RN ATI ADULT MEDICAL-SURGICAL TIMED
PRACTICE EXAM (NGN-ALIGNED) 2026/2027
QUESTIONS & WELL REVISED ANSWERS WITH
RATIONALES
Total Questions: 110
Time Limit: 3 HOURS (180 minutes)
Instructions:
Answer all questions
Do not use notes
Choose the best answer
SATA = select all that apply
Treat as a real proctored exam
SECTION I: CARDIOVASCULAR (Q1–15)
Q1. A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. The client reports sudden onset of shortness of breath and chest pain. Which action
should the nurse take FIRST?
A. Administer prescribed pain medication
B. Elevate the head of the bed
C. Apply oxygen and activate the rapid response team
D. Obtain a STAT chest x-ray
Q2. Which assessment finding best indicates decreased cardiac output?
A. Bounding pulses
B. Elevated blood pressure
C. Altered mental status
D. Warm, flushed skin
Q3. Which assessment finding is expected in left-sided heart failure?
RN ATI ADULT MEDICAL-SURGICAL TIMED PRACTICE EXAM (NGN-ALIGNED) 2026/2027 QUESTIONS & WELL REVISED ANSWERS WITH RATIONALES
,A. Peripheral edema
B. Jugular vein distention
C. Pulmonary crackles
D. Ascites
Q4. (SATA) Which findings are associated with acute myocardial infarction?
Select all that apply.
A. Chest pain
B. Diaphoresis
C. Nausea
D. Bradycardia
E. ST-segment elevation
Q5. Which laboratory value is the priority for a client receiving digoxin therapy?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Q6. A client with atrial fibrillation is at greatest risk for which complication?
A. Heart failure
B. Stroke
C. Hypotension
D. Cardiac tamponade
Q7. Nitroglycerin is contraindicated in a client taking which medication?
A. Metoprolol
B. Furosemide
C. Sildenafil
D. Aspirin
RN ATI ADULT MEDICAL-SURGICAL TIMED PRACTICE EXAM (NGN-ALIGNED) 2026/2027 QUESTIONS & WELL REVISED ANSWERS WITH RATIONALES
, Q8. A client develops hypotension following a myocardial infarction. What is the nurse’s
priority action?
A. Administer IV fluids
B. Reassess blood pressure in 15 minutes
C. Assess perfusion and notify the provider
D. Place the client supine
Q9. Which cardiac rhythm requires immediate defibrillation?
A. Sinus tachycardia
B. Atrial fibrillation
C. Ventricular fibrillation
D. Asystole
Q10. Chest pain that is relieved by rest is characteristic of which condition?
A. Unstable angina
B. Stable angina
C. Myocardial infarction
D. Pericarditis
Q11. What is the best position for a client experiencing acute heart failure?
A. Supine
B. Left lateral
C. High-Fowler’s
D. Trendelenburg
Q12. Which medication primarily reduces preload?
A. Metoprolol
B. Nitroglycerin
C. Digoxin
D. Lisinopril
RN ATI ADULT MEDICAL-SURGICAL TIMED PRACTICE EXAM (NGN-ALIGNED) 2026/2027 QUESTIONS & WELL REVISED ANSWERS WITH RATIONALES
PRACTICE EXAM (NGN-ALIGNED) 2026/2027
QUESTIONS & WELL REVISED ANSWERS WITH
RATIONALES
Total Questions: 110
Time Limit: 3 HOURS (180 minutes)
Instructions:
Answer all questions
Do not use notes
Choose the best answer
SATA = select all that apply
Treat as a real proctored exam
SECTION I: CARDIOVASCULAR (Q1–15)
Q1. A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. The client reports sudden onset of shortness of breath and chest pain. Which action
should the nurse take FIRST?
A. Administer prescribed pain medication
B. Elevate the head of the bed
C. Apply oxygen and activate the rapid response team
D. Obtain a STAT chest x-ray
Q2. Which assessment finding best indicates decreased cardiac output?
A. Bounding pulses
B. Elevated blood pressure
C. Altered mental status
D. Warm, flushed skin
Q3. Which assessment finding is expected in left-sided heart failure?
RN ATI ADULT MEDICAL-SURGICAL TIMED PRACTICE EXAM (NGN-ALIGNED) 2026/2027 QUESTIONS & WELL REVISED ANSWERS WITH RATIONALES
,A. Peripheral edema
B. Jugular vein distention
C. Pulmonary crackles
D. Ascites
Q4. (SATA) Which findings are associated with acute myocardial infarction?
Select all that apply.
A. Chest pain
B. Diaphoresis
C. Nausea
D. Bradycardia
E. ST-segment elevation
Q5. Which laboratory value is the priority for a client receiving digoxin therapy?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Q6. A client with atrial fibrillation is at greatest risk for which complication?
A. Heart failure
B. Stroke
C. Hypotension
D. Cardiac tamponade
Q7. Nitroglycerin is contraindicated in a client taking which medication?
A. Metoprolol
B. Furosemide
C. Sildenafil
D. Aspirin
RN ATI ADULT MEDICAL-SURGICAL TIMED PRACTICE EXAM (NGN-ALIGNED) 2026/2027 QUESTIONS & WELL REVISED ANSWERS WITH RATIONALES
, Q8. A client develops hypotension following a myocardial infarction. What is the nurse’s
priority action?
A. Administer IV fluids
B. Reassess blood pressure in 15 minutes
C. Assess perfusion and notify the provider
D. Place the client supine
Q9. Which cardiac rhythm requires immediate defibrillation?
A. Sinus tachycardia
B. Atrial fibrillation
C. Ventricular fibrillation
D. Asystole
Q10. Chest pain that is relieved by rest is characteristic of which condition?
A. Unstable angina
B. Stable angina
C. Myocardial infarction
D. Pericarditis
Q11. What is the best position for a client experiencing acute heart failure?
A. Supine
B. Left lateral
C. High-Fowler’s
D. Trendelenburg
Q12. Which medication primarily reduces preload?
A. Metoprolol
B. Nitroglycerin
C. Digoxin
D. Lisinopril
RN ATI ADULT MEDICAL-SURGICAL TIMED PRACTICE EXAM (NGN-ALIGNED) 2026/2027 QUESTIONS & WELL REVISED ANSWERS WITH RATIONALES
