ATI Critical Care Proctored Exam V3 |
2026 Q&A with Rationale (ATI Critical
Care Proctored Exam 2026)
1. A nurse in the intensive care unit is caring for a client on mechanical ventilation when the
high-pressure alarm sounds. Which of the following actions should the nurse take first?
A. Silence the alarm and check the machine settings.
B. Drain the water from the ventilator tubing.
C. Suction the client’s endotracheal tube for secretions.
D. Assess the client’s breath sounds and respiratory status.
Correct Answer: D
Rationale: The first action the nurse should take is to assess the client to determine the
cause of the alarm. High-pressure alarms are often triggered by secretions, kinks in the
tubing, or the client biting the tube. By assessing the client first, the nurse can prioritize
interventions based on clinical findings such as respiratory distress or adventitious breath
sounds.
2. A nurse is monitoring a client who has a pulmonary artery catheter. The nurse notes that
the pulmonary artery wedge pressure (PAWP) is 18 mmHg. The nurse should identify that this
finding is indicative of which of the following?
A. Hypovolemic shock
,B. Right-sided heart failure
C. Left-sided heart failure
D. Pulmonary hypertension
Correct Answer: C
Rationale: A normal PAWP ranges from 4 to 12 mmHg, and an elevation indicates
increased pressure in the left atrium and left ventricle. Findings above 12 mmHg often
suggest fluid volume excess or left-sided heart failure. The nurse should assess the client
for symptoms of pulmonary edema such as crackles and dyspnea.
3. A nurse is caring for a client who is in the early stages of septic shock. Which of the
following clinical manifestations should the nurse expect?
A. Cool, clammy skin
B. Bradycardia
C. Increased urine output
D. Warm, flushed skin
Correct Answer: D
Rationale: In the early (hyperdynamic) stage of septic shock, the client typically exhibits
warm, flushed skin due to systemic vasodilation. This stage is also characterized by a high
cardiac output and tachycardia as the body attempts to compensate for infection. As the
,shock progresses to the late stage, the skin becomes cool and mottled as cardiac output
drops.
4. A nurse is caring for a client who has a chest tube connected to a water-seal drainage
system. The nurse observes continuous bubbling in the water-seal chamber. Which of the
following actions should the nurse take?
A. Check the system for an air leak.
B. Document this as a normal finding.
C. Increase the suction pressure.
D. Clamp the chest tube for 24 hours.
Correct Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system or from the client’s pleural space. Intermittent bubbling is expected during
expiration or coughing, but continuous activity requires investigation. The nurse should
check all connections and the insertion site to locate and resolve the leak.
5. A nurse is assessing a client who has a traumatic brain injury and notes a Glasow Coma
Scale (GCS) score of 6. Which of the following interventions is the priority?
A. Ensure the client has a patent airway.
B. Prepare the client for emergency surgery.
C. Assess the client’s pupillary response.
, D. Administer mannitol intravenously.
Correct Answer: A
Rationale: A GCS score of 8 or less typically indicates a severe head injury and a high risk
for airway compromise. The priority in emergency care is always the airway, as the client
may lose the ability to maintain their own respiratory effort. Once the airway is stabilized,
other neurological assessments and treatments like mannitol can be initiated.
6. A nurse is caring for a client with acute respiratory distress syndrome (ARDS) who is
receiving mechanical ventilation with positive end-expiratory pressure (PEEP). The nurse
should monitor for which of the following complications?
A. Left ventricular hypertrophy
B. Hypervolemia
C. Decreased intracranial pressure
D. Pneumothorax
Correct Answer: D
Rationale: PEEP improves oxygenation by keeping alveoli open, but high levels can cause
barotrauma. This increased pressure can lead to a pneumothorax or subcutaneous
emphysema. The nurse must monitor breath sounds and chest symmetry to detect these
complications early.
2026 Q&A with Rationale (ATI Critical
Care Proctored Exam 2026)
1. A nurse in the intensive care unit is caring for a client on mechanical ventilation when the
high-pressure alarm sounds. Which of the following actions should the nurse take first?
A. Silence the alarm and check the machine settings.
B. Drain the water from the ventilator tubing.
C. Suction the client’s endotracheal tube for secretions.
D. Assess the client’s breath sounds and respiratory status.
Correct Answer: D
Rationale: The first action the nurse should take is to assess the client to determine the
cause of the alarm. High-pressure alarms are often triggered by secretions, kinks in the
tubing, or the client biting the tube. By assessing the client first, the nurse can prioritize
interventions based on clinical findings such as respiratory distress or adventitious breath
sounds.
2. A nurse is monitoring a client who has a pulmonary artery catheter. The nurse notes that
the pulmonary artery wedge pressure (PAWP) is 18 mmHg. The nurse should identify that this
finding is indicative of which of the following?
A. Hypovolemic shock
,B. Right-sided heart failure
C. Left-sided heart failure
D. Pulmonary hypertension
Correct Answer: C
Rationale: A normal PAWP ranges from 4 to 12 mmHg, and an elevation indicates
increased pressure in the left atrium and left ventricle. Findings above 12 mmHg often
suggest fluid volume excess or left-sided heart failure. The nurse should assess the client
for symptoms of pulmonary edema such as crackles and dyspnea.
3. A nurse is caring for a client who is in the early stages of septic shock. Which of the
following clinical manifestations should the nurse expect?
A. Cool, clammy skin
B. Bradycardia
C. Increased urine output
D. Warm, flushed skin
Correct Answer: D
Rationale: In the early (hyperdynamic) stage of septic shock, the client typically exhibits
warm, flushed skin due to systemic vasodilation. This stage is also characterized by a high
cardiac output and tachycardia as the body attempts to compensate for infection. As the
,shock progresses to the late stage, the skin becomes cool and mottled as cardiac output
drops.
4. A nurse is caring for a client who has a chest tube connected to a water-seal drainage
system. The nurse observes continuous bubbling in the water-seal chamber. Which of the
following actions should the nurse take?
A. Check the system for an air leak.
B. Document this as a normal finding.
C. Increase the suction pressure.
D. Clamp the chest tube for 24 hours.
Correct Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system or from the client’s pleural space. Intermittent bubbling is expected during
expiration or coughing, but continuous activity requires investigation. The nurse should
check all connections and the insertion site to locate and resolve the leak.
5. A nurse is assessing a client who has a traumatic brain injury and notes a Glasow Coma
Scale (GCS) score of 6. Which of the following interventions is the priority?
A. Ensure the client has a patent airway.
B. Prepare the client for emergency surgery.
C. Assess the client’s pupillary response.
, D. Administer mannitol intravenously.
Correct Answer: A
Rationale: A GCS score of 8 or less typically indicates a severe head injury and a high risk
for airway compromise. The priority in emergency care is always the airway, as the client
may lose the ability to maintain their own respiratory effort. Once the airway is stabilized,
other neurological assessments and treatments like mannitol can be initiated.
6. A nurse is caring for a client with acute respiratory distress syndrome (ARDS) who is
receiving mechanical ventilation with positive end-expiratory pressure (PEEP). The nurse
should monitor for which of the following complications?
A. Left ventricular hypertrophy
B. Hypervolemia
C. Decreased intracranial pressure
D. Pneumothorax
Correct Answer: D
Rationale: PEEP improves oxygenation by keeping alveoli open, but high levels can cause
barotrauma. This increased pressure can lead to a pneumothorax or subcutaneous
emphysema. The nurse must monitor breath sounds and chest symmetry to detect these
complications early.
