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ATI Med-Surg Proctored Exam 2025/2026 – 100 NGN Questions with Detailed Rationales | Complete Test Bank | Updated Medical-Surgical Review for Nursing Students PDF

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The Ultimate Preparation Tool for the ATI Medical-Surgical Proctored Exam. This premium, 2025/2026 Updated Edition is meticulously aligned with the Next Generation NCLEX (NGN) test plan. It provides 100 high-yield practice questions with verified rationales, focusing on clinical judgment, priority-setting, and the physiological management of complex adult health conditions. Key Content Domains Covered: 1. Cardiovascular System Nitroglycerin Education: Mastering the protocol for sublingual administration (1 tablet every 5 mins up to 3 doses) and safety measures like sitting or lying down to prevent orthostatic syncope. Cardiac Catheterization: Prioritizing post-procedure care, including monitoring the insertion site for hematoma and checking peripheral pulses distal to the site. 2. Respiratory System Incentive Spirometry: Education on preventing atelectasis by encouraging deep, sustained inhalation. Tension Pneumothorax: Recognizing medical emergencies—tracheal deviation to the unaffected side, absent breath sounds, and respiratory distress. 3. Endocrine & Metabolic Disorders SIADH vs. Diabetes Insipidus: SIADH: Excessive ADH, leading to water retention and dilutional hyponatremia. DI: Deficient ADH, leading to massive polyuria and dehydration. Diabetic Ketoacidosis (DKA): Emergency management involving rapid fluid resuscitation followed by regular insulin infusion. 4. Oncology & Hematology Anemia Care: Clustering nursing activities to conserve energy and reduce oxygen demand. Radiation Therapy: Managing common side effects like fatigue through activity planning and skin care for radiation dermatitis. 5. Renal & Gastrointestinal Chronic Kidney Disease (CKD): Managing electrolyte imbalances, particularly hyperkalemia, and understanding the restrictions for a renal diet. Gastrointestinal Bleeding: Assessing for signs of hypovolemic shock (tachycardia, hypotension, cool/clammy skin). ATI Med-Surg Quick Review Summary: | Topic | Priority Nursing Action | | :--- | :--- | | Nitroglycerin | Take first dose, sit down. Call 911 if pain persists after 5 mins. | | SIADH | Restrict fluids and monitor for low sodium levels. | | Pneumothorax | Assist with immediate chest tube insertion or needle decompression. | | Post-Op | Priority is ABCs: Airway patency, Breathing depth, and Circulation/Vitals. | This guide provides NCLEX-style NGN questions that challenge students to apply clinical reasoning, making it an essential resource for achieving Level 2 or Level 3 proficiency on the ATI Proctored Exam. ATI Med-Surg Proctored Exam 2026, Medical-Surgical Nursing Practice Questions, Nitroglycerin Patient Education, SIADH vs DI Nursing, Tension Pneumothorax Tracheal Deviation, DKA Management Protocol, Oncology Nursing Radiation Fatigue, ATI Level 3 Mastery, NGN Nursing Case Studies.

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Institution
ATI MED-SURG
Course
ATI MED-SURG

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ATI Med-Surg Proctored
Exam100 COMPREHENSIVE
Practice Questions with
Detailed Rationales
Latest 2025/2026 | NGN-
Style | All Body Systems
Covered
1|Page

,CARDIOVASCULAR SYSTEM


(Questions 1-15)




Question 1
A nurse is providing discharge teaching to a client who has a new prescription for
sublingual nitroglycerin. Which of the following client statements indicates an
understanding of the teaching?

A. "I can keep my medication for 1 year before replacing it."
B. "I should lie down when I take this medication."
C. "I should discontinue this medication if I develop a headache."
D. "I can take up to five tablets in 15 minutes before seeking medical attention."




Correct Answer: B

Rationale: Nitroglycerin causes vasodilation, which can lead to hypotension, dizziness, and
syncope. The client should lie down to prevent falls and reduce myocardial oxygen demand.
Nitroglycerin should be replaced every 6 months (not 1 year, A). Headache is an expected
side effect due to vasodilation and should not prompt discontinuation (C). The correct
protocol is to take one tablet every 5 minutes for up to three doses; if pain persists after 15
minutes, seek emergency care (not five tablets in 15 minutes, D) .




Question 2
A nurse is planning care for a client following a cardiac catheterization. Which of the
following actions should the nurse take?

A. Keep the client on bed rest for 24 hours
B. Limit the client's fluid intake to 1 L per day

2|Page

,C. Maintain the client's affected extremity in extension
D. Change the client's dressing every 8 hours




Correct Answer: C

Rationale: Following cardiac catheterization, the affected extremity (usually the leg)
should be maintained in extension (straight) to prevent bleeding or hematoma formation at
the insertion site. Bed rest duration varies but is typically 2-6 hours, not 24 hours (A).
Fluids are encouraged to help flush contrast dye from the kidneys (B). The initial dressing
is typically assessed and reinforced, not routinely changed every 8 hours (D) .




Question 3
A nurse is caring for a client who is 6 hours post-operative following a cardiac
catheterization via the femoral artery. Which assessment finding requires immediate
intervention?

A. BP 128/76 mm Hg
B. Small amount of dried blood on the dressing
C. Large, hard swelling at the insertion site
D. Client reports thirst




Correct Answer: C

Rationale: A large, hard swelling at the femoral insertion site suggests hematoma
formation or possible retroperitoneal bleeding, which requires immediate assessment and
intervention. BP 128/76 (A) is normal. Small dried blood (B) may be expected. Thirst (D) is
common post-procedure but not immediately concerning .




3|Page

, Question 4
A client with heart failure is receiving furosemide (Lasix). Which assessment finding
requires immediate notification of the healthcare provider?

A. Blood pressure 130/80 mm Hg
B. Urine output of 50 mL over 2 hours
C. Potassium level of 3.2 mEq/L
D. Mild ankle edema




Correct Answer: C

Rationale: Furosemide is a loop diuretic that causes potassium loss. A potassium level of
3.2 mEq/L indicates hypokalemia (normal 3.5-5.0), which can lead to cardiac arrhythmias
and requires immediate reporting and intervention. Urine output of 50 mL over 2 hours
(25 mL/hr) is low but not as immediately critical as hypokalemia (B). Mild edema (D) may
be expected. BP 130/80 (A) is acceptable .




Question 5
A nurse is providing discharge teaching to a client who has heart failure and instructs him
to limit sodium intake to 2 g per day. Which of the following statements by the client
indicates an understanding of the teaching?

A. "I can season my foods with garlic and onion salts."
B. "I can have mayonnaise on my sandwiches."
C. "I can have a frozen fruit juice bar for dessert."
D. "I can drink vegetable juice with a meal."




Correct Answer: C

Rationale: Frozen fruit juice bars are typically low in sodium and are an acceptable dessert
option for a low-sodium diet. Garlic and onion salts (A) contain sodium and should be


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