RN ATI CONCEPT BASED ASSESSMENT PROCTORED FOR LEVEL 3/ CONCEP
BASED PROCTORED LEVEL 3 NEWEST UPDATE 2026!!!
Question 1
A nurse in a mental health clinic is assessing a client who states, "I don't think my gambling is as
big of a problem as my friends think it is." Which of the following findings should the nurse
identify as meeting the diagnostic criteria of gambling disorder?
A) The client makes no attempts to stop gambling.
B) The client gambles when feeling happy or enthusiastic.
C) The client gambles the same amount of money each week.
D) The client asks others for money to compensate for gambling losses.
E) The client only gambles on weekends.
Correct Answer: D) the client asks others for money to compensate for gambling losses.
Rationale: One of the diagnostic criteria for a gambling disorder is a reliance on others to
provide money to help with negative financial situations that are a direct result of gambling
losses. A diagnosis requires meeting four or more defined criteria over a 12-month period.
Question 2
A nurse is assessing a client who has schizophrenia. Which of the following manifestations
should the nurse identify as a positive symptom of this disorder?
A) Flat affect
B) Emotional ambivalence
C) Auditory hallucinations
D) Social withdrawal
E) Alogia
Correct Answer: C) auditory hallucinations.
Rationale: Positive symptoms of schizophrenia are "add-on" behaviors that are not
normally present. These include hallucinations, delusions, magical thinking, and clang
associations. Negative symptoms, like flat affect, represent a loss of normal function.
Question 3
A nurse is assessing a client who has schizophrenia and observes the client choosing words based
on their sounds rather than their meanings. The nurse should document this as which of the
following?
A) Magical thinking
B) Clang association
C) Echolalia
D) Word salad
E) Neologisms
Correct Answer: B) clang association.
Rationale: Clang association is a positive symptom of schizophrenia where the client picks
words because they rhyme or have a similar sound, regardless of whether the sentence
makes logical sense.
, 2
Question 4
A nurse is assessing a client who has end-stage COPD. Which of the following findings should
the nurse identify as a late manifestation of chronic oxygen deprivation?
A) Flexion or contraction of the joints
B) Swan neck deformation
C) Tophi in the earlobes
D) Digital clubbing
E) Increased capillary refill time
Correct Answer: D) digital clubbing.
Rationale: Digital clubbing is a late manifestation of COPD and other terminal respiratory
illnesses. it is evidence of chronic decreased arterial oxygen levels occurring over a long
period.
Question 5
A nurse in an emergency department is assessing a newly admitted client. The nurse should
identify that which of the following findings is a manifestation of acute cocaine toxicity?
A) Hypotension
B) Pinpoint pupils
C) Agitation
D) Hypothermia
E) Bradycardia
Correct Answer: C) agitation.
Rationale: Cocaine is a central nervous system (CNS) stimulant. Acute toxicity typically
manifests as agitation, dizziness, tremors, tachycardia, and dilated pupils. Severe toxicity
can lead to seizures and myocardial infarction.
Question 6
A nurse is providing teaching to a client who has preeclampsia without severe symptoms. Which
of the following instructions should the nurse include?
A) Monitor temperature twice each day.
B) Restrict fluid intake to 1 liter per day.
C) Maintain a dark, quiet environment at all times.
D) Use a side-lying position when resting in bed.
E) Avoid all physical activity including sitting up.
Correct Answer: D) use a side lying position when resting in bed or on the couch.
Rationale: The side-lying position is recommended because it increases blood flow to the
uterus and placenta, optimizing oxygen and nutrient delivery to the fetus. Supine
positioning can cause hypotension and decrease placental perfusion.
Question 7
A nurse is planning care for a client who has a gambling disorder. Which of the following
, 3
interventions should the nurse include in the plan?
A) Recommend joining a self-help group.
B) Administer high-dose antipsychotic medications.
C) Begin disulfiram therapy.
D) Initiate aversion therapy for financial management.
E) Provide the client with a credit card to test self-control.
Correct Answer: A) recommend joining a self help group.
Rationale: Self-help groups, such as Gamblers Anonymous, are effective treatments for
gambling disorders. Aversion therapy is typically used for paraphilias, and disulfiram is
used for alcohol abstinence.
Question 8
A nurse is caring for a client who has Alzheimer's disease (AD). The client's daughter asks the
nurse about her own risk of developing AD. Which of the following responses should the nurse
make regarding genetic disposition?
A) You can be tested for the presence of apolipoprotein, which indicates an increased risk.
B) Having a family history of AD is not a known risk factor for the disease.
C) Individuals who develop AD generally have a history of frequent bacterial infections.
D) AD is more common in men, so your brothers have a higher risk than you.
E) There is no genetic component to Alzheimer's disease.
Correct Answer: A) you can be tested for the presence of apolipoprotein, an indication of an
increased risk of developing AD.
Rationale: The presence of apolipoprotein E (APOE) is a known genetic marker associated
with an increased risk of developing Alzheimer's disease. Family history is a significant risk
factor.
Question 9
A nurse in a mental health clinic is planning care for a client who has post-traumatic stress
disorder (PTSD). Which of the following strategies should the nurse include?
A) Assist the client to identify their stage in the grief process.
B) Encourage the client to avoid discussing their trauma.
C) Offer the client alone time when flashbacks occur.
D) Provide the client with a rotating staffing assignment.
E) Administer disulfiram to prevent anxiety.
Correct Answer: A) assist the client to identify their stage in the grief process.
Rationale: Identifying the stage of grief is a helpful strategy in the treatment of PTSD.
Avoiding the trauma, leaving the client alone during a flashback, or using rotating staff can
increase anxiety and hinder the therapeutic relationship.
Question 10
A nurse is reviewing the laboratory findings of a client who has acute pancreatitis. Which of the
, 4
following findings should the nurse expect?
A) Calcium 10.2 mg/dL
B) Amylase 300 units/L
C) WBC count 7000 mm3
D) Blood glucose 100 mg/dL
E) Amylase 50 units/L
Correct Answer: B) amylase 300 units/L
Rationale: Acute pancreatitis causes a significant rise in serum amylase levels, usually
exceeding the normal range of 30-220 units/L. This rise typically occurs within 12 to 24
hours of the onset of symptoms.
Question 11
A nurse is caring for a client who has schizophrenia and states, "The government has spies here
monitoring me in my room." Which of the following responses should the nurse give?
A) The government is not monitoring your room.
B) What would you like me to do about the government being here?
C) I understand that you believe the government is here, but I don't see any evidence of this.
D) Let's go see if the government is monitoring your room.
E) Why do you think the government is interested in you?
Correct Answer: C) i understand that you believe the government is here, but i don't see any
evidence of this.
Rationale: The nurse should acknowledge the client's feelings (validating their reality) while
presenting the factual truth without arguing or playing into the delusion.
Question 12
A nurse is reviewing the medical history of a client. Which of the following findings indicates
the client is at an increased risk for a stroke?
A) History of hypopituitarism.
B) Takes a combination oral contraceptive.
C) Drinks 150 mL of wine each day.
D) Avoids saturated fats in cooking.
E) Has a BMI of 22.
Correct Answer: B) takes a combination oral contraceptive.
Rationale: Combination oral contraceptives increase the risk of vascular events, including
stroke and blood clots, especially in clients who smoke or have migraines with aura.
Question 13
A nurse is caring for a client who is 4 hours postpartum and is experiencing excessive vaginal
bleeding. Which of the following actions is the nurse's priority?
A) Administer oxytocin IV.
B) Massage the client's fundus.
BASED PROCTORED LEVEL 3 NEWEST UPDATE 2026!!!
Question 1
A nurse in a mental health clinic is assessing a client who states, "I don't think my gambling is as
big of a problem as my friends think it is." Which of the following findings should the nurse
identify as meeting the diagnostic criteria of gambling disorder?
A) The client makes no attempts to stop gambling.
B) The client gambles when feeling happy or enthusiastic.
C) The client gambles the same amount of money each week.
D) The client asks others for money to compensate for gambling losses.
E) The client only gambles on weekends.
Correct Answer: D) the client asks others for money to compensate for gambling losses.
Rationale: One of the diagnostic criteria for a gambling disorder is a reliance on others to
provide money to help with negative financial situations that are a direct result of gambling
losses. A diagnosis requires meeting four or more defined criteria over a 12-month period.
Question 2
A nurse is assessing a client who has schizophrenia. Which of the following manifestations
should the nurse identify as a positive symptom of this disorder?
A) Flat affect
B) Emotional ambivalence
C) Auditory hallucinations
D) Social withdrawal
E) Alogia
Correct Answer: C) auditory hallucinations.
Rationale: Positive symptoms of schizophrenia are "add-on" behaviors that are not
normally present. These include hallucinations, delusions, magical thinking, and clang
associations. Negative symptoms, like flat affect, represent a loss of normal function.
Question 3
A nurse is assessing a client who has schizophrenia and observes the client choosing words based
on their sounds rather than their meanings. The nurse should document this as which of the
following?
A) Magical thinking
B) Clang association
C) Echolalia
D) Word salad
E) Neologisms
Correct Answer: B) clang association.
Rationale: Clang association is a positive symptom of schizophrenia where the client picks
words because they rhyme or have a similar sound, regardless of whether the sentence
makes logical sense.
, 2
Question 4
A nurse is assessing a client who has end-stage COPD. Which of the following findings should
the nurse identify as a late manifestation of chronic oxygen deprivation?
A) Flexion or contraction of the joints
B) Swan neck deformation
C) Tophi in the earlobes
D) Digital clubbing
E) Increased capillary refill time
Correct Answer: D) digital clubbing.
Rationale: Digital clubbing is a late manifestation of COPD and other terminal respiratory
illnesses. it is evidence of chronic decreased arterial oxygen levels occurring over a long
period.
Question 5
A nurse in an emergency department is assessing a newly admitted client. The nurse should
identify that which of the following findings is a manifestation of acute cocaine toxicity?
A) Hypotension
B) Pinpoint pupils
C) Agitation
D) Hypothermia
E) Bradycardia
Correct Answer: C) agitation.
Rationale: Cocaine is a central nervous system (CNS) stimulant. Acute toxicity typically
manifests as agitation, dizziness, tremors, tachycardia, and dilated pupils. Severe toxicity
can lead to seizures and myocardial infarction.
Question 6
A nurse is providing teaching to a client who has preeclampsia without severe symptoms. Which
of the following instructions should the nurse include?
A) Monitor temperature twice each day.
B) Restrict fluid intake to 1 liter per day.
C) Maintain a dark, quiet environment at all times.
D) Use a side-lying position when resting in bed.
E) Avoid all physical activity including sitting up.
Correct Answer: D) use a side lying position when resting in bed or on the couch.
Rationale: The side-lying position is recommended because it increases blood flow to the
uterus and placenta, optimizing oxygen and nutrient delivery to the fetus. Supine
positioning can cause hypotension and decrease placental perfusion.
Question 7
A nurse is planning care for a client who has a gambling disorder. Which of the following
, 3
interventions should the nurse include in the plan?
A) Recommend joining a self-help group.
B) Administer high-dose antipsychotic medications.
C) Begin disulfiram therapy.
D) Initiate aversion therapy for financial management.
E) Provide the client with a credit card to test self-control.
Correct Answer: A) recommend joining a self help group.
Rationale: Self-help groups, such as Gamblers Anonymous, are effective treatments for
gambling disorders. Aversion therapy is typically used for paraphilias, and disulfiram is
used for alcohol abstinence.
Question 8
A nurse is caring for a client who has Alzheimer's disease (AD). The client's daughter asks the
nurse about her own risk of developing AD. Which of the following responses should the nurse
make regarding genetic disposition?
A) You can be tested for the presence of apolipoprotein, which indicates an increased risk.
B) Having a family history of AD is not a known risk factor for the disease.
C) Individuals who develop AD generally have a history of frequent bacterial infections.
D) AD is more common in men, so your brothers have a higher risk than you.
E) There is no genetic component to Alzheimer's disease.
Correct Answer: A) you can be tested for the presence of apolipoprotein, an indication of an
increased risk of developing AD.
Rationale: The presence of apolipoprotein E (APOE) is a known genetic marker associated
with an increased risk of developing Alzheimer's disease. Family history is a significant risk
factor.
Question 9
A nurse in a mental health clinic is planning care for a client who has post-traumatic stress
disorder (PTSD). Which of the following strategies should the nurse include?
A) Assist the client to identify their stage in the grief process.
B) Encourage the client to avoid discussing their trauma.
C) Offer the client alone time when flashbacks occur.
D) Provide the client with a rotating staffing assignment.
E) Administer disulfiram to prevent anxiety.
Correct Answer: A) assist the client to identify their stage in the grief process.
Rationale: Identifying the stage of grief is a helpful strategy in the treatment of PTSD.
Avoiding the trauma, leaving the client alone during a flashback, or using rotating staff can
increase anxiety and hinder the therapeutic relationship.
Question 10
A nurse is reviewing the laboratory findings of a client who has acute pancreatitis. Which of the
, 4
following findings should the nurse expect?
A) Calcium 10.2 mg/dL
B) Amylase 300 units/L
C) WBC count 7000 mm3
D) Blood glucose 100 mg/dL
E) Amylase 50 units/L
Correct Answer: B) amylase 300 units/L
Rationale: Acute pancreatitis causes a significant rise in serum amylase levels, usually
exceeding the normal range of 30-220 units/L. This rise typically occurs within 12 to 24
hours of the onset of symptoms.
Question 11
A nurse is caring for a client who has schizophrenia and states, "The government has spies here
monitoring me in my room." Which of the following responses should the nurse give?
A) The government is not monitoring your room.
B) What would you like me to do about the government being here?
C) I understand that you believe the government is here, but I don't see any evidence of this.
D) Let's go see if the government is monitoring your room.
E) Why do you think the government is interested in you?
Correct Answer: C) i understand that you believe the government is here, but i don't see any
evidence of this.
Rationale: The nurse should acknowledge the client's feelings (validating their reality) while
presenting the factual truth without arguing or playing into the delusion.
Question 12
A nurse is reviewing the medical history of a client. Which of the following findings indicates
the client is at an increased risk for a stroke?
A) History of hypopituitarism.
B) Takes a combination oral contraceptive.
C) Drinks 150 mL of wine each day.
D) Avoids saturated fats in cooking.
E) Has a BMI of 22.
Correct Answer: B) takes a combination oral contraceptive.
Rationale: Combination oral contraceptives increase the risk of vascular events, including
stroke and blood clots, especially in clients who smoke or have migraines with aura.
Question 13
A nurse is caring for a client who is 4 hours postpartum and is experiencing excessive vaginal
bleeding. Which of the following actions is the nurse's priority?
A) Administer oxytocin IV.
B) Massage the client's fundus.
