ATI RN CONCEPT BASED ASSESSMENT LEVEL 3 PROCTORED
2025-2026 EXAM
COMPREHENSIVE PRACTICE EXAM WITH DETAILED
RATIONALES
QUESTION 1
A nurse is caring for a postoperative client following a bowel resection who suddenly reports shortness
of breath, anxiety, and chest pain. Vital signs reveal tachycardia and decreased SpO₂. The nurse notes
petechiae on the upper chest. Which action should the nurse take first?
A. Apply a nonrebreather mask at 15 L/min
B. Place the client in high-Fowler's position
C. Notify the rapid response team
D. Obtain a STAT ECG
Correct ANSWER✔✨-: B
Rationale: High-Fowler's position promotes maximum lung expansion and facilitates breathing. This is
the priority intervention to improve oxygenation before other interventions. The client is showing signs
of a pulmonary embolism, and positioning helps optimize ventilation-perfusion matching. Option A
would be appropriate after positioning. Option C is necessary but not the first action. Option D is not the
priority in this situation.
QUESTION 2
,A nurse assesses an older adult client with dehydration and notes decreased skin turgor, dry mucous
membranes, confusion, and tachycardia. Which provider order should the nurse implement first?
A. Draw a serum electrolyte panel
B. Initiate a 1-L normal saline bolus
C. Insert a urinary catheter
D. Begin continuous cardiac monitoring
Correct ANSWER✔✨-: B
Rationale: Fluid replacement is the priority to restore circulating volume and prevent hypovolemic
shock. The client is showing signs of severe dehydration with hemodynamic compromise. Option A can
be done after initiating fluids. Option C is not immediately necessary. Option D is supportive but not the
priority.
QUESTION 3
A nurse is teaching a client with newly diagnosed type 1 diabetes about preventing hypoglycemia during
exercise. Which statement indicates understanding?
A. "I will increase my insulin dose on exercise days."
B. "I should exercise before breakfast to burn glucose."
C. "I will eat a carbohydrate snack before exercising."
,D. "I will avoid checking my glucose before exercise."
Correct ANSWER✔✨-: C
Rationale: Consuming a carbohydrate snack before exercise helps prevent exercise-induced
hypoglycemia by providing readily available glucose. Option A is incorrect as increasing insulin would
increase hypoglycemia risk. Option B would increase hypoglycemia risk. Option D is dangerous as
checking glucose is essential.
QUESTION 4
A client receiving morphine via PCA becomes difficult to arouse, with a respiratory rate of 8
breaths/min. Which action should the nurse perform first?
A. Stop the PCA infusion
B. Call the rapid response team
C. Stimulate the client and apply oxygen
D. Prepare naloxone for administration
Correct ANSWER✔✨-: C
Rationale: Immediate stimulation and oxygenation help support respirations and assess responsiveness.
This is the first step to evaluate the severity of respiratory depression. Option A should be done after
stimulating the client. Option B may be needed but not first. Option D is appropriate but requires
assessment first.
QUESTION 5
, A nurse caring for a client with heart failure notes crackles, pink frothy sputum, and anxiety. Which
intervention is the priority?
A. Insert a Foley catheter
B. Administer IV furosemide
C. Obtain a chest x-ray
D. Prepare for echocardiography
Correct ANSWER✔✨-: B
Rationale: IV furosemide rapidly reduces fluid overload by promoting diuresis, decreasing preload, and
relieving pulmonary edema. Option A may be needed but not immediately. Option C can be done after
initiating treatment. Option D is not the priority.
QUESTION 6
A nurse evaluates teaching for a client starting warfarin therapy. Which statement requires
intervention?
A. "I will increase my intake of green leafy vegetables."
B. "I will have my INR checked regularly."
C. "I will use an electric razor."
D. "I'll notify my provider before taking aspirin."
2025-2026 EXAM
COMPREHENSIVE PRACTICE EXAM WITH DETAILED
RATIONALES
QUESTION 1
A nurse is caring for a postoperative client following a bowel resection who suddenly reports shortness
of breath, anxiety, and chest pain. Vital signs reveal tachycardia and decreased SpO₂. The nurse notes
petechiae on the upper chest. Which action should the nurse take first?
A. Apply a nonrebreather mask at 15 L/min
B. Place the client in high-Fowler's position
C. Notify the rapid response team
D. Obtain a STAT ECG
Correct ANSWER✔✨-: B
Rationale: High-Fowler's position promotes maximum lung expansion and facilitates breathing. This is
the priority intervention to improve oxygenation before other interventions. The client is showing signs
of a pulmonary embolism, and positioning helps optimize ventilation-perfusion matching. Option A
would be appropriate after positioning. Option C is necessary but not the first action. Option D is not the
priority in this situation.
QUESTION 2
,A nurse assesses an older adult client with dehydration and notes decreased skin turgor, dry mucous
membranes, confusion, and tachycardia. Which provider order should the nurse implement first?
A. Draw a serum electrolyte panel
B. Initiate a 1-L normal saline bolus
C. Insert a urinary catheter
D. Begin continuous cardiac monitoring
Correct ANSWER✔✨-: B
Rationale: Fluid replacement is the priority to restore circulating volume and prevent hypovolemic
shock. The client is showing signs of severe dehydration with hemodynamic compromise. Option A can
be done after initiating fluids. Option C is not immediately necessary. Option D is supportive but not the
priority.
QUESTION 3
A nurse is teaching a client with newly diagnosed type 1 diabetes about preventing hypoglycemia during
exercise. Which statement indicates understanding?
A. "I will increase my insulin dose on exercise days."
B. "I should exercise before breakfast to burn glucose."
C. "I will eat a carbohydrate snack before exercising."
,D. "I will avoid checking my glucose before exercise."
Correct ANSWER✔✨-: C
Rationale: Consuming a carbohydrate snack before exercise helps prevent exercise-induced
hypoglycemia by providing readily available glucose. Option A is incorrect as increasing insulin would
increase hypoglycemia risk. Option B would increase hypoglycemia risk. Option D is dangerous as
checking glucose is essential.
QUESTION 4
A client receiving morphine via PCA becomes difficult to arouse, with a respiratory rate of 8
breaths/min. Which action should the nurse perform first?
A. Stop the PCA infusion
B. Call the rapid response team
C. Stimulate the client and apply oxygen
D. Prepare naloxone for administration
Correct ANSWER✔✨-: C
Rationale: Immediate stimulation and oxygenation help support respirations and assess responsiveness.
This is the first step to evaluate the severity of respiratory depression. Option A should be done after
stimulating the client. Option B may be needed but not first. Option D is appropriate but requires
assessment first.
QUESTION 5
, A nurse caring for a client with heart failure notes crackles, pink frothy sputum, and anxiety. Which
intervention is the priority?
A. Insert a Foley catheter
B. Administer IV furosemide
C. Obtain a chest x-ray
D. Prepare for echocardiography
Correct ANSWER✔✨-: B
Rationale: IV furosemide rapidly reduces fluid overload by promoting diuresis, decreasing preload, and
relieving pulmonary edema. Option A may be needed but not immediately. Option C can be done after
initiating treatment. Option D is not the priority.
QUESTION 6
A nurse evaluates teaching for a client starting warfarin therapy. Which statement requires
intervention?
A. "I will increase my intake of green leafy vegetables."
B. "I will have my INR checked regularly."
C. "I will use an electric razor."
D. "I'll notify my provider before taking aspirin."
