2026/2027 ATI CRITICAL
CARE PROCTORED EXAM:
ULTIMATE MASTERY GUIDE
Comprehensive Preparation Guide, Expert
Rationales & Visual Study Aids
Edition Year: 2026
THE CANDIDATE'S TOOLKIT
(FRONT MATTER)
,Topic Index & Strategic Module
Breakdown
Success on the ATI Critical Care Proctored Exam requires more than rote memorization; it
demands a nuanced understanding of physiological interdependence. The exam blueprint is not
merely a list of topics but a structural framework that assesses a candidate's ability to prioritize
care in high-acuity environments. This guide organizes the vast curriculum into five strategic
modules, reflecting the weighted domains of the exam, including Management of Care (approx.
20%) and Pharmacological & Parenteral Therapies (approx. 15%).
The following module breakdown outlines the core competencies targeted in this guide:
Module Core Competencies & Key Blueprint Weight
Themes
1. Cardiovascular Hemodynamic Monitoring: High Yield
Hemodynamics & Shock CVP, PAOP, SVR, MAP,
,Module Core Competencies & Key Blueprint Weight
Themes
Cardiac Index interpretation.
Shock States: Differentiating
Cardiogenic, Hypovolemic,
Septic, and Neurogenic
profiles. Dysrhythmias: Lethal
rhythms, AV blocks, and ACLS
protocols. ACS Management:
MI localization and
post-intervention care
(CABG/PCI).
2. Respiratory Critical Care Mechanical Ventilation: High Yield
Modes (AC, SIMV, PSV),
Weaning, and Troubleshooting
Alarms. Gas Exchange:
Advanced ABG interpretation,
ARDS pathology, and
Pulmonary Embolism
management. Airway
Management: Artificial
airways, suctioning protocols,
and chest tube management.
3. Neurocritical Care ICP Dynamics: Monroe-Kellie Moderate Yield
hypothesis, CPP calculation,
and herniation syndromes.
Trauma & Stroke: TBI
management (GCS), Spinal
Cord Injury (Autonomic
Dysreflexia), and Ischemic vs.
Hemorrhagic Stroke
interventions. Sensory: Brain
death testing and sedation
assessment.
4. Renal, Endocrine & Renal Failure: AKI phases, Moderate Yield
Metabolic RIFLE criteria, and CRRT vs.
Hemodialysis nuances.
Endocrine Crises: DKA vs.
HHS differentiation, Adrenal
Crisis, and Thyroid
Storm/Myxedema Coma.
Electrolytes: Life-threatening
imbalances (Hyperkalemia,
Hyponatremia).
5. Trauma, Burn & GI Trauma Resuscitation: Moderate Yield
Emergencies Primary/Secondary Survey
(ABCDE), Massive Transfusion.
, Module Core Competencies & Key Blueprint Weight
Themes
Burns: Fluid resuscitation
(Parkland), inhalation injury,
and wound care.
GI/Multi-System: GI Bleeding,
Pancreatitis, Organ Donation,
and Triage ethics.
High-Yield Formula Sheet: The "Math of Survival"
In the critical care environment, rapid calculation is often the difference between stability and
decompensation. The following formulas are essential for the exam and clinical practice.
Candidates must not only memorize the equation but understand the physiological implications
of the variables.
1. Mean Arterial Pressure (MAP)
The MAP is the average pressure in a patient’s arteries during one cardiac cycle. It is
considered a better indicator of perfusion to vital organs than systolic blood pressure alone
because diastole lasts twice as long as systole.
● Formula:
● Clinical Significance: A MAP of at least 60-65 mm Hg is required to maintain adequate
tissue perfusion to the coronary arteries, kidneys, and brain. In sepsis, the Surviving
Sepsis Campaign targets a MAP \ge 65 mm Hg.
● Exam Application: You will likely be given a BP (e.g., 90/40) and asked if perfusion is
adequate.
○ Calculation: [(2 \times 40) + 90] / 3 = = 56.6 mm Hg.
CARE PROCTORED EXAM:
ULTIMATE MASTERY GUIDE
Comprehensive Preparation Guide, Expert
Rationales & Visual Study Aids
Edition Year: 2026
THE CANDIDATE'S TOOLKIT
(FRONT MATTER)
,Topic Index & Strategic Module
Breakdown
Success on the ATI Critical Care Proctored Exam requires more than rote memorization; it
demands a nuanced understanding of physiological interdependence. The exam blueprint is not
merely a list of topics but a structural framework that assesses a candidate's ability to prioritize
care in high-acuity environments. This guide organizes the vast curriculum into five strategic
modules, reflecting the weighted domains of the exam, including Management of Care (approx.
20%) and Pharmacological & Parenteral Therapies (approx. 15%).
The following module breakdown outlines the core competencies targeted in this guide:
Module Core Competencies & Key Blueprint Weight
Themes
1. Cardiovascular Hemodynamic Monitoring: High Yield
Hemodynamics & Shock CVP, PAOP, SVR, MAP,
,Module Core Competencies & Key Blueprint Weight
Themes
Cardiac Index interpretation.
Shock States: Differentiating
Cardiogenic, Hypovolemic,
Septic, and Neurogenic
profiles. Dysrhythmias: Lethal
rhythms, AV blocks, and ACLS
protocols. ACS Management:
MI localization and
post-intervention care
(CABG/PCI).
2. Respiratory Critical Care Mechanical Ventilation: High Yield
Modes (AC, SIMV, PSV),
Weaning, and Troubleshooting
Alarms. Gas Exchange:
Advanced ABG interpretation,
ARDS pathology, and
Pulmonary Embolism
management. Airway
Management: Artificial
airways, suctioning protocols,
and chest tube management.
3. Neurocritical Care ICP Dynamics: Monroe-Kellie Moderate Yield
hypothesis, CPP calculation,
and herniation syndromes.
Trauma & Stroke: TBI
management (GCS), Spinal
Cord Injury (Autonomic
Dysreflexia), and Ischemic vs.
Hemorrhagic Stroke
interventions. Sensory: Brain
death testing and sedation
assessment.
4. Renal, Endocrine & Renal Failure: AKI phases, Moderate Yield
Metabolic RIFLE criteria, and CRRT vs.
Hemodialysis nuances.
Endocrine Crises: DKA vs.
HHS differentiation, Adrenal
Crisis, and Thyroid
Storm/Myxedema Coma.
Electrolytes: Life-threatening
imbalances (Hyperkalemia,
Hyponatremia).
5. Trauma, Burn & GI Trauma Resuscitation: Moderate Yield
Emergencies Primary/Secondary Survey
(ABCDE), Massive Transfusion.
, Module Core Competencies & Key Blueprint Weight
Themes
Burns: Fluid resuscitation
(Parkland), inhalation injury,
and wound care.
GI/Multi-System: GI Bleeding,
Pancreatitis, Organ Donation,
and Triage ethics.
High-Yield Formula Sheet: The "Math of Survival"
In the critical care environment, rapid calculation is often the difference between stability and
decompensation. The following formulas are essential for the exam and clinical practice.
Candidates must not only memorize the equation but understand the physiological implications
of the variables.
1. Mean Arterial Pressure (MAP)
The MAP is the average pressure in a patient’s arteries during one cardiac cycle. It is
considered a better indicator of perfusion to vital organs than systolic blood pressure alone
because diastole lasts twice as long as systole.
● Formula:
● Clinical Significance: A MAP of at least 60-65 mm Hg is required to maintain adequate
tissue perfusion to the coronary arteries, kidneys, and brain. In sepsis, the Surviving
Sepsis Campaign targets a MAP \ge 65 mm Hg.
● Exam Application: You will likely be given a BP (e.g., 90/40) and asked if perfusion is
adequate.
○ Calculation: [(2 \times 40) + 90] / 3 = = 56.6 mm Hg.
