✅ ATI RN Concept-Based Assessment –
LEVEL 3 (2025_2026
Questions | Original | Correct Answers | Rationales
1. A nurse is caring for a client with septic shock. Priority
intervention?
A. Start D5W infusion
B. Administer broad-spectrum antibiotics
C. Give oral fluids
D. Insert NG tube
Correct Answer: B
Rationale: Antibiotics must be started within 1 hour to reduce mortality.
2. A client receiving norepinephrine develops cold, pale
fingers. What is the priority?
A. Decrease the infusion rate
B. Increase IV fluids
C. Apply warm compresses
D. Stop infusion and notify provider
Correct Answer: D
Rationale: Indicates extravasation or vasoconstriction → stop medication.
,3. A nurse assesses a client with diabetic ketoacidosis.
Which finding is expected?
A. Metabolic alkalosis
B. Rapid, deep respirations
C. Bradycardia
D. Hypoglycemia
Correct Answer: B
Rationale: Kussmaul respirations compensate for metabolic acidosis.
4. Which action helps prevent increased ICP in a client
with TBI?
A. Flexing the hips
B. Keeping head midline
C. Providing frequent suctioning
D. Trendelenburg position
Correct Answer: B
Rationale: Maintains venous drainage and reduces intracranial pressure.
5. A nurse monitors a client on mechanical ventilation.
Which finding indicates ventilator-associated
pneumonia?
A. Thick, yellow sputum
B. Bradycardia
C. Decreased chest expansion
D. Clear lung sounds
Correct Answer: A
Rationale: Purulent secretions = VAP.
,6. A client with acute kidney injury has a K⁺ of 6.8 mEq/L.
Anticipated intervention?
A. Administer IV calcium gluconate
B. Increase potassium in diet
C. Give NS bolus
D. Restrict sodium intake
Correct Answer: A
Rationale: Calcium gluconate stabilizes cardiac membranes in severe hyperkalemia.
7. A client develops stridor after thyroidectomy. Priority
action?
A. Encourage deep breathing
B. Provide ice chips
C. Prepare for tracheostomy
D. Give oral calcium
Correct Answer: C
Rationale: Stridor indicates airway obstruction.
8. Chest tube drainage suddenly stops. What is the
nurse’s first action?
A. Clamp tubing
B. Check for kinks or occlusion
C. Remove chest tube
D. Increase suction
Correct Answer: B
Rationale: Most likely cause is kinked tubing.
9. A client with myasthenia gravis is in crisis. Which
intervention is priority?
, A. Provide high-calorie meal
B. Assess respiratory status
C. Give acetaminophen
D. Limit visitors
Correct Answer: B
Rationale: MG crisis → respiratory failure risk.
10. A nurse caring for a client in restraints must:
A. Renew order every 8 hr
B. Tie restraints to side rail
C. Document every 15 minutes
D. Remove restraints every 2 hours
Correct Answer: D
Rationale: Allows assessment of circulation & mobility.
11. A client receiving mannitol for ICP shows serum
osmolality of 330. What should the nurse do?
A. Increase IV rate
B. Withhold next dose
C. Elevate legs
D. Give hypertonic saline
Correct Answer: B
Rationale: Osmolality >320 = mannitol toxicity.
12. Which medication is used for a spinal cord injury at
T4 with severe hypertension and bradycardia?
A. Epinephrine
B. Atropine
C. IV labetalol
D. Nitroglycerin
LEVEL 3 (2025_2026
Questions | Original | Correct Answers | Rationales
1. A nurse is caring for a client with septic shock. Priority
intervention?
A. Start D5W infusion
B. Administer broad-spectrum antibiotics
C. Give oral fluids
D. Insert NG tube
Correct Answer: B
Rationale: Antibiotics must be started within 1 hour to reduce mortality.
2. A client receiving norepinephrine develops cold, pale
fingers. What is the priority?
A. Decrease the infusion rate
B. Increase IV fluids
C. Apply warm compresses
D. Stop infusion and notify provider
Correct Answer: D
Rationale: Indicates extravasation or vasoconstriction → stop medication.
,3. A nurse assesses a client with diabetic ketoacidosis.
Which finding is expected?
A. Metabolic alkalosis
B. Rapid, deep respirations
C. Bradycardia
D. Hypoglycemia
Correct Answer: B
Rationale: Kussmaul respirations compensate for metabolic acidosis.
4. Which action helps prevent increased ICP in a client
with TBI?
A. Flexing the hips
B. Keeping head midline
C. Providing frequent suctioning
D. Trendelenburg position
Correct Answer: B
Rationale: Maintains venous drainage and reduces intracranial pressure.
5. A nurse monitors a client on mechanical ventilation.
Which finding indicates ventilator-associated
pneumonia?
A. Thick, yellow sputum
B. Bradycardia
C. Decreased chest expansion
D. Clear lung sounds
Correct Answer: A
Rationale: Purulent secretions = VAP.
,6. A client with acute kidney injury has a K⁺ of 6.8 mEq/L.
Anticipated intervention?
A. Administer IV calcium gluconate
B. Increase potassium in diet
C. Give NS bolus
D. Restrict sodium intake
Correct Answer: A
Rationale: Calcium gluconate stabilizes cardiac membranes in severe hyperkalemia.
7. A client develops stridor after thyroidectomy. Priority
action?
A. Encourage deep breathing
B. Provide ice chips
C. Prepare for tracheostomy
D. Give oral calcium
Correct Answer: C
Rationale: Stridor indicates airway obstruction.
8. Chest tube drainage suddenly stops. What is the
nurse’s first action?
A. Clamp tubing
B. Check for kinks or occlusion
C. Remove chest tube
D. Increase suction
Correct Answer: B
Rationale: Most likely cause is kinked tubing.
9. A client with myasthenia gravis is in crisis. Which
intervention is priority?
, A. Provide high-calorie meal
B. Assess respiratory status
C. Give acetaminophen
D. Limit visitors
Correct Answer: B
Rationale: MG crisis → respiratory failure risk.
10. A nurse caring for a client in restraints must:
A. Renew order every 8 hr
B. Tie restraints to side rail
C. Document every 15 minutes
D. Remove restraints every 2 hours
Correct Answer: D
Rationale: Allows assessment of circulation & mobility.
11. A client receiving mannitol for ICP shows serum
osmolality of 330. What should the nurse do?
A. Increase IV rate
B. Withhold next dose
C. Elevate legs
D. Give hypertonic saline
Correct Answer: B
Rationale: Osmolality >320 = mannitol toxicity.
12. Which medication is used for a spinal cord injury at
T4 with severe hypertension and bradycardia?
A. Epinephrine
B. Atropine
C. IV labetalol
D. Nitroglycerin
