RN ATI CONCEPT-BASED ASSESSMENT LEVEL 4
PROCTORED EXAM |With 100+ Question with answers
and rationales graded A+
THIS EXAM INCLUDES:
• ATI RN Concept-Based Assessment Level 4. This exam is specifically
designed for nursing students at the end of a concept-based curriculum
and has been shown to have predictive value for first-time NCLEX-RN
success.
• The Level 4 assessment covers advanced nursing topics that require
strong clinical judgment. Below is a breakdown of common focus areas
with sample questions to help you study.
❖ Professional Nursing & Legal/Ethical Issues
❖ Medical-Surgical & Emergency Nursing
❖ Pharmacology
❖ Nutrition & Hematology
, ATI RN Concept-Based Assessment Level 4
1. A nurse is caring for a client with new-onset heart failure. Which action
should the nurse take first?
• A) Administer furosemide IV push
• B) Place the client in high-Fowler’s position
• C) Assess breath sounds
• D) Check oxygen saturation
Rationale: C. Assess breath sounds. This follows ABCs (Airway, Breathing,
Circulation) to determine severity of pulmonary congestion.
2. A nurse is reviewing an ECG for a client with angina. Which finding is
expected?
• A) ST-segment elevation
• B) T-wave inversion
• C) Widened QRS complex
• D) Absent P waves
Rationale: B. T-wave inversion indicates myocardial ischemia during an
anginal episode.
3. A nurse is assessing an infant with meningitis. Which finding is expected?
(Select all that apply – choose the best single answer)
• A) Vomiting
• B) Hyperactive deep tendon reflexes
• C) Sunken fontanel
• D) Bradycardia
Rationale: A. Vomiting is a common sign of increased intracranial pressure
in meningitis. Kernig’s and Brudzinski’s signs may also occur.
,4. A nurse is planning hydrotherapy for a burn client. Which action should be
included?
• A) Apply pressure to adherent tissue
• B) Use forceps and scissors to remove loose, non-viable tissue
• C) Scrub the wound vigorously with a brush
• D) Keep the client in cold water for 30 minutes
Rationale: B. Debridement of loose necrotic tissue during hydrotherapy
promotes wound healing and prevents infection.
5. A client has a partial-thickness burn and a prescription for silver sulfadiazine.
What is a priority nursing intervention?
• A) Apply thick layer over eschar
• B) Monitor WBC count
• C) Administer with food
• D) Restrict fluids
Rationale: B. Silver sulfadiazine can cause leukopenia; monitor WBC count
for bone marrow suppression.
6. In a mass casualty event, a responsive client with a major burn covering 15%
BSA receives which triage tag?
• A) Black (Expectant)
• B) Green (Minor)
• C) Yellow (Delayed)
• D) Red (Immediate)
Rationale: D. 15% BSA major burn is life-threatening but survivable with
immediate treatment → red tag.
, 7. A child with cystic fibrosis (CF) needs dietary planning. Which intervention is
appropriate?
• A) Low-fat, low-calorie diet
• B) Increase daily fat intake to 40% of total calories
• C) Restrict fluids
• D) Avoid pancreatic enzymes
Rationale: B. CF causes fat malabsorption; high-fat, high-calorie diet with
pancreatic enzymes is required.
8. A client with cirrhosis has an ammonia level of 120 mcg/dL. This finding
suggests which complication?
• A) Hepatic encephalopathy
• B) Ascites
• C) Esophageal varices
• D) Hepatorenal syndrome
Rationale: A. Elevated ammonia is a key indicator of hepatic
encephalopathy.
9. A nurse is teaching about DIC (disseminated intravascular coagulation). DIC
alters which body process?
• A) Oxygen transport
• B) Blood-clotting process
• C) Glucose metabolism
• D) Acid-base balance
Rationale: B. DIC causes widespread clotting followed by bleeding due to
depletion of clotting factors.
PROCTORED EXAM |With 100+ Question with answers
and rationales graded A+
THIS EXAM INCLUDES:
• ATI RN Concept-Based Assessment Level 4. This exam is specifically
designed for nursing students at the end of a concept-based curriculum
and has been shown to have predictive value for first-time NCLEX-RN
success.
• The Level 4 assessment covers advanced nursing topics that require
strong clinical judgment. Below is a breakdown of common focus areas
with sample questions to help you study.
❖ Professional Nursing & Legal/Ethical Issues
❖ Medical-Surgical & Emergency Nursing
❖ Pharmacology
❖ Nutrition & Hematology
, ATI RN Concept-Based Assessment Level 4
1. A nurse is caring for a client with new-onset heart failure. Which action
should the nurse take first?
• A) Administer furosemide IV push
• B) Place the client in high-Fowler’s position
• C) Assess breath sounds
• D) Check oxygen saturation
Rationale: C. Assess breath sounds. This follows ABCs (Airway, Breathing,
Circulation) to determine severity of pulmonary congestion.
2. A nurse is reviewing an ECG for a client with angina. Which finding is
expected?
• A) ST-segment elevation
• B) T-wave inversion
• C) Widened QRS complex
• D) Absent P waves
Rationale: B. T-wave inversion indicates myocardial ischemia during an
anginal episode.
3. A nurse is assessing an infant with meningitis. Which finding is expected?
(Select all that apply – choose the best single answer)
• A) Vomiting
• B) Hyperactive deep tendon reflexes
• C) Sunken fontanel
• D) Bradycardia
Rationale: A. Vomiting is a common sign of increased intracranial pressure
in meningitis. Kernig’s and Brudzinski’s signs may also occur.
,4. A nurse is planning hydrotherapy for a burn client. Which action should be
included?
• A) Apply pressure to adherent tissue
• B) Use forceps and scissors to remove loose, non-viable tissue
• C) Scrub the wound vigorously with a brush
• D) Keep the client in cold water for 30 minutes
Rationale: B. Debridement of loose necrotic tissue during hydrotherapy
promotes wound healing and prevents infection.
5. A client has a partial-thickness burn and a prescription for silver sulfadiazine.
What is a priority nursing intervention?
• A) Apply thick layer over eschar
• B) Monitor WBC count
• C) Administer with food
• D) Restrict fluids
Rationale: B. Silver sulfadiazine can cause leukopenia; monitor WBC count
for bone marrow suppression.
6. In a mass casualty event, a responsive client with a major burn covering 15%
BSA receives which triage tag?
• A) Black (Expectant)
• B) Green (Minor)
• C) Yellow (Delayed)
• D) Red (Immediate)
Rationale: D. 15% BSA major burn is life-threatening but survivable with
immediate treatment → red tag.
, 7. A child with cystic fibrosis (CF) needs dietary planning. Which intervention is
appropriate?
• A) Low-fat, low-calorie diet
• B) Increase daily fat intake to 40% of total calories
• C) Restrict fluids
• D) Avoid pancreatic enzymes
Rationale: B. CF causes fat malabsorption; high-fat, high-calorie diet with
pancreatic enzymes is required.
8. A client with cirrhosis has an ammonia level of 120 mcg/dL. This finding
suggests which complication?
• A) Hepatic encephalopathy
• B) Ascites
• C) Esophageal varices
• D) Hepatorenal syndrome
Rationale: A. Elevated ammonia is a key indicator of hepatic
encephalopathy.
9. A nurse is teaching about DIC (disseminated intravascular coagulation). DIC
alters which body process?
• A) Oxygen transport
• B) Blood-clotting process
• C) Glucose metabolism
• D) Acid-base balance
Rationale: B. DIC causes widespread clotting followed by bleeding due to
depletion of clotting factors.
