ATI Critical Care Proctored Exam V2 |
2026 Q&A with Rationale (ATI Critical
Care Proctored Exam 2026)
1. A nurse is caring for a client who is on mechanical ventilation and the high-pressure alarm
sounds. Which of the following actions should the nurse take first?
A. Auscultate the client’s breath sounds.
B. Check for a disconnection in the ventilator circuit.
C. Suction the client’s endotracheal tube.
D. Increase the oxygen concentration setting.
Correct Answer: A
Rationale: The nurse should first assess the client by auscultating breath sounds to
identify the cause of the high-pressure alarm, such as a pneumothorax or airway
obstruction. Assessment is the first step of the nursing process and provides immediate
data on the client’s status. High-pressure alarms are often caused by secretions, biting the
tube, or decreased lung compliance.
2. A nurse is monitoring a client’s central venous pressure (CVP). The reading is 1 mm Hg.
Which of the following interpretations should the nurse make?
A. The client has a decreased preload.
B. The client is experiencing right-sided heart failure.
,C. The client has fluid volume overload.
D. The client’s cardiac output is high.
Correct Answer: A
Rationale: A CVP of 1 mm Hg is below the normal range of 2 to 8 mm Hg, indicating
hypovolemia or decreased preload. Low CVP readings typically suggest that the client
requires fluid resuscitation. The nurse should correlate this finding with other clinical data
such as heart rate and urine output.
3. A nurse is assessing a client with a Glascow Coma Scale (GCS) score of 7. Which of the
following actions is the priority for this client?
A. Perform a detailed neurological assessment.
B. Administer an osmotic diuretic.
C. Assess the client’s pupil reactivity.
D. Prepare for endotracheal intubation.
Correct Answer: D
Rationale: A GCS score of 8 or less typically indicates a severe brain injury and the inability
of the client to protect their own airway. Airway management is the priority in accordance
with ABC principles. The nurse must facilitate intubation to ensure adequate oxygenation
and ventilation.
,4. A nurse is caring for a client in the early stages of septic shock. Which of the following
findings should the nurse expect?
A. Cool, clammy skin
B. Decreased cardiac output
C. Warm, flushed skin
D. Increased systemic vascular resistance
Correct Answer: C
Rationale: In the early (hyperdynamic) stage of septic shock, the client often exhibits
warm, flushed skin due to peripheral vasodilation. During this phase, cardiac output is
typically increased as a compensatory mechanism. Later stages of shock involve cool, pale
skin as the body enters the hypodynamic phase.
5. A nurse is reviewing the arterial blood gas (ABG) results for a client: pH 7.30, PaCO2 55 mm
Hg, HCO3 26 mEq/L. Which of the following imbalances is present? (Select All That Apply)
A. Metabolic acidosis
B. Respiratory acidosis
C. Uncompensated
D. Fully compensated
E. Metabolic alkalosis
F. Respiratory alkalosis
, Correct Answer: B,C
Rationale: The pH is low (acidosis) and the PaCO2 is high, which indicates a primary
respiratory problem. Since the HCO3 is within the normal range, the body has not yet
begun to compensate for the imbalance. Therefore, this is uncompensated respiratory
acidosis.
6. A nurse is preparing to administer dopamine at 5 mcg/kg/min for a client in cardiogenic
shock. What is the primary therapeutic effect of this dosage?
A. Vasoconstriction of the peripheral vessels.
B. Increased myocardial contractility.
C. Dilation of renal and mesenteric arteries.
D. Reduction of heart rate.
Correct Answer: B
Rationale: At medium doses (2 to 10 mcg/kg/min), dopamine primarily stimulates beta-1
receptors, increasing myocardial contractility and cardiac output. Lower doses typically
target dopaminergic receptors for renal perfusion, while higher doses cause alpha-
adrenergic vasoconstriction. The nurse must monitor for tachycardia as a potential side
effect.
7. A nurse is caring for a client with an intracranial pressure (ICP) of 22 mm Hg. Which of the
following nursing interventions should be implemented?
A. Keep the head of the bed flat.
2026 Q&A with Rationale (ATI Critical
Care Proctored Exam 2026)
1. A nurse is caring for a client who is on mechanical ventilation and the high-pressure alarm
sounds. Which of the following actions should the nurse take first?
A. Auscultate the client’s breath sounds.
B. Check for a disconnection in the ventilator circuit.
C. Suction the client’s endotracheal tube.
D. Increase the oxygen concentration setting.
Correct Answer: A
Rationale: The nurse should first assess the client by auscultating breath sounds to
identify the cause of the high-pressure alarm, such as a pneumothorax or airway
obstruction. Assessment is the first step of the nursing process and provides immediate
data on the client’s status. High-pressure alarms are often caused by secretions, biting the
tube, or decreased lung compliance.
2. A nurse is monitoring a client’s central venous pressure (CVP). The reading is 1 mm Hg.
Which of the following interpretations should the nurse make?
A. The client has a decreased preload.
B. The client is experiencing right-sided heart failure.
,C. The client has fluid volume overload.
D. The client’s cardiac output is high.
Correct Answer: A
Rationale: A CVP of 1 mm Hg is below the normal range of 2 to 8 mm Hg, indicating
hypovolemia or decreased preload. Low CVP readings typically suggest that the client
requires fluid resuscitation. The nurse should correlate this finding with other clinical data
such as heart rate and urine output.
3. A nurse is assessing a client with a Glascow Coma Scale (GCS) score of 7. Which of the
following actions is the priority for this client?
A. Perform a detailed neurological assessment.
B. Administer an osmotic diuretic.
C. Assess the client’s pupil reactivity.
D. Prepare for endotracheal intubation.
Correct Answer: D
Rationale: A GCS score of 8 or less typically indicates a severe brain injury and the inability
of the client to protect their own airway. Airway management is the priority in accordance
with ABC principles. The nurse must facilitate intubation to ensure adequate oxygenation
and ventilation.
,4. A nurse is caring for a client in the early stages of septic shock. Which of the following
findings should the nurse expect?
A. Cool, clammy skin
B. Decreased cardiac output
C. Warm, flushed skin
D. Increased systemic vascular resistance
Correct Answer: C
Rationale: In the early (hyperdynamic) stage of septic shock, the client often exhibits
warm, flushed skin due to peripheral vasodilation. During this phase, cardiac output is
typically increased as a compensatory mechanism. Later stages of shock involve cool, pale
skin as the body enters the hypodynamic phase.
5. A nurse is reviewing the arterial blood gas (ABG) results for a client: pH 7.30, PaCO2 55 mm
Hg, HCO3 26 mEq/L. Which of the following imbalances is present? (Select All That Apply)
A. Metabolic acidosis
B. Respiratory acidosis
C. Uncompensated
D. Fully compensated
E. Metabolic alkalosis
F. Respiratory alkalosis
, Correct Answer: B,C
Rationale: The pH is low (acidosis) and the PaCO2 is high, which indicates a primary
respiratory problem. Since the HCO3 is within the normal range, the body has not yet
begun to compensate for the imbalance. Therefore, this is uncompensated respiratory
acidosis.
6. A nurse is preparing to administer dopamine at 5 mcg/kg/min for a client in cardiogenic
shock. What is the primary therapeutic effect of this dosage?
A. Vasoconstriction of the peripheral vessels.
B. Increased myocardial contractility.
C. Dilation of renal and mesenteric arteries.
D. Reduction of heart rate.
Correct Answer: B
Rationale: At medium doses (2 to 10 mcg/kg/min), dopamine primarily stimulates beta-1
receptors, increasing myocardial contractility and cardiac output. Lower doses typically
target dopaminergic receptors for renal perfusion, while higher doses cause alpha-
adrenergic vasoconstriction. The nurse must monitor for tachycardia as a potential side
effect.
7. A nurse is caring for a client with an intracranial pressure (ICP) of 22 mm Hg. Which of the
following nursing interventions should be implemented?
A. Keep the head of the bed flat.
