ATI Critical Care Proctored Exam V1 |
2026 Q&A with Rationale (ATI Critical
Care Proctored Exam 2026)
1. A nurse is caring for a client who is being monitored with a central venous pressure (CVP)
catheter. The CVP reading is 1 mm Hg. Which of the following actions should the nurse take?
A. Initiate a fluid bolus as prescribed.
B. Administer a prescribed diuretic.
C. Place the client in a high-Fowler’s position.
D. Perform chest physiotherapy.
Correct Answer: A
Rationale: A normal CVP range is typically 2 to 8 mm Hg. A reading of 1 mm Hg indicates
low preload, which is commonly seen in hypovolemia. The nurse should anticipate
administering a fluid bolus or increasing the rate of IV fluids to improve volume status.
Diuretics and high-Fowler’s positioning would be appropriate for fluid volume excess, not
deficit.
2. A nurse is monitoring a client who has a suspected head injury and an intracranial pressure
(ICP) monitor. Which of the following findings should the nurse identify as an early indicator
of increased ICP?
A. Widening pulse pressure
,B. Fixed and dilated pupils
C. Bradypnea
D. Restlessness and irritability
Correct Answer: D
Rationale: Changes in level of consciousness, such as restlessness, agitation, or irritability,
are the earliest signs of increasing intracranial pressure. Widening pulse pressure and
bradypnea are part of Cushing’s triad, which is a late sign of neurological deterioration.
Fixed and dilated pupils occur late when herniation is imminent.
3. A nurse is caring for a client on mechanical ventilation in Assist-Control (AC) mode. The
high-pressure alarm begins to sound. Which of the following actions should the nurse take
first?
A. Check for a leak in the ventilator circuit.
B. Assess the client for the need for suctioning.
C. Check if the client has become disconnected.
D. Call the respiratory therapist to adjust the sensitivity.
Correct Answer: B
Rationale: High-pressure alarms are triggered by increased resistance in the system, such
as secretions, kinking of the tube, or the client biting the tube. Assessing the client’s airway
,and the need for suctioning is the priority action. Low-pressure alarms are typically
associated with circuit leaks or disconnections.
4. A nurse is providing care for a client who has 40% total body surface area (TBSA) burns. The
client weighs 70 kg. Using the Parkland formula (4 mL x kg x %TBSA), how many mL of
lactated Ringer’s should the nurse administer in the first 8 hours?
A. 2,800 mL
B. 11,200 mL
C. 5,600 mL
D. 7,400 mL
Correct Answer: C
Rationale: The total volume for 24 hours is calculated as 4 mL x 70 kg x 40 = 11,200 mL.
According to the Parkland formula, half of the total volume (5,600 mL) should be
administered within the first 8 hours of the burn injury. The remaining half is administered
over the subsequent 16 hours.
5. A nurse is caring for a client who is in the compensatory stage of shock. Which of the
following findings should the nurse expect?
A. Mean arterial pressure (MAP) less than 60 mm Hg
B. Cool, clammy skin
C. Anuria
, D. Lethargy
Correct Answer: B
Rationale: During the compensatory stage of shock, blood is shunted from the skin,
kidneys, and GI tract to the heart and brain, resulting in cool, clammy skin. The MAP is
usually maintained within normal limits during this stage due to compensatory
mechanisms. Anuria and lethargy are clinical manifestations typically seen in the
progressive or refractory stages of shock.
6. A nurse is assessing a client with a pulmonary artery catheter. Which of the following
readings suggests cardiogenic shock? (Select All That Apply)
A. Increased pulmonary artery wedge pressure (PAWP)
B. Decreased cardiac index
C. Decreased systemic vascular resistance (SVR)
D. Increased central venous pressure (CVP)
E. Increased cardiac output
F. Decreased pulmonary artery wedge pressure (PAWP)
Correct Answer: ABD
Rationale: In cardiogenic shock, the heart fails to pump effectively, leading to a decreased
cardiac index and cardiac output. This failure causes blood to back up into the pulmonary
2026 Q&A with Rationale (ATI Critical
Care Proctored Exam 2026)
1. A nurse is caring for a client who is being monitored with a central venous pressure (CVP)
catheter. The CVP reading is 1 mm Hg. Which of the following actions should the nurse take?
A. Initiate a fluid bolus as prescribed.
B. Administer a prescribed diuretic.
C. Place the client in a high-Fowler’s position.
D. Perform chest physiotherapy.
Correct Answer: A
Rationale: A normal CVP range is typically 2 to 8 mm Hg. A reading of 1 mm Hg indicates
low preload, which is commonly seen in hypovolemia. The nurse should anticipate
administering a fluid bolus or increasing the rate of IV fluids to improve volume status.
Diuretics and high-Fowler’s positioning would be appropriate for fluid volume excess, not
deficit.
2. A nurse is monitoring a client who has a suspected head injury and an intracranial pressure
(ICP) monitor. Which of the following findings should the nurse identify as an early indicator
of increased ICP?
A. Widening pulse pressure
,B. Fixed and dilated pupils
C. Bradypnea
D. Restlessness and irritability
Correct Answer: D
Rationale: Changes in level of consciousness, such as restlessness, agitation, or irritability,
are the earliest signs of increasing intracranial pressure. Widening pulse pressure and
bradypnea are part of Cushing’s triad, which is a late sign of neurological deterioration.
Fixed and dilated pupils occur late when herniation is imminent.
3. A nurse is caring for a client on mechanical ventilation in Assist-Control (AC) mode. The
high-pressure alarm begins to sound. Which of the following actions should the nurse take
first?
A. Check for a leak in the ventilator circuit.
B. Assess the client for the need for suctioning.
C. Check if the client has become disconnected.
D. Call the respiratory therapist to adjust the sensitivity.
Correct Answer: B
Rationale: High-pressure alarms are triggered by increased resistance in the system, such
as secretions, kinking of the tube, or the client biting the tube. Assessing the client’s airway
,and the need for suctioning is the priority action. Low-pressure alarms are typically
associated with circuit leaks or disconnections.
4. A nurse is providing care for a client who has 40% total body surface area (TBSA) burns. The
client weighs 70 kg. Using the Parkland formula (4 mL x kg x %TBSA), how many mL of
lactated Ringer’s should the nurse administer in the first 8 hours?
A. 2,800 mL
B. 11,200 mL
C. 5,600 mL
D. 7,400 mL
Correct Answer: C
Rationale: The total volume for 24 hours is calculated as 4 mL x 70 kg x 40 = 11,200 mL.
According to the Parkland formula, half of the total volume (5,600 mL) should be
administered within the first 8 hours of the burn injury. The remaining half is administered
over the subsequent 16 hours.
5. A nurse is caring for a client who is in the compensatory stage of shock. Which of the
following findings should the nurse expect?
A. Mean arterial pressure (MAP) less than 60 mm Hg
B. Cool, clammy skin
C. Anuria
, D. Lethargy
Correct Answer: B
Rationale: During the compensatory stage of shock, blood is shunted from the skin,
kidneys, and GI tract to the heart and brain, resulting in cool, clammy skin. The MAP is
usually maintained within normal limits during this stage due to compensatory
mechanisms. Anuria and lethargy are clinical manifestations typically seen in the
progressive or refractory stages of shock.
6. A nurse is assessing a client with a pulmonary artery catheter. Which of the following
readings suggests cardiogenic shock? (Select All That Apply)
A. Increased pulmonary artery wedge pressure (PAWP)
B. Decreased cardiac index
C. Decreased systemic vascular resistance (SVR)
D. Increased central venous pressure (CVP)
E. Increased cardiac output
F. Decreased pulmonary artery wedge pressure (PAWP)
Correct Answer: ABD
Rationale: In cardiogenic shock, the heart fails to pump effectively, leading to a decreased
cardiac index and cardiac output. This failure causes blood to back up into the pulmonary
