RN ATI CONCEPT-BASED ASSESSMENT LEVEL 1
PROCTORED EXAM | Fall 2026/2027 Updated Test Bank |
Pass Guaranteed - A+ Graded
Assessment Type: ATI Concept-Based Assessment (Proctored) | Level: 1 (First
Semester/Early Nursing Student) | Total Questions: 120 | Format: NCLEX-Style
(Multiple Choice, SATA, Ordered Response, Bowtie, Chart/Exhibit)
Blueprint Alignment: ATI Concept-Based Curriculum (44 Concepts) | NCSBN
NCLEX-RN 2026 Test Plan | Fall 2026/2027 Updates
[SECTION 1: CONCEPT: FLUID & ELECTROLYTE BALANCE (Q1-
15)]
Q1. A nurse is caring for a client who has been vomiting for 24 hours. The nurse
assesses dry mucous membranes, decreased skin turgor, and tachycardia. These
findings are consistent with which concept?
A. Fluid volume excess
B. Fluid volume deficit
C. Electrolyte imbalance
D. Acid-base imbalance
Correct Answer: B. Fluid volume deficit [CORRECT]
Rationale: Vomiting causes loss of gastric fluids, leading to hypovolemia. Dry
mucous membranes, poor skin turgor, and tachycardia are classic manifestations of
fluid volume deficit. Option A would show edema, weight gain, and JVD. Options C
and D may coexist but the primary concept demonstrated is fluid volume deficit. ATI
Level 1 Strategy: Cluster assessment findings to identify the primary concept before
addressing secondary issues.
,Q2. A client with heart failure has 2+ pitting edema in the lower extremities, JVD, and
crackles in the lung bases. Which nursing intervention is the priority?
A. Encourage increased oral fluid intake
B. Administer furosemide as prescribed and monitor daily weights
C. Place the client in Trendelenburg position
D. Administer IV normal saline at 125 mL/hr
Correct Answer: B. Administer furosemide as prescribed and monitor daily
weights [CORRECT]
Rationale: These findings indicate fluid volume excess from heart failure. Furosemide
(loop diuretic) promotes fluid excretion, and daily weights track fluid status (1 kg = 1
L fluid). Option A worsens fluid overload. Option C increases venous return and
worsens heart failure. Option D adds more fluid. ATI Level 1 Strategy: Fluid volume
excess = diuretics, fluid/sodium restriction, daily weights, lung sounds. Fluid volume
deficit = isotonic fluids.
Q3. A client's laboratory results show sodium 128 mEq/L. The nurse understands that
this client has:
A. Hypernatremia
B. Hyponatremia
C. Normal sodium level
D. Hyperkalemia
Correct Answer: B. Hyponatremia [CORRECT]
Rationale: Normal sodium is 135-145 mEq/L. A level of 128 mEq/L indicates
hyponatremia. Option A is sodium >145. Option C is incorrect. Option D involves
potassium, not sodium. ATI Level 1 Strategy: Memorize normal electrolyte values:
Na+ 135-145, K+ 3.5-5.0, Ca2+ 8.5-10.5, Mg2+ 1.7-2.2, Phos 2.5-4.5.
,Q4. A client with hyponatremia reports headache, confusion, and nausea. The nurse
should monitor for which potential complication?
A. Seizures
B. Bradycardia
C. Hyperglycemia
D. Hypertension
Correct Answer: A. Seizures [CORRECT]
Rationale: Severe hyponatremia (<120 mEq/L) causes cerebral edema, leading to
seizures, coma, and death. Options B, C, and D are not primary complications of
hyponatremia. ATI Level 1 Strategy: Hyponatremia manifestations progress from
nausea/confusion (mild) to seizures/coma (severe). Hypernatremia causes thirst,
restlessness, and seizures.
Q5. A nurse is caring for a client with a potassium level of 5.8 mEq/L. Which EKG
change should the nurse anticipate?
A. Flat T waves and U waves
B. Peaked T waves and widened QRS complex
C. ST elevation and pathological Q waves
D. Prolonged PR interval and bradycardia
Correct Answer: B. Peaked T waves and widened QRS complex [CORRECT]
Rationale: Hyperkalemia (>5.0 mEq/L) causes peaked T waves, widened QRS, and
eventually sine wave pattern. Option A describes hypokalemia. Option C describes
MI. Option D describes heart block. ATI Level 1 Strategy: Hyperkalemia EKG =
peaked T waves → widened QRS → sine wave → cardiac arrest. Hypokalemia = flat T
waves, U waves, ST depression.
, Q6. A client receiving IV potassium chloride complains of burning at the insertion
site. The nurse notes the solution is infusing at 30 mEq/hr via peripheral IV. Which
action should the nurse take first?
A. Slow the infusion and assess for infiltration
B. Increase the rate to complete the infusion faster
C. Discontinue the IV and restart in the opposite arm
D. Apply a warm compress and continue the infusion
Correct Answer: A. Slow the infusion and assess for infiltration [CORRECT]
Rationale: IV potassium should not exceed 10 mEq/hr peripherally due to vein
irritation and risk of tissue necrosis if infiltrated. The nurse must slow the infusion and
assess for infiltration. Option B worsens the risk. Option C may be needed but
assessment comes first. Option D doesn't address the excessive rate. ATI Level 1
Strategy: IV potassium maximum = 10 mEq/hr peripheral, 20 mEq/hr central. Never
give IV push.
Q7. A client with hypocalcemia demonstrates which clinical manifestation?
A. Positive Trousseau sign and Chvostek sign
B. Peaked T waves on EKG
C. Deep tendon hyperreflexia
D. Flaccid paralysis
Correct Answer: A. Positive Trousseau sign and Chvostek sign [CORRECT]
Rationale: Hypocalcemia causes neuromuscular irritability demonstrated by
Trousseau sign (carpal spasm with BP cuff inflation) and Chvostek sign (facial
twitching with facial nerve tap). Option B is hyperkalemia. Options C and D are
hyperkalemia/hypermagnesemia manifestations. ATI Level 1 Strategy: Hypocalcemia
= tetany, seizures, Chvostek/Trousseau. Hypercalcemia = stones, bones, groans,
thrones, psychiatric overtones.
PROCTORED EXAM | Fall 2026/2027 Updated Test Bank |
Pass Guaranteed - A+ Graded
Assessment Type: ATI Concept-Based Assessment (Proctored) | Level: 1 (First
Semester/Early Nursing Student) | Total Questions: 120 | Format: NCLEX-Style
(Multiple Choice, SATA, Ordered Response, Bowtie, Chart/Exhibit)
Blueprint Alignment: ATI Concept-Based Curriculum (44 Concepts) | NCSBN
NCLEX-RN 2026 Test Plan | Fall 2026/2027 Updates
[SECTION 1: CONCEPT: FLUID & ELECTROLYTE BALANCE (Q1-
15)]
Q1. A nurse is caring for a client who has been vomiting for 24 hours. The nurse
assesses dry mucous membranes, decreased skin turgor, and tachycardia. These
findings are consistent with which concept?
A. Fluid volume excess
B. Fluid volume deficit
C. Electrolyte imbalance
D. Acid-base imbalance
Correct Answer: B. Fluid volume deficit [CORRECT]
Rationale: Vomiting causes loss of gastric fluids, leading to hypovolemia. Dry
mucous membranes, poor skin turgor, and tachycardia are classic manifestations of
fluid volume deficit. Option A would show edema, weight gain, and JVD. Options C
and D may coexist but the primary concept demonstrated is fluid volume deficit. ATI
Level 1 Strategy: Cluster assessment findings to identify the primary concept before
addressing secondary issues.
,Q2. A client with heart failure has 2+ pitting edema in the lower extremities, JVD, and
crackles in the lung bases. Which nursing intervention is the priority?
A. Encourage increased oral fluid intake
B. Administer furosemide as prescribed and monitor daily weights
C. Place the client in Trendelenburg position
D. Administer IV normal saline at 125 mL/hr
Correct Answer: B. Administer furosemide as prescribed and monitor daily
weights [CORRECT]
Rationale: These findings indicate fluid volume excess from heart failure. Furosemide
(loop diuretic) promotes fluid excretion, and daily weights track fluid status (1 kg = 1
L fluid). Option A worsens fluid overload. Option C increases venous return and
worsens heart failure. Option D adds more fluid. ATI Level 1 Strategy: Fluid volume
excess = diuretics, fluid/sodium restriction, daily weights, lung sounds. Fluid volume
deficit = isotonic fluids.
Q3. A client's laboratory results show sodium 128 mEq/L. The nurse understands that
this client has:
A. Hypernatremia
B. Hyponatremia
C. Normal sodium level
D. Hyperkalemia
Correct Answer: B. Hyponatremia [CORRECT]
Rationale: Normal sodium is 135-145 mEq/L. A level of 128 mEq/L indicates
hyponatremia. Option A is sodium >145. Option C is incorrect. Option D involves
potassium, not sodium. ATI Level 1 Strategy: Memorize normal electrolyte values:
Na+ 135-145, K+ 3.5-5.0, Ca2+ 8.5-10.5, Mg2+ 1.7-2.2, Phos 2.5-4.5.
,Q4. A client with hyponatremia reports headache, confusion, and nausea. The nurse
should monitor for which potential complication?
A. Seizures
B. Bradycardia
C. Hyperglycemia
D. Hypertension
Correct Answer: A. Seizures [CORRECT]
Rationale: Severe hyponatremia (<120 mEq/L) causes cerebral edema, leading to
seizures, coma, and death. Options B, C, and D are not primary complications of
hyponatremia. ATI Level 1 Strategy: Hyponatremia manifestations progress from
nausea/confusion (mild) to seizures/coma (severe). Hypernatremia causes thirst,
restlessness, and seizures.
Q5. A nurse is caring for a client with a potassium level of 5.8 mEq/L. Which EKG
change should the nurse anticipate?
A. Flat T waves and U waves
B. Peaked T waves and widened QRS complex
C. ST elevation and pathological Q waves
D. Prolonged PR interval and bradycardia
Correct Answer: B. Peaked T waves and widened QRS complex [CORRECT]
Rationale: Hyperkalemia (>5.0 mEq/L) causes peaked T waves, widened QRS, and
eventually sine wave pattern. Option A describes hypokalemia. Option C describes
MI. Option D describes heart block. ATI Level 1 Strategy: Hyperkalemia EKG =
peaked T waves → widened QRS → sine wave → cardiac arrest. Hypokalemia = flat T
waves, U waves, ST depression.
, Q6. A client receiving IV potassium chloride complains of burning at the insertion
site. The nurse notes the solution is infusing at 30 mEq/hr via peripheral IV. Which
action should the nurse take first?
A. Slow the infusion and assess for infiltration
B. Increase the rate to complete the infusion faster
C. Discontinue the IV and restart in the opposite arm
D. Apply a warm compress and continue the infusion
Correct Answer: A. Slow the infusion and assess for infiltration [CORRECT]
Rationale: IV potassium should not exceed 10 mEq/hr peripherally due to vein
irritation and risk of tissue necrosis if infiltrated. The nurse must slow the infusion and
assess for infiltration. Option B worsens the risk. Option C may be needed but
assessment comes first. Option D doesn't address the excessive rate. ATI Level 1
Strategy: IV potassium maximum = 10 mEq/hr peripheral, 20 mEq/hr central. Never
give IV push.
Q7. A client with hypocalcemia demonstrates which clinical manifestation?
A. Positive Trousseau sign and Chvostek sign
B. Peaked T waves on EKG
C. Deep tendon hyperreflexia
D. Flaccid paralysis
Correct Answer: A. Positive Trousseau sign and Chvostek sign [CORRECT]
Rationale: Hypocalcemia causes neuromuscular irritability demonstrated by
Trousseau sign (carpal spasm with BP cuff inflation) and Chvostek sign (facial
twitching with facial nerve tap). Option B is hyperkalemia. Options C and D are
hyperkalemia/hypermagnesemia manifestations. ATI Level 1 Strategy: Hypocalcemia
= tetany, seizures, Chvostek/Trousseau. Hypercalcemia = stones, bones, groans,
thrones, psychiatric overtones.
