ATI RN CONCEPT-BASED ASSESSMENT LEVEL 2
PROCTORED EXAM 2026
COMPLETE PRACTICE QUESTION BANK
Latest 2026 Update | Verified Questions & Detailed Rationales
Exam Preparation Material | Already Graded A+
DOMAIN 1: ADVANCED CLINICAL JUDGMENT & PRIORITY
SETTING (Questions 1-25)
1. A patient with a STEMI receives tPA and suddenly develops a severe headache
and vomiting. BP 200/110 mmHg. What is the nurse's immediate action?
• A) Administer antiemetic
• B) Notify provider and prepare for emergency CT scan
• C) Lower head of bed
• D) Give acetaminophen
Rationale: Sudden severe headache, vomiting, and hypertension after tPA administration
are classic signs of intracranial hemorrhage—a life-threatening complication. Rapid
imaging and neurosurgical consult are critical. Administering an antiemetic or
acetaminophen delays definitive treatment .
,2. A patient with sepsis has a lactate of 5.2 mmol/L and BP 82/48 mmHg after 30
mL/kg crystalloid. What is the next priority?
• A) Start dopamine
• B) Begin norepinephrine to maintain MAP ≥ 65 mmHg
• C) Obtain CT scan
• D) Administer antibiotics
Rationale: Fluid-refractory septic shock requires vasopressor support. According to the
Surviving Sepsis Campaign Guidelines, norepinephrine is the first-line vasopressor to
maintain mean arterial pressure (MAP) ≥ 65 mmHg. Antibiotics should have been given
earlier .
3. A patient post-craniotomy has a sudden decrease in LOC and blown pupil. What
is the nurse's first action?
• A) Obtain CT order
• B) Raise head of bed 30° and hyperventilate
• C) Give mannitol
• D) Call family
Rationale: Sudden decreased LOC and blown pupil indicate herniation from increased ICP.
Immediate interventions include elevating the head of bed (HOB) to 30° to promote
venous drainage and hyperventilating to reduce PaCO₂, which causes cerebral
vasoconstriction. These actions buy time while preparing for mannitol or hypertonic
saline .
,4. A nurse receives report on four patients. Which patient should be assessed first?
• A) Post-op day 2 with incisional pain 5/10
• B) Diabetes with blood glucose 180 mg/dL
• C) COPD with SpO2 88% on 2 L/min oxygen
• D) Heart failure with 1+ pitting edema
*Rationale: SpO2 <90% indicates hypoxemia, which is life-threatening (ABC priority). The
COPD
1-200 NO LINKS ,,NO NUMBER OF QUESTIONS,,,,NO NAME STUVIA
ATI RN CONCEPT-BASED ASSESSMENT LEVEL 2
PROCTORED EXAM 2026
COMPLETE PRACTICE QUESTION BANK
Verified Questions & Detailed Rationales | Exam Preparation Material
A patient with a STEMI receives tPA and suddenly develops a severe headache and
vomiting. BP 200/110 mmHg. What is the nurse's immediate action?
• A) Administer antiemetic
• B) Notify provider and prepare for emergency CT scan
• C) Lower head of bed
• D) Give acetaminophen
Rationale: Sudden severe headache, vomiting, and hypertension after tPA administration
are classic signs of intracranial hemorrhage—a life-threatening complication. Rapid
imaging and neurosurgical consult are critical. Administering an antiemetic or
acetaminophen delays definitive treatment and could worsen outcomes.
, A patient with sepsis has a lactate of 5.2 mmol/L and BP 82/48 mmHg after 30 mL/kg
crystalloid. What is the next priority?
• A) Start dopamine
• B) Begin norepinephrine to maintain MAP ≥ 65 mmHg
• C) Obtain CT scan
• D) Administer antibiotics
Rationale: Fluid-refractory septic shock requires vasopressor support. According to the
Surviving Sepsis Campaign Guidelines, norepinephrine is the first-line vasopressor to
maintain mean arterial pressure (MAP) ≥ 65 mmHg. Antibiotics should have been given
within the first hour of recognition.
A patient post-craniotomy has a sudden decrease in LOC and blown pupil. What is the
nurse's first action?
• A) Obtain CT order
• B) Raise head of bed 30° and hyperventilate
• C) Give mannitol
• D) Call family
Rationale: Sudden decreased LOC and blown pupil indicate herniation from increased ICP.
Immediate interventions include elevating the head of bed (HOB) to 30° to promote
venous drainage and hyperventilating to reduce PaCO₂, which causes cerebral
vasoconstriction. These actions buy time while preparing for mannitol or hypertonic saline.
PROCTORED EXAM 2026
COMPLETE PRACTICE QUESTION BANK
Latest 2026 Update | Verified Questions & Detailed Rationales
Exam Preparation Material | Already Graded A+
DOMAIN 1: ADVANCED CLINICAL JUDGMENT & PRIORITY
SETTING (Questions 1-25)
1. A patient with a STEMI receives tPA and suddenly develops a severe headache
and vomiting. BP 200/110 mmHg. What is the nurse's immediate action?
• A) Administer antiemetic
• B) Notify provider and prepare for emergency CT scan
• C) Lower head of bed
• D) Give acetaminophen
Rationale: Sudden severe headache, vomiting, and hypertension after tPA administration
are classic signs of intracranial hemorrhage—a life-threatening complication. Rapid
imaging and neurosurgical consult are critical. Administering an antiemetic or
acetaminophen delays definitive treatment .
,2. A patient with sepsis has a lactate of 5.2 mmol/L and BP 82/48 mmHg after 30
mL/kg crystalloid. What is the next priority?
• A) Start dopamine
• B) Begin norepinephrine to maintain MAP ≥ 65 mmHg
• C) Obtain CT scan
• D) Administer antibiotics
Rationale: Fluid-refractory septic shock requires vasopressor support. According to the
Surviving Sepsis Campaign Guidelines, norepinephrine is the first-line vasopressor to
maintain mean arterial pressure (MAP) ≥ 65 mmHg. Antibiotics should have been given
earlier .
3. A patient post-craniotomy has a sudden decrease in LOC and blown pupil. What
is the nurse's first action?
• A) Obtain CT order
• B) Raise head of bed 30° and hyperventilate
• C) Give mannitol
• D) Call family
Rationale: Sudden decreased LOC and blown pupil indicate herniation from increased ICP.
Immediate interventions include elevating the head of bed (HOB) to 30° to promote
venous drainage and hyperventilating to reduce PaCO₂, which causes cerebral
vasoconstriction. These actions buy time while preparing for mannitol or hypertonic
saline .
,4. A nurse receives report on four patients. Which patient should be assessed first?
• A) Post-op day 2 with incisional pain 5/10
• B) Diabetes with blood glucose 180 mg/dL
• C) COPD with SpO2 88% on 2 L/min oxygen
• D) Heart failure with 1+ pitting edema
*Rationale: SpO2 <90% indicates hypoxemia, which is life-threatening (ABC priority). The
COPD
1-200 NO LINKS ,,NO NUMBER OF QUESTIONS,,,,NO NAME STUVIA
ATI RN CONCEPT-BASED ASSESSMENT LEVEL 2
PROCTORED EXAM 2026
COMPLETE PRACTICE QUESTION BANK
Verified Questions & Detailed Rationales | Exam Preparation Material
A patient with a STEMI receives tPA and suddenly develops a severe headache and
vomiting. BP 200/110 mmHg. What is the nurse's immediate action?
• A) Administer antiemetic
• B) Notify provider and prepare for emergency CT scan
• C) Lower head of bed
• D) Give acetaminophen
Rationale: Sudden severe headache, vomiting, and hypertension after tPA administration
are classic signs of intracranial hemorrhage—a life-threatening complication. Rapid
imaging and neurosurgical consult are critical. Administering an antiemetic or
acetaminophen delays definitive treatment and could worsen outcomes.
, A patient with sepsis has a lactate of 5.2 mmol/L and BP 82/48 mmHg after 30 mL/kg
crystalloid. What is the next priority?
• A) Start dopamine
• B) Begin norepinephrine to maintain MAP ≥ 65 mmHg
• C) Obtain CT scan
• D) Administer antibiotics
Rationale: Fluid-refractory septic shock requires vasopressor support. According to the
Surviving Sepsis Campaign Guidelines, norepinephrine is the first-line vasopressor to
maintain mean arterial pressure (MAP) ≥ 65 mmHg. Antibiotics should have been given
within the first hour of recognition.
A patient post-craniotomy has a sudden decrease in LOC and blown pupil. What is the
nurse's first action?
• A) Obtain CT order
• B) Raise head of bed 30° and hyperventilate
• C) Give mannitol
• D) Call family
Rationale: Sudden decreased LOC and blown pupil indicate herniation from increased ICP.
Immediate interventions include elevating the head of bed (HOB) to 30° to promote
venous drainage and hyperventilating to reduce PaCO₂, which causes cerebral
vasoconstriction. These actions buy time while preparing for mannitol or hypertonic saline.
