ATI RN CRITICAL CARE EXAM NEWEST EVALUATED
PRACTICE EXAM 100 QUESTIONS 2026-
2027|ORIGINAL QUESTIONS & ANSWERS
|DETAILED RATIONALES |HINTED COMPLETE
EXAM PREP GRADED A+*INSTANT DOWNLOAD
PDF*
1. A nurse is caring for a client with septic shock who has received 30
mL/kg of IV crystalloid. The client's blood pressure remains 82/48 mm
Hg. Which prescription should the nurse anticipate?
A. Furosemide IV
B. Norepinephrine IV infusion
C. Oral propranolol
D. Sodium bicarbonate IV push
Answer: B. Norepinephrine IV infusion
Rationale: Norepinephrine is a first-line vasopressor for persistent
hypotension in septic shock after adequate fluid resuscitation.
2. A client with increased intracranial pressure (ICP) is being monitored.
Which finding requires immediate intervention?
A. Headache
B. Restlessness
C. Unequal pupils
D. Nausea
Answer: C. Unequal pupils
,Rationale: New unequal or nonreactive pupils can indicate neurologic
deterioration and impending brain herniation, requiring immediate
evaluation and intervention.
3. A nurse is caring for a client receiving mechanical ventilation. Which
finding indicates possible barotrauma?
A. Crackles
B. Sudden unilateral absence of breath sounds
C. Bradycardia
D. Increased urine output
Answer: B. Sudden unilateral absence of breath sounds
Rationale: Sudden unilateral absence of breath sounds in a
mechanically ventilated client can indicate pneumothorax caused by
positive-pressure ventilation.
4. A client with acute respiratory distress syndrome (ARDS) is receiving
mechanical ventilation. Which intervention is appropriate?
A. Maintain the client supine
B. Use low tidal-volume ventilation
C. Administer large amounts of IV fluid
D. Avoid positive end-expiratory pressure (PEEP)
Answer: B. Use low tidal-volume ventilation
Rationale: Low tidal-volume ventilation helps reduce ventilator-
induced lung injury in clients with ARDS.
,5. A client receiving a norepinephrine infusion has a blood pressure of
78/42 mm Hg. Which action should the nurse take first?
A. Stop the infusion
B. Assess the IV access and infusion system
C. Administer oral fluids
D. Place the client in a sitting position
Answer: B. Assess the IV access and infusion system
Rationale: Norepinephrine is a critical continuous infusion. The nurse
should rapidly assess the infusion system and vascular access while
supporting circulation and following the prescribed titration protocol.
6. A client develops ventricular fibrillation. Which intervention should
the nurse expect?
A. Synchronized cardioversion
B. Defibrillation
C. Vagal stimulation
D. Atropine administration
Answer: B. Defibrillation
Rationale: Ventricular fibrillation is a pulseless shockable rhythm
requiring immediate unsynchronized defibrillation and CPR.
7. Which electrolyte imbalance places a client at greatest risk for
cardiac dysrhythmias?
A. Hypernatremia
B. Hypokalemia
, C. Hyperchloremia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Low potassium levels increase myocardial irritability and
can cause potentially life-threatening dysrhythmias.
8. A client with severe hyperkalemia has peaked T waves on the ECG.
Which medication should the nurse anticipate administering first to
stabilize the cardiac membrane?
A. Regular insulin
B. Calcium gluconate
C. Sodium polystyrene sulfonate
D. Furosemide
Answer: B. Calcium gluconate
Rationale: IV calcium stabilizes the myocardial membrane in severe
hyperkalemia but does not remove potassium from the body.
9. A client with septic shock has a serum lactate level of 5 mmol/L.
What does this finding most likely indicate?
A. Improved tissue perfusion
B. Tissue hypoperfusion
C. Respiratory alkalosis
D. Renal recovery
Answer: B. Tissue hypoperfusion
Rationale: Elevated lactate commonly reflects impaired tissue oxygen
delivery/utilization and is an important marker of severity in shock.
PRACTICE EXAM 100 QUESTIONS 2026-
2027|ORIGINAL QUESTIONS & ANSWERS
|DETAILED RATIONALES |HINTED COMPLETE
EXAM PREP GRADED A+*INSTANT DOWNLOAD
PDF*
1. A nurse is caring for a client with septic shock who has received 30
mL/kg of IV crystalloid. The client's blood pressure remains 82/48 mm
Hg. Which prescription should the nurse anticipate?
A. Furosemide IV
B. Norepinephrine IV infusion
C. Oral propranolol
D. Sodium bicarbonate IV push
Answer: B. Norepinephrine IV infusion
Rationale: Norepinephrine is a first-line vasopressor for persistent
hypotension in septic shock after adequate fluid resuscitation.
2. A client with increased intracranial pressure (ICP) is being monitored.
Which finding requires immediate intervention?
A. Headache
B. Restlessness
C. Unequal pupils
D. Nausea
Answer: C. Unequal pupils
,Rationale: New unequal or nonreactive pupils can indicate neurologic
deterioration and impending brain herniation, requiring immediate
evaluation and intervention.
3. A nurse is caring for a client receiving mechanical ventilation. Which
finding indicates possible barotrauma?
A. Crackles
B. Sudden unilateral absence of breath sounds
C. Bradycardia
D. Increased urine output
Answer: B. Sudden unilateral absence of breath sounds
Rationale: Sudden unilateral absence of breath sounds in a
mechanically ventilated client can indicate pneumothorax caused by
positive-pressure ventilation.
4. A client with acute respiratory distress syndrome (ARDS) is receiving
mechanical ventilation. Which intervention is appropriate?
A. Maintain the client supine
B. Use low tidal-volume ventilation
C. Administer large amounts of IV fluid
D. Avoid positive end-expiratory pressure (PEEP)
Answer: B. Use low tidal-volume ventilation
Rationale: Low tidal-volume ventilation helps reduce ventilator-
induced lung injury in clients with ARDS.
,5. A client receiving a norepinephrine infusion has a blood pressure of
78/42 mm Hg. Which action should the nurse take first?
A. Stop the infusion
B. Assess the IV access and infusion system
C. Administer oral fluids
D. Place the client in a sitting position
Answer: B. Assess the IV access and infusion system
Rationale: Norepinephrine is a critical continuous infusion. The nurse
should rapidly assess the infusion system and vascular access while
supporting circulation and following the prescribed titration protocol.
6. A client develops ventricular fibrillation. Which intervention should
the nurse expect?
A. Synchronized cardioversion
B. Defibrillation
C. Vagal stimulation
D. Atropine administration
Answer: B. Defibrillation
Rationale: Ventricular fibrillation is a pulseless shockable rhythm
requiring immediate unsynchronized defibrillation and CPR.
7. Which electrolyte imbalance places a client at greatest risk for
cardiac dysrhythmias?
A. Hypernatremia
B. Hypokalemia
, C. Hyperchloremia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Low potassium levels increase myocardial irritability and
can cause potentially life-threatening dysrhythmias.
8. A client with severe hyperkalemia has peaked T waves on the ECG.
Which medication should the nurse anticipate administering first to
stabilize the cardiac membrane?
A. Regular insulin
B. Calcium gluconate
C. Sodium polystyrene sulfonate
D. Furosemide
Answer: B. Calcium gluconate
Rationale: IV calcium stabilizes the myocardial membrane in severe
hyperkalemia but does not remove potassium from the body.
9. A client with septic shock has a serum lactate level of 5 mmol/L.
What does this finding most likely indicate?
A. Improved tissue perfusion
B. Tissue hypoperfusion
C. Respiratory alkalosis
D. Renal recovery
Answer: B. Tissue hypoperfusion
Rationale: Elevated lactate commonly reflects impaired tissue oxygen
delivery/utilization and is an important marker of severity in shock.
