ATI PN MED-SURG PROCTORED EXAM 2026 COMPLETE STUDY
GUIDE | VERIFIED QUESTIONS & ANSWERS WITH RATIONALES
[DETAILED EXPERT RATIONALES A+ GRADED] | MEDICAL-
SURGICAL NURSING | LATEST UPDATE
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–30)
QUESTION 1
A nurse is caring for a client with left-sided heart failure. Which assessment
finding should the nurse expect?
A. Jugular vein distension
B. Peripheral pitting edema
C. Hepatomegaly
D. Crackles in the lung bases
E. Ascites
Correct Answer: D. Crackles in the lung bases
EXPERT RATIONALE: Left-sided heart failure causes fluid to back up into the
pulmonary circulation, resulting in pulmonary congestion and crackles (rales)
in the lung bases. Options A, B, C, and E are manifestations of right-sided
heart failure due to systemic venous congestion. Left-sided heart failure
also presents with dyspnea, orthopnea, paroxysmal nocturnal dyspnea, cough,
and fatigue.
QUESTION 2
A nurse is assessing a client who is experiencing a myocardial infarction.
Which symptom is most commonly reported?
A. Nausea and vomiting
1
,B. Jaw pain
C. Crushing substernal chest pain
D. Epigastric pain
E. Back pain
Correct Answer: C. Crushing substernal chest pain
EXPERT RATIONALE: The most common symptom of a myocardial infarction is
crushing substernal chest pain that may radiate to the left arm, jaw, or
back. While nausea and vomiting (A), jaw pain (B), epigastric pain (D),
and back pain (E) can occur, especially in women, the elderly, and diabetics,
the classic presentation is substernal chest pain. Women and diabetics may
present with atypical symptoms.
QUESTION 3
A nurse is caring for a client with peripheral artery disease (PAD). Which
assessment finding is expected?
A. Bilateral lower extremity edema
B. Warm, flushed skin on the lower extremities
C. Diminished dorsalis pedis pulses
D. Brown discoloration of the lower legs
E. Varicose veins
Correct Answer: C. Diminished dorsalis pedis pulses
EXPERT RATIONALE: Peripheral artery disease (PAD) causes reduced blood flow
to the extremities, resulting in diminished or absent peripheral pulses,
cool skin, pallor, and hair loss on the lower extremities. Bilateral edema
(A), warm skin (B), brown discoloration (D), and varicose veins (E) are
associated with venous insufficiency, not arterial insufficiency.
2
,QUESTION 4
A nurse is providing teaching to a client with hypertension. Which dietary
recommendation is most appropriate?
A. Increase sodium intake to 3,000 mg/day
B. Follow the DASH diet (Dietary Approaches to Stop Hypertension)
C. Increase caffeine intake
D. Restrict potassium-rich foods
E. Increase saturated fat intake
Correct Answer: B. Follow the DASH diet
EXPERT RATIONALE: The DASH diet is specifically designed to reduce blood
pressure by emphasizing fruits, vegetables, whole grains, lean proteins, and
low-fat dairy while limiting sodium, saturated fat, and added sugars. Sodium
should be limited to <2,300 mg/day (A). Caffeine (C) can increase blood
pressure. Potassium-rich foods (D) are encouraged. Saturated fats (E) should
be limited.
QUESTION 5
A nurse is assessing a client with infective endocarditis. Which finding is
most concerning?
A. Fever
B. Heart murmur
C. Splinter hemorrhages
D. Septic emboli to the brain
E. Osler's nodes
3
, Correct Answer: D. Septic emboli to the brain
EXPERT RATIONALE: Septic emboli to the brain can cause a stroke, which is a
life-threatening complication of infective endocarditis. Fever (A), heart
murmur (B), splinter hemorrhages (C), and Osler's nodes (E) are all
characteristic findings of endocarditis but are not as immediately
life-threatening as septic emboli to the brain.
QUESTION 6
A nurse is caring for a client with pericarditis. Which position provides the
greatest relief of chest pain?
A. Supine position
B. Left lateral position
C. Sitting upright and leaning forward
D. Trendelenburg position
E. Prone position
Correct Answer: C. Sitting upright and leaning forward
EXPERT RATIONALE: Pericarditis pain is relieved by sitting upright and
leaning forward because this position reduces pressure on the pericardium.
Supine (A) and left lateral (B) positions often worsen the pain. Trendelenburg
(D) and prone (E) positions do not provide relief.
QUESTION 7
A nurse is caring for a client with an abdominal aortic aneurysm (AAA). Which
finding indicates impending rupture?
4
GUIDE | VERIFIED QUESTIONS & ANSWERS WITH RATIONALES
[DETAILED EXPERT RATIONALES A+ GRADED] | MEDICAL-
SURGICAL NURSING | LATEST UPDATE
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–30)
QUESTION 1
A nurse is caring for a client with left-sided heart failure. Which assessment
finding should the nurse expect?
A. Jugular vein distension
B. Peripheral pitting edema
C. Hepatomegaly
D. Crackles in the lung bases
E. Ascites
Correct Answer: D. Crackles in the lung bases
EXPERT RATIONALE: Left-sided heart failure causes fluid to back up into the
pulmonary circulation, resulting in pulmonary congestion and crackles (rales)
in the lung bases. Options A, B, C, and E are manifestations of right-sided
heart failure due to systemic venous congestion. Left-sided heart failure
also presents with dyspnea, orthopnea, paroxysmal nocturnal dyspnea, cough,
and fatigue.
QUESTION 2
A nurse is assessing a client who is experiencing a myocardial infarction.
Which symptom is most commonly reported?
A. Nausea and vomiting
1
,B. Jaw pain
C. Crushing substernal chest pain
D. Epigastric pain
E. Back pain
Correct Answer: C. Crushing substernal chest pain
EXPERT RATIONALE: The most common symptom of a myocardial infarction is
crushing substernal chest pain that may radiate to the left arm, jaw, or
back. While nausea and vomiting (A), jaw pain (B), epigastric pain (D),
and back pain (E) can occur, especially in women, the elderly, and diabetics,
the classic presentation is substernal chest pain. Women and diabetics may
present with atypical symptoms.
QUESTION 3
A nurse is caring for a client with peripheral artery disease (PAD). Which
assessment finding is expected?
A. Bilateral lower extremity edema
B. Warm, flushed skin on the lower extremities
C. Diminished dorsalis pedis pulses
D. Brown discoloration of the lower legs
E. Varicose veins
Correct Answer: C. Diminished dorsalis pedis pulses
EXPERT RATIONALE: Peripheral artery disease (PAD) causes reduced blood flow
to the extremities, resulting in diminished or absent peripheral pulses,
cool skin, pallor, and hair loss on the lower extremities. Bilateral edema
(A), warm skin (B), brown discoloration (D), and varicose veins (E) are
associated with venous insufficiency, not arterial insufficiency.
2
,QUESTION 4
A nurse is providing teaching to a client with hypertension. Which dietary
recommendation is most appropriate?
A. Increase sodium intake to 3,000 mg/day
B. Follow the DASH diet (Dietary Approaches to Stop Hypertension)
C. Increase caffeine intake
D. Restrict potassium-rich foods
E. Increase saturated fat intake
Correct Answer: B. Follow the DASH diet
EXPERT RATIONALE: The DASH diet is specifically designed to reduce blood
pressure by emphasizing fruits, vegetables, whole grains, lean proteins, and
low-fat dairy while limiting sodium, saturated fat, and added sugars. Sodium
should be limited to <2,300 mg/day (A). Caffeine (C) can increase blood
pressure. Potassium-rich foods (D) are encouraged. Saturated fats (E) should
be limited.
QUESTION 5
A nurse is assessing a client with infective endocarditis. Which finding is
most concerning?
A. Fever
B. Heart murmur
C. Splinter hemorrhages
D. Septic emboli to the brain
E. Osler's nodes
3
, Correct Answer: D. Septic emboli to the brain
EXPERT RATIONALE: Septic emboli to the brain can cause a stroke, which is a
life-threatening complication of infective endocarditis. Fever (A), heart
murmur (B), splinter hemorrhages (C), and Osler's nodes (E) are all
characteristic findings of endocarditis but are not as immediately
life-threatening as septic emboli to the brain.
QUESTION 6
A nurse is caring for a client with pericarditis. Which position provides the
greatest relief of chest pain?
A. Supine position
B. Left lateral position
C. Sitting upright and leaning forward
D. Trendelenburg position
E. Prone position
Correct Answer: C. Sitting upright and leaning forward
EXPERT RATIONALE: Pericarditis pain is relieved by sitting upright and
leaning forward because this position reduces pressure on the pericardium.
Supine (A) and left lateral (B) positions often worsen the pain. Trendelenburg
(D) and prone (E) positions do not provide relief.
QUESTION 7
A nurse is caring for a client with an abdominal aortic aneurysm (AAA). Which
finding indicates impending rupture?
4
