ATI CRITICAL THINKING ACTUAL EXAM
CRITICAL THINKING ATI PROCTORED EXAM PREPARATION
ATI CRITICAL THINKING PRACTICE EXAM LATEST VERSION
Real Exam Questions | A Grade
Exam Details
Total Questions: 150 Multiple Choice
Sections: 6 Comprehensive Sections
Edition: 2026-2027 Latest Version
Clinical Judgment, Decision-Making, Data Interpretation, Nursing Process,
Focus:
Critical Thinking
Framework: CJMM, Tanner's Model, ABC, Maslow, ADPIE, NGN Clinical Judgment
Section 1: Clinical Judgment and Decision-Making (Q1-Q30)
Section 2: Interpretation and Analysis of Client Data (Q31-Q60)
Section 3: Application of the Nursing Process / ADPIE (Q61-Q90)
Section 4: Problem Recognition and Formulation (Q91-Q110)
Section 5: Evaluation of Interventions and Outcomes (Q111-Q130)
Section 6: Integrated Clinical Scenarios and Comprehensive Reasoning (Q131-Q150)
Aligned with 2026-2027 ATI Critical Thinking Standards
,Section 1: Clinical Judgment and Decision-Making (Priority Setting, ABCs,
Maslow, & Safety Frameworks) - Q1-30
Q1: A nurse receives report on four clients. Which client should the nurse assess first?
A. A client with a blood pressure of 118/76 mmHg who is scheduled for a CT scan
B. A client with a blood pressure of 88/54 mmHg who reports dizziness upon standing [CORRECT]
C. A client with a blood pressure of 140/90 mmHg who is receiving IV antibiotics
D. A client with a blood pressure of 126/82 mmHg who requests pain medication
Correct Answer: B
Rationale: The ABC (Airway, Breathing, Circulation) framework establishes that circulatory compromise takes priority over stable
vital signs. A blood pressure of 88/54 mmHg with dizziness indicates hypotension and potential shock, requiring immediate
assessment and intervention. The other clients have stable vital signs and non-emergent needs that can be addressed after the
unstable client is stabilized. Maslow's hierarchy also supports this prioritization as physiological needs (adequate perfusion)
supersede safety or comfort needs.
Q2: A nurse is caring for a client who is 2 hours postoperative following a cholecystectomy. The client reports
severe abdominal pain rated 8/10. Which action should the nurse take first?
A. Administer the prescribed PRN analgesic
B. Assess the surgical incision site and vital signs [CORRECT]
C. Reposition the client to a side-lying position
D. Document the pain rating in the medical record
Correct Answer: B
Rationale: According to the nursing process, assessment is always the first step. Before administering pain medication, the nurse must
assess the surgical site and vital signs to determine whether the pain is expected postoperative discomfort or a sign of a complication
such as internal bleeding or infection. Administering analgesics without assessment could mask a developing emergency. The NCSBN
Clinical Judgment Measurement Model (CJMM) emphasizes recognizing cues and analyzing them before taking action.
Q3: Which of the following frameworks should the nurse use to prioritize care for multiple clients? Select the
framework that is ALWAYS the highest priority.
A. Maslow's Hierarchy of Needs
B. ABC (Airway, Breathing, Circulation) [CORRECT]
C. Gordon's Functional Health Patterns
D. Roy's Adaptation Model
Correct Answer: B
Rationale: The ABC framework is ALWAYS the highest priority in nursing because it addresses immediate life-threatening
conditions. Airway, breathing, and circulation must be intact before any other needs can be addressed. While Maslow's Hierarchy
of Needs is valuable for prioritization, ABC supersedes it when a client has compromised airway, breathing, or circulation. Gordon's
Functional Health Patterns and Roy's Adaptation Model are assessment and theoretical frameworks, respectively, not acute
priority-setting tools.
Q4: A nurse is assigned to care for four clients. Using Maslow's Hierarchy of Needs, which client should the
nurse see first?
A. A client who is anxious about an upcoming diagnostic procedure
B. A client who has not eaten in 24 hours and has a blood glucose of 58 mg/dL [CORRECT]
C. A client who expresses feelings of loneliness and isolation
D. A client who requests information about a support group for their condition
,Correct Answer: B
Rationale: Maslow's Hierarchy prioritizes physiological needs first. A client with hypoglycemia (blood glucose 58 mg/dL) has an
unmet physiological need that requires immediate intervention to prevent seizures, loss of consciousness, or death. Anxiety, loneliness,
and need for information represent higher-level needs (safety, love/belonging, and self-actualization) that are addressed after
physiological stability is ensured.
Q5: A nurse on a medical-surgical unit receives four phone calls simultaneously. Which call should the nurse
return first?
A. A laboratory calling to report a potassium level of 6.8 mEq/L on a client receiving IV potassium
[CORRECT]
B. A client's family member asking for an update on the client's condition
C. Physical therapy requesting to reschedule a therapy session
D. The pharmacy confirming a medication reconciliation for a stable client
Correct Answer: A
Rationale: A potassium level of 6.8 mEq/L is critically high (normal 3.5-5.0 mEq/L) and places the client at risk for life-threatening
cardiac dysrhythmias, including ventricular fibrillation and cardiac arrest. This lab value requires immediate physician notification
and intervention. Using the ABC and safety frameworks, this is the highest priority because it directly threatens life. The other calls
involve non-urgent requests that can be addressed after the critical lab result is managed.
Q6: A nurse is providing care for a client who has a do-not-resuscitate (DNR) order. The client's heart rate
drops to 38 bpm and they become unresponsive. Which action is most appropriate?
A. Begin chest compressions immediately
B. Assess the client's breathing and notify the healthcare provider [CORRECT]
C. Document the event and continue routine care
D. Ask the family if they want to override the DNR order
Correct Answer: B
Rationale: A DNR order specifically prohibits resuscitation efforts (CPR, defibrillation) in the event of cardiac or respiratory arrest.
However, the nurse must still assess the client, provide comfort measures, and notify the healthcare provider. A heart rate of 38 bpm
with unresponsiveness requires assessment to determine if this is a terminal event or a treatable condition (e.g., medication-induced
bradycardia). Beginning chest compressions would violate the legal DNR order. The nurse should never ask the family to override a
valid DNR, as this undermines the client's autonomous decision.
Q7: A client is admitted with dehydration secondary to vomiting and diarrhea. The nurse notes the client's
mucous membranes are dry, skin turgor is decreased, and urine output is 20 mL over the past 2 hours. Which
nursing diagnosis should take priority?
A. Deficient Fluid Volume [CORRECT]
B. Risk for Impaired Skin Integrity
C. Acute Pain
D. Imbalanced Nutrition: Less Than Body Requirements
Correct Answer: A
Rationale: Deficient Fluid Volume is the priority nursing diagnosis because the assessment findings (dry mucous membranes,
decreased skin turgor, oliguria of 20 mL/2 hrs) directly indicate significant hypovolemia. This is a physiological priority that, if
uncorrected, can lead to hypovolemic shock, acute kidney injury, and death. Using Maslow's framework, fluid balance is a
fundamental physiological need. The other diagnoses are potential or secondary concerns that become relevant only after fluid
volume is restored.
Q8: A nurse is delegating tasks to a licensed practical nurse (LPN) and an unlicensed assistive personnel
(UAP). Which task is most appropriate to delegate to the UAP?
, A. Administering oral medications to a stable client
B. Measuring and recording intake and output for a client with heart failure [CORRECT]
C. Assessing a postoperative client's wound for signs of infection
D. Teaching a client with diabetes about insulin self-administration
Correct Answer: B
Rationale: Measuring and recording intake and output is a standard, repetitive task that falls within the UAP scope of practice and
does not require nursing judgment. Administering medications (even oral) and assessing wounds require nursing education and
licensure and must be performed by an LPN or RN. Teaching requires advanced nursing knowledge and critical thinking, which is
exclusively within the RN scope of practice. The RN retains accountability for all delegated tasks and must provide appropriate
supervision.
Q9: A nurse is caring for a client who was admitted with a pulmonary embolism. Which finding requires the
most immediate intervention by the nurse?
A. Heart rate of 102 bpm
B. New onset of substernal chest pain and dyspnea [CORRECT]
C. Temperature of 38.1 degrees C (100.6 degrees F)
D. White blood cell count of 11,000/mm3
Correct Answer: B
Rationale: New onset of substernal chest pain and dyspnea in a client with a known pulmonary embolism may indicate extension of
the clot, worsening perfusion, or impending respiratory failure. This requires immediate intervention per the ABC framework, as
breathing and circulation are compromised. A heart rate of 102 bpm is expected with a pulmonary embolism due to hypoxia and
stress response. A mildly elevated temperature and WBC count are non-urgent findings that can be monitored.
Q10: A nurse is reviewing the Tanner Clinical Judgment Model. Which component involves noticing changes
in a client's condition based on expected vs. unexpected findings?
A. Noticing [CORRECT]
B. Interpreting
C. Responding
D. Reflecting
Correct Answer: A
Rationale: The Noticing component of Tanner's Clinical Judgment Model involves the nurse's ability to recognize relevant clinical
data and distinguish between expected and unexpected findings. It requires a foundational understanding of what is normal so that
deviations can be identified. Interpreting involves making sense of the noticed data, Responding involves taking appropriate nursing
action, and Reflecting involves evaluating the effectiveness of the response and learning from the experience.
Q11: A nurse in the emergency department receives four clients from a multi-vehicle accident. Using the
ABC triage framework, which client should be seen first?
A. A client with a fractured femur who is awake and alert
B. A client with an open wound on the forearm with controlled bleeding
C. A client with gurgling respirations and decreased oxygen saturation [CORRECT]
D. A client with multiple abrasions and complaints of back pain
Correct Answer: C
Rationale: The client with gurgling respirations and decreased oxygen saturation has a compromised airway, which per the ABC
framework is the highest priority. Gurgling suggests fluid or secretions in the airway that require immediate suctioning and
intervention to prevent complete airway obstruction. The clients with fractures, controlled bleeding, and abrasions have more stable
conditions that, while important, do not represent immediate life threats.
CRITICAL THINKING ATI PROCTORED EXAM PREPARATION
ATI CRITICAL THINKING PRACTICE EXAM LATEST VERSION
Real Exam Questions | A Grade
Exam Details
Total Questions: 150 Multiple Choice
Sections: 6 Comprehensive Sections
Edition: 2026-2027 Latest Version
Clinical Judgment, Decision-Making, Data Interpretation, Nursing Process,
Focus:
Critical Thinking
Framework: CJMM, Tanner's Model, ABC, Maslow, ADPIE, NGN Clinical Judgment
Section 1: Clinical Judgment and Decision-Making (Q1-Q30)
Section 2: Interpretation and Analysis of Client Data (Q31-Q60)
Section 3: Application of the Nursing Process / ADPIE (Q61-Q90)
Section 4: Problem Recognition and Formulation (Q91-Q110)
Section 5: Evaluation of Interventions and Outcomes (Q111-Q130)
Section 6: Integrated Clinical Scenarios and Comprehensive Reasoning (Q131-Q150)
Aligned with 2026-2027 ATI Critical Thinking Standards
,Section 1: Clinical Judgment and Decision-Making (Priority Setting, ABCs,
Maslow, & Safety Frameworks) - Q1-30
Q1: A nurse receives report on four clients. Which client should the nurse assess first?
A. A client with a blood pressure of 118/76 mmHg who is scheduled for a CT scan
B. A client with a blood pressure of 88/54 mmHg who reports dizziness upon standing [CORRECT]
C. A client with a blood pressure of 140/90 mmHg who is receiving IV antibiotics
D. A client with a blood pressure of 126/82 mmHg who requests pain medication
Correct Answer: B
Rationale: The ABC (Airway, Breathing, Circulation) framework establishes that circulatory compromise takes priority over stable
vital signs. A blood pressure of 88/54 mmHg with dizziness indicates hypotension and potential shock, requiring immediate
assessment and intervention. The other clients have stable vital signs and non-emergent needs that can be addressed after the
unstable client is stabilized. Maslow's hierarchy also supports this prioritization as physiological needs (adequate perfusion)
supersede safety or comfort needs.
Q2: A nurse is caring for a client who is 2 hours postoperative following a cholecystectomy. The client reports
severe abdominal pain rated 8/10. Which action should the nurse take first?
A. Administer the prescribed PRN analgesic
B. Assess the surgical incision site and vital signs [CORRECT]
C. Reposition the client to a side-lying position
D. Document the pain rating in the medical record
Correct Answer: B
Rationale: According to the nursing process, assessment is always the first step. Before administering pain medication, the nurse must
assess the surgical site and vital signs to determine whether the pain is expected postoperative discomfort or a sign of a complication
such as internal bleeding or infection. Administering analgesics without assessment could mask a developing emergency. The NCSBN
Clinical Judgment Measurement Model (CJMM) emphasizes recognizing cues and analyzing them before taking action.
Q3: Which of the following frameworks should the nurse use to prioritize care for multiple clients? Select the
framework that is ALWAYS the highest priority.
A. Maslow's Hierarchy of Needs
B. ABC (Airway, Breathing, Circulation) [CORRECT]
C. Gordon's Functional Health Patterns
D. Roy's Adaptation Model
Correct Answer: B
Rationale: The ABC framework is ALWAYS the highest priority in nursing because it addresses immediate life-threatening
conditions. Airway, breathing, and circulation must be intact before any other needs can be addressed. While Maslow's Hierarchy
of Needs is valuable for prioritization, ABC supersedes it when a client has compromised airway, breathing, or circulation. Gordon's
Functional Health Patterns and Roy's Adaptation Model are assessment and theoretical frameworks, respectively, not acute
priority-setting tools.
Q4: A nurse is assigned to care for four clients. Using Maslow's Hierarchy of Needs, which client should the
nurse see first?
A. A client who is anxious about an upcoming diagnostic procedure
B. A client who has not eaten in 24 hours and has a blood glucose of 58 mg/dL [CORRECT]
C. A client who expresses feelings of loneliness and isolation
D. A client who requests information about a support group for their condition
,Correct Answer: B
Rationale: Maslow's Hierarchy prioritizes physiological needs first. A client with hypoglycemia (blood glucose 58 mg/dL) has an
unmet physiological need that requires immediate intervention to prevent seizures, loss of consciousness, or death. Anxiety, loneliness,
and need for information represent higher-level needs (safety, love/belonging, and self-actualization) that are addressed after
physiological stability is ensured.
Q5: A nurse on a medical-surgical unit receives four phone calls simultaneously. Which call should the nurse
return first?
A. A laboratory calling to report a potassium level of 6.8 mEq/L on a client receiving IV potassium
[CORRECT]
B. A client's family member asking for an update on the client's condition
C. Physical therapy requesting to reschedule a therapy session
D. The pharmacy confirming a medication reconciliation for a stable client
Correct Answer: A
Rationale: A potassium level of 6.8 mEq/L is critically high (normal 3.5-5.0 mEq/L) and places the client at risk for life-threatening
cardiac dysrhythmias, including ventricular fibrillation and cardiac arrest. This lab value requires immediate physician notification
and intervention. Using the ABC and safety frameworks, this is the highest priority because it directly threatens life. The other calls
involve non-urgent requests that can be addressed after the critical lab result is managed.
Q6: A nurse is providing care for a client who has a do-not-resuscitate (DNR) order. The client's heart rate
drops to 38 bpm and they become unresponsive. Which action is most appropriate?
A. Begin chest compressions immediately
B. Assess the client's breathing and notify the healthcare provider [CORRECT]
C. Document the event and continue routine care
D. Ask the family if they want to override the DNR order
Correct Answer: B
Rationale: A DNR order specifically prohibits resuscitation efforts (CPR, defibrillation) in the event of cardiac or respiratory arrest.
However, the nurse must still assess the client, provide comfort measures, and notify the healthcare provider. A heart rate of 38 bpm
with unresponsiveness requires assessment to determine if this is a terminal event or a treatable condition (e.g., medication-induced
bradycardia). Beginning chest compressions would violate the legal DNR order. The nurse should never ask the family to override a
valid DNR, as this undermines the client's autonomous decision.
Q7: A client is admitted with dehydration secondary to vomiting and diarrhea. The nurse notes the client's
mucous membranes are dry, skin turgor is decreased, and urine output is 20 mL over the past 2 hours. Which
nursing diagnosis should take priority?
A. Deficient Fluid Volume [CORRECT]
B. Risk for Impaired Skin Integrity
C. Acute Pain
D. Imbalanced Nutrition: Less Than Body Requirements
Correct Answer: A
Rationale: Deficient Fluid Volume is the priority nursing diagnosis because the assessment findings (dry mucous membranes,
decreased skin turgor, oliguria of 20 mL/2 hrs) directly indicate significant hypovolemia. This is a physiological priority that, if
uncorrected, can lead to hypovolemic shock, acute kidney injury, and death. Using Maslow's framework, fluid balance is a
fundamental physiological need. The other diagnoses are potential or secondary concerns that become relevant only after fluid
volume is restored.
Q8: A nurse is delegating tasks to a licensed practical nurse (LPN) and an unlicensed assistive personnel
(UAP). Which task is most appropriate to delegate to the UAP?
, A. Administering oral medications to a stable client
B. Measuring and recording intake and output for a client with heart failure [CORRECT]
C. Assessing a postoperative client's wound for signs of infection
D. Teaching a client with diabetes about insulin self-administration
Correct Answer: B
Rationale: Measuring and recording intake and output is a standard, repetitive task that falls within the UAP scope of practice and
does not require nursing judgment. Administering medications (even oral) and assessing wounds require nursing education and
licensure and must be performed by an LPN or RN. Teaching requires advanced nursing knowledge and critical thinking, which is
exclusively within the RN scope of practice. The RN retains accountability for all delegated tasks and must provide appropriate
supervision.
Q9: A nurse is caring for a client who was admitted with a pulmonary embolism. Which finding requires the
most immediate intervention by the nurse?
A. Heart rate of 102 bpm
B. New onset of substernal chest pain and dyspnea [CORRECT]
C. Temperature of 38.1 degrees C (100.6 degrees F)
D. White blood cell count of 11,000/mm3
Correct Answer: B
Rationale: New onset of substernal chest pain and dyspnea in a client with a known pulmonary embolism may indicate extension of
the clot, worsening perfusion, or impending respiratory failure. This requires immediate intervention per the ABC framework, as
breathing and circulation are compromised. A heart rate of 102 bpm is expected with a pulmonary embolism due to hypoxia and
stress response. A mildly elevated temperature and WBC count are non-urgent findings that can be monitored.
Q10: A nurse is reviewing the Tanner Clinical Judgment Model. Which component involves noticing changes
in a client's condition based on expected vs. unexpected findings?
A. Noticing [CORRECT]
B. Interpreting
C. Responding
D. Reflecting
Correct Answer: A
Rationale: The Noticing component of Tanner's Clinical Judgment Model involves the nurse's ability to recognize relevant clinical
data and distinguish between expected and unexpected findings. It requires a foundational understanding of what is normal so that
deviations can be identified. Interpreting involves making sense of the noticed data, Responding involves taking appropriate nursing
action, and Reflecting involves evaluating the effectiveness of the response and learning from the experience.
Q11: A nurse in the emergency department receives four clients from a multi-vehicle accident. Using the
ABC triage framework, which client should be seen first?
A. A client with a fractured femur who is awake and alert
B. A client with an open wound on the forearm with controlled bleeding
C. A client with gurgling respirations and decreased oxygen saturation [CORRECT]
D. A client with multiple abrasions and complaints of back pain
Correct Answer: C
Rationale: The client with gurgling respirations and decreased oxygen saturation has a compromised airway, which per the ABC
framework is the highest priority. Gurgling suggests fluid or secretions in the airway that require immediate suctioning and
intervention to prevent complete airway obstruction. The clients with fractures, controlled bleeding, and abrasions have more stable
conditions that, while important, do not represent immediate life threats.
