ATI RN Med-Surg Proctored Exam 2026/2027: 200
Real Questions with Verified Answers &
Rationales – Complete Study Guide | LATEST
UPDATE THIS YEAR.pdf
Exam Overview:
The ATI RN Medical-Surgical Proctored Exam is a comprehensive assessment covering
adult health nursing across all major body systems. The exam features traditional multiple-
choice, select-all-that-apply (SATA), ordered response, and Next Generation NCLEX (NGN)
case study questions . This test bank includes 200+ questions with verified answers and
detailed rationales for the 2025–2026 testing cycle .
EXAM FORMAT
Feature Detail
Total 200+ (varies by version)
Questions
Versions Forms A, B, C available
Format Multiple-choice, SATA, ordered response, NGN case studies
Content Cardiovascular, Respiratory, GI, Renal, Endocrine, Neuro,
Areas Musculoskeletal, Immune, Oncology, Emergency, Infection Control
Updated For 2025-2026
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-35)
Question 1
A nurse is assessing a client who is 6 hours post-operative following a cardiac
catheterization via the femoral artery. Which finding requires immediate intervention?
A) Blood pressure 110/70 mm Hg
B) Heart rate 88 bpm
,C) Pallor and coolness of the right foot
D) Small amount of serous drainage at the insertion site
Answer: C) Pallor and coolness of the right foot
Rationale: Pallor and coolness of the extremity indicate arterial insufficiency, possibly
from a thrombus or hematoma compressing the artery. This is a critical finding that requires
immediate intervention to prevent limb loss. The other options are expected or non-urgent .
Question 2
A client with heart failure has a new prescription for furosemide (Lasix). Which laboratory
value should the nurse monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B) Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia
is a common and potentially dangerous side effect that can precipitate cardiac arrhythmias,
especially in clients taking digoxin .
Question 3
A nurse is caring for a client with heart failure who reports dyspnea, orthopnea, and a
weight gain of 5 lb in 2 days. Which action should the nurse take first?
A) Administer furosemide IV
B) Place the client in high-Fowler's position
C) Obtain a stat chest x-ray
D) Auscultate breath sounds
Answer: B) Place the client in high-Fowler's position
,Rationale: High-Fowler's position reduces venous return and improves ventilation,
which is the immediate priority before other interventions. This position uses gravity to
reduce pulmonary congestion .
Question 4
A client with atrial fibrillation is prescribed warfarin. The INR is 4.5. Which action should the
nurse take?
A) Administer the next dose as scheduled
B) Hold the dose and notify the provider
C) Administer vitamin K 10 mg IM
D) Increase the warfarin dose
Answer: B) Hold the dose and notify the provider
Rationale: INR 4.5 is above the therapeutic range (2-3 for atrial fibrillation). The dose
should be held and the provider notified. Vitamin K is reserved for significantly elevated
INRs with bleeding .
Question 5
A client with hypertension is prescribed lisinopril. Which finding requires immediate
intervention?
A) Dry cough
B) Serum potassium 5.8 mEq/L
C) Headache
D) Dizziness upon standing
Answer: B) Serum potassium 5.8 mEq/L
Rationale: Hyperkalemia (K⁺ >5.5 mEq/L) can cause life-threatening arrhythmias. The
provider should be notified immediately. Dry cough is a common but non-emergent side
effect of ACE inhibitors .
Question 6
, A nurse is providing discharge teaching to a client with heart failure. Which statement
indicates understanding?
A) "I will weigh myself daily before breakfast."
B) "I will restrict my fluid intake to 3 liters per day."
C) "I will take ibuprofen for joint pain."
D) "I will stop taking my diuretic if I feel dizzy."
Answer: A) "I will weigh myself daily before breakfast."
Rationale: Daily weight monitoring is essential to detect fluid retention early. A weight
gain of 2-3 pounds in 2 days should be reported to the provider .
Question 7
A client with unstable angina is admitted to the telemetry unit. The nurse should prioritize
which assessment?
A) Pain level
B) Oxygen saturation
C) Blood pressure
D) ECG rhythm
Answer: D) ECG rhythm
Rationale: Continuous ECG monitoring is critical to detect ischemia, arrhythmias, or
progression to myocardial infarction .
Question 8
A client is receiving a continuous heparin infusion. Which laboratory value should the nurse
monitor?
A) aPTT
B) PT/INR
C) Platelet count
D) All of the above
Answer: D) All of the above
Real Questions with Verified Answers &
Rationales – Complete Study Guide | LATEST
UPDATE THIS YEAR.pdf
Exam Overview:
The ATI RN Medical-Surgical Proctored Exam is a comprehensive assessment covering
adult health nursing across all major body systems. The exam features traditional multiple-
choice, select-all-that-apply (SATA), ordered response, and Next Generation NCLEX (NGN)
case study questions . This test bank includes 200+ questions with verified answers and
detailed rationales for the 2025–2026 testing cycle .
EXAM FORMAT
Feature Detail
Total 200+ (varies by version)
Questions
Versions Forms A, B, C available
Format Multiple-choice, SATA, ordered response, NGN case studies
Content Cardiovascular, Respiratory, GI, Renal, Endocrine, Neuro,
Areas Musculoskeletal, Immune, Oncology, Emergency, Infection Control
Updated For 2025-2026
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-35)
Question 1
A nurse is assessing a client who is 6 hours post-operative following a cardiac
catheterization via the femoral artery. Which finding requires immediate intervention?
A) Blood pressure 110/70 mm Hg
B) Heart rate 88 bpm
,C) Pallor and coolness of the right foot
D) Small amount of serous drainage at the insertion site
Answer: C) Pallor and coolness of the right foot
Rationale: Pallor and coolness of the extremity indicate arterial insufficiency, possibly
from a thrombus or hematoma compressing the artery. This is a critical finding that requires
immediate intervention to prevent limb loss. The other options are expected or non-urgent .
Question 2
A client with heart failure has a new prescription for furosemide (Lasix). Which laboratory
value should the nurse monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B) Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia
is a common and potentially dangerous side effect that can precipitate cardiac arrhythmias,
especially in clients taking digoxin .
Question 3
A nurse is caring for a client with heart failure who reports dyspnea, orthopnea, and a
weight gain of 5 lb in 2 days. Which action should the nurse take first?
A) Administer furosemide IV
B) Place the client in high-Fowler's position
C) Obtain a stat chest x-ray
D) Auscultate breath sounds
Answer: B) Place the client in high-Fowler's position
,Rationale: High-Fowler's position reduces venous return and improves ventilation,
which is the immediate priority before other interventions. This position uses gravity to
reduce pulmonary congestion .
Question 4
A client with atrial fibrillation is prescribed warfarin. The INR is 4.5. Which action should the
nurse take?
A) Administer the next dose as scheduled
B) Hold the dose and notify the provider
C) Administer vitamin K 10 mg IM
D) Increase the warfarin dose
Answer: B) Hold the dose and notify the provider
Rationale: INR 4.5 is above the therapeutic range (2-3 for atrial fibrillation). The dose
should be held and the provider notified. Vitamin K is reserved for significantly elevated
INRs with bleeding .
Question 5
A client with hypertension is prescribed lisinopril. Which finding requires immediate
intervention?
A) Dry cough
B) Serum potassium 5.8 mEq/L
C) Headache
D) Dizziness upon standing
Answer: B) Serum potassium 5.8 mEq/L
Rationale: Hyperkalemia (K⁺ >5.5 mEq/L) can cause life-threatening arrhythmias. The
provider should be notified immediately. Dry cough is a common but non-emergent side
effect of ACE inhibitors .
Question 6
, A nurse is providing discharge teaching to a client with heart failure. Which statement
indicates understanding?
A) "I will weigh myself daily before breakfast."
B) "I will restrict my fluid intake to 3 liters per day."
C) "I will take ibuprofen for joint pain."
D) "I will stop taking my diuretic if I feel dizzy."
Answer: A) "I will weigh myself daily before breakfast."
Rationale: Daily weight monitoring is essential to detect fluid retention early. A weight
gain of 2-3 pounds in 2 days should be reported to the provider .
Question 7
A client with unstable angina is admitted to the telemetry unit. The nurse should prioritize
which assessment?
A) Pain level
B) Oxygen saturation
C) Blood pressure
D) ECG rhythm
Answer: D) ECG rhythm
Rationale: Continuous ECG monitoring is critical to detect ischemia, arrhythmias, or
progression to myocardial infarction .
Question 8
A client is receiving a continuous heparin infusion. Which laboratory value should the nurse
monitor?
A) aPTT
B) PT/INR
C) Platelet count
D) All of the above
Answer: D) All of the above
