ATI RN Adult Medical-Surgical Proctored Exam with NGN – 2024/2025 Edition: Complete Test Bank
with 300+ Questions, Case Studies, and Detailed Rationales (Forms A, B, & C)
📋 COMPLETE 150+ QUESTION BANK WITH ANSWERS &
RATIONALES
(Organized by Clinical Topic Area – New Questions Added)
Cardiovascular & Hematologic Disorders (Questions 1-25)
Q1. A nurse is assessing a client who is 12 hr postoperative following a colon resection. Which of the
following findings should the nurse report to the surgeon?
a. Heart rate 90/min
b. Absent bowel sounds
c. Hgb 8.2 g/dL
d. Gastric pH of 3.0
Correct Answer: c. Hgb 8.2 g/dL
Rationale: Normal hemoglobin is 13-18 g/dL for males and 12-16 g/dL for females. A level of 8.2 g/dL
is significantly low and indicates possible postoperative hemorrhage, which requires immediate
reporting to the surgeon.
Q2. A nurse is caring for a client who is receiving a blood transfusion. The nurse observes that the
client has bounding peripheral pulses, hypertension, and distended jugular veins. The nurse should
anticipate administering which of the following prescribed medications?
a. Diphenhydramine
b. Acetaminophen
c. Pantoprazole
d. Furosemide
Correct Answer: d. Furosemide
Rationale: These signs indicate circulatory overload (fluid volume excess). Furosemide is a loop diuretic
that reduces fluid volume by promoting diuresis.
,Q3. A nurse is reviewing a client's ABG results: pH 7.42, PaCO2 30 mm Hg, and HCO3 21 mEq/L. The
nurse should recognize these findings as indication of which condition?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Compensated respiratory alkalosis
d. Uncompensated respiratory acidosis
Correct Answer: c. Compensated respiratory alkalosis
Rationale: The pH is within normal range (7.35-7.45), indicating compensation. PaCO2 is low (normal
35-45 mm Hg), indicating respiratory alkalosis. The HCO3 is slightly low (normal 22-26 mEq/L),
showing the kidneys are attempting to compensate.
Q4. A nurse is admitting a client who reports chest pain and has been placed on a telemetry monitor.
Which of the following should the nurse analyze to determine whether the client is experiencing a
myocardial infarction?
a. PR interval
b. QRS duration
c. T wave
d. ST segment
Correct Answer: d. ST segment
Rationale: ST segment elevation or depression is the key ECG indicator of myocardial ischemia or
infarction.
Q5. A client with chest pain has an ECG showing ST-elevation in leads II, III, and aVF. What is the
priority nursing action?
a. Administer nitroglycerin
b. Prepare for percutaneous coronary intervention (PCI)
c. Start oxygen at 2 L/min
d. Obtain a troponin level
Correct Answer: b. Prepare for percutaneous coronary intervention (PCI)
Rationale: ST-elevation in inferior leads suggests an acute STEMI, requiring urgent PCI to restore
coronary blood flow. Other actions support but are secondary.
,Q6. A nurse is caring for a client receiving heparin therapy. Which lab value should the nurse monitor
to evaluate therapeutic effect?
a. INR
b. aPTT
c. Platelet count
d. Hemoglobin
Correct Answer: b. aPTT
Rationale: Activated partial thromboplastin time (aPTT) evaluates therapeutic heparin levels. INR is for
warfarin. Platelets should be monitored for HIT but aPTT is the therapeutic level.
Q7. A client taking digoxin presents with nausea, visual halos, and a serum level of 2.5 ng/mL. What is
the priority nursing intervention?
a. Administer activated charcoal
b. Hold digoxin and obtain ECG
c. Increase the digoxin dose
d. Encourage a high-potassium diet
Correct Answer: b. Hold digoxin and obtain ECG
Rationale: Signs of digoxin toxicity require cessation of the drug and cardiac monitoring. Therapeutic
range is 0.5-2 ng/mL. Visual disturbances and GI symptoms are classic toxicity signs.
Q8. A client is 6 hours post-angiogram via the right femoral artery. Which finding requires immediate
action?
a. A blood pressure of 128/74 mm Hg
b. A heart rate of 86 bpm
c. A small amount of bloody drainage on the pressure dressing
d. A palpable, hard lump at the catheter insertion site
Correct Answer: d. A palpable, hard lump at the catheter insertion site
Rationale: A palpable, hard lump at the insertion site indicates a hematoma, which may suggest
bleeding or pseudoaneurysm requiring immediate intervention.
, Q9. A nurse is providing discharge teaching to a client who has a new prescription for sublingual
nitroglycerin. Which client statement indicates understanding?
a. "I can keep my medications 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. "I should lie down when I take this medication"
Rationale: Nitroglycerin can cause hypotension and dizziness; lying down prevents injury from falls.
Headache is an expected side effect, not a reason to discontinue.
Q10. A nurse is taking an admission history from a client who reports Raynaud's disease. Which
assessment finding should the nurse identify as a potential trigger for exacerbations?
a. Eating a strict vegetarian diet
b. A history of herpes zoster
c. Taking amlodipine for hypertension
d. Using a nicotine transdermal patch
Correct Answer: d. Using a nicotine transdermal patch
Rationale: Nicotine causes vasoconstriction, which triggers Raynaud's exacerbations. Clients should
avoid all nicotine products.
Q11. A nurse is caring for a client who has a central venous access device and notes the tubing has
become disconnected. The client develops dyspnea and tachycardia. Which action should the nurse
take first?
a. Perform an ECG
b. Obtain ABG values
c. Turn the client to his left side
d. Clamp the catheter
Correct Answer: d. Clamp the catheter
Rationale: Disconnected tubing with dyspnea and tachycardia suggests air embolism. Clamping the
catheter prevents further air entry. Turning the client to the left side (Trendelenburg) is secondary.
with 300+ Questions, Case Studies, and Detailed Rationales (Forms A, B, & C)
📋 COMPLETE 150+ QUESTION BANK WITH ANSWERS &
RATIONALES
(Organized by Clinical Topic Area – New Questions Added)
Cardiovascular & Hematologic Disorders (Questions 1-25)
Q1. A nurse is assessing a client who is 12 hr postoperative following a colon resection. Which of the
following findings should the nurse report to the surgeon?
a. Heart rate 90/min
b. Absent bowel sounds
c. Hgb 8.2 g/dL
d. Gastric pH of 3.0
Correct Answer: c. Hgb 8.2 g/dL
Rationale: Normal hemoglobin is 13-18 g/dL for males and 12-16 g/dL for females. A level of 8.2 g/dL
is significantly low and indicates possible postoperative hemorrhage, which requires immediate
reporting to the surgeon.
Q2. A nurse is caring for a client who is receiving a blood transfusion. The nurse observes that the
client has bounding peripheral pulses, hypertension, and distended jugular veins. The nurse should
anticipate administering which of the following prescribed medications?
a. Diphenhydramine
b. Acetaminophen
c. Pantoprazole
d. Furosemide
Correct Answer: d. Furosemide
Rationale: These signs indicate circulatory overload (fluid volume excess). Furosemide is a loop diuretic
that reduces fluid volume by promoting diuresis.
,Q3. A nurse is reviewing a client's ABG results: pH 7.42, PaCO2 30 mm Hg, and HCO3 21 mEq/L. The
nurse should recognize these findings as indication of which condition?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Compensated respiratory alkalosis
d. Uncompensated respiratory acidosis
Correct Answer: c. Compensated respiratory alkalosis
Rationale: The pH is within normal range (7.35-7.45), indicating compensation. PaCO2 is low (normal
35-45 mm Hg), indicating respiratory alkalosis. The HCO3 is slightly low (normal 22-26 mEq/L),
showing the kidneys are attempting to compensate.
Q4. A nurse is admitting a client who reports chest pain and has been placed on a telemetry monitor.
Which of the following should the nurse analyze to determine whether the client is experiencing a
myocardial infarction?
a. PR interval
b. QRS duration
c. T wave
d. ST segment
Correct Answer: d. ST segment
Rationale: ST segment elevation or depression is the key ECG indicator of myocardial ischemia or
infarction.
Q5. A client with chest pain has an ECG showing ST-elevation in leads II, III, and aVF. What is the
priority nursing action?
a. Administer nitroglycerin
b. Prepare for percutaneous coronary intervention (PCI)
c. Start oxygen at 2 L/min
d. Obtain a troponin level
Correct Answer: b. Prepare for percutaneous coronary intervention (PCI)
Rationale: ST-elevation in inferior leads suggests an acute STEMI, requiring urgent PCI to restore
coronary blood flow. Other actions support but are secondary.
,Q6. A nurse is caring for a client receiving heparin therapy. Which lab value should the nurse monitor
to evaluate therapeutic effect?
a. INR
b. aPTT
c. Platelet count
d. Hemoglobin
Correct Answer: b. aPTT
Rationale: Activated partial thromboplastin time (aPTT) evaluates therapeutic heparin levels. INR is for
warfarin. Platelets should be monitored for HIT but aPTT is the therapeutic level.
Q7. A client taking digoxin presents with nausea, visual halos, and a serum level of 2.5 ng/mL. What is
the priority nursing intervention?
a. Administer activated charcoal
b. Hold digoxin and obtain ECG
c. Increase the digoxin dose
d. Encourage a high-potassium diet
Correct Answer: b. Hold digoxin and obtain ECG
Rationale: Signs of digoxin toxicity require cessation of the drug and cardiac monitoring. Therapeutic
range is 0.5-2 ng/mL. Visual disturbances and GI symptoms are classic toxicity signs.
Q8. A client is 6 hours post-angiogram via the right femoral artery. Which finding requires immediate
action?
a. A blood pressure of 128/74 mm Hg
b. A heart rate of 86 bpm
c. A small amount of bloody drainage on the pressure dressing
d. A palpable, hard lump at the catheter insertion site
Correct Answer: d. A palpable, hard lump at the catheter insertion site
Rationale: A palpable, hard lump at the insertion site indicates a hematoma, which may suggest
bleeding or pseudoaneurysm requiring immediate intervention.
, Q9. A nurse is providing discharge teaching to a client who has a new prescription for sublingual
nitroglycerin. Which client statement indicates understanding?
a. "I can keep my medications 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. "I should lie down when I take this medication"
Rationale: Nitroglycerin can cause hypotension and dizziness; lying down prevents injury from falls.
Headache is an expected side effect, not a reason to discontinue.
Q10. A nurse is taking an admission history from a client who reports Raynaud's disease. Which
assessment finding should the nurse identify as a potential trigger for exacerbations?
a. Eating a strict vegetarian diet
b. A history of herpes zoster
c. Taking amlodipine for hypertension
d. Using a nicotine transdermal patch
Correct Answer: d. Using a nicotine transdermal patch
Rationale: Nicotine causes vasoconstriction, which triggers Raynaud's exacerbations. Clients should
avoid all nicotine products.
Q11. A nurse is caring for a client who has a central venous access device and notes the tubing has
become disconnected. The client develops dyspnea and tachycardia. Which action should the nurse
take first?
a. Perform an ECG
b. Obtain ABG values
c. Turn the client to his left side
d. Clamp the catheter
Correct Answer: d. Clamp the catheter
Rationale: Disconnected tubing with dyspnea and tachycardia suggests air embolism. Clamping the
catheter prevents further air entry. Turning the client to the left side (Trendelenburg) is secondary.
