ATI RN MEDICAL-SURGICAL RETAKE 1, 2, & 3
(2026/2027) | COMPLETE RETAKE
EXAMINATION SERIES | NCLEX-RN®
ATI RN Medical-Surgical Retake Comprehensive Examination Series | Core Domains:
Advanced Medical-Surgical Nursing Knowledge, Clinical Judgment in Complex Patient
Scenarios, Pharmacology & Advanced Medication Management, Multisystem Disorders &
Complications, Critical Care & Emergency Interventions, Patient Safety & Quality
Improvement, and NCLEX®-Style Test-Taking Strategies | Nursing Program Remediation &
Readiness Focus | Comprehensive Retake Assessment Series Format
Exam Structure
• ATI RN Medical-Surgical Retake Exam 1: 75-question, multiple-choice question (MCQ)
examination.
• ATI RN Medical-Surgical Retake Exam 2: 75-question, multiple-choice question (MCQ)
examination.
• ATI RN Medical-Surgical Retake Exam 3: 75-question, multiple-choice question (MCQ)
examination.
Introduction
This ATI RN Medical-Surgical Retake Exam series guide for the 2026/2027 cycle provides a
complete remediation pathway for students requiring mastery of complex adult health nursing
content. Each exam in the series progressively assesses and reinforces knowledge across all
major body systems, focusing on clinical reasoning, prioritization, and the application of
evidence-based practices essential for NCLEX-RN® success and safe clinical practice.
Retake 1 1. A client with heart failure is receiving furosemide 40 mg IV twice daily.
Which laboratory value should the nurse monitor most closely?
A. Sodium 138 mEq/L
B. Potassium 3.1 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 1.8 mg/dL
,B. Potassium 3.1 mEq/L
Furosemide is a loop diuretic that causes significant potassium excretion, leading to
hypokalemia (normal range: 3.5–5.0 mEq/L). Hypokalemia increases the risk of
life-threatening dysrhythmias, especially in clients with heart failure who may also be on
digoxin. The priority is to recognize and correct low potassium before complications arise.
This integrates pathophysiology (renal K⁺ wasting), pharmacology (diuretic mechanism), and
NCLEX prioritization (safety over comfort).
Retake 1 2. A postoperative client has sudden onset of shortness of breath,
tachycardia, and chest pain. The nurse suspects pulmonary embolism. What is the
priority action?
A. Administer oxygen
B. Elevate the head of the bed
C. Notify the provider immediately
D. Apply sequential compression devices
A. Administer oxygen
Using the ABC (Airway, Breathing, Circulation) framework, impaired gas exchange is the
immediate threat in pulmonary embolism. Administering oxygen improves oxygenation and
prevents hypoxia-induced organ damage. While notifying the provider is essential, the nurse
must first address the client’s breathing per NCLEX safety protocols. This demonstrates
clinical judgment in acute respiratory compromise.
Retake 1 3. A client with type 1 diabetes has a blood glucose of 52 mg/dL and is
conscious but confused. What is the nurse’s best action?
A. Administer glucagon IM
B. Give 4 oz of orange juice
C. Provide a protein snack
D. Recheck blood glucose in 15 minutes
,B. Give 4 oz of orange juice
For a conscious client with hypoglycemia (<70 mg/dL), the priority is rapid correction with
15–20 g of fast-acting carbohydrate (e.g., 4 oz juice). Glucagon is reserved for unconscious
clients. This aligns with ADA guidelines and NCLEX test-taking strategy: match the
intervention to the client’s level of consciousness. Delaying treatment risks progression to
coma or seizure.
Retake 1 4. A client is 2 hours post-op from abdominal surgery. Vital signs: BP
88/50, HR 118, RR 24, SpO₂ 95%. The client is pale and diaphoretic. What is the
nurse’s priority action?
A. Administer PRN pain medication
B. Increase IV fluid rate
C. Notify the provider immediately
D. Elevate the head of bed
C. Notify the provider immediately
These signs indicate hypovolemic shock, likely from postoperative hemorrhage. While
increasing IV fluids may be ordered, the nurse must first notify the provider for rapid
intervention (e.g., return to OR). This reflects NCLEX prioritization: recognize and escalate
life-threatening complications early. Delaying notification risks irreversible organ failure.
Retake 1 5. A client with chronic kidney disease (CKD) has a serum potassium of 6.0
mEq/L. Which ECG change should the nurse anticipate?
A. Prolonged PR interval
B. Peaked T waves
C. ST segment depression
D. U waves
B. Peaked T waves
, Hyperkalemia causes characteristic ECG changes: peaked T waves (early), widened QRS, and
sine wave (late). Peaked T waves are the hallmark sign at K⁺ >5.5 mEq/L. Immediate
interventions include calcium gluconate to stabilize the myocardium. This integrates
pathophysiology (K⁺ effect on cardiac conduction) and emergency response—key for NCLEX
critical thinking.
Retake 1 6. A client is receiving a blood transfusion. Ten minutes after starting, the
client complains of chills and back pain. What is the nurse’s first action?
A. Slow the infusion rate
B. Stop the transfusion immediately
C. Administer acetaminophen
D. Check vital signs
B. Stop the transfusion immediately
Chills and back pain during transfusion suggest acute hemolytic reaction—a medical
emergency. The first action is to stop the transfusion to prevent further antigen exposure. Keep
IV line open with normal saline only. This follows blood administration protocols and
prioritizes patient safety over symptom management.
Retake 1 7. A client with cirrhosis develops hepatic encephalopathy. Which
medication is expected?
A. Lactulose
B. Omeprazole
C. Spironolactone
D. Propranolol
A. Lactulose
Lactulose reduces ammonia levels by acidifying the colon and promoting excretion. Ammonia
buildup causes the altered mental status in hepatic encephalopathy. The goal is 2–3 soft stools
(2026/2027) | COMPLETE RETAKE
EXAMINATION SERIES | NCLEX-RN®
ATI RN Medical-Surgical Retake Comprehensive Examination Series | Core Domains:
Advanced Medical-Surgical Nursing Knowledge, Clinical Judgment in Complex Patient
Scenarios, Pharmacology & Advanced Medication Management, Multisystem Disorders &
Complications, Critical Care & Emergency Interventions, Patient Safety & Quality
Improvement, and NCLEX®-Style Test-Taking Strategies | Nursing Program Remediation &
Readiness Focus | Comprehensive Retake Assessment Series Format
Exam Structure
• ATI RN Medical-Surgical Retake Exam 1: 75-question, multiple-choice question (MCQ)
examination.
• ATI RN Medical-Surgical Retake Exam 2: 75-question, multiple-choice question (MCQ)
examination.
• ATI RN Medical-Surgical Retake Exam 3: 75-question, multiple-choice question (MCQ)
examination.
Introduction
This ATI RN Medical-Surgical Retake Exam series guide for the 2026/2027 cycle provides a
complete remediation pathway for students requiring mastery of complex adult health nursing
content. Each exam in the series progressively assesses and reinforces knowledge across all
major body systems, focusing on clinical reasoning, prioritization, and the application of
evidence-based practices essential for NCLEX-RN® success and safe clinical practice.
Retake 1 1. A client with heart failure is receiving furosemide 40 mg IV twice daily.
Which laboratory value should the nurse monitor most closely?
A. Sodium 138 mEq/L
B. Potassium 3.1 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 1.8 mg/dL
,B. Potassium 3.1 mEq/L
Furosemide is a loop diuretic that causes significant potassium excretion, leading to
hypokalemia (normal range: 3.5–5.0 mEq/L). Hypokalemia increases the risk of
life-threatening dysrhythmias, especially in clients with heart failure who may also be on
digoxin. The priority is to recognize and correct low potassium before complications arise.
This integrates pathophysiology (renal K⁺ wasting), pharmacology (diuretic mechanism), and
NCLEX prioritization (safety over comfort).
Retake 1 2. A postoperative client has sudden onset of shortness of breath,
tachycardia, and chest pain. The nurse suspects pulmonary embolism. What is the
priority action?
A. Administer oxygen
B. Elevate the head of the bed
C. Notify the provider immediately
D. Apply sequential compression devices
A. Administer oxygen
Using the ABC (Airway, Breathing, Circulation) framework, impaired gas exchange is the
immediate threat in pulmonary embolism. Administering oxygen improves oxygenation and
prevents hypoxia-induced organ damage. While notifying the provider is essential, the nurse
must first address the client’s breathing per NCLEX safety protocols. This demonstrates
clinical judgment in acute respiratory compromise.
Retake 1 3. A client with type 1 diabetes has a blood glucose of 52 mg/dL and is
conscious but confused. What is the nurse’s best action?
A. Administer glucagon IM
B. Give 4 oz of orange juice
C. Provide a protein snack
D. Recheck blood glucose in 15 minutes
,B. Give 4 oz of orange juice
For a conscious client with hypoglycemia (<70 mg/dL), the priority is rapid correction with
15–20 g of fast-acting carbohydrate (e.g., 4 oz juice). Glucagon is reserved for unconscious
clients. This aligns with ADA guidelines and NCLEX test-taking strategy: match the
intervention to the client’s level of consciousness. Delaying treatment risks progression to
coma or seizure.
Retake 1 4. A client is 2 hours post-op from abdominal surgery. Vital signs: BP
88/50, HR 118, RR 24, SpO₂ 95%. The client is pale and diaphoretic. What is the
nurse’s priority action?
A. Administer PRN pain medication
B. Increase IV fluid rate
C. Notify the provider immediately
D. Elevate the head of bed
C. Notify the provider immediately
These signs indicate hypovolemic shock, likely from postoperative hemorrhage. While
increasing IV fluids may be ordered, the nurse must first notify the provider for rapid
intervention (e.g., return to OR). This reflects NCLEX prioritization: recognize and escalate
life-threatening complications early. Delaying notification risks irreversible organ failure.
Retake 1 5. A client with chronic kidney disease (CKD) has a serum potassium of 6.0
mEq/L. Which ECG change should the nurse anticipate?
A. Prolonged PR interval
B. Peaked T waves
C. ST segment depression
D. U waves
B. Peaked T waves
, Hyperkalemia causes characteristic ECG changes: peaked T waves (early), widened QRS, and
sine wave (late). Peaked T waves are the hallmark sign at K⁺ >5.5 mEq/L. Immediate
interventions include calcium gluconate to stabilize the myocardium. This integrates
pathophysiology (K⁺ effect on cardiac conduction) and emergency response—key for NCLEX
critical thinking.
Retake 1 6. A client is receiving a blood transfusion. Ten minutes after starting, the
client complains of chills and back pain. What is the nurse’s first action?
A. Slow the infusion rate
B. Stop the transfusion immediately
C. Administer acetaminophen
D. Check vital signs
B. Stop the transfusion immediately
Chills and back pain during transfusion suggest acute hemolytic reaction—a medical
emergency. The first action is to stop the transfusion to prevent further antigen exposure. Keep
IV line open with normal saline only. This follows blood administration protocols and
prioritizes patient safety over symptom management.
Retake 1 7. A client with cirrhosis develops hepatic encephalopathy. Which
medication is expected?
A. Lactulose
B. Omeprazole
C. Spironolactone
D. Propranolol
A. Lactulose
Lactulose reduces ammonia levels by acidifying the colon and promoting excretion. Ammonia
buildup causes the altered mental status in hepatic encephalopathy. The goal is 2–3 soft stools
