ATI Capstone Adult Medical-Surgical
Comprehensive Examination - V2.0
Advanced-Level Practice Questions with
Rationales
Cardiovascular Disorders (Questions 1-10)
1. A nurse in the emergency department is caring for a client who
presents with sudden onset of severe, tearing chest pain radiating
to the back. The client's blood pressure is 180/110 mmHg in the
right arm and 100/60 mmHg in the left arm. Which of the
following conditions should the nurse suspect?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Correct Answer: C
Rationale: Aortic dissection is characterized by sudden, severe,
tearing chest pain that radiates to the back. A key diagnostic
finding is a difference in blood pressure between arms (≥ 20 mmHg
systolic difference). This occurs because the dissection flap can
compromise blood flow to different arteries. Acute MI typically
,presents with crushing substernal pain, pulmonary embolism with
pleuritic chest pain and dyspnea, and pericarditis with sharp pain
that worsens with inspiration and improves when leaning forward.
2. A nurse is assessing a client who has heart failure and is
receiving intravenous furosemide. Which of the following
findings indicates the medication is having the desired
therapeutic effect?
A. Decreased peripheral edema
B. Increased heart rate
C. Increased blood pressure
D. Decreased urine output
Correct Answer: A
Rationale: Furosemide is a loop diuretic used to reduce fluid
volume overload in heart failure. The desired therapeutic effect is
decreased peripheral edema, decreased pulmonary congestion, and
reduced jugular venous distention. Increased heart rate and
increased blood pressure are not desired effects. Urine output
should increase (not decrease) following furosemide administration.
3. A nurse is assessing a client who has a history of coronary
artery disease and reports chest pain that occurs with exertion
and is relieved by rest. The client reports taking sublingual
,nitroglycerin with relief. Which of the following types of angina is
the client experiencing?
A. Unstable angina
B. Stable angina
C. Variant (Prinzmetal's) angina
D. Microvascular angina
Correct Answer: B
Rationale: Stable angina is characterized by chest pain that occurs
with exertion (or emotional stress) and is relieved by rest or
sublingual nitroglycerin. Unstable angina occurs at rest or with
minimal exertion and is not predictably relieved. Variant angina
occurs at rest due to coronary artery spasm. Microvascular angina is
caused by dysfunction of small coronary vessels.
4. A nurse is preparing to administer digoxin to a client who has
heart failure. Which of the following assessments should the
nurse perform prior to administration?
A. Auscultate apical pulse for one full minute
B. Assess serum potassium level
C. Assess for visual disturbances
D. All of the above
Correct Answer: D
Rationale: Prior to administering digoxin, the nurse should assess
the apical pulse for one full minute (hold if < 60/min in adults),
, assess serum potassium levels (hypokalemia increases risk of
digoxin toxicity), and assess for visual disturbances (yellow-green
halos, blurred vision) which may indicate digoxin toxicity. All of
these assessments are essential for safe medication administration.
5. A nurse is caring for a client who is 6 hours postoperative
following a coronary artery bypass graft (CABG). Which of the
following findings should the nurse report immediately?
A. Heart rate of 88/min
B. Blood pressure of 110/70 mmHg
C. Jugular venous distention
D. Temperature of 37°C (98.6°F)
Correct Answer: C
Rationale: Jugular venous distention following CABG may indicate
cardiac tamponade or heart failure, which requires immediate
reporting. A heart rate of 88/min, blood pressure of 110/70 mmHg,
and temperature of 37°C are all within normal limits and expected
postoperative findings.
6. A nurse is teaching a client who has peripheral artery disease
(PAD). Which of the following client statements indicates an
understanding of the condition?
Comprehensive Examination - V2.0
Advanced-Level Practice Questions with
Rationales
Cardiovascular Disorders (Questions 1-10)
1. A nurse in the emergency department is caring for a client who
presents with sudden onset of severe, tearing chest pain radiating
to the back. The client's blood pressure is 180/110 mmHg in the
right arm and 100/60 mmHg in the left arm. Which of the
following conditions should the nurse suspect?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Correct Answer: C
Rationale: Aortic dissection is characterized by sudden, severe,
tearing chest pain that radiates to the back. A key diagnostic
finding is a difference in blood pressure between arms (≥ 20 mmHg
systolic difference). This occurs because the dissection flap can
compromise blood flow to different arteries. Acute MI typically
,presents with crushing substernal pain, pulmonary embolism with
pleuritic chest pain and dyspnea, and pericarditis with sharp pain
that worsens with inspiration and improves when leaning forward.
2. A nurse is assessing a client who has heart failure and is
receiving intravenous furosemide. Which of the following
findings indicates the medication is having the desired
therapeutic effect?
A. Decreased peripheral edema
B. Increased heart rate
C. Increased blood pressure
D. Decreased urine output
Correct Answer: A
Rationale: Furosemide is a loop diuretic used to reduce fluid
volume overload in heart failure. The desired therapeutic effect is
decreased peripheral edema, decreased pulmonary congestion, and
reduced jugular venous distention. Increased heart rate and
increased blood pressure are not desired effects. Urine output
should increase (not decrease) following furosemide administration.
3. A nurse is assessing a client who has a history of coronary
artery disease and reports chest pain that occurs with exertion
and is relieved by rest. The client reports taking sublingual
,nitroglycerin with relief. Which of the following types of angina is
the client experiencing?
A. Unstable angina
B. Stable angina
C. Variant (Prinzmetal's) angina
D. Microvascular angina
Correct Answer: B
Rationale: Stable angina is characterized by chest pain that occurs
with exertion (or emotional stress) and is relieved by rest or
sublingual nitroglycerin. Unstable angina occurs at rest or with
minimal exertion and is not predictably relieved. Variant angina
occurs at rest due to coronary artery spasm. Microvascular angina is
caused by dysfunction of small coronary vessels.
4. A nurse is preparing to administer digoxin to a client who has
heart failure. Which of the following assessments should the
nurse perform prior to administration?
A. Auscultate apical pulse for one full minute
B. Assess serum potassium level
C. Assess for visual disturbances
D. All of the above
Correct Answer: D
Rationale: Prior to administering digoxin, the nurse should assess
the apical pulse for one full minute (hold if < 60/min in adults),
, assess serum potassium levels (hypokalemia increases risk of
digoxin toxicity), and assess for visual disturbances (yellow-green
halos, blurred vision) which may indicate digoxin toxicity. All of
these assessments are essential for safe medication administration.
5. A nurse is caring for a client who is 6 hours postoperative
following a coronary artery bypass graft (CABG). Which of the
following findings should the nurse report immediately?
A. Heart rate of 88/min
B. Blood pressure of 110/70 mmHg
C. Jugular venous distention
D. Temperature of 37°C (98.6°F)
Correct Answer: C
Rationale: Jugular venous distention following CABG may indicate
cardiac tamponade or heart failure, which requires immediate
reporting. A heart rate of 88/min, blood pressure of 110/70 mmHg,
and temperature of 37°C are all within normal limits and expected
postoperative findings.
6. A nurse is teaching a client who has peripheral artery disease
(PAD). Which of the following client statements indicates an
understanding of the condition?
