ATI RN CONCEPT BASED ASSESSMENT LEVEL 4 PROCTORED 2025”2026
EXAM ALL 150 QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES COVERING THE MOST TESTED QUESTIONS GUARANTEE
A+ GRADE |ALREADY GRADED A+
1. A 68-year-old client with septic shock has MAP 50 mmHg after 3L NS, HR 135, and urine
output 10 mL/hr. Which intervention is priority?
A. Continue monitoring
B. Initiate vasopressors and notify provider immediately
C. Encourage oral hydration
D. Document findings
Rationale: Persistent hypotension after aggressive fluids indicates refractory septic shock;
vasopressors are life-saving.
2. A client with acute MI develops sudden hypotension, cold extremities, and oliguria. Which
action is priority?
A. Encourage rest
B. Assess for cardiogenic shock and notify provider
C. Administer oral nitroglycerin
D. Document findings
Rationale: Post-MI cardiogenic shock is life-threatening; early recognition and intervention
improve survival.
3. A client post-thyroidectomy has tingling lips, positive Chvostek’s sign, and laryngospasm.
Priority action?
A. Apply warm compress
B. Maintain airway and administer IV calcium as prescribed
C. Encourage deep breathing
D. Document findings
Rationale: Hypocalcemia can cause airway compromise; immediate calcium replacement is
critical.
,4. A client with DKA has K⁺ 2.8 mEq/L, glucose 620 mg/dL. Priority intervention?
A. Administer IV insulin immediately
B. Replace potassium first and monitor ECG
C. Encourage oral fluids
D. Document findings
Rationale: Insulin lowers potassium further; severe hypokalemia can cause fatal arrhythmias.
5. A post-op client develops sudden shortness of breath, chest pain, and SpO₂ 82%. What is
priority?
A. Encourage deep breathing
B. Assess for pulmonary embolism and notify provider
C. Administer routine oxygen
D. Document findings
Rationale: Pulmonary embolism is life-threatening; early recognition is critical.
6. A client with acute pancreatitis develops hypotension, tachycardia, and low urine output.
Priority action?
A. Encourage oral hydration
B. Initiate aggressive IV fluids and notify provider
C. Administer pain meds only
D. Document findings
Rationale: Hypovolemia from third spacing can lead to shock; fluid resuscitation is urgent.
7. A client with severe hyperkalemia (K⁺ 7.5 mEq/L) has peaked T waves. What is priority
action?
A. Administer low-potassium diet
B. Give IV calcium gluconate and notify provider immediately
C. Monitor ECG only
D. Document findings
,Rationale: ECG changes with hyperkalemia indicate high risk for cardiac arrest; calcium
stabilizes cardiac membranes.
8. A client with acute asthma exacerbation presents with SpO₂ 80%, accessory muscle use,
and audible wheezing. Priority action?
A. Administer oral corticosteroids
B. Administer short-acting bronchodilator immediately
C. Encourage oral fluids
D. Document findings
Rationale: Severe hypoxia and airway obstruction require immediate bronchodilator therapy.
9. A client with DVT on IV heparin develops melena and hypotension. Priority action?
A. Continue heparin
B. Stop heparin and notify provider – possible life-threatening bleeding
C. Encourage fluids only
D. Document findings
Rationale: Active GI bleeding requires stopping anticoagulants and rapid provider intervention.
10. A client post-MI develops acute pulmonary edema with pink frothy sputum, SpO₂ 84%,
and dyspnea. Priority action?
A. Administer oral beta-blocker only
B. Provide oxygen, place upright, and notify provider
C. Document findings
D. Encourage ambulation
Rationale: Acute pulmonary edema is life-threatening; oxygenation and positioning improve
ventilation.
11. A client with septic shock has MAP 55 mmHg after fluids and rising lactate. Which is
priority?
A. Encourage oral hydration
B. Initiate vasopressors per protocol
, C. Document vitals
D. Reposition client
Rationale: Persistent hypotension indicates refractory shock; vasopressors are required to
maintain organ perfusion.
12. A client post-op develops sudden confusion, slurred speech, and right-sided weakness.
Priority action?
A. Encourage oral fluids
B. Notify provider – possible stroke
C. Document findings
D. Reposition client
Rationale: Acute neurological deficits may indicate a stroke; immediate intervention improves
outcomes.
13. A client with severe burns has absent distal pulses and increasing pain in extremity.
Priority action?
A. Apply topical antibiotics
B. Notify provider for possible compartment syndrome
C. Elevate extremity only
D. Encourage fluids
Rationale: Compartment syndrome can cause permanent tissue damage; urgent assessment is
critical.
14. A client with acute renal failure has K⁺ 6.8 mEq/L, oliguria, and peaked T waves. Priority
action?
A. Encourage oral hydration
B. Administer IV calcium gluconate and notify provider
C. Monitor ECG only
D. Document findings
Rationale: Hyperkalemia with ECG changes is life-threatening; rapid intervention prevents
cardiac arrest.
EXAM ALL 150 QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES COVERING THE MOST TESTED QUESTIONS GUARANTEE
A+ GRADE |ALREADY GRADED A+
1. A 68-year-old client with septic shock has MAP 50 mmHg after 3L NS, HR 135, and urine
output 10 mL/hr. Which intervention is priority?
A. Continue monitoring
B. Initiate vasopressors and notify provider immediately
C. Encourage oral hydration
D. Document findings
Rationale: Persistent hypotension after aggressive fluids indicates refractory septic shock;
vasopressors are life-saving.
2. A client with acute MI develops sudden hypotension, cold extremities, and oliguria. Which
action is priority?
A. Encourage rest
B. Assess for cardiogenic shock and notify provider
C. Administer oral nitroglycerin
D. Document findings
Rationale: Post-MI cardiogenic shock is life-threatening; early recognition and intervention
improve survival.
3. A client post-thyroidectomy has tingling lips, positive Chvostek’s sign, and laryngospasm.
Priority action?
A. Apply warm compress
B. Maintain airway and administer IV calcium as prescribed
C. Encourage deep breathing
D. Document findings
Rationale: Hypocalcemia can cause airway compromise; immediate calcium replacement is
critical.
,4. A client with DKA has K⁺ 2.8 mEq/L, glucose 620 mg/dL. Priority intervention?
A. Administer IV insulin immediately
B. Replace potassium first and monitor ECG
C. Encourage oral fluids
D. Document findings
Rationale: Insulin lowers potassium further; severe hypokalemia can cause fatal arrhythmias.
5. A post-op client develops sudden shortness of breath, chest pain, and SpO₂ 82%. What is
priority?
A. Encourage deep breathing
B. Assess for pulmonary embolism and notify provider
C. Administer routine oxygen
D. Document findings
Rationale: Pulmonary embolism is life-threatening; early recognition is critical.
6. A client with acute pancreatitis develops hypotension, tachycardia, and low urine output.
Priority action?
A. Encourage oral hydration
B. Initiate aggressive IV fluids and notify provider
C. Administer pain meds only
D. Document findings
Rationale: Hypovolemia from third spacing can lead to shock; fluid resuscitation is urgent.
7. A client with severe hyperkalemia (K⁺ 7.5 mEq/L) has peaked T waves. What is priority
action?
A. Administer low-potassium diet
B. Give IV calcium gluconate and notify provider immediately
C. Monitor ECG only
D. Document findings
,Rationale: ECG changes with hyperkalemia indicate high risk for cardiac arrest; calcium
stabilizes cardiac membranes.
8. A client with acute asthma exacerbation presents with SpO₂ 80%, accessory muscle use,
and audible wheezing. Priority action?
A. Administer oral corticosteroids
B. Administer short-acting bronchodilator immediately
C. Encourage oral fluids
D. Document findings
Rationale: Severe hypoxia and airway obstruction require immediate bronchodilator therapy.
9. A client with DVT on IV heparin develops melena and hypotension. Priority action?
A. Continue heparin
B. Stop heparin and notify provider – possible life-threatening bleeding
C. Encourage fluids only
D. Document findings
Rationale: Active GI bleeding requires stopping anticoagulants and rapid provider intervention.
10. A client post-MI develops acute pulmonary edema with pink frothy sputum, SpO₂ 84%,
and dyspnea. Priority action?
A. Administer oral beta-blocker only
B. Provide oxygen, place upright, and notify provider
C. Document findings
D. Encourage ambulation
Rationale: Acute pulmonary edema is life-threatening; oxygenation and positioning improve
ventilation.
11. A client with septic shock has MAP 55 mmHg after fluids and rising lactate. Which is
priority?
A. Encourage oral hydration
B. Initiate vasopressors per protocol
, C. Document vitals
D. Reposition client
Rationale: Persistent hypotension indicates refractory shock; vasopressors are required to
maintain organ perfusion.
12. A client post-op develops sudden confusion, slurred speech, and right-sided weakness.
Priority action?
A. Encourage oral fluids
B. Notify provider – possible stroke
C. Document findings
D. Reposition client
Rationale: Acute neurological deficits may indicate a stroke; immediate intervention improves
outcomes.
13. A client with severe burns has absent distal pulses and increasing pain in extremity.
Priority action?
A. Apply topical antibiotics
B. Notify provider for possible compartment syndrome
C. Elevate extremity only
D. Encourage fluids
Rationale: Compartment syndrome can cause permanent tissue damage; urgent assessment is
critical.
14. A client with acute renal failure has K⁺ 6.8 mEq/L, oliguria, and peaked T waves. Priority
action?
A. Encourage oral hydration
B. Administer IV calcium gluconate and notify provider
C. Monitor ECG only
D. Document findings
Rationale: Hyperkalemia with ECG changes is life-threatening; rapid intervention prevents
cardiac arrest.
