ATI RN Concept-Based Assessment Level 2 Proctored Exam
–With 350+ Verified Questions and Answers with Rationale
| Complete Exam Preparation Material
THIS EXAM INCLUDES:
• This document contains verified questions and answers for the ATI RN
Concept-Based Assessment Level 2 Proctored Exam, including detailed
rationales for each answer.
• It covers key nursing concepts, clinical judgment, and exam-focused
topics to support effective preparation. The material is structured to
reflect actual exam standards and is suitable for revision and self-
assessment.
,ATI RN Concept-Based Assessment Level 2 Proctored Exam
Sample Questions & Rationales
1. A patient with a STEMI receives tPA and suddenly develops a severe
headache and vomiting. BP is 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
Correct Answer: B. Notify provider and prepare for emergency CT scan.
Rationale: A severe headache and elevated BP following tPA administration are
classic signs of intracranial hemorrhage, a life-threatening complication of
thrombolytic therapy. The priority is to notify the provider immediately and
prepare the patient for an emergency CT scan to confirm the diagnosis and guide
urgent intervention .
2. A patient with sepsis has a lactate of 5.2 mmol/L and BP 82/48 mmHg after
receiving 30 mL/kg of crystalloid fluids. What is the next priority?
A. Start dopamine
B. Begin norepinephrine to maintain MAP ≥ 65 mmHg
C. Obtain CT scan
D. Administer antibiotics
Correct Answer: B. Begin norepinephrine to maintain MAP ≥ 65 mmHg.
Rationale: This patient is in fluid-refractory septic shock. According to the
Surviving Sepsis Campaign guidelines, the next step is to initiate a vasopressor.
Norepinephrine is the first-line vasopressor recommended to maintain a mean
arterial pressure (MAP) of 65 mmHg or greater .
3. A patient with a subdural hematoma has an ICP of 18 mmHg and BP of 90/60
mmHg. What is the priority?
A. Give mannitol
B. Increase BP to maintain cerebral perfusion pressure (CPP ≥ 60 mmHg)
,C. Lower head of bed
D. Hyperventilate rapidly
Correct Answer: B. Increase BP to maintain cerebral perfusion pressure (CPP ≥
60 mmHg).
Rationale: Cerebral Perfusion Pressure (CPP) is calculated as MAP minus ICP (CPP
= MAP - ICP). With an ICP of 18 and a low MAP of 70 (calculated from 90/60), the
CPP is critically low at 52 mmHg (70-18). This is below the target of 60 mmHg,
leading to inadequate brain perfusion. The priority is to increase the MAP with
fluids or vasopressors to improve CPP .
4. A nurse is assessing a client who has appendicitis. Which of the following
findings should the nurse report to the provider immediately?
A. WBC 16,000/mm³
B. Board-like abdomen
C. Nausea and vomiting
D. Temperature of 38° C (100.4° F)
Correct Answer: B. Board-like abdomen.
Rationale: A board-like abdomen is a sign of peritonitis, a life-threatening
complication of appendicitis involving inflammation of the abdominal lining. Using
the urgent vs. nonurgent approach, this finding is the priority to report to the
provider immediately, as it requires urgent surgical intervention .
5. A nurse is reviewing the medical record of a client who has a peptic ulcer.
Which of the following findings is a priority to report to the provider?
A. Melena stools
B. Hemoglobin 7.6 mg/dL
C. Weight gain of 1.4 kg (3 lb) in 2 weeks
D. Dyspepsia during the day
Correct Answer: B. Hemoglobin 7.6 mg/dL.
Rationale: This hemoglobin level is significantly below the expected reference
range (typically 12-16 mg/dL for women and 14-18 mg/dL for men). It indicates a
chronic, bleeding peptic ulcer and places the patient at risk for severe anemia and
, hemodynamic instability. This is an urgent finding that must be reported to the
provider immediately .
6. A nurse is providing teaching to a client who is experiencing malabsorption
related to lactose intolerance. Which of the following foods should the nurse
recommend as the best non-dairy source of calcium?
A. Ground beef
B. Collard greens
C. Cauliflower
D. Walnuts
Correct Answer: B. Collard greens.
Rationale: For clients with lactose intolerance who need calcium for bone health,
non-dairy sources are essential. Collard greens are an excellent source, with one
cup providing approximately 268 mg of calcium, making them the best choice
among the options listed .
7. A client with chronic heart failure complains of increased shortness of breath
and 2+ pitting edema in both legs. Which initial action should the nurse take?
A. Encourage bed rest and call provider
B. Assess oxygen saturation and lung sounds
C. Start IV furosemide immediately without order
D. Obtain a 12-lead ECG
Correct Answer: B. Assess oxygen saturation and lung sounds.
Rationale: The nurse's initial action should always be to assess the patient.
Shortness of breath could indicate worsening heart failure or pulmonary edema.
Assessing oxygen saturation and lung sounds (for crackles) will provide objective
data on the severity of the patient's respiratory status and guide the need for
immediate interventions like supplemental oxygen or diuretics .
8. A patient receiving a heparin infusion has an aPTT that is 2.5 times the
control. The nurse should:
A. Increase infusion rate
B. Stop infusion and notify provider
C. Continue current rate and recheck in 12 hours
D. Administer protamine sulfate immediately
–With 350+ Verified Questions and Answers with Rationale
| Complete Exam Preparation Material
THIS EXAM INCLUDES:
• This document contains verified questions and answers for the ATI RN
Concept-Based Assessment Level 2 Proctored Exam, including detailed
rationales for each answer.
• It covers key nursing concepts, clinical judgment, and exam-focused
topics to support effective preparation. The material is structured to
reflect actual exam standards and is suitable for revision and self-
assessment.
,ATI RN Concept-Based Assessment Level 2 Proctored Exam
Sample Questions & Rationales
1. A patient with a STEMI receives tPA and suddenly develops a severe
headache and vomiting. BP is 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
Correct Answer: B. Notify provider and prepare for emergency CT scan.
Rationale: A severe headache and elevated BP following tPA administration are
classic signs of intracranial hemorrhage, a life-threatening complication of
thrombolytic therapy. The priority is to notify the provider immediately and
prepare the patient for an emergency CT scan to confirm the diagnosis and guide
urgent intervention .
2. A patient with sepsis has a lactate of 5.2 mmol/L and BP 82/48 mmHg after
receiving 30 mL/kg of crystalloid fluids. What is the next priority?
A. Start dopamine
B. Begin norepinephrine to maintain MAP ≥ 65 mmHg
C. Obtain CT scan
D. Administer antibiotics
Correct Answer: B. Begin norepinephrine to maintain MAP ≥ 65 mmHg.
Rationale: This patient is in fluid-refractory septic shock. According to the
Surviving Sepsis Campaign guidelines, the next step is to initiate a vasopressor.
Norepinephrine is the first-line vasopressor recommended to maintain a mean
arterial pressure (MAP) of 65 mmHg or greater .
3. A patient with a subdural hematoma has an ICP of 18 mmHg and BP of 90/60
mmHg. What is the priority?
A. Give mannitol
B. Increase BP to maintain cerebral perfusion pressure (CPP ≥ 60 mmHg)
,C. Lower head of bed
D. Hyperventilate rapidly
Correct Answer: B. Increase BP to maintain cerebral perfusion pressure (CPP ≥
60 mmHg).
Rationale: Cerebral Perfusion Pressure (CPP) is calculated as MAP minus ICP (CPP
= MAP - ICP). With an ICP of 18 and a low MAP of 70 (calculated from 90/60), the
CPP is critically low at 52 mmHg (70-18). This is below the target of 60 mmHg,
leading to inadequate brain perfusion. The priority is to increase the MAP with
fluids or vasopressors to improve CPP .
4. A nurse is assessing a client who has appendicitis. Which of the following
findings should the nurse report to the provider immediately?
A. WBC 16,000/mm³
B. Board-like abdomen
C. Nausea and vomiting
D. Temperature of 38° C (100.4° F)
Correct Answer: B. Board-like abdomen.
Rationale: A board-like abdomen is a sign of peritonitis, a life-threatening
complication of appendicitis involving inflammation of the abdominal lining. Using
the urgent vs. nonurgent approach, this finding is the priority to report to the
provider immediately, as it requires urgent surgical intervention .
5. A nurse is reviewing the medical record of a client who has a peptic ulcer.
Which of the following findings is a priority to report to the provider?
A. Melena stools
B. Hemoglobin 7.6 mg/dL
C. Weight gain of 1.4 kg (3 lb) in 2 weeks
D. Dyspepsia during the day
Correct Answer: B. Hemoglobin 7.6 mg/dL.
Rationale: This hemoglobin level is significantly below the expected reference
range (typically 12-16 mg/dL for women and 14-18 mg/dL for men). It indicates a
chronic, bleeding peptic ulcer and places the patient at risk for severe anemia and
, hemodynamic instability. This is an urgent finding that must be reported to the
provider immediately .
6. A nurse is providing teaching to a client who is experiencing malabsorption
related to lactose intolerance. Which of the following foods should the nurse
recommend as the best non-dairy source of calcium?
A. Ground beef
B. Collard greens
C. Cauliflower
D. Walnuts
Correct Answer: B. Collard greens.
Rationale: For clients with lactose intolerance who need calcium for bone health,
non-dairy sources are essential. Collard greens are an excellent source, with one
cup providing approximately 268 mg of calcium, making them the best choice
among the options listed .
7. A client with chronic heart failure complains of increased shortness of breath
and 2+ pitting edema in both legs. Which initial action should the nurse take?
A. Encourage bed rest and call provider
B. Assess oxygen saturation and lung sounds
C. Start IV furosemide immediately without order
D. Obtain a 12-lead ECG
Correct Answer: B. Assess oxygen saturation and lung sounds.
Rationale: The nurse's initial action should always be to assess the patient.
Shortness of breath could indicate worsening heart failure or pulmonary edema.
Assessing oxygen saturation and lung sounds (for crackles) will provide objective
data on the severity of the patient's respiratory status and guide the need for
immediate interventions like supplemental oxygen or diuretics .
8. A patient receiving a heparin infusion has an aPTT that is 2.5 times the
control. The nurse should:
A. Increase infusion rate
B. Stop infusion and notify provider
C. Continue current rate and recheck in 12 hours
D. Administer protamine sulfate immediately
