ATI Med Surg Proctored Exam NGN Retake Prep:
300 Q&As with Verified Answers & Rationales
(Latest 2026 Edition) Chamberlain University
This comprehensive, high-yield practice question bank features 300 verified Next-Generation NCLEX
(NGN) style questions designed specifically for nursing students facing their ATI Medical-Surgical retake.
Each entry provides direct, bolded correct answers and in-depth clinical rationales to reinforce
prioritization frameworks like ABCs and Maslow’s Hierarchy. Perfect for quick remediation, this
commercial-grade resource guarantees a deep understanding of core body systems to secure a Level 2
or 3 proficiency.
uestion 1
A nurse is assessing a client who is 4 hours postoperative following a subtotal
thyroidectomy. The client reports a tingling sensation in their fingers and around the
mouth. Which of the following actions should the nurse take first?
A. Assess the client's surgical dressing for bleeding.
B. Check for Chvostek's sign.
C. Administer an oral calcium supplement.
D. Request a prescription for an opioid analgesic.
ANSWER: B. Check for Chvostek's sign.
RATIONALE: Tingling around the mouth (circumoral paresthesia) and in the
fingers are classic early signs of hypocalcemia, a potential complication of a
thyroidectomy if the parathyroid glands were accidentally damaged or removed.
Checking for Chvostek's sign (facial muscle twitching when the facial nerve is
tapped) or Trousseau's sign confirms hypocalcemia. The nurse must verify this
clinical cue immediately before interventions like administering medication can
occur.
Question 2
A nurse in the emergency department is caring for a client who reports crushing chest
pain radiating to the left arm. The nurse obtains a 12-lead ECG showing ST-segment
elevation in leads V1 through V4. Which of the following interventions is the absolute
priority?
A. Administer morphine sulfate IV.
B. Administer oxygen therapy if saturation is below 90%.
C. Administer chewable aspirin.
, D. Obtain blood samples for cardiac enzymes.
ANSWER: C. Administer chewable aspirin.
RATIONALE: In an acute MI (STEMI), platelet aggregation must be inhibited
immediately to prevent further occlusion of the coronary artery. While oxygen,
morphine, and labs are important components of the acute coronary syndrome
protocol, administering chewable aspirin has the most significant immediate
impact on reducing mortality by preventing the thrombus from expanding.
Question 3
A nurse is assessing a client with history of left-sided heart failure. Which of the
following clinical findings should the nurse expect?
A. Jugular venous distention
B. Dependent pitting edema
C. Hepatomegaly
D. Oliguria during the day
ANSWER: D. Oliguria during the day
RATIONALE: Left-sided heart failure causes decreased cardiac output and
reduced renal perfusion during waking hours, leading to daytime oliguria (and
subsequent nocturia when recumbent). Options A, B, and C are classic signs of
fluid backup into the systemic venous circulation, which indicates right-sided
heart failure.
Question 4
A nurse is reviewing the arterial blood gas (ABG) results of a client with an acute
exacerbation of chronic obstructive pulmonary disease (COPD). The results are: pH
7.31, PaCO2 58 mm Hg, HCO3 26 mEq/L, PaO2 65 mm Hg. How should the nurse
interpret these findings?
A. Uncompensated respiratory acidosis
B. Fully compensated metabolic acidosis
C. Partially compensated respiratory acidosis
D. Uncompensated metabolic alkalosis
ANSWER: A. Uncompensated respiratory acidosis
RATIONALE: The pH is below normal (7.35–7.45), indicating acidosis. The PaCO2
is elevated above normal (35–45 mm Hg), which matches the acidic pH and
confirms a respiratory origin. The HCO3 is within the normal reference range (22–
26 mEq/L), meaning the metabolic system has not yet compensated for the
respiratory imbalance. Therefore, it is uncompensated respiratory acidosis.
Question 5
A nurse is caring for a client with Diabetic Ketoacidosis (DKA). The client's current
laboratory values reveal a blood glucose of 350 mg/dL and a serum potassium level of
3.2 mEq/L. Which of the following actions should the nurse anticipate taking first?
A. Initiate a continuous IV insulin infusion at 0.1 units/kg/hr.
B. Administer an IV bolus of regular insulin.
, C. Infuse potassium chloride IV replacement.
D. Administer subcutaneous insulin glargine.
ANSWER: C. Infuse potassium chloride IV replacement.
RATIONALE: Insulin shifts potassium from the extracellular fluid into the
intracellular fluid, which will further drop the serum potassium level. If insulin is
administered when potassium is already low (< 3.3 mEq/L), it can cause fatal
cardiac arrhythmias. Potassium replacement must be initiated before or
concurrently with insulin therapy to ensure client safety.
Question 6
A nurse is assessing a client who is in the compensatory stage of hypovolemic shock.
Which of the following manifestations should the nurse expect?
A. Tachycardia and cold, clammy skin
B. Bradycardia and bounding pulses
C. Hypotension and lethargy
D. Anuria and metabolic alkalosis
ANSWER: A. Tachycardia and cold, clammy skin
RATIONALE: During the compensatory stage of shock, the sympathetic nervous
system triggers a fight-or-flight response. This results in tachycardia to maintain
cardiac output and peripheral vasoconstriction to shunt blood to vital organs,
causing the skin to feel cool, pale, and clammy. Hypotension and lethargy
indicate the progressive or refractory stages.
Question 7
A nurse is providing discharge teaching to a client newly diagnosed with Crohn's
disease. Which of the following dietary recommendations should the nurse include?
A. Consume a high-fiber, low-calorie diet.
B. Eat a low-residue, high-protein diet.
C. Increase intake of lactose-containing dairy products.
D. Restrict fluid intake to less than 1,500 mL per day.
ANSWER: B. Eat a low-residue, high-protein diet.
RATIONALE: Clients with Crohn's disease should follow a low-residue (low-fiber)
diet during flare-ups to decrease bowel stimulation, reduce diarrhea, and prevent
intestinal blockages. A high-protein, high-calorie diet is necessary to promote
tissue healing and counteract malnutrition caused by malabsorption. Fluids
should be increased, not restricted.
Question 8
A nurse is assessing a client who has a chest tube connected to a water-seal drainage
system. The nurse notes continuous bubbling in the water-seal chamber. Which of the
following issues does this finding indicate?
A. The system is functioning normally.
B. There is an air leak in the system or the client's thorax.
C. The lung has fully re-expanded.
, D. The suction control chamber needs more sterile water.
ANSWER: B. There is an air leak in the system or the client's thorax.
RATIONALE: Intermittent bubbling in the water-seal chamber is normal during
expiration, coughing, or sneezing when air is clearing from the pleural space.
However, continuous bubbling indicates an active air leak somewhere between
the client and the drainage system. The nurse must locate and clamp the source
of the leak immediately.
Question 9
A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following interventions is appropriate to prevent a common
surgical complication?
A. Maintain the affected leg in an adducted position.
B. Place a pillow under the client's knees while in bed.
C. Apply sequential compression devices (SCDs) to both legs.
D. Instruct the client to perform Valsalva maneuvers during position changes.
ANSWER: C. Apply sequential compression devices (SCDs) to both legs.
RATIONALE: Deep vein thrombosis (DVT) and pulmonary embolism are major
risks following orthopedic surgeries. Applying SCDs and administering
prescribed anticoagulants effectively prevents venous stasis. The affected leg
should be abducted (not adducted) to prevent dislocation, and pillows under the
knees are avoided as they compress popliteal vessels.
Question 10
A nurse is planning care for a client who has an acute stroke and is experiencing
dysphagia. Which of the following nursing interventions should be included in the plan of
care?
A. Offer thin liquids to drink through a straw.
B. Flex the client's head forward into a chin-tuck position when swallowing.
C. Feed the client while they are resting in a semi-Fowler's position.
D. Place food on the weaker, affected side of the client's mouth.
ANSWER: B. Flex the client's head forward into a chin-tuck position when
swallowing.
RATIONALE: Flexing the neck into a chin-tuck position during swallowing closes
off the trachea and opens up the esophagus, reducing the risk of aspiration. Thin
liquids should be avoided (thickened liquids are preferred), straws increase
aspiration risk, the client should be fully upright (90 degrees), and food must be
placed on the unaffected side of the mouth.
Question 11
A nurse is caring for a client who has a prescription for a transfusion of packed red
blood cells (PRBCs). Which of the following actions must the nurse take within the first
15 minutes of initiating the transfusion?
A. Run the blood at the maximum prescribed rate.
300 Q&As with Verified Answers & Rationales
(Latest 2026 Edition) Chamberlain University
This comprehensive, high-yield practice question bank features 300 verified Next-Generation NCLEX
(NGN) style questions designed specifically for nursing students facing their ATI Medical-Surgical retake.
Each entry provides direct, bolded correct answers and in-depth clinical rationales to reinforce
prioritization frameworks like ABCs and Maslow’s Hierarchy. Perfect for quick remediation, this
commercial-grade resource guarantees a deep understanding of core body systems to secure a Level 2
or 3 proficiency.
uestion 1
A nurse is assessing a client who is 4 hours postoperative following a subtotal
thyroidectomy. The client reports a tingling sensation in their fingers and around the
mouth. Which of the following actions should the nurse take first?
A. Assess the client's surgical dressing for bleeding.
B. Check for Chvostek's sign.
C. Administer an oral calcium supplement.
D. Request a prescription for an opioid analgesic.
ANSWER: B. Check for Chvostek's sign.
RATIONALE: Tingling around the mouth (circumoral paresthesia) and in the
fingers are classic early signs of hypocalcemia, a potential complication of a
thyroidectomy if the parathyroid glands were accidentally damaged or removed.
Checking for Chvostek's sign (facial muscle twitching when the facial nerve is
tapped) or Trousseau's sign confirms hypocalcemia. The nurse must verify this
clinical cue immediately before interventions like administering medication can
occur.
Question 2
A nurse in the emergency department is caring for a client who reports crushing chest
pain radiating to the left arm. The nurse obtains a 12-lead ECG showing ST-segment
elevation in leads V1 through V4. Which of the following interventions is the absolute
priority?
A. Administer morphine sulfate IV.
B. Administer oxygen therapy if saturation is below 90%.
C. Administer chewable aspirin.
, D. Obtain blood samples for cardiac enzymes.
ANSWER: C. Administer chewable aspirin.
RATIONALE: In an acute MI (STEMI), platelet aggregation must be inhibited
immediately to prevent further occlusion of the coronary artery. While oxygen,
morphine, and labs are important components of the acute coronary syndrome
protocol, administering chewable aspirin has the most significant immediate
impact on reducing mortality by preventing the thrombus from expanding.
Question 3
A nurse is assessing a client with history of left-sided heart failure. Which of the
following clinical findings should the nurse expect?
A. Jugular venous distention
B. Dependent pitting edema
C. Hepatomegaly
D. Oliguria during the day
ANSWER: D. Oliguria during the day
RATIONALE: Left-sided heart failure causes decreased cardiac output and
reduced renal perfusion during waking hours, leading to daytime oliguria (and
subsequent nocturia when recumbent). Options A, B, and C are classic signs of
fluid backup into the systemic venous circulation, which indicates right-sided
heart failure.
Question 4
A nurse is reviewing the arterial blood gas (ABG) results of a client with an acute
exacerbation of chronic obstructive pulmonary disease (COPD). The results are: pH
7.31, PaCO2 58 mm Hg, HCO3 26 mEq/L, PaO2 65 mm Hg. How should the nurse
interpret these findings?
A. Uncompensated respiratory acidosis
B. Fully compensated metabolic acidosis
C. Partially compensated respiratory acidosis
D. Uncompensated metabolic alkalosis
ANSWER: A. Uncompensated respiratory acidosis
RATIONALE: The pH is below normal (7.35–7.45), indicating acidosis. The PaCO2
is elevated above normal (35–45 mm Hg), which matches the acidic pH and
confirms a respiratory origin. The HCO3 is within the normal reference range (22–
26 mEq/L), meaning the metabolic system has not yet compensated for the
respiratory imbalance. Therefore, it is uncompensated respiratory acidosis.
Question 5
A nurse is caring for a client with Diabetic Ketoacidosis (DKA). The client's current
laboratory values reveal a blood glucose of 350 mg/dL and a serum potassium level of
3.2 mEq/L. Which of the following actions should the nurse anticipate taking first?
A. Initiate a continuous IV insulin infusion at 0.1 units/kg/hr.
B. Administer an IV bolus of regular insulin.
, C. Infuse potassium chloride IV replacement.
D. Administer subcutaneous insulin glargine.
ANSWER: C. Infuse potassium chloride IV replacement.
RATIONALE: Insulin shifts potassium from the extracellular fluid into the
intracellular fluid, which will further drop the serum potassium level. If insulin is
administered when potassium is already low (< 3.3 mEq/L), it can cause fatal
cardiac arrhythmias. Potassium replacement must be initiated before or
concurrently with insulin therapy to ensure client safety.
Question 6
A nurse is assessing a client who is in the compensatory stage of hypovolemic shock.
Which of the following manifestations should the nurse expect?
A. Tachycardia and cold, clammy skin
B. Bradycardia and bounding pulses
C. Hypotension and lethargy
D. Anuria and metabolic alkalosis
ANSWER: A. Tachycardia and cold, clammy skin
RATIONALE: During the compensatory stage of shock, the sympathetic nervous
system triggers a fight-or-flight response. This results in tachycardia to maintain
cardiac output and peripheral vasoconstriction to shunt blood to vital organs,
causing the skin to feel cool, pale, and clammy. Hypotension and lethargy
indicate the progressive or refractory stages.
Question 7
A nurse is providing discharge teaching to a client newly diagnosed with Crohn's
disease. Which of the following dietary recommendations should the nurse include?
A. Consume a high-fiber, low-calorie diet.
B. Eat a low-residue, high-protein diet.
C. Increase intake of lactose-containing dairy products.
D. Restrict fluid intake to less than 1,500 mL per day.
ANSWER: B. Eat a low-residue, high-protein diet.
RATIONALE: Clients with Crohn's disease should follow a low-residue (low-fiber)
diet during flare-ups to decrease bowel stimulation, reduce diarrhea, and prevent
intestinal blockages. A high-protein, high-calorie diet is necessary to promote
tissue healing and counteract malnutrition caused by malabsorption. Fluids
should be increased, not restricted.
Question 8
A nurse is assessing a client who has a chest tube connected to a water-seal drainage
system. The nurse notes continuous bubbling in the water-seal chamber. Which of the
following issues does this finding indicate?
A. The system is functioning normally.
B. There is an air leak in the system or the client's thorax.
C. The lung has fully re-expanded.
, D. The suction control chamber needs more sterile water.
ANSWER: B. There is an air leak in the system or the client's thorax.
RATIONALE: Intermittent bubbling in the water-seal chamber is normal during
expiration, coughing, or sneezing when air is clearing from the pleural space.
However, continuous bubbling indicates an active air leak somewhere between
the client and the drainage system. The nurse must locate and clamp the source
of the leak immediately.
Question 9
A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following interventions is appropriate to prevent a common
surgical complication?
A. Maintain the affected leg in an adducted position.
B. Place a pillow under the client's knees while in bed.
C. Apply sequential compression devices (SCDs) to both legs.
D. Instruct the client to perform Valsalva maneuvers during position changes.
ANSWER: C. Apply sequential compression devices (SCDs) to both legs.
RATIONALE: Deep vein thrombosis (DVT) and pulmonary embolism are major
risks following orthopedic surgeries. Applying SCDs and administering
prescribed anticoagulants effectively prevents venous stasis. The affected leg
should be abducted (not adducted) to prevent dislocation, and pillows under the
knees are avoided as they compress popliteal vessels.
Question 10
A nurse is planning care for a client who has an acute stroke and is experiencing
dysphagia. Which of the following nursing interventions should be included in the plan of
care?
A. Offer thin liquids to drink through a straw.
B. Flex the client's head forward into a chin-tuck position when swallowing.
C. Feed the client while they are resting in a semi-Fowler's position.
D. Place food on the weaker, affected side of the client's mouth.
ANSWER: B. Flex the client's head forward into a chin-tuck position when
swallowing.
RATIONALE: Flexing the neck into a chin-tuck position during swallowing closes
off the trachea and opens up the esophagus, reducing the risk of aspiration. Thin
liquids should be avoided (thickened liquids are preferred), straws increase
aspiration risk, the client should be fully upright (90 degrees), and food must be
placed on the unaffected side of the mouth.
Question 11
A nurse is caring for a client who has a prescription for a transfusion of packed red
blood cells (PRBCs). Which of the following actions must the nurse take within the first
15 minutes of initiating the transfusion?
A. Run the blood at the maximum prescribed rate.
