ATI RN Medical-Surgical Master Exam 2026
ATI RN Medical-Surgical Master Exam 2026 | 100
Questions with Answers and Detailed Rationales
1. A client with chronic obstructive pulmonary disease (COPD) reports increased
dyspnea. Which nursing intervention is most appropriate?
A. Encourage the client to perform pursed-lip breathing.
B. Administer high-flow oxygen at 10 L/min via nonrebreather mask.
C. Instruct the client to lie flat and rest.
D. Encourage forceful coughing every hour.
Answer: A. Encourage the client to perform pursed-lip breathing.
Rationale: Pursed-lip breathing helps improve oxygenation and prevents airway
collapse by creating positive pressure during exhalation. High-flow O2 can reduce
the respiratory drive in COPD clients, lying flat can worsen dyspnea, and forceful
coughing may cause fatigue.
2. A post-op client develops sudden shortness of breath, chest pain, and
tachycardia. What is the nurse’s priority action?
A. Administer prescribed analgesics.
B. Place the client in high Fowler’s position and notify the provider.
C. Encourage deep breathing and coughing exercises.
D. Check the surgical site for bleeding.
Answer: B. Place the client in high Fowler’s position and notify the provider.
Rationale: These are signs of a pulmonary embolism. High Fowler’s improves
oxygenation, and notifying the provider ensures rapid intervention. Analgesics and
coughing exercises do not address the acute problem, and the surgical site may
not reveal embolism.
3. A client with type 1 diabetes presents with fruity breath, nausea, and rapid
breathing. Which lab result confirms the suspected condition?
A. Blood glucose 150 mg/dL
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,ATI RN Medical-Surgical Master Exam 2026
B. Serum potassium 3.2 mEq/L
C. Arterial pH 7.25
D. Hemoglobin A1c 5.8%
Answer: C. Arterial pH 7.25
Rationale: The client shows signs of diabetic ketoacidosis (DKA). A pH <7.35
confirms metabolic acidosis. Blood glucose is usually >250 mg/dL, potassium may
be elevated initially, and A1c reflects long-term control.
4. A client is receiving heparin therapy for a deep vein thrombosis. Which lab
value should the nurse monitor to evaluate the effectiveness?
A. PT
B. INR
C. aPTT
D. Platelet count
Answer: C. aPTT
Rationale: Activated partial thromboplastin time (aPTT) monitors heparin therapy.
PT/INR monitor warfarin, and platelet count is checked for heparin-induced
thrombocytopenia but does not measure anticoagulation effect.
5. A client with heart failure reports swelling in the ankles and shortness of
breath. Which nursing intervention is highest priority?
A. Encourage a high-protein diet
B. Assess lung sounds and oxygen saturation
C. Instruct client to elevate legs at night
D. Monitor intake and output
Answer: B. Assess lung sounds and oxygen saturation
Rationale: Respiratory compromise is the most critical risk in heart failure.
Assessing lungs and oxygenation identifies early pulmonary edema. Leg elevation
and monitoring intake/output are supportive but secondary priorities.
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,ATI RN Medical-Surgical Master Exam 2026
6. A nurse is caring for a client with acute pancreatitis. Which lab result is most
indicative of this condition?
A. Amylase 250 U/L
B. ALT 20 U/L
C. WBC 6,000/mm³
D. Serum sodium 140 mEq/L
Answer: A. Amylase 250 U/L
Rationale: Elevated amylase is a key indicator of pancreatitis. ALT may indicate
liver involvement, WBC may rise with infection, and sodium is usually normal
unless severe vomiting occurs.
7. A client with chronic kidney disease (CKD) is prescribed erythropoietin. Which
lab value indicates the medication is effective?
A. Serum creatinine
B. Hematocrit
C. Potassium
D. BUN
Answer: B. Hematocrit
Rationale: Erythropoietin stimulates RBC production. Rising hematocrit indicates
effective treatment for CKD-related anemia. Creatinine and BUN reflect kidney
function, potassium indicates electrolyte status.
8. A client with peptic ulcer disease asks what to avoid to prevent exacerbation.
Which response is correct?
A. “Avoid foods high in protein.”
B. “Avoid alcohol, caffeine, and NSAIDs.”
C. “Avoid foods high in calcium.”
D. “Avoid cold foods and fluids.”
Answer: B. “Avoid alcohol, caffeine, and NSAIDs.”
Rationale: These irritants increase gastric acid and exacerbate ulcers. Protein and
calcium intake do not worsen ulcers; temperature of food is not a significant
factor.
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, ATI RN Medical-Surgical Master Exam 2026
9. A client is receiving total parenteral nutrition (TPN). Which intervention is
priority?
A. Monitor daily weight
B. Check blood glucose every 4–6 hours
C. Administer vitamin supplements
D. Monitor bowel movements
Answer: B. Check blood glucose every 4–6 hours
Rationale: TPN is high in glucose, putting the client at risk for hyperglycemia.
Frequent monitoring allows prompt intervention. Weight and vitamins are
important but secondary.
10. A client with a chest tube reports sudden subcutaneous emphysema around
the insertion site. What should the nurse do first?
A. Apply warm compresses
B. Assess for respiratory distress
C. Clamp the chest tube
D. Notify the provider
Answer: B. Assess for respiratory distress
Rationale: Subcutaneous emphysema can indicate air leakage or pneumothorax.
First, assess airway and breathing. Clamping the tube without evaluation can
worsen the condition.
11. SATA: A client with deep vein thrombosis is prescribed warfarin. Which
instructions should the nurse provide?
A. Use a soft-bristled toothbrush
B. Avoid foods high in vitamin K
C. Increase physical activity to prevent clotting
D. Monitor for signs of bleeding
E. Stop medication once symptoms resolve
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ATI RN Medical-Surgical Master Exam 2026 | 100
Questions with Answers and Detailed Rationales
1. A client with chronic obstructive pulmonary disease (COPD) reports increased
dyspnea. Which nursing intervention is most appropriate?
A. Encourage the client to perform pursed-lip breathing.
B. Administer high-flow oxygen at 10 L/min via nonrebreather mask.
C. Instruct the client to lie flat and rest.
D. Encourage forceful coughing every hour.
Answer: A. Encourage the client to perform pursed-lip breathing.
Rationale: Pursed-lip breathing helps improve oxygenation and prevents airway
collapse by creating positive pressure during exhalation. High-flow O2 can reduce
the respiratory drive in COPD clients, lying flat can worsen dyspnea, and forceful
coughing may cause fatigue.
2. A post-op client develops sudden shortness of breath, chest pain, and
tachycardia. What is the nurse’s priority action?
A. Administer prescribed analgesics.
B. Place the client in high Fowler’s position and notify the provider.
C. Encourage deep breathing and coughing exercises.
D. Check the surgical site for bleeding.
Answer: B. Place the client in high Fowler’s position and notify the provider.
Rationale: These are signs of a pulmonary embolism. High Fowler’s improves
oxygenation, and notifying the provider ensures rapid intervention. Analgesics and
coughing exercises do not address the acute problem, and the surgical site may
not reveal embolism.
3. A client with type 1 diabetes presents with fruity breath, nausea, and rapid
breathing. Which lab result confirms the suspected condition?
A. Blood glucose 150 mg/dL
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,ATI RN Medical-Surgical Master Exam 2026
B. Serum potassium 3.2 mEq/L
C. Arterial pH 7.25
D. Hemoglobin A1c 5.8%
Answer: C. Arterial pH 7.25
Rationale: The client shows signs of diabetic ketoacidosis (DKA). A pH <7.35
confirms metabolic acidosis. Blood glucose is usually >250 mg/dL, potassium may
be elevated initially, and A1c reflects long-term control.
4. A client is receiving heparin therapy for a deep vein thrombosis. Which lab
value should the nurse monitor to evaluate the effectiveness?
A. PT
B. INR
C. aPTT
D. Platelet count
Answer: C. aPTT
Rationale: Activated partial thromboplastin time (aPTT) monitors heparin therapy.
PT/INR monitor warfarin, and platelet count is checked for heparin-induced
thrombocytopenia but does not measure anticoagulation effect.
5. A client with heart failure reports swelling in the ankles and shortness of
breath. Which nursing intervention is highest priority?
A. Encourage a high-protein diet
B. Assess lung sounds and oxygen saturation
C. Instruct client to elevate legs at night
D. Monitor intake and output
Answer: B. Assess lung sounds and oxygen saturation
Rationale: Respiratory compromise is the most critical risk in heart failure.
Assessing lungs and oxygenation identifies early pulmonary edema. Leg elevation
and monitoring intake/output are supportive but secondary priorities.
2|Page
,ATI RN Medical-Surgical Master Exam 2026
6. A nurse is caring for a client with acute pancreatitis. Which lab result is most
indicative of this condition?
A. Amylase 250 U/L
B. ALT 20 U/L
C. WBC 6,000/mm³
D. Serum sodium 140 mEq/L
Answer: A. Amylase 250 U/L
Rationale: Elevated amylase is a key indicator of pancreatitis. ALT may indicate
liver involvement, WBC may rise with infection, and sodium is usually normal
unless severe vomiting occurs.
7. A client with chronic kidney disease (CKD) is prescribed erythropoietin. Which
lab value indicates the medication is effective?
A. Serum creatinine
B. Hematocrit
C. Potassium
D. BUN
Answer: B. Hematocrit
Rationale: Erythropoietin stimulates RBC production. Rising hematocrit indicates
effective treatment for CKD-related anemia. Creatinine and BUN reflect kidney
function, potassium indicates electrolyte status.
8. A client with peptic ulcer disease asks what to avoid to prevent exacerbation.
Which response is correct?
A. “Avoid foods high in protein.”
B. “Avoid alcohol, caffeine, and NSAIDs.”
C. “Avoid foods high in calcium.”
D. “Avoid cold foods and fluids.”
Answer: B. “Avoid alcohol, caffeine, and NSAIDs.”
Rationale: These irritants increase gastric acid and exacerbate ulcers. Protein and
calcium intake do not worsen ulcers; temperature of food is not a significant
factor.
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, ATI RN Medical-Surgical Master Exam 2026
9. A client is receiving total parenteral nutrition (TPN). Which intervention is
priority?
A. Monitor daily weight
B. Check blood glucose every 4–6 hours
C. Administer vitamin supplements
D. Monitor bowel movements
Answer: B. Check blood glucose every 4–6 hours
Rationale: TPN is high in glucose, putting the client at risk for hyperglycemia.
Frequent monitoring allows prompt intervention. Weight and vitamins are
important but secondary.
10. A client with a chest tube reports sudden subcutaneous emphysema around
the insertion site. What should the nurse do first?
A. Apply warm compresses
B. Assess for respiratory distress
C. Clamp the chest tube
D. Notify the provider
Answer: B. Assess for respiratory distress
Rationale: Subcutaneous emphysema can indicate air leakage or pneumothorax.
First, assess airway and breathing. Clamping the tube without evaluation can
worsen the condition.
11. SATA: A client with deep vein thrombosis is prescribed warfarin. Which
instructions should the nurse provide?
A. Use a soft-bristled toothbrush
B. Avoid foods high in vitamin K
C. Increase physical activity to prevent clotting
D. Monitor for signs of bleeding
E. Stop medication once symptoms resolve
4|Page
