Ultimate ATI RN 2026 Proctored Exam
Bundle: Comprehensive Predictor, Med-
Surg, Peds, Pharmacology,
Fundamentals, Maternal Newborn,
Mental Health, Leadership, Community
Health, and Nutrition Mastery Review
Table of Contents
1. Comprehensive Predictor & Critical Care (Questions 1-15)
2. Medical-Surgical Nursing (Questions 16-35)
3. Pharmacology & Parenteral Therapies (Questions 36-55)
4. Fundamentals of Nursing (Questions 56-70)
5. Maternal & Newborn Care (Questions 71-85)
6. Pediatric Nursing (Questions 86-100)
7. Mental Health Nursing (Questions 101-115)
8. Leadership & Management (Questions 116-125)
9. Community Health & Nutrition (Questions 126-135)
10. Integrated Concepts & Prioritization (Questions 136-150)
1. Comprehensive Predictor & Critical Care
🟢 1. A nurse is caring for a client who is 24 hours post-operative from a coronary artery bypass graft
(CABG). The client's chest tube output has suddenly increased to 250 mL/hr of bright red blood. Which
action should the nurse take first?
A. Increase the IV fluid rate.
B. Prepare the client for emergency re-exploration.
C. Check the client's hemoglobin and hematocrit.
D. Administer a bolus of protamine sulfate.
Correct Answer: B
✔✔ Rationale: Output > 150-200 mL/hr indicates hemorrhage (cardiac tamponade risk). The priority is
,surgical intervention. Checking labs (C) takes too long; the client is actively bleeding. Fluid resuscitation
(A) is supportive but not the priority over surgical control.
🟢 2. A client is admitted with severe sepsis. The provider orders a 30 mL/kg bolus of 0.9% NaCl. The
client weighs 80 kg. The nurse has 500 mL bags of 0.9% NaCl. How many bags will the nurse need to
administer to fulfill this order?
A. 2 Bags
B. 3 Bags
C. 4 Bags
D. 5 Bags
Correct Answer: D
✔✔ Rationale: 80 kg x 30 mL = 2400 mL. 2400 mL / 500 mL per bag = 4.8 bags. Since you cannot give a
partial bag, you need 5 bags.
🟢 3. A nurse is assessing a client with a traumatic brain injury. The client's ICP is 20 mmHg and MAP is
60 mmHg. What is the client's Cerebral Perfusion Pressure (CPP)?
A. 40 mmHg
B. 80 mmHg
C. 20 mmHg
D. 100 mmHg
Correct Answer: A
✔✔ Rationale: CPP = MAP - ICP. 60 - 20 = 40 mmHg. The goal is to keep CPP > 60 mmHg.
🟢 4. A client is in the compensatory stage of shock. Which finding should the nurse expect?
A. Decreased heart rate.
B. Warm, flushed skin.
C. Increased respiratory rate.
D. Anuria.
Correct Answer: C
✔✔ Rationale: In the compensatory stage, the body attempts to maintain perfusion. Respiratory rate
increases to compensate for metabolic acidosis. HR increases (A is wrong). Skin is cool/clammy (B is
wrong). Urine output decreases but is not yet anuric (D is wrong).
🟢 5. A nurse is caring for a client on a ventilator with ARDS. Which ventilator setting is most
appropriate to recruit collapsed alveoli?
A. High tidal volume.
B. Low PEEP.
C. High PEEP.
D. Low respiratory rate.
Correct Answer: C
✔✔ Rationale: Positive End-Expiratory Pressure (PEEP) keeps alveoli open and prevents collapse. High
tidal volumes (A) can cause volutrauma.
,🟢 6. A client is admitted with DKA. The nurse notes Kussmaul respirations. What is the physiological
purpose of this breathing pattern?
A. To increase oxygen intake.
B. To blow off carbon dioxide and decrease acid.
C. To increase lung expansion.
D. To prevent respiratory alkalosis.
Correct Answer: B
✔✔ Rationale: Kussmaul respirations are deep and rapid to exhale CO2 (an acid) to compensate for
metabolic acidosis.
🟢 7. A nurse is assessing a client with a spinal cord injury at T6. The client reports a severe headache
and has a BP of 210/110. What is the priority action?
A. Administer antihypertensives.
B. Check for bladder distension.
C. Place the client supine.
D. Administer oxygen.
Correct Answer: B
✔✔ Rationale: This is autonomic dysreflexia. The priority is to find and remove the noxious stimulus
(usually a full bladder or bowel). Place the client upright (C is wrong).
🟢 8. A client with a pulmonary embolism is started on a heparin infusion. Which lab value should the
nurse monitor to evaluate therapeutic effectiveness?
A. PT/INR.
B. aPTT.
C. Platelet count.
D. D-dimer.
Correct Answer: B
✔✔ Rationale: aPTT is used to monitor unfractionated heparin. PT/INR monitors warfarin.
🟢 9. A nurse is caring for a client with a chest tube. The nurse notices bubbling in the water seal
chamber. What is the appropriate interpretation?
A. The lung has re-expanded.
B. There is an air leak.
C. The system is functioning correctly.
D. The tube is clogged.
Correct Answer: B
✔✔ Rationale: Continuous bubbling in the water seal chamber indicates an air leak. Intermittent
bubbling is normal with coughing.
🟢 10. A client is prescribed dopamine. The nurse should monitor for which adverse effect?
A. Bradycardia.
B. Hypertension.
, C. Hypotension.
D. Hypoglycemia.
Correct Answer: B
✔✔ Rationale: Dopamine is a vasopressor and can cause severe hypertension and tachycardia.
🟢 11. A nurse is assessing a client with increased intracranial pressure. Which position is
contraindicated?
A. Head of bed elevated 30 degrees.
B. Neutral neck position.
C. Trendelenburg position.
D. Supine with head turned to the side.
Correct Answer: C
✔✔ Rationale: Trendelenburg increases ICP. HOB should be elevated.
🟢 12. A client is in hypovolemic shock. Which finding indicates the client is entering the progressive
stage?
A. Thirst.
B. Lethargy.
C. Tachycardia.
D. Oliguria.
Correct Answer: D
✔✔ Rationale: Oliguria (decreased urine output) indicates decreased renal perfusion, a sign of the
progressive stage where compensatory mechanisms are failing.
🟢 13. A nurse is caring for a client post-cardiac catheterization. Which finding requires immediate
intervention?
A. Minor bruising at the insertion site.
B. Back pain.
C. Bleeding at the insertion site.
D. Warm toes.
Correct Answer: C
✔✔ Rationale: Bleeding indicates hemorrhage. Back pain (B) could indicate retroperitoneal bleeding,
but active external bleeding is the priority.
🟢 14. A client is admitted with COPD. Which oxygen delivery method is safest?
A. Nasal cannula at 2 L/min.
B. Non-rebreather mask at 10 L/min.
C. Simple face mask at 8 L/min.
D. Venturi mask at 4 L/min.
Correct Answer: A
✔✔ Rationale: COPD clients are at risk for CO2 retention. Low-flow oxygen (1-3 L/min) is standard.
Bundle: Comprehensive Predictor, Med-
Surg, Peds, Pharmacology,
Fundamentals, Maternal Newborn,
Mental Health, Leadership, Community
Health, and Nutrition Mastery Review
Table of Contents
1. Comprehensive Predictor & Critical Care (Questions 1-15)
2. Medical-Surgical Nursing (Questions 16-35)
3. Pharmacology & Parenteral Therapies (Questions 36-55)
4. Fundamentals of Nursing (Questions 56-70)
5. Maternal & Newborn Care (Questions 71-85)
6. Pediatric Nursing (Questions 86-100)
7. Mental Health Nursing (Questions 101-115)
8. Leadership & Management (Questions 116-125)
9. Community Health & Nutrition (Questions 126-135)
10. Integrated Concepts & Prioritization (Questions 136-150)
1. Comprehensive Predictor & Critical Care
🟢 1. A nurse is caring for a client who is 24 hours post-operative from a coronary artery bypass graft
(CABG). The client's chest tube output has suddenly increased to 250 mL/hr of bright red blood. Which
action should the nurse take first?
A. Increase the IV fluid rate.
B. Prepare the client for emergency re-exploration.
C. Check the client's hemoglobin and hematocrit.
D. Administer a bolus of protamine sulfate.
Correct Answer: B
✔✔ Rationale: Output > 150-200 mL/hr indicates hemorrhage (cardiac tamponade risk). The priority is
,surgical intervention. Checking labs (C) takes too long; the client is actively bleeding. Fluid resuscitation
(A) is supportive but not the priority over surgical control.
🟢 2. A client is admitted with severe sepsis. The provider orders a 30 mL/kg bolus of 0.9% NaCl. The
client weighs 80 kg. The nurse has 500 mL bags of 0.9% NaCl. How many bags will the nurse need to
administer to fulfill this order?
A. 2 Bags
B. 3 Bags
C. 4 Bags
D. 5 Bags
Correct Answer: D
✔✔ Rationale: 80 kg x 30 mL = 2400 mL. 2400 mL / 500 mL per bag = 4.8 bags. Since you cannot give a
partial bag, you need 5 bags.
🟢 3. A nurse is assessing a client with a traumatic brain injury. The client's ICP is 20 mmHg and MAP is
60 mmHg. What is the client's Cerebral Perfusion Pressure (CPP)?
A. 40 mmHg
B. 80 mmHg
C. 20 mmHg
D. 100 mmHg
Correct Answer: A
✔✔ Rationale: CPP = MAP - ICP. 60 - 20 = 40 mmHg. The goal is to keep CPP > 60 mmHg.
🟢 4. A client is in the compensatory stage of shock. Which finding should the nurse expect?
A. Decreased heart rate.
B. Warm, flushed skin.
C. Increased respiratory rate.
D. Anuria.
Correct Answer: C
✔✔ Rationale: In the compensatory stage, the body attempts to maintain perfusion. Respiratory rate
increases to compensate for metabolic acidosis. HR increases (A is wrong). Skin is cool/clammy (B is
wrong). Urine output decreases but is not yet anuric (D is wrong).
🟢 5. A nurse is caring for a client on a ventilator with ARDS. Which ventilator setting is most
appropriate to recruit collapsed alveoli?
A. High tidal volume.
B. Low PEEP.
C. High PEEP.
D. Low respiratory rate.
Correct Answer: C
✔✔ Rationale: Positive End-Expiratory Pressure (PEEP) keeps alveoli open and prevents collapse. High
tidal volumes (A) can cause volutrauma.
,🟢 6. A client is admitted with DKA. The nurse notes Kussmaul respirations. What is the physiological
purpose of this breathing pattern?
A. To increase oxygen intake.
B. To blow off carbon dioxide and decrease acid.
C. To increase lung expansion.
D. To prevent respiratory alkalosis.
Correct Answer: B
✔✔ Rationale: Kussmaul respirations are deep and rapid to exhale CO2 (an acid) to compensate for
metabolic acidosis.
🟢 7. A nurse is assessing a client with a spinal cord injury at T6. The client reports a severe headache
and has a BP of 210/110. What is the priority action?
A. Administer antihypertensives.
B. Check for bladder distension.
C. Place the client supine.
D. Administer oxygen.
Correct Answer: B
✔✔ Rationale: This is autonomic dysreflexia. The priority is to find and remove the noxious stimulus
(usually a full bladder or bowel). Place the client upright (C is wrong).
🟢 8. A client with a pulmonary embolism is started on a heparin infusion. Which lab value should the
nurse monitor to evaluate therapeutic effectiveness?
A. PT/INR.
B. aPTT.
C. Platelet count.
D. D-dimer.
Correct Answer: B
✔✔ Rationale: aPTT is used to monitor unfractionated heparin. PT/INR monitors warfarin.
🟢 9. A nurse is caring for a client with a chest tube. The nurse notices bubbling in the water seal
chamber. What is the appropriate interpretation?
A. The lung has re-expanded.
B. There is an air leak.
C. The system is functioning correctly.
D. The tube is clogged.
Correct Answer: B
✔✔ Rationale: Continuous bubbling in the water seal chamber indicates an air leak. Intermittent
bubbling is normal with coughing.
🟢 10. A client is prescribed dopamine. The nurse should monitor for which adverse effect?
A. Bradycardia.
B. Hypertension.
, C. Hypotension.
D. Hypoglycemia.
Correct Answer: B
✔✔ Rationale: Dopamine is a vasopressor and can cause severe hypertension and tachycardia.
🟢 11. A nurse is assessing a client with increased intracranial pressure. Which position is
contraindicated?
A. Head of bed elevated 30 degrees.
B. Neutral neck position.
C. Trendelenburg position.
D. Supine with head turned to the side.
Correct Answer: C
✔✔ Rationale: Trendelenburg increases ICP. HOB should be elevated.
🟢 12. A client is in hypovolemic shock. Which finding indicates the client is entering the progressive
stage?
A. Thirst.
B. Lethargy.
C. Tachycardia.
D. Oliguria.
Correct Answer: D
✔✔ Rationale: Oliguria (decreased urine output) indicates decreased renal perfusion, a sign of the
progressive stage where compensatory mechanisms are failing.
🟢 13. A nurse is caring for a client post-cardiac catheterization. Which finding requires immediate
intervention?
A. Minor bruising at the insertion site.
B. Back pain.
C. Bleeding at the insertion site.
D. Warm toes.
Correct Answer: C
✔✔ Rationale: Bleeding indicates hemorrhage. Back pain (B) could indicate retroperitoneal bleeding,
but active external bleeding is the priority.
🟢 14. A client is admitted with COPD. Which oxygen delivery method is safest?
A. Nasal cannula at 2 L/min.
B. Non-rebreather mask at 10 L/min.
C. Simple face mask at 8 L/min.
D. Venturi mask at 4 L/min.
Correct Answer: A
✔✔ Rationale: COPD clients are at risk for CO2 retention. Low-flow oxygen (1-3 L/min) is standard.
