2026 RN ATI CONCEPT-BASED
ASSESSMENT PROCTORED
PRACTICE EXAM
LATEST MOCK PRACTICE SET
180 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
2026 RN ATI CONCEPT-BASED ASSESSMENT PROCTORED PRACTICE EXAM COMPREHENSIVE
QUESTION REVIEW WITH NGN STYLE CLINICAL JUDGMENT AND RATIONALES PDF. It contains 180
carefully selected questions that reflect the most current exam content and testing strategies. Each question is
accompanied by a correct answer and a detailed rationale that explains the underlying pathophysiology,
pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 180 Questions
Foundations - Application - 2026 RN ATI Concept-based Assessment Proctored Comprehensive Review
WITH NGN Style Clinical Judgment AND Rationales PDF Nursing Concept-based Curriculum WITH NGN
Clinical Judgment Undergraduate YEAR 4 / Pre-licensure BSN
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
2026 RN ATI Concept-based 1-30 Indicates, Finding, Intervention, Syndrome, Laboratory
Assessment Proctored
Comprehensive Review WITH
NGN Style Clinical Judgment
AND Rationales PDF Nursing
Concept-based Curriculum
WITH NGN Clinical Judgment
Undergraduate YEAR 4 /
Pre-licensure BSN
Indicates 31-60 Finding, Receiving, Laboratory, Prescribed, Value
Prescribed 61-90 Indicates, Finding, Intervention, Appropriate, Value
Laboratory 91-120 Finding, Intervention, Appropriate, Evaluating, Patient S
Receiving 121-150 Prescribed, Finding, Chronic, Kidney, Heart Failure
Intervention 151-180 Finding, Indicates, Caring, Chronic, Receiving
TOTAL 180 All questions include answers and detailed rationales
,Section A - 2026 RN ATI Concept-based Assessment
Proctored Comprehensive Review WITH NGN Style Clinical
Judgment AND Rationales PDF Nursing Concept-based
Curriculum WITH NGN Clinical Judgment Undergraduate
YEAR 4 / Pre-licensure BSN
Q1.
A patient on a medical-surgical unit develops sudden onset of dyspnea, tachypnea, and
hypoxemia 24 hours after major abdominal surgery. The nurse notes a drop in end-tidal
CO2 and an elevated D-dimer. Which pathophysiological mechanism most directly
explains the patient's clinical presentation?
A. Pulmonary vasoconstriction leading to B. Alveolar hypoventilation due to
increased dead space ventilation postoperative opioid-induced respiratory
depression
C. Pulmonary edema from left ventricular D. Bronchospasm from an allergic reaction
failure causing ventilation-perfusion to perioperative antibiotics
mismatch
Correct: A - Pulmonary vasoconstriction leading to increased dead space ventilation
Rationale:Acute pulmonary embolism causes pulmonary artery obstruction, leading to
increased alveolar dead space and vasoconstriction, which impairs gas exchange.
Hypoxemia and decreased ETCO2 reflect this V/Q mismatch. Opioid depression would cause
hypercapnia, not decreased ETCO2; pulmonary edema and bronchospasm have different
mechanisms.
Q2.
A nurse is caring for a patient with chronic kidney disease (CKD) stage 4 who is
prescribed erythropoietin. Which laboratory value indicates the therapy is effective?
A. Reticulocyte count of 2.5% B. Hemoglobin of 9 g/dL
C. Serum ferritin of 100 ng/mL D. Transferrin saturation of 15%
Correct: A - Reticulocyte count of 2.5%
Rationale:Erythropoietin stimulates red blood cell production, so an increased reticulocyte
count indicates a bone marrow response. Hemoglobin should rise over weeks, but a single
value of 9 g/dL is still low. Ferritin and transferrin saturation assess iron stores, not direct
effectiveness of erythropoietin.
Page 3
, Section A - 2026 RN ATI Concept-based Assessment Proctored Comprehensive Review WITH NGN Style Clinical Judgment AND Rationales
PDF Nursing Concept-based Curriculum WITH NGN Clinical Judgment Undergraduate YEAR 4 / Pre-licensure BSN
Q3.
A patient with type 2 diabetes is started on metformin. Which instruction is most
important for the nurse to include?
A. Take the medication with meals to reduce B. Report any episodes of hypoglycemia
gastrointestinal distress. immediately.
C. Avoid alcohol to reduce the risk of lactic D. Monitor blood glucose levels only in the
acidosis. morning.
Correct: C - Avoid alcohol to reduce the risk of lactic acidosis.
Rationale:Metformin is contraindicated with significant alcohol intake due to an increased risk
of lactic acidosis, a rare but life-threatening adverse effect. Taking with meals reduces GI
upset, but that is not the most critical teaching. Hypoglycemia is uncommon with metformin
monotherapy. Blood glucose monitoring should be more frequent, not only morning.
Q4.
A nurse is reviewing the arterial blood gas (ABG) results of a patient with acute
respiratory distress syndrome (ARDS): pH 7.32, PaCO2 50 mm Hg, HCO3 24 mEq/L. Which
acid-base disturbance is present?
A. Metabolic acidosis with partial B. Respiratory acidosis with no
compensation compensation
C. Respiratory alkalosis with renal D. Metabolic alkalosis with respiratory
compensation compensation
Correct: B - Respiratory acidosis with no compensation
Rationale:The pH is low (acidemia), PaCO2 is high (>45), and HCO3 is normal (22-26),
indicating acute respiratory acidosis without metabolic compensation. ARDS causes impaired
CO2 elimination. Metabolic acidosis would show low HCO3; alkalosis would have high pH.
Q5.
A nurse is preparing to administer a blood transfusion. Which action is most important to
prevent a transfusion-associated circulatory overload (TACO)?
A. Administer a diuretic before the B. Infuse the blood over 4 hours
transfusion
C. Elevate the head of the bed to 30 D. Use a smaller gauge IV catheter
degrees
Correct: A - Administer a diuretic before the transfusion
Page 4
ASSESSMENT PROCTORED
PRACTICE EXAM
LATEST MOCK PRACTICE SET
180 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
2026 RN ATI CONCEPT-BASED ASSESSMENT PROCTORED PRACTICE EXAM COMPREHENSIVE
QUESTION REVIEW WITH NGN STYLE CLINICAL JUDGMENT AND RATIONALES PDF. It contains 180
carefully selected questions that reflect the most current exam content and testing strategies. Each question is
accompanied by a correct answer and a detailed rationale that explains the underlying pathophysiology,
pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 180 Questions
Foundations - Application - 2026 RN ATI Concept-based Assessment Proctored Comprehensive Review
WITH NGN Style Clinical Judgment AND Rationales PDF Nursing Concept-based Curriculum WITH NGN
Clinical Judgment Undergraduate YEAR 4 / Pre-licensure BSN
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
2026 RN ATI Concept-based 1-30 Indicates, Finding, Intervention, Syndrome, Laboratory
Assessment Proctored
Comprehensive Review WITH
NGN Style Clinical Judgment
AND Rationales PDF Nursing
Concept-based Curriculum
WITH NGN Clinical Judgment
Undergraduate YEAR 4 /
Pre-licensure BSN
Indicates 31-60 Finding, Receiving, Laboratory, Prescribed, Value
Prescribed 61-90 Indicates, Finding, Intervention, Appropriate, Value
Laboratory 91-120 Finding, Intervention, Appropriate, Evaluating, Patient S
Receiving 121-150 Prescribed, Finding, Chronic, Kidney, Heart Failure
Intervention 151-180 Finding, Indicates, Caring, Chronic, Receiving
TOTAL 180 All questions include answers and detailed rationales
,Section A - 2026 RN ATI Concept-based Assessment
Proctored Comprehensive Review WITH NGN Style Clinical
Judgment AND Rationales PDF Nursing Concept-based
Curriculum WITH NGN Clinical Judgment Undergraduate
YEAR 4 / Pre-licensure BSN
Q1.
A patient on a medical-surgical unit develops sudden onset of dyspnea, tachypnea, and
hypoxemia 24 hours after major abdominal surgery. The nurse notes a drop in end-tidal
CO2 and an elevated D-dimer. Which pathophysiological mechanism most directly
explains the patient's clinical presentation?
A. Pulmonary vasoconstriction leading to B. Alveolar hypoventilation due to
increased dead space ventilation postoperative opioid-induced respiratory
depression
C. Pulmonary edema from left ventricular D. Bronchospasm from an allergic reaction
failure causing ventilation-perfusion to perioperative antibiotics
mismatch
Correct: A - Pulmonary vasoconstriction leading to increased dead space ventilation
Rationale:Acute pulmonary embolism causes pulmonary artery obstruction, leading to
increased alveolar dead space and vasoconstriction, which impairs gas exchange.
Hypoxemia and decreased ETCO2 reflect this V/Q mismatch. Opioid depression would cause
hypercapnia, not decreased ETCO2; pulmonary edema and bronchospasm have different
mechanisms.
Q2.
A nurse is caring for a patient with chronic kidney disease (CKD) stage 4 who is
prescribed erythropoietin. Which laboratory value indicates the therapy is effective?
A. Reticulocyte count of 2.5% B. Hemoglobin of 9 g/dL
C. Serum ferritin of 100 ng/mL D. Transferrin saturation of 15%
Correct: A - Reticulocyte count of 2.5%
Rationale:Erythropoietin stimulates red blood cell production, so an increased reticulocyte
count indicates a bone marrow response. Hemoglobin should rise over weeks, but a single
value of 9 g/dL is still low. Ferritin and transferrin saturation assess iron stores, not direct
effectiveness of erythropoietin.
Page 3
, Section A - 2026 RN ATI Concept-based Assessment Proctored Comprehensive Review WITH NGN Style Clinical Judgment AND Rationales
PDF Nursing Concept-based Curriculum WITH NGN Clinical Judgment Undergraduate YEAR 4 / Pre-licensure BSN
Q3.
A patient with type 2 diabetes is started on metformin. Which instruction is most
important for the nurse to include?
A. Take the medication with meals to reduce B. Report any episodes of hypoglycemia
gastrointestinal distress. immediately.
C. Avoid alcohol to reduce the risk of lactic D. Monitor blood glucose levels only in the
acidosis. morning.
Correct: C - Avoid alcohol to reduce the risk of lactic acidosis.
Rationale:Metformin is contraindicated with significant alcohol intake due to an increased risk
of lactic acidosis, a rare but life-threatening adverse effect. Taking with meals reduces GI
upset, but that is not the most critical teaching. Hypoglycemia is uncommon with metformin
monotherapy. Blood glucose monitoring should be more frequent, not only morning.
Q4.
A nurse is reviewing the arterial blood gas (ABG) results of a patient with acute
respiratory distress syndrome (ARDS): pH 7.32, PaCO2 50 mm Hg, HCO3 24 mEq/L. Which
acid-base disturbance is present?
A. Metabolic acidosis with partial B. Respiratory acidosis with no
compensation compensation
C. Respiratory alkalosis with renal D. Metabolic alkalosis with respiratory
compensation compensation
Correct: B - Respiratory acidosis with no compensation
Rationale:The pH is low (acidemia), PaCO2 is high (>45), and HCO3 is normal (22-26),
indicating acute respiratory acidosis without metabolic compensation. ARDS causes impaired
CO2 elimination. Metabolic acidosis would show low HCO3; alkalosis would have high pH.
Q5.
A nurse is preparing to administer a blood transfusion. Which action is most important to
prevent a transfusion-associated circulatory overload (TACO)?
A. Administer a diuretic before the B. Infuse the blood over 4 hours
transfusion
C. Elevate the head of the bed to 30 D. Use a smaller gauge IV catheter
degrees
Correct: A - Administer a diuretic before the transfusion
Page 4
