ATI Adult Medical Surgical NGN Test Bank: 300 Original Questions with Answers and Rationales –
2026 Edition
📋 COMPLETE 300-QUESTION TEST BANK
SECTION 1: Cardiovascular Disorders (Questions 1-40)
Q1. A nurse is assessing a client with heart failure. Which finding is most concerning?
A) +2 pedal edema
B) Crackles in both lung bases
C) Weight gain of 2 lbs in 24 hours
D) Oxygen saturation 88% on room air
Rationale: SpO2 below 90% indicates hypoxemia and requires immediate intervention. Edema,
crackles, and gradual weight gain are expected but less urgent.
Q2. A client with atrial fibrillation has a new prescription for warfarin. The nurse should monitor which
laboratory value?
A) aPTT
B) Platelet count
C) INR
D) Hemoglobin
Rationale: INR is used to monitor warfarin therapy. Therapeutic INR is 2.0-3.0 for atrial fibrillation. aPTT
monitors heparin.
Q3. A client receiving IV heparin has an aPTT of 110 seconds. Normal is 25-35 seconds. What should
the nurse do?
A) Continue infusion as ordered
B) Hold infusion and notify provider
C) Increase infusion rate
D) Draw a stat platelet count
,Rationale: Therapeutic aPTT for heparin is 1.5-2.5 times normal (45-85 seconds). 110 seconds indicates
excessive anticoagulation and bleeding risk.
Q4. A nurse is teaching a client about sublingual nitroglycerin. Which statement indicates
understanding?
A) "I will take it with a full glass of water"
B) "I will lie down before taking it"
C) "I can take 5 tablets in 10 minutes"
D) "I will stop taking it if I get a headache"
Rationale: Nitroglycerin causes vasodilation and hypotension. Lying down prevents falls. Headache is
expected. Correct dosing is 1 tablet every 5 minutes for up to 3 doses.
Q5. A client with hypertension is prescribed lisinopril. Which adverse effect requires immediate
provider notification?
A) Dry cough
B) Swelling of lips and tongue
C) Dizziness
D) Fatigue
Rationale: Swelling of lips/tongue indicates angioedema, a life-threatening allergic reaction to ACE
inhibitors. Dry cough is common but not emergent.
Q6. A client post-cardiac catheterization via the right femoral artery reports severe groin pain. The
nurse finds a hard, expanding lump at the insertion site. What is the priority action?
A) Apply warm compress
B) Apply firm pressure above the site
C) Lower the head of bed
D) Administer pain medication
Rationale: A hard, expanding lump indicates a hematoma from arterial bleeding. Firm pressure above
the site can stop bleeding. Provider notification is next.
,Q7. A client with heart failure has jugular vein distention and +3 pitting edema. Which medication
does the nurse expect?
A) Metoprolol
B) Furosemide
C) Digoxin
D) Spironolactone
Rationale: JVD and edema indicate fluid overload. Furosemide is a loop diuretic that rapidly reduces
fluid volume. Digoxin improves contractility but does not remove fluid.
Q8. A client is prescribed digoxin. Which finding indicates toxicity?
A) Heart rate 72 bpm
B) Nausea and yellow vision
C) Blood pressure 120/80
D) Urinary frequency
Rationale: Nausea, vomiting, and visual disturbances (yellow or halos around lights) are classic signs of
digoxin toxicity. Therapeutic digoxin level is 0.5-2.0 ng/mL.
Q9. A nurse is caring for a client with deep vein thrombosis receiving heparin. Which finding indicates
a complication?
A) aPTT 65 seconds
B) Bruising at IV site
C) Blood in the urine
D) Platelets 180,000/mm³
Rationale: Blood in urine indicates bleeding, a complication of heparin therapy. aPTT 65 seconds is
therapeutic. Some bruising is expected. Platelets 180,000 is normal.
Q10. A client with peripheral artery disease reports leg pain when walking that stops with rest. The
nurse documents this as:
A) Intermittent claudication
B) Rest pain
C) Venous stasis
, D) Neuropathy
Rationale: Intermittent claudication is muscle pain caused by inadequate blood flow during exercise,
relieved by rest. It is characteristic of peripheral artery disease.
Q11. A nurse is assessing a client with left-sided heart failure. Which finding is expected?
A) Jugular vein distention
B) Hepatomegaly
C) Crackles in lung bases
D) Peripheral edema
Rationale: Left-sided heart failure causes pulmonary congestion, leading to crackles. Right-sided
failure causes systemic congestion (JVD, hepatomegaly, edema).
Q12. A client is 1 day post-coronary artery bypass graft. Which finding requires immediate action?
A) Temperature 99.5°F
B) Pain 4/10
C) Chest tube output 200 mL in 1 hour
D) Heart rate 88 bpm
Rationale: Chest tube output >100 mL/hr indicates possible postoperative hemorrhage requiring
immediate provider notification.
Q13. A nurse is teaching a client about warfarin. Which food should the client eat consistently?
A) Cranberries
B) Dairy products
C) Green leafy vegetables
D) Red meat
Rationale: Green leafy vegetables contain vitamin K, which antagonizes warfarin. Clients should
maintain consistent vitamin K intake rather than avoiding it completely.
Q14. A client with atrial fibrillation suddenly reports chest pain and shortness of breath. What is the
priority action?
2026 Edition
📋 COMPLETE 300-QUESTION TEST BANK
SECTION 1: Cardiovascular Disorders (Questions 1-40)
Q1. A nurse is assessing a client with heart failure. Which finding is most concerning?
A) +2 pedal edema
B) Crackles in both lung bases
C) Weight gain of 2 lbs in 24 hours
D) Oxygen saturation 88% on room air
Rationale: SpO2 below 90% indicates hypoxemia and requires immediate intervention. Edema,
crackles, and gradual weight gain are expected but less urgent.
Q2. A client with atrial fibrillation has a new prescription for warfarin. The nurse should monitor which
laboratory value?
A) aPTT
B) Platelet count
C) INR
D) Hemoglobin
Rationale: INR is used to monitor warfarin therapy. Therapeutic INR is 2.0-3.0 for atrial fibrillation. aPTT
monitors heparin.
Q3. A client receiving IV heparin has an aPTT of 110 seconds. Normal is 25-35 seconds. What should
the nurse do?
A) Continue infusion as ordered
B) Hold infusion and notify provider
C) Increase infusion rate
D) Draw a stat platelet count
,Rationale: Therapeutic aPTT for heparin is 1.5-2.5 times normal (45-85 seconds). 110 seconds indicates
excessive anticoagulation and bleeding risk.
Q4. A nurse is teaching a client about sublingual nitroglycerin. Which statement indicates
understanding?
A) "I will take it with a full glass of water"
B) "I will lie down before taking it"
C) "I can take 5 tablets in 10 minutes"
D) "I will stop taking it if I get a headache"
Rationale: Nitroglycerin causes vasodilation and hypotension. Lying down prevents falls. Headache is
expected. Correct dosing is 1 tablet every 5 minutes for up to 3 doses.
Q5. A client with hypertension is prescribed lisinopril. Which adverse effect requires immediate
provider notification?
A) Dry cough
B) Swelling of lips and tongue
C) Dizziness
D) Fatigue
Rationale: Swelling of lips/tongue indicates angioedema, a life-threatening allergic reaction to ACE
inhibitors. Dry cough is common but not emergent.
Q6. A client post-cardiac catheterization via the right femoral artery reports severe groin pain. The
nurse finds a hard, expanding lump at the insertion site. What is the priority action?
A) Apply warm compress
B) Apply firm pressure above the site
C) Lower the head of bed
D) Administer pain medication
Rationale: A hard, expanding lump indicates a hematoma from arterial bleeding. Firm pressure above
the site can stop bleeding. Provider notification is next.
,Q7. A client with heart failure has jugular vein distention and +3 pitting edema. Which medication
does the nurse expect?
A) Metoprolol
B) Furosemide
C) Digoxin
D) Spironolactone
Rationale: JVD and edema indicate fluid overload. Furosemide is a loop diuretic that rapidly reduces
fluid volume. Digoxin improves contractility but does not remove fluid.
Q8. A client is prescribed digoxin. Which finding indicates toxicity?
A) Heart rate 72 bpm
B) Nausea and yellow vision
C) Blood pressure 120/80
D) Urinary frequency
Rationale: Nausea, vomiting, and visual disturbances (yellow or halos around lights) are classic signs of
digoxin toxicity. Therapeutic digoxin level is 0.5-2.0 ng/mL.
Q9. A nurse is caring for a client with deep vein thrombosis receiving heparin. Which finding indicates
a complication?
A) aPTT 65 seconds
B) Bruising at IV site
C) Blood in the urine
D) Platelets 180,000/mm³
Rationale: Blood in urine indicates bleeding, a complication of heparin therapy. aPTT 65 seconds is
therapeutic. Some bruising is expected. Platelets 180,000 is normal.
Q10. A client with peripheral artery disease reports leg pain when walking that stops with rest. The
nurse documents this as:
A) Intermittent claudication
B) Rest pain
C) Venous stasis
, D) Neuropathy
Rationale: Intermittent claudication is muscle pain caused by inadequate blood flow during exercise,
relieved by rest. It is characteristic of peripheral artery disease.
Q11. A nurse is assessing a client with left-sided heart failure. Which finding is expected?
A) Jugular vein distention
B) Hepatomegaly
C) Crackles in lung bases
D) Peripheral edema
Rationale: Left-sided heart failure causes pulmonary congestion, leading to crackles. Right-sided
failure causes systemic congestion (JVD, hepatomegaly, edema).
Q12. A client is 1 day post-coronary artery bypass graft. Which finding requires immediate action?
A) Temperature 99.5°F
B) Pain 4/10
C) Chest tube output 200 mL in 1 hour
D) Heart rate 88 bpm
Rationale: Chest tube output >100 mL/hr indicates possible postoperative hemorrhage requiring
immediate provider notification.
Q13. A nurse is teaching a client about warfarin. Which food should the client eat consistently?
A) Cranberries
B) Dairy products
C) Green leafy vegetables
D) Red meat
Rationale: Green leafy vegetables contain vitamin K, which antagonizes warfarin. Clients should
maintain consistent vitamin K intake rather than avoiding it completely.
Q14. A client with atrial fibrillation suddenly reports chest pain and shortness of breath. What is the
priority action?
