify the provider for a pain management consultation
Correct Answer: A
Rationale: The priority action is to administer the prescribed morphine because pain is a subjective experience and the patient's
self-report is the gold standard for pain assessment. In palliative care, symptom management is the primary focus, and opioid
analgesics such as morphine are the mainstay of treatment for severe cancer pain. While guided imagery, repositioning, and provider
notification are appropriate interventions, they do not take priority over administering the ordered analgesic for severe pain. The
WHO Pain Ladder supports using strong opioids for severe pain (Step 3). ATI prioritization frameworks emphasize addressing the
most immediate physiological need first.
Q2: A nurse is providing hospice care to a client with a prognosis of less than six months. The client's family
asks the nurse what hospice care entails. Which of the following is the most appropriate response by the nurse?
A. "Hospice focuses on curing the underlying disease while providing comfort measures."
B. "Hospice provides interdisciplinary care focused on comfort and quality of life when cure is no longer the
goal." [CORRECT]
C. "Hospice is only provided in an inpatient hospital setting."
D. "Hospice care continues until the client is discharged from the healthcare system."
Correct Answer: B
Rationale: Hospice care is interdisciplinary care focused on improving quality of life for patients and families when curative
treatment is no longer the goal. It requires a physician certification of a prognosis of six months or less and patient or family consent.
Hospice care can be provided in multiple settings including the home, inpatient hospice facilities, and long-term care facilities. The
focus is exclusively on comfort and quality of life rather than cure. Options A, C, and D contain inaccurate information about
hospice care.
Q3: A nurse is assessing a client with end-stage liver disease who reports increasing dyspnea. Which of the
following interventions should the nurse implement first?
A. Administer prescribed supplemental oxygen
B. Elevate the head of the bed [CORRECT]
C. Administer morphine as prescribed
D. Obtain a pulse oximetry reading
Correct Answer: B
Rationale: Elevating the head of the bed is the first intervention because it is an independent nursing action that immediately
improves breathing by reducing pressure on the diaphragm and promoting lung expansion. The ABCs framework (Airway,
Breathing, Circulation) guides prioritization, and positioning is a noninvasive, immediate intervention for dyspnea. Supplemental
oxygen, morphine for dyspnea, and pulse oximetry are also appropriate but should follow positioning. ATI emphasizes using the least
invasive intervention first before progressing to more complex measures.
Q4: A nurse is caring for a client who is experiencing nausea related to chemotherapy. Which of the following
medications should the nurse anticipate administering?
,ATI RN Concept-Based Assessment Level 3 Proctored Examination 150 Questions | 100% Verified
A. Ondansetron
B. Metoclopramide
C. Ondansetron or metoclopramide as prescribed [CORRECT]
D. Lorazepam
Correct Answer: C
Rationale: Both ondansetron (a serotonin 5-HT3 receptor antagonist) and metoclopramide (a dopamine antagonist and prokinetic
agent) are appropriate antiemetics for chemotherapy-induced nausea. The specific medication choice depends on the prescriber's
order and the emetogenic potential of the chemotherapy regimen. Ondansetron is considered first-line for moderate to highly
emetogenic chemotherapy. Lorazepam is used for anticipatory nausea and anxiety rather than as a primary antiemetic. ATI
emphasizes administering medications as prescribed while understanding the pharmacological rationale for each.
Q5: A nurse is assessing pain in an 82-year-old client who has advanced dementia and is nonverbal. Which of
the following pain assessment tools is the most appropriate for this client?
A. Numeric rating scale (0-10)
B. Visual Analog Scale (VAS)
C. PAINAD scale [CORRECT]
D. Wong-Baker FACES scale
Correct Answer: C
Rationale: The PAINAD (Pain Assessment in Advanced Dementia) scale is specifically designed for assessing pain in elderly,
nonverbal clients with advanced dementia. It evaluates five behavioral indicators: breathing, negative vocalization, facial expression,
body language, and consolability. The numeric rating scale and VAS require self-report and are inappropriate for nonverbal clients.
The Wong-Baker FACES scale may be used for children but is not validated for advanced dementia. ATI emphasizes using
validated, population-specific assessment tools for accurate clinical evaluation.
Q6: A nurse is caring for a client who is prescribed morphine via patient-controlled analgesia (PCA) for
postoperative pain. Which of the following assessments is the priority for the nurse to monitor?
A. Constipation
B. Respiratory depression [CORRECT]
C. Sedation
D. Nausea and vomiting
Correct Answer: B
Rationale: Respiratory depression is the priority assessment because it is the most life-threatening side effect of opioid analgesics.
Using the ABCs prioritization framework, breathing takes precedence over all other concerns. The nurse should monitor respiratory
rate, depth, and oxygen saturation closely, particularly during the first 24 hours of PCA therapy and after any dose increase. While
constipation, sedation, and nausea are common opioid side effects, they are not immediately life-threatening. ATI emphasizes that
respiratory depression is always the priority concern with opioid administration.
Q7: A nurse is using the LEARN model to provide culturally competent care to a client from a different
cultural background. The nurse listens to the client's explanation of their health beliefs, then acknowledges
those beliefs. Which of the following steps should the nurse take next according to the LEARN model?
A. Negotiate a treatment plan
B. Explain the medical perspective [CORRECT]
C. Recommend a course of action
D. Refer the client to a cultural liaison
Correct Answer: B
Rationale: The LEARN model stands for Listen, Explain, Acknowledge, Recommend, and Negotiate. After listening and
acknowledging, the next step is to explain the medical or nursing perspective on the health issue. This creates a dialogue where both
perspectives are shared before moving to recommendations and negotiation. ATI emphasizes the importance of following
communication models in sequence to build therapeutic relationships.
Page 2
, ATI RN Concept-Based Assessment Level 3 Proctored Examination 150 Questions | 100% Verified
Q8: A nurse is providing discharge teaching to a client with limited health literacy. Which of the following
techniques should the nurse use to evaluate the client's understanding?
A. Provide written materials at a 12th-grade reading level
B. Ask the client if they understand the instructions
C. Use the teach-back method [CORRECT]
D. Provide a list of medical terminology with definitions
Correct Answer: C
Rationale: The teach-back method is the most effective technique for evaluating a client's understanding of health information,
particularly for those with limited health literacy. The nurse asks the client to explain in their own words what they have been taught,
which confirms comprehension or identifies areas needing reinforcement. Simply asking 'Do you understand?' is ineffective because
clients often say yes regardless of actual comprehension. ATI identifies teach-back as the gold standard for confirming patient
understanding.
Q9: A nurse is communicating with a client who was recently diagnosed with terminal cancer. The client states,
"I don't know how I'm going to tell my children." Which of the following therapeutic communication
techniques is the nurse using by responding, "This must be very difficult for you."?
A. Restating
B. Reflecting
C. Validation [CORRECT]
D. Clarifying
Correct Answer: C
Rationale: Validation is the therapeutic technique being used because the nurse is acknowledging the client's feelings and
communicating that those feelings are understandable and acceptable. Validation differs from restating (repeating the client's main
idea), reflecting (directing back the client's underlying feelings), and clarifying (asking questions to make the client's message
clearer). Validation is particularly important in end-of-life care because it supports emotional processing without judgment. ATI
emphasizes validation as a key therapeutic communication technique.
Q10: A nurse is providing education to a community group about primary prevention strategies. Which of the
following is an example of primary prevention?
A. Annual mammography screening for women over 40
B. Administration of the HPV vaccine to adolescents [CORRECT]
C. Cardiac rehabilitation following a myocardial infarction
D. Daily blood glucose monitoring for a client with diabetes
Correct Answer: B
Rationale: Administration of the HPV vaccine is primary prevention because it aims to prevent disease before it occurs. Primary
prevention includes vaccinations, health education, and lifestyle modifications. Annual mammography is secondary prevention
(screening and early detection). Cardiac rehabilitation and blood glucose monitoring are tertiary prevention (rehabilitation and
disease management after illness onset). ATI distinguishes clearly between the three levels of prevention.
Q11: A client who speaks limited English needs an interpreter for a surgical consent discussion. Which of the
following is the most appropriate action by the nurse?
A. Ask the client's bilingual family member to interpret
B. Use a professional medical interpreter [CORRECT]
C. Write the information down for the client to read
D. Use hand gestures and simple English words
Correct Answer: B
Rationale: A professional medical interpreter is the most appropriate choice because they are trained in medical terminology,
maintain confidentiality, and provide accurate, unbiased interpretation. Family members should not be used as interpreters because
they may filter information, lack medical vocabulary, or impose their own opinions. ATI mandates the use of professional interpreter
Page 3
ATI RN Concept-
Based Assessment
Level 3
Comprehensive 150-question examination covering patient-
centered care, evidence-based practice, safety and
infection control, clinical decision-making, healthcare
systems, delegation, medical-surgical nursing, mental
health, maternal-newborn and pediatric nursing, and
integrated NGN-style clinical judgment scenarios aligned
All 150 Questions with Correct Answers and Detailed Rationales
with 2026-2027 ATI competencies.
100% Verified | A+ Graded Content
20 26 - 20 27 AT I C O N C E P T- B A S E D A S S E S S M E N T C O M P E T E N C I E S
,Section 1: Patient-Centered Care (Comfort, End-of-Life, Diversity,
Communication, Health Promotion) [Q1-Q20]
Q1: A nurse is caring for a client who is receiving palliative care for end-stage pancreatic cancer. The client
reports severe pain rated 9 on a 0-10 scale. Which of the following is the priority nursing action?
A. Administer the prescribed morphine as ordered [CORRECT]
B. Encourage the client to use guided imagery techniques
C. Reposition the client for comfort
D. Notify the provider for a pain management consultation
Correct Answer: A
Rationale: The priority action is to administer the prescribed morphine because pain is a subjective experience and the patient's
self-report is the gold standard for pain assessment. In palliative care, symptom management is the primary focus, and opioid
analgesics such as morphine are the mainstay of treatment for severe cancer pain. While guided imagery, repositioning, and provider
notification are appropriate interventions, they do not take priority over administering the ordered analgesic for severe pain. The
WHO Pain Ladder supports using strong opioids for severe pain (Step 3). ATI prioritization frameworks emphasize addressing the
most immediate physiological need first.
Q2: A nurse is providing hospice care to a client with a prognosis of less than six months. The client's family
asks the nurse what hospice care entails. Which of the following is the most appropriate response by the nurse?
A. "Hospice focuses on curing the underlying disease while providing comfort measures."
B. "Hospice provides interdisciplinary care focused on comfort and quality of life when cure is no longer the
goal." [CORRECT]
C. "Hospice is only provided in an inpatient hospital setting."
D. "Hospice care continues until the client is discharged from the healthcare system."
Correct Answer: B
Rationale: Hospice care is interdisciplinary care focused on improving quality of life for patients and families when curative
treatment is no longer the goal. It requires a physician certification of a prognosis of six months or less and patient or family consent.
Hospice care can be provided in multiple settings including the home, inpatient hospice facilities, and long-term care facilities. The
focus is exclusively on comfort and quality of life rather than cure. Options A, C, and D contain inaccurate information about
hospice care.
Q3: A nurse is assessing a client with end-stage liver disease who reports increasing dyspnea. Which of the
following interventions should the nurse implement first?
A. Administer prescribed supplemental oxygen
B. Elevate the head of the bed [CORRECT]
C. Administer morphine as prescribed
D. Obtain a pulse oximetry reading
Correct Answer: B
Rationale: Elevating the head of the bed is the first intervention because it is an independent nursing action that immediately
improves breathing by reducing pressure on the diaphragm and promoting lung expansion. The ABCs framework (Airway,
Breathing, Circulation) guides prioritization, and positioning is a noninvasive, immediate intervention for dyspnea. Supplemental
oxygen, morphine for dyspnea, and pulse oximetry are also appropriate but should follow positioning. ATI emphasizes using the least
invasive intervention first before progressing to more complex measures.
Q4: A nurse is caring for a client who is experiencing nausea related to chemotherapy. Which of the following
medications should the nurse anticipate administering?
,ATI RN Concept-Based Assessment Level 3 Proctored Examination 150 Questions | 100% Verified
A. Ondansetron
B. Metoclopramide
C. Ondansetron or metoclopramide as prescribed [CORRECT]
D. Lorazepam
Correct Answer: C
Rationale: Both ondansetron (a serotonin 5-HT3 receptor antagonist) and metoclopramide (a dopamine antagonist and prokinetic
agent) are appropriate antiemetics for chemotherapy-induced nausea. The specific medication choice depends on the prescriber's
order and the emetogenic potential of the chemotherapy regimen. Ondansetron is considered first-line for moderate to highly
emetogenic chemotherapy. Lorazepam is used for anticipatory nausea and anxiety rather than as a primary antiemetic. ATI
emphasizes administering medications as prescribed while understanding the pharmacological rationale for each.
Q5: A nurse is assessing pain in an 82-year-old client who has advanced dementia and is nonverbal. Which of
the following pain assessment tools is the most appropriate for this client?
A. Numeric rating scale (0-10)
B. Visual Analog Scale (VAS)
C. PAINAD scale [CORRECT]
D. Wong-Baker FACES scale
Correct Answer: C
Rationale: The PAINAD (Pain Assessment in Advanced Dementia) scale is specifically designed for assessing pain in elderly,
nonverbal clients with advanced dementia. It evaluates five behavioral indicators: breathing, negative vocalization, facial expression,
body language, and consolability. The numeric rating scale and VAS require self-report and are inappropriate for nonverbal clients.
The Wong-Baker FACES scale may be used for children but is not validated for advanced dementia. ATI emphasizes using
validated, population-specific assessment tools for accurate clinical evaluation.
Q6: A nurse is caring for a client who is prescribed morphine via patient-controlled analgesia (PCA) for
postoperative pain. Which of the following assessments is the priority for the nurse to monitor?
A. Constipation
B. Respiratory depression [CORRECT]
C. Sedation
D. Nausea and vomiting
Correct Answer: B
Rationale: Respiratory depression is the priority assessment because it is the most life-threatening side effect of opioid analgesics.
Using the ABCs prioritization framework, breathing takes precedence over all other concerns. The nurse should monitor respiratory
rate, depth, and oxygen saturation closely, particularly during the first 24 hours of PCA therapy and after any dose increase. While
constipation, sedation, and nausea are common opioid side effects, they are not immediately life-threatening. ATI emphasizes that
respiratory depression is always the priority concern with opioid administration.
Q7: A nurse is using the LEARN model to provide culturally competent care to a client from a different
cultural background. The nurse listens to the client's explanation of their health beliefs, then acknowledges
those beliefs. Which of the following steps should the nurse take next according to the LEARN model?
A. Negotiate a treatment plan
B. Explain the medical perspective [CORRECT]
C. Recommend a course of action
D. Refer the client to a cultural liaison
Correct Answer: B
Rationale: The LEARN model stands for Listen, Explain, Acknowledge, Recommend, and Negotiate. After listening and
acknowledging, the next step is to explain the medical or nursing perspective on the health issue. This creates a dialogue where both
perspectives are shared before moving to recommendations and negotiation. ATI emphasizes the importance of following
communication models in sequence to build therapeutic relationships.
Page 2
, ATI RN Concept-Based Assessment Level 3 Proctored Examination 150 Questions | 100% Verified
Q8: A nurse is providing discharge teaching to a client with limited health literacy. Which of the following
techniques should the nurse use to evaluate the client's understanding?
A. Provide written materials at a 12th-grade reading level
B. Ask the client if they understand the instructions
C. Use the teach-back method [CORRECT]
D. Provide a list of medical terminology with definitions
Correct Answer: C
Rationale: The teach-back method is the most effective technique for evaluating a client's understanding of health information,
particularly for those with limited health literacy. The nurse asks the client to explain in their own words what they have been taught,
which confirms comprehension or identifies areas needing reinforcement. Simply asking 'Do you understand?' is ineffective because
clients often say yes regardless of actual comprehension. ATI identifies teach-back as the gold standard for confirming patient
understanding.
Q9: A nurse is communicating with a client who was recently diagnosed with terminal cancer. The client states,
"I don't know how I'm going to tell my children." Which of the following therapeutic communication
techniques is the nurse using by responding, "This must be very difficult for you."?
A. Restating
B. Reflecting
C. Validation [CORRECT]
D. Clarifying
Correct Answer: C
Rationale: Validation is the therapeutic technique being used because the nurse is acknowledging the client's feelings and
communicating that those feelings are understandable and acceptable. Validation differs from restating (repeating the client's main
idea), reflecting (directing back the client's underlying feelings), and clarifying (asking questions to make the client's message
clearer). Validation is particularly important in end-of-life care because it supports emotional processing without judgment. ATI
emphasizes validation as a key therapeutic communication technique.
Q10: A nurse is providing education to a community group about primary prevention strategies. Which of the
following is an example of primary prevention?
A. Annual mammography screening for women over 40
B. Administration of the HPV vaccine to adolescents [CORRECT]
C. Cardiac rehabilitation following a myocardial infarction
D. Daily blood glucose monitoring for a client with diabetes
Correct Answer: B
Rationale: Administration of the HPV vaccine is primary prevention because it aims to prevent disease before it occurs. Primary
prevention includes vaccinations, health education, and lifestyle modifications. Annual mammography is secondary prevention
(screening and early detection). Cardiac rehabilitation and blood glucose monitoring are tertiary prevention (rehabilitation and
disease management after illness onset). ATI distinguishes clearly between the three levels of prevention.
Q11: A client who speaks limited English needs an interpreter for a surgical consent discussion. Which of the
following is the most appropriate action by the nurse?
A. Ask the client's bilingual family member to interpret
B. Use a professional medical interpreter [CORRECT]
C. Write the information down for the client to read
D. Use hand gestures and simple English words
Correct Answer: B
Rationale: A professional medical interpreter is the most appropriate choice because they are trained in medical terminology,
maintain confidentiality, and provide accurate, unbiased interpretation. Family members should not be used as interpreters because
they may filter information, lack medical vocabulary, or impose their own opinions. ATI mandates the use of professional interpreter
Page 3
