ATI PN ADULT MEDICAL SURGICAL (MED-SURG)
2026/2027 Proctored Exam with NGN Actual Exam
100% Verified Questions and Answers Pass
Guaranteed - A+ Graded
Total Questions: 100 | Time: 120 min | Pass: 80%
TABLE OF CONTENTS
Section 1 | Perioperative & Intraoperative Care | Q1 – Q17
Section 2 | Respiratory Disorders | Q18 – Q33
Section 3 | Cardiovascular Disorders | Q34 – Q49
Section 4 | Gastrointestinal & Nutritional Disorders | Q50 – Q65
Section 5 | Renal, Genitourinary & Endocrine Disorders | Q66 – Q81
Section 6 | Neurologic, Musculoskeletal & Integumentary Disorders | Q82 – Q100
Instructions: Choose the single best answer. Pass: 80% in 120 minutes.
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SECTION 1: PERIOPERATIVE & INTRAOPERATIVE CARE Q1 – Q17
══════════════════════════════════════
Question 1 of 100
A 74-year-old client is scheduled for a total hip replacement in the morning. During the
preoperative assessment, the nurse reviews the client's home medications. The nurse
should clarify with the surgeon about continuing which medication the night before or
morning of surgery?
A. Atorvastatin
B. Levothyroxine
C. Aspirin ✓ CORRECT
D. Multivitamin
Correct Answer: C
,Rationale: Aspirin increases bleeding risk and is typically held five to seven days before
major surgery unless the surgeon specifically instructs otherwise. Levothyroxine and
most statins are usually continued, and a multivitamin has no significant surgical
implications. Always verify anticoagulant and antiplatelet holds with the prescribing
provider because stopping them abruptly can also be harmful in some cases.
Question 2 of 100
A 62-year-old client arrives in the post-anesthesia care unit after a laparoscopic
cholecystectomy. The client is drowsy but responds to verbal stimuli. Fifteen minutes
later, the nurse notices the client is snoring loudly with periods of apnea lasting about
10 seconds. Which action should the nurse take first?
A. Apply a nasal cannula at 4 L/min
B. Insert an oral airway
C. Stimulate the client and reposition the head ✓ CORRECT
D. Prepare for immediate intubation
Correct Answer: C
Rationale: Stimulating the client and repositioning the head opens the airway by
relieving tongue obstruction, which is the most common cause of postoperative snoring
and apnea. Inserting an oral airway is appropriate if repositioning fails, but it is not the
first step. PACU nurses always address airway issues immediately because opioid
sedation and residual anesthesia depress the respiratory drive.
Question 3 of 100
A 69-year-old client had a total knee replacement 4 hours ago. The nurse enters the
room and finds the surgical dressing saturated with bright red blood and a 3-cm pool of
blood on the sheet under the extremity. The client's blood pressure is 128/82 mmHg
and heart rate is 92 bpm. What is the priority nursing action?
,A. Remove the dressing to assess the incision
B. Apply a sterile pressure dressing over the existing dressing ✓ CORRECT
C. Reinforce the dressing and document the findings
D. Prepare the client for return to the operating room
Correct Answer: B
Rationale: Applying a sterile pressure dressing over the saturated dressing helps control
bleeding without exposing the incision to contamination. Removing the first dressing is
contraindicated unless specifically ordered, as it can dislodge clots and worsen
hemorrhage. The surgeon must be notified immediately, but the nurse should not wait
to apply pressure because visible active bleeding requires prompt intervention.
Question 4 of 100
A 58-year-old client with a terminal diagnosis of metastatic pancreatic cancer tells the
nurse they do not want to undergo the scheduled Whipple procedure. The client's adult
children arrive and insist the nurse prepare the client for surgery immediately. What is
the nurse's best response?
A. Explain that the family must obtain a court order to stop the surgery
B. Inform the children that a competent adult has the right to refuse treatment ✓
CORRECT
C. Suggest the children speak with the hospital chaplain about their grief
D. Ask the children to select one family member to be the spokesperson
Correct Answer: B
Rationale: A mentally competent adult has the legal and ethical right to refuse any
surgical intervention, and the nurse must advocate for the client's autonomy. Seeking a
court order or deferring to family wishes violates the client's right to self-determination.
The nurse can offer chaplain support later, but the immediate priority is to uphold the
client's decision and notify the surgeon.
Question 5 of 100
, A 45-year-old client is on postoperative day 1 following a laparoscopic appendectomy.
The client is alert, pain is controlled, and vital signs are stable. The nurse is developing
the plan of care to prevent postoperative complications. Which intervention is most
important for this client at this time?
A. Encourage the client to perform leg exercises every hour while awake ✓ CORRECT
B. Keep the client on strict bed rest for the first 24 hours after surgery
C. Apply sequential compression devices only during nighttime sleep
D. Massage the client's calves twice per shift to promote circulation
Correct Answer: A
Rationale: Early and frequent leg exercises promote venous return and are a
cornerstone of DVT prophylaxis in postoperative clients. Strict bed rest increases
thrombosis risk, sequential compression devices should be used continuously when the
client is not ambulating, and calf massage is contraindicated because it can dislodge a
thrombus. Ambulation should also be encouraged as soon as the surgeon clears the
client.
Question 6 of 100
A 52-year-old client is on postoperative day 4 after an open abdominal hysterectomy.
While coughing, the client feels a sudden pulling sensation at the incision site and calls
for the nurse. The nurse observes a 4-cm opening in the incision with pinkish tissue
visible beneath the sutures. What is the nurse's immediate action?
A. Cover the wound with a sterile saline-moistened dressing ✓ CORRECT
B. Push the protruding tissue back into the abdominal cavity
C. Apply an abdominal binder and encourage deep breathing
D. Place the client in high Fowler's position with legs extended
Correct Answer: A
Rationale: Covering the dehisced wound with a sterile saline-moistened dressing
protects the exposed tissue from infection and drying until the surgeon arrives. Pushing
2026/2027 Proctored Exam with NGN Actual Exam
100% Verified Questions and Answers Pass
Guaranteed - A+ Graded
Total Questions: 100 | Time: 120 min | Pass: 80%
TABLE OF CONTENTS
Section 1 | Perioperative & Intraoperative Care | Q1 – Q17
Section 2 | Respiratory Disorders | Q18 – Q33
Section 3 | Cardiovascular Disorders | Q34 – Q49
Section 4 | Gastrointestinal & Nutritional Disorders | Q50 – Q65
Section 5 | Renal, Genitourinary & Endocrine Disorders | Q66 – Q81
Section 6 | Neurologic, Musculoskeletal & Integumentary Disorders | Q82 – Q100
Instructions: Choose the single best answer. Pass: 80% in 120 minutes.
══════════════════════════════════════
SECTION 1: PERIOPERATIVE & INTRAOPERATIVE CARE Q1 – Q17
══════════════════════════════════════
Question 1 of 100
A 74-year-old client is scheduled for a total hip replacement in the morning. During the
preoperative assessment, the nurse reviews the client's home medications. The nurse
should clarify with the surgeon about continuing which medication the night before or
morning of surgery?
A. Atorvastatin
B. Levothyroxine
C. Aspirin ✓ CORRECT
D. Multivitamin
Correct Answer: C
,Rationale: Aspirin increases bleeding risk and is typically held five to seven days before
major surgery unless the surgeon specifically instructs otherwise. Levothyroxine and
most statins are usually continued, and a multivitamin has no significant surgical
implications. Always verify anticoagulant and antiplatelet holds with the prescribing
provider because stopping them abruptly can also be harmful in some cases.
Question 2 of 100
A 62-year-old client arrives in the post-anesthesia care unit after a laparoscopic
cholecystectomy. The client is drowsy but responds to verbal stimuli. Fifteen minutes
later, the nurse notices the client is snoring loudly with periods of apnea lasting about
10 seconds. Which action should the nurse take first?
A. Apply a nasal cannula at 4 L/min
B. Insert an oral airway
C. Stimulate the client and reposition the head ✓ CORRECT
D. Prepare for immediate intubation
Correct Answer: C
Rationale: Stimulating the client and repositioning the head opens the airway by
relieving tongue obstruction, which is the most common cause of postoperative snoring
and apnea. Inserting an oral airway is appropriate if repositioning fails, but it is not the
first step. PACU nurses always address airway issues immediately because opioid
sedation and residual anesthesia depress the respiratory drive.
Question 3 of 100
A 69-year-old client had a total knee replacement 4 hours ago. The nurse enters the
room and finds the surgical dressing saturated with bright red blood and a 3-cm pool of
blood on the sheet under the extremity. The client's blood pressure is 128/82 mmHg
and heart rate is 92 bpm. What is the priority nursing action?
,A. Remove the dressing to assess the incision
B. Apply a sterile pressure dressing over the existing dressing ✓ CORRECT
C. Reinforce the dressing and document the findings
D. Prepare the client for return to the operating room
Correct Answer: B
Rationale: Applying a sterile pressure dressing over the saturated dressing helps control
bleeding without exposing the incision to contamination. Removing the first dressing is
contraindicated unless specifically ordered, as it can dislodge clots and worsen
hemorrhage. The surgeon must be notified immediately, but the nurse should not wait
to apply pressure because visible active bleeding requires prompt intervention.
Question 4 of 100
A 58-year-old client with a terminal diagnosis of metastatic pancreatic cancer tells the
nurse they do not want to undergo the scheduled Whipple procedure. The client's adult
children arrive and insist the nurse prepare the client for surgery immediately. What is
the nurse's best response?
A. Explain that the family must obtain a court order to stop the surgery
B. Inform the children that a competent adult has the right to refuse treatment ✓
CORRECT
C. Suggest the children speak with the hospital chaplain about their grief
D. Ask the children to select one family member to be the spokesperson
Correct Answer: B
Rationale: A mentally competent adult has the legal and ethical right to refuse any
surgical intervention, and the nurse must advocate for the client's autonomy. Seeking a
court order or deferring to family wishes violates the client's right to self-determination.
The nurse can offer chaplain support later, but the immediate priority is to uphold the
client's decision and notify the surgeon.
Question 5 of 100
, A 45-year-old client is on postoperative day 1 following a laparoscopic appendectomy.
The client is alert, pain is controlled, and vital signs are stable. The nurse is developing
the plan of care to prevent postoperative complications. Which intervention is most
important for this client at this time?
A. Encourage the client to perform leg exercises every hour while awake ✓ CORRECT
B. Keep the client on strict bed rest for the first 24 hours after surgery
C. Apply sequential compression devices only during nighttime sleep
D. Massage the client's calves twice per shift to promote circulation
Correct Answer: A
Rationale: Early and frequent leg exercises promote venous return and are a
cornerstone of DVT prophylaxis in postoperative clients. Strict bed rest increases
thrombosis risk, sequential compression devices should be used continuously when the
client is not ambulating, and calf massage is contraindicated because it can dislodge a
thrombus. Ambulation should also be encouraged as soon as the surgeon clears the
client.
Question 6 of 100
A 52-year-old client is on postoperative day 4 after an open abdominal hysterectomy.
While coughing, the client feels a sudden pulling sensation at the incision site and calls
for the nurse. The nurse observes a 4-cm opening in the incision with pinkish tissue
visible beneath the sutures. What is the nurse's immediate action?
A. Cover the wound with a sterile saline-moistened dressing ✓ CORRECT
B. Push the protruding tissue back into the abdominal cavity
C. Apply an abdominal binder and encourage deep breathing
D. Place the client in high Fowler's position with legs extended
Correct Answer: A
Rationale: Covering the dehisced wound with a sterile saline-moistened dressing
protects the exposed tissue from infection and drying until the surgeon arrives. Pushing
