ATI PN ADULT MEDICAL SURGICAL (MED-
SURG) PROCTORED EXAM WITH NGN STUDY
GUIDE | VERIFIED PRACTICE QUESTIONS &
ANSWERS | COMPREHENSIVE ATI PN MED-
SURG EXAM PREP 2026
ATI PN ADULT MEDICAL SURGICAL (MED-SURG) PROCTORED EXAM WITH NGN
STUDY GUIDE | VERIFIED PRACTICE QUESTIONS & ANSWERS | COMPREHENSIVE
ATI PN MED-SURG EXAM PREP 2026
OVERVIEW & STUDY FEATURES
• Comprehensive Coverage: verified practice questions spanning all major ATI PN
Med-Surg exam topics including cardiovascular, respiratory, gastrointestinal,
musculoskeletal, neurological, endocrine, renal, and oncology nursing care with
detailed EXPERT RATIONALE for each answer.
• Strategic Study Approach: Use this material to reinforce clinical concepts
through active recall; review incorrect answers with special attention to EXPERT
RATIONALE; complete all questions to build confidence and ensure mastery of
priority nursing interventions for adult medical-surgical patients.
QUESTION 1: A 58-year-old client with acute MI is experiencing chest pain.
Which of the following actions should the PN take FIRST?
A) Administer oxygen and place the client on continuous cardiac monitoring
B) Obtain a 12-lead ECG and notify the provider immediately
C) Provide morphine IV for pain management
D) Elevate the client's head of bed to 45 degrees
E) Establish IV access and draw blood samples
, CORRECT ANSWER: B - Obtain a 12-lead ECG and notify the provider
immediately
EXPERT RATIONALE: The 12-lead ECG is the priority intervention during suspected
acute MI because it provides critical diagnostic information about the location and
extent of myocardial damage and guides treatment decisions. The ECG should be
obtained within 10 minutes of symptom onset. While oxygen and monitoring are
important, the ECG must be done first to confirm MI and rule out other causes. This
allows the provider to make time-sensitive treatment decisions (such as
thrombolytics or PCI).
QUESTION 2: A client recovering from cardiac catheterization has a nursing
diagnosis of Risk for Bleeding related to arterial puncture site. Which
assessment finding would indicate a potential complication?
A) Mild ecchymosis around the insertion site
B) A small hematoma (2 cm) at the groin site
C) Rapid expansion of hematoma with decreased hemoglobin
D) Slight oozing controlled by gentle pressure dressing
E) Absent pedal pulses bilaterally
CORRECT ANSWER: C - Rapid expansion of hematoma with decreased
hemoglobin
EXPERT RATIONALE: A rapidly expanding hematoma with a drop in hemoglobin
indicates active bleeding into the tissues, which is a serious complication requiring
immediate intervention. This suggests a potential pseudoaneurysm or significant
vessel damage. Small hematomas and mild ecchymosis are common minor
complications. Slight oozing controlled by pressure is expected. Absent bilateral
pedal pulses would suggest a different vascular complication but are less common
than unilateral changes. The combination of expanding hematoma plus decreased
,hemoglobin indicates blood loss and requires urgent provider notification and
possible surgical intervention.
QUESTION 3: A 62-year-old client with heart failure has been prescribed
furosemide 40 mg daily. The PN should monitor for which electrolyte
imbalance as a side effect of this medication?
A) Hyperkalemia and hypernatremia
B) Hypokalemia and hyponatremia
C) Hypercalcemia and hyperphosphatemia
D) Hypomagnesemia and hypocalcemia
E) Hyperchloremia and hyperkalemia
CORRECT ANSWER: B - Hypokalemia and hyponatremia
EXPERT RATIONALE: Loop diuretics like furosemide promote excretion of
potassium, sodium, and other electrolytes through increased urinary output.
Hypokalemia (low potassium) is a major concern because it can cause cardiac
arrhythmias, muscle weakness, and fatigue. Hyponatremia (low sodium) occurs due
to the osmotic effect and dilutional changes. The client should be monitored for
signs of hypokalemia such as muscle cramps, palpitations, and weakness.
Potassium supplements or potassium-sparing diuretics may be prescribed
concurrently. Serum electrolytes should be checked regularly during diuretic
therapy.
QUESTION 4: A client with chronic obstructive pulmonary disease (COPD) is
experiencing an acute exacerbation. Which respiratory pattern should the PN
expect to observe?
A) Bradypnea with deep, regular breathing
, B) Tachypnea with use of accessory muscles and pursed-lip breathing
C) Cheyne-Stokes respirations alternating with apnea
D) Kussmaul respirations with fruity-smelling breath
E) Biot's respirations with irregular depth and rate
CORRECT ANSWER: B - Tachypnea with use of accessory muscles and
pursed-lip breathing
EXPERT RATIONALE: During an acute COPD exacerbation, clients typically exhibit
tachypnea (increased respiratory rate) as they work to overcome airway obstruction
and hypoxemia. Use of accessory muscles (intercostal, scalene, and abdominal
muscles) indicates increased work of breathing. Pursed-lip breathing is a
compensatory mechanism clients use to maintain positive airway pressure and
prevent small airway collapse. This pattern allows for more complete exhalation
and reduces air trapping. Bradypnea would indicate severe deterioration or
respiratory depression. Cheyne-Stokes, Kussmaul, and Biot's respirations are
associated with other conditions (heart failure, metabolic acidosis, and neurological
disorders respectively).
QUESTION 5: A 45-year-old client is admitted with acute cholecystitis. Which
of the following assessment findings would the PN expect?
A) Rebound tenderness in the left lower quadrant with fever
B) Right upper quadrant pain radiating to the right shoulder with nausea
C) Epigastric pain with projectile vomiting and rigid abdomen
D) Left-sided flank pain with costovertebral angle tenderness
E) Periumbilical pain with guarding and decreased bowel sounds
CORRECT ANSWER: B - Right upper quadrant pain radiating to the right
shoulder with nausea
SURG) PROCTORED EXAM WITH NGN STUDY
GUIDE | VERIFIED PRACTICE QUESTIONS &
ANSWERS | COMPREHENSIVE ATI PN MED-
SURG EXAM PREP 2026
ATI PN ADULT MEDICAL SURGICAL (MED-SURG) PROCTORED EXAM WITH NGN
STUDY GUIDE | VERIFIED PRACTICE QUESTIONS & ANSWERS | COMPREHENSIVE
ATI PN MED-SURG EXAM PREP 2026
OVERVIEW & STUDY FEATURES
• Comprehensive Coverage: verified practice questions spanning all major ATI PN
Med-Surg exam topics including cardiovascular, respiratory, gastrointestinal,
musculoskeletal, neurological, endocrine, renal, and oncology nursing care with
detailed EXPERT RATIONALE for each answer.
• Strategic Study Approach: Use this material to reinforce clinical concepts
through active recall; review incorrect answers with special attention to EXPERT
RATIONALE; complete all questions to build confidence and ensure mastery of
priority nursing interventions for adult medical-surgical patients.
QUESTION 1: A 58-year-old client with acute MI is experiencing chest pain.
Which of the following actions should the PN take FIRST?
A) Administer oxygen and place the client on continuous cardiac monitoring
B) Obtain a 12-lead ECG and notify the provider immediately
C) Provide morphine IV for pain management
D) Elevate the client's head of bed to 45 degrees
E) Establish IV access and draw blood samples
, CORRECT ANSWER: B - Obtain a 12-lead ECG and notify the provider
immediately
EXPERT RATIONALE: The 12-lead ECG is the priority intervention during suspected
acute MI because it provides critical diagnostic information about the location and
extent of myocardial damage and guides treatment decisions. The ECG should be
obtained within 10 minutes of symptom onset. While oxygen and monitoring are
important, the ECG must be done first to confirm MI and rule out other causes. This
allows the provider to make time-sensitive treatment decisions (such as
thrombolytics or PCI).
QUESTION 2: A client recovering from cardiac catheterization has a nursing
diagnosis of Risk for Bleeding related to arterial puncture site. Which
assessment finding would indicate a potential complication?
A) Mild ecchymosis around the insertion site
B) A small hematoma (2 cm) at the groin site
C) Rapid expansion of hematoma with decreased hemoglobin
D) Slight oozing controlled by gentle pressure dressing
E) Absent pedal pulses bilaterally
CORRECT ANSWER: C - Rapid expansion of hematoma with decreased
hemoglobin
EXPERT RATIONALE: A rapidly expanding hematoma with a drop in hemoglobin
indicates active bleeding into the tissues, which is a serious complication requiring
immediate intervention. This suggests a potential pseudoaneurysm or significant
vessel damage. Small hematomas and mild ecchymosis are common minor
complications. Slight oozing controlled by pressure is expected. Absent bilateral
pedal pulses would suggest a different vascular complication but are less common
than unilateral changes. The combination of expanding hematoma plus decreased
,hemoglobin indicates blood loss and requires urgent provider notification and
possible surgical intervention.
QUESTION 3: A 62-year-old client with heart failure has been prescribed
furosemide 40 mg daily. The PN should monitor for which electrolyte
imbalance as a side effect of this medication?
A) Hyperkalemia and hypernatremia
B) Hypokalemia and hyponatremia
C) Hypercalcemia and hyperphosphatemia
D) Hypomagnesemia and hypocalcemia
E) Hyperchloremia and hyperkalemia
CORRECT ANSWER: B - Hypokalemia and hyponatremia
EXPERT RATIONALE: Loop diuretics like furosemide promote excretion of
potassium, sodium, and other electrolytes through increased urinary output.
Hypokalemia (low potassium) is a major concern because it can cause cardiac
arrhythmias, muscle weakness, and fatigue. Hyponatremia (low sodium) occurs due
to the osmotic effect and dilutional changes. The client should be monitored for
signs of hypokalemia such as muscle cramps, palpitations, and weakness.
Potassium supplements or potassium-sparing diuretics may be prescribed
concurrently. Serum electrolytes should be checked regularly during diuretic
therapy.
QUESTION 4: A client with chronic obstructive pulmonary disease (COPD) is
experiencing an acute exacerbation. Which respiratory pattern should the PN
expect to observe?
A) Bradypnea with deep, regular breathing
, B) Tachypnea with use of accessory muscles and pursed-lip breathing
C) Cheyne-Stokes respirations alternating with apnea
D) Kussmaul respirations with fruity-smelling breath
E) Biot's respirations with irregular depth and rate
CORRECT ANSWER: B - Tachypnea with use of accessory muscles and
pursed-lip breathing
EXPERT RATIONALE: During an acute COPD exacerbation, clients typically exhibit
tachypnea (increased respiratory rate) as they work to overcome airway obstruction
and hypoxemia. Use of accessory muscles (intercostal, scalene, and abdominal
muscles) indicates increased work of breathing. Pursed-lip breathing is a
compensatory mechanism clients use to maintain positive airway pressure and
prevent small airway collapse. This pattern allows for more complete exhalation
and reduces air trapping. Bradypnea would indicate severe deterioration or
respiratory depression. Cheyne-Stokes, Kussmaul, and Biot's respirations are
associated with other conditions (heart failure, metabolic acidosis, and neurological
disorders respectively).
QUESTION 5: A 45-year-old client is admitted with acute cholecystitis. Which
of the following assessment findings would the PN expect?
A) Rebound tenderness in the left lower quadrant with fever
B) Right upper quadrant pain radiating to the right shoulder with nausea
C) Epigastric pain with projectile vomiting and rigid abdomen
D) Left-sided flank pain with costovertebral angle tenderness
E) Periumbilical pain with guarding and decreased bowel sounds
CORRECT ANSWER: B - Right upper quadrant pain radiating to the right
shoulder with nausea
