ATI RN CONCEPT-BASED ASSESSMENT LEVEL
1 EXAM PREP 2025/2026 | 235+ VERIFIED
PRACTICE QUESTIONS & ANSWERS |
COMPLETE NURSING CONCEPTS, CLINICAL
APPLICATION & ATI RN STUDY GUIDE
ATI RN CONCEPT-BASED ASSESSMENT LEVEL 1
EXAM PREP | 400 VERIFIED PRACTICE QUESTIONS & ANSWERS
Complete Nursing Concepts, Clinical Application & ATI RN Study Guide
HOW TO READ THIS EXAM: = CORRECT ANSWER | Each question has 5
options (A–E) | RATIONALE follows each question
SECTION 1: CARDIOVASCULAR CONCEPTS
1. A nurse is caring for a client who has heart failure and is experiencing dyspnea.
Which position should the nurse place the client in to relieve respiratory
distress?
A. Prone position B. Supine with legs elevated C. Left lateral recumbent D.
Trendelenburg position E. High Fowler's position (sitting upright at 90°)
✦ RATIONALE: High Fowler's position uses gravity to reduce venous return to the
heart and allows the diaphragm to descend, improving lung expansion. This position is
the priority intervention for a client with dyspnea related to heart failure.
2. A nurse is reviewing the ECG of a client and notes a prolonged PR interval
greater than 0.20 seconds. Which dysrhythmia should the nurse document?
A. Ventricular fibrillation B. Atrial flutter C. Third-degree heart block D. First-degree
heart block E. Atrial fibrillation
✦ RATIONALE: A PR interval greater than 0.20 seconds is diagnostic of first-
degree heart block, in which conduction through the AV node is delayed but every
impulse still reaches the ventricles.
,3. A nurse is caring for a client who is receiving a continuous IV heparin infusion.
Which laboratory value is most important to monitor?
A. PT/INR B. Platelet count C. Hemoglobin and hematocrit D. Serum creatinine E.
Activated partial thromboplastin time (aPTT)
✦ RATIONALE: The aPTT is used to monitor the therapeutic effectiveness and
safety of heparin therapy. The therapeutic range is 1.5–2.5 times the normal control
value (60–100 seconds).
4. A nurse is preparing to administer digoxin to a client. Which finding should
cause the nurse to withhold the medication?
A. Blood pressure 118/76 mmHg B. Potassium level 4.0 mEq/L C. Heart rate 68
beats/min D. Heart rate 52 beats/min E. Digoxin level 1.5 ng/mL
✦ RATIONALE: Digoxin should be withheld if the apical pulse is below 60 beats/min
in adults. Bradycardia is a sign of digoxin toxicity. The nurse should hold the dose and
notify the provider.
5. A client is admitted with suspected myocardial infarction. Which laboratory
value is the most specific indicator of myocardial damage?
A. Myoglobin B. LDH C. WBC D. Troponin I E. CK (total creatine kinase)
✦ RATIONALE: Troponin I is the most cardiac-specific biomarker. It rises within 3–6
hours of myocardial infarction, peaks at 14–18 hours, and remains elevated for 5–7
days, making it the gold standard for MI diagnosis.
6. A nurse is caring for a client who has peripheral artery disease (PAD). Which
assessment finding is most consistent with this diagnosis?
A. Edema and weeping wounds of the lower extremities B. Warm, reddened skin with
varicosities C. Bounding peripheral pulses bilaterally D. Intermittent claudication and
absent pedal pulses E. Pitting edema that worsens at night
,✦ RATIONALE: PAD is characterized by decreased arterial blood flow leading to
intermittent claudication (leg pain with activity), diminished or absent pulses, cool/pale
skin, and delayed capillary refill.
7. A nurse is caring for a client who had a coronary artery bypass graft (CABG) 2
days ago. Which assessment finding requires the nurse to contact the provider
immediately?
A. Incision site tenderness B. Mild fatigue with activity C. Heart rate of 88 beats/min D.
Serosanguineous drainage from chest tube E. Temperature of 38.9°C (102°F) and
purulent sternal wound drainage
✦ RATIONALE: Purulent wound drainage and elevated temperature are signs of
sternal wound infection, which is a life-threatening complication post-CABG.
Mediastinitis carries a high mortality rate and requires immediate intervention.
8. A client is prescribed metoprolol (Lopressor) for hypertension. Which client
statement indicates the need for further teaching?
A. "I will check my pulse before taking this medication." B. "I will avoid suddenly
stopping this medication." C. "I may feel more tired than usual." D. "I can stop taking
this medication once my blood pressure is normal." E. "I will report shortness of breath
to my doctor."
✦ RATIONALE: Beta-blockers must never be abruptly discontinued. Stopping them
suddenly can cause rebound hypertension, angina, or myocardial infarction. Clients
need lifelong education on medication adherence.
9. A nurse is assessing a client who has a history of heart failure. Which finding
indicates the client's condition is worsening?
A. Blood pressure 130/80 mmHg B. Clear bilateral lung sounds C. Weight gain of 0.5 kg
over 1 week D. Urine output of 50 mL/hr E. Weight gain of 2 kg (4.4 lbs) in 24 hours
✦ RATIONALE: A rapid weight gain of 2 kg or more in 24 hours indicates significant
fluid retention, which is a hallmark sign of worsening heart failure. The nurse should
notify the provider immediately.
, 10. A nurse is teaching a client with hypertension about the DASH diet. Which
food choice by the client indicates understanding of the teaching?
A. Canned soup with crackers B. Processed deli meats C. Fast food hamburger D.
Fresh fruits, vegetables, and low-fat dairy E. Pickled vegetables and soy sauce
✦ RATIONALE: The DASH (Dietary Approaches to Stop Hypertension) diet
emphasizes fresh fruits, vegetables, whole grains, and low-fat dairy while limiting
sodium, saturated fats, and processed foods.
SECTION 2: RESPIRATORY CONCEPTS
11. A nurse is caring for a client who has chronic obstructive pulmonary disease
(COPD). Which oxygen delivery method is most appropriate?
A. Non-rebreather mask at 12 L/min B. Simple face mask at 10 L/min C. Venturi mask at
50% FiO₂ D. Nasal cannula at 1–2 L/min E. Bag-valve mask at 15 L/min
✦ RATIONALE: Clients with COPD rely on hypoxic drive to breathe. High-flow
oxygen can eliminate this drive and cause respiratory depression. Low-flow oxygen (1–
2 L/min via nasal cannula) is the safest approach.
12. A nurse is assessing a client with pneumonia. Which assessment finding is
the priority?
A. Productive cough with yellow sputum B. Fever of 38.2°C (100.7°F) C. Fatigue and
malaise D. Oxygen saturation of 88% on room air E. Crackles in bilateral lung bases
✦ RATIONALE: An oxygen saturation of 88% is critically low and represents
impaired gas exchange, which is a life-threatening finding. This is the priority using the
ABCs framework — airway and oxygenation take precedence.
13. A nurse is preparing to perform nasotracheal suctioning on an adult client.
What is the maximum recommended suction time per pass?
1 EXAM PREP 2025/2026 | 235+ VERIFIED
PRACTICE QUESTIONS & ANSWERS |
COMPLETE NURSING CONCEPTS, CLINICAL
APPLICATION & ATI RN STUDY GUIDE
ATI RN CONCEPT-BASED ASSESSMENT LEVEL 1
EXAM PREP | 400 VERIFIED PRACTICE QUESTIONS & ANSWERS
Complete Nursing Concepts, Clinical Application & ATI RN Study Guide
HOW TO READ THIS EXAM: = CORRECT ANSWER | Each question has 5
options (A–E) | RATIONALE follows each question
SECTION 1: CARDIOVASCULAR CONCEPTS
1. A nurse is caring for a client who has heart failure and is experiencing dyspnea.
Which position should the nurse place the client in to relieve respiratory
distress?
A. Prone position B. Supine with legs elevated C. Left lateral recumbent D.
Trendelenburg position E. High Fowler's position (sitting upright at 90°)
✦ RATIONALE: High Fowler's position uses gravity to reduce venous return to the
heart and allows the diaphragm to descend, improving lung expansion. This position is
the priority intervention for a client with dyspnea related to heart failure.
2. A nurse is reviewing the ECG of a client and notes a prolonged PR interval
greater than 0.20 seconds. Which dysrhythmia should the nurse document?
A. Ventricular fibrillation B. Atrial flutter C. Third-degree heart block D. First-degree
heart block E. Atrial fibrillation
✦ RATIONALE: A PR interval greater than 0.20 seconds is diagnostic of first-
degree heart block, in which conduction through the AV node is delayed but every
impulse still reaches the ventricles.
,3. A nurse is caring for a client who is receiving a continuous IV heparin infusion.
Which laboratory value is most important to monitor?
A. PT/INR B. Platelet count C. Hemoglobin and hematocrit D. Serum creatinine E.
Activated partial thromboplastin time (aPTT)
✦ RATIONALE: The aPTT is used to monitor the therapeutic effectiveness and
safety of heparin therapy. The therapeutic range is 1.5–2.5 times the normal control
value (60–100 seconds).
4. A nurse is preparing to administer digoxin to a client. Which finding should
cause the nurse to withhold the medication?
A. Blood pressure 118/76 mmHg B. Potassium level 4.0 mEq/L C. Heart rate 68
beats/min D. Heart rate 52 beats/min E. Digoxin level 1.5 ng/mL
✦ RATIONALE: Digoxin should be withheld if the apical pulse is below 60 beats/min
in adults. Bradycardia is a sign of digoxin toxicity. The nurse should hold the dose and
notify the provider.
5. A client is admitted with suspected myocardial infarction. Which laboratory
value is the most specific indicator of myocardial damage?
A. Myoglobin B. LDH C. WBC D. Troponin I E. CK (total creatine kinase)
✦ RATIONALE: Troponin I is the most cardiac-specific biomarker. It rises within 3–6
hours of myocardial infarction, peaks at 14–18 hours, and remains elevated for 5–7
days, making it the gold standard for MI diagnosis.
6. A nurse is caring for a client who has peripheral artery disease (PAD). Which
assessment finding is most consistent with this diagnosis?
A. Edema and weeping wounds of the lower extremities B. Warm, reddened skin with
varicosities C. Bounding peripheral pulses bilaterally D. Intermittent claudication and
absent pedal pulses E. Pitting edema that worsens at night
,✦ RATIONALE: PAD is characterized by decreased arterial blood flow leading to
intermittent claudication (leg pain with activity), diminished or absent pulses, cool/pale
skin, and delayed capillary refill.
7. A nurse is caring for a client who had a coronary artery bypass graft (CABG) 2
days ago. Which assessment finding requires the nurse to contact the provider
immediately?
A. Incision site tenderness B. Mild fatigue with activity C. Heart rate of 88 beats/min D.
Serosanguineous drainage from chest tube E. Temperature of 38.9°C (102°F) and
purulent sternal wound drainage
✦ RATIONALE: Purulent wound drainage and elevated temperature are signs of
sternal wound infection, which is a life-threatening complication post-CABG.
Mediastinitis carries a high mortality rate and requires immediate intervention.
8. A client is prescribed metoprolol (Lopressor) for hypertension. Which client
statement indicates the need for further teaching?
A. "I will check my pulse before taking this medication." B. "I will avoid suddenly
stopping this medication." C. "I may feel more tired than usual." D. "I can stop taking
this medication once my blood pressure is normal." E. "I will report shortness of breath
to my doctor."
✦ RATIONALE: Beta-blockers must never be abruptly discontinued. Stopping them
suddenly can cause rebound hypertension, angina, or myocardial infarction. Clients
need lifelong education on medication adherence.
9. A nurse is assessing a client who has a history of heart failure. Which finding
indicates the client's condition is worsening?
A. Blood pressure 130/80 mmHg B. Clear bilateral lung sounds C. Weight gain of 0.5 kg
over 1 week D. Urine output of 50 mL/hr E. Weight gain of 2 kg (4.4 lbs) in 24 hours
✦ RATIONALE: A rapid weight gain of 2 kg or more in 24 hours indicates significant
fluid retention, which is a hallmark sign of worsening heart failure. The nurse should
notify the provider immediately.
, 10. A nurse is teaching a client with hypertension about the DASH diet. Which
food choice by the client indicates understanding of the teaching?
A. Canned soup with crackers B. Processed deli meats C. Fast food hamburger D.
Fresh fruits, vegetables, and low-fat dairy E. Pickled vegetables and soy sauce
✦ RATIONALE: The DASH (Dietary Approaches to Stop Hypertension) diet
emphasizes fresh fruits, vegetables, whole grains, and low-fat dairy while limiting
sodium, saturated fats, and processed foods.
SECTION 2: RESPIRATORY CONCEPTS
11. A nurse is caring for a client who has chronic obstructive pulmonary disease
(COPD). Which oxygen delivery method is most appropriate?
A. Non-rebreather mask at 12 L/min B. Simple face mask at 10 L/min C. Venturi mask at
50% FiO₂ D. Nasal cannula at 1–2 L/min E. Bag-valve mask at 15 L/min
✦ RATIONALE: Clients with COPD rely on hypoxic drive to breathe. High-flow
oxygen can eliminate this drive and cause respiratory depression. Low-flow oxygen (1–
2 L/min via nasal cannula) is the safest approach.
12. A nurse is assessing a client with pneumonia. Which assessment finding is
the priority?
A. Productive cough with yellow sputum B. Fever of 38.2°C (100.7°F) C. Fatigue and
malaise D. Oxygen saturation of 88% on room air E. Crackles in bilateral lung bases
✦ RATIONALE: An oxygen saturation of 88% is critically low and represents
impaired gas exchange, which is a life-threatening finding. This is the priority using the
ABCs framework — airway and oxygenation take precedence.
13. A nurse is preparing to perform nasotracheal suctioning on an adult client.
What is the maximum recommended suction time per pass?
