ATI Content Mastery Series (CMS) Mock
Examination (2026–2027)
Field of Study: Nursing / Medical-Surgical Content Mastery
Edition: 2026–2027
1. A client with heart failure is receiving furosemide 40 mg IV push. Which assessment finding indicates
the medication is having a therapeutic effect?
A) Weight gain of 1 kg in 24 hours
B) Lung sounds clear bilaterally after having crackles
C) Blood pressure increases from 100/60 to 130/80
D) Urine output decreases to 20 mL/hour
Correct Answer: B
Rationale: Furosemide is a loop diuretic that reduces fluid overload; clearing of lung crackles indicates
decreased pulmonary congestion. Weight gain (A) and decreased urine output (D) would indicate
worsening. Increased blood pressure (C) is not the desired effect.
2. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via nasal
cannula. The client becomes drowsy and the respiratory rate drops to 8 breaths per minute. Which action
should the nurse take first?
A) Increase the oxygen flow to 4 L/min
B) Decrease the oxygen flow to 1 L/min and notify the healthcare provider
C) Initiate cardiopulmonary resuscitation
D) Place the client in a supine position
Correct Answer: B
Rationale: In COPD, high oxygen levels may suppress the hypoxic drive, causing CO2 retention. The
nurse should lower the oxygen to maintain SpO2 88–92% and notify the provider. Increasing oxygen (A)
,would worsen the condition; CPR (C) is not indicated unless the client is pulseless; supine position (D)
may worsen respiratory effort.
3. A client is admitted with acute pancreatitis. Which laboratory result would the nurse expect to be
elevated?
A) Serum amylase
B) Blood urea nitrogen
C) Hemoglobin
D) Serum albumin
Correct Answer: A
Rationale: Serum amylase and lipase are markedly elevated in acute pancreatitis. BUN (B) may increase
with dehydration but is not diagnostic; hemoglobin (C) and albumin (D) are not specific to pancreatitis.
4. The nurse is caring for a client 12 hours after a total thyroidectomy. Which finding requires immediate
intervention?
A) Pain at the incision site
B) Hoarseness of the voice
C) Positive Chvostek's sign
D) Temperature 99.2°F (37.3°C)
Correct Answer: C
Rationale: A positive Chvostek's sign indicates hypocalcemia, a possible complication due to parathyroid
gland injury during thyroidectomy. This can cause tetany and requires immediate intervention. Pain (A)
and hoarseness (B) are expected; a mild temperature elevation (D) is common post-operatively.
5. A client is receiving a continuous heparin infusion. Which laboratory value should the nurse monitor to
evaluate the therapeutic effect?
A) Prothrombin time (PT)
B) International normalized ratio (INR)
,C) Activated partial thromboplastin time (aPTT)
D) Platelet count
Correct Answer: C
Rationale: Unfractionated heparin therapy is monitored using the aPTT. PT/INR (A, B) monitor warfarin
therapy; platelet count (D) is monitored for heparin-induced thrombocytopenia but not therapeutic effect.
6. A client with diabetes mellitus is found diaphoretic and confused. The blood glucose is 45 mg/dL.
Which action should the nurse take first?
A) Administer insulin lispro subcutaneously
B) Give 4 ounces of orange juice if the client is able to swallow
C) Administer 50% dextrose intravenously
D) Wait 15 minutes and recheck blood glucose
Correct Answer: B
Rationale: The client is hypoglycemic and conscious with an intact gag reflex; the first treatment is 15–20
grams of fast-acting carbohydrate such as orange juice. Insulin (A) would lower glucose further; IV
dextrose (C) is for unconscious or NPO clients; waiting (D) delays treatment.
7. A client is admitted with cirrhosis and ascites. Which diet should the nurse anticipate?
A) High protein, high sodium
B) Low sodium, moderate protein
C) High potassium, low carbohydrate
D) Low calcium, high fat
Correct Answer: B
Rationale: Sodium restriction reduces fluid retention and ascites; protein is moderated to prevent hepatic
encephalopathy. High protein (A) may precipitate encephalopathy; high potassium (C) is not indicated
unless the client is hypokalemic; low calcium/high fat (D) is not standard.
8. The nurse is performing an assessment on a client with peripheral arterial disease (PAD). Which
finding is expected?
, A) Brown discoloration of the lower legs
B) Diminished or absent pedal pulses
C) Large, weeping ulcers on the medial ankle
D) Edema in the lower extremities
Correct Answer: B
Rationale: PAD is characterized by decreased arterial blood flow, resulting in diminished or absent
pulses, shiny skin, and hair loss. Brown discoloration (A) and edema (D) are common in venous
insufficiency; medial ankle ulcers (C) are typical of venous stasis, not arterial disease.
9. A client is scheduled for a cardiac catheterization. Which pre-procedure intervention is most important?
A) Administer a sedative immediately
B) Assess for allergy to iodine or shellfish
C) Shave the groin area with a razor
D) Have the client sign a consent form after pre-medication
Correct Answer: B
Rationale: Assessing for contrast dye allergy is critical to prevent anaphylaxis. The consent form (D)
must be signed before sedation. Shaving (C) is no longer recommended due to infection risk. Sedation (A)
is given per order but not before allergy assessment.
10. A client with a chest tube to water seal drainage has continuous bubbling in the water seal chamber.
What should the nurse do first?
A) Clamp the chest tube
B) Notify the surgeon immediately
C) Check for air leaks in the system and at the insertion site
D) Add more sterile water to the chamber
Correct Answer: C
Rationale: Continuous bubbling indicates an air leak. The nurse should first check connections and the
Examination (2026–2027)
Field of Study: Nursing / Medical-Surgical Content Mastery
Edition: 2026–2027
1. A client with heart failure is receiving furosemide 40 mg IV push. Which assessment finding indicates
the medication is having a therapeutic effect?
A) Weight gain of 1 kg in 24 hours
B) Lung sounds clear bilaterally after having crackles
C) Blood pressure increases from 100/60 to 130/80
D) Urine output decreases to 20 mL/hour
Correct Answer: B
Rationale: Furosemide is a loop diuretic that reduces fluid overload; clearing of lung crackles indicates
decreased pulmonary congestion. Weight gain (A) and decreased urine output (D) would indicate
worsening. Increased blood pressure (C) is not the desired effect.
2. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via nasal
cannula. The client becomes drowsy and the respiratory rate drops to 8 breaths per minute. Which action
should the nurse take first?
A) Increase the oxygen flow to 4 L/min
B) Decrease the oxygen flow to 1 L/min and notify the healthcare provider
C) Initiate cardiopulmonary resuscitation
D) Place the client in a supine position
Correct Answer: B
Rationale: In COPD, high oxygen levels may suppress the hypoxic drive, causing CO2 retention. The
nurse should lower the oxygen to maintain SpO2 88–92% and notify the provider. Increasing oxygen (A)
,would worsen the condition; CPR (C) is not indicated unless the client is pulseless; supine position (D)
may worsen respiratory effort.
3. A client is admitted with acute pancreatitis. Which laboratory result would the nurse expect to be
elevated?
A) Serum amylase
B) Blood urea nitrogen
C) Hemoglobin
D) Serum albumin
Correct Answer: A
Rationale: Serum amylase and lipase are markedly elevated in acute pancreatitis. BUN (B) may increase
with dehydration but is not diagnostic; hemoglobin (C) and albumin (D) are not specific to pancreatitis.
4. The nurse is caring for a client 12 hours after a total thyroidectomy. Which finding requires immediate
intervention?
A) Pain at the incision site
B) Hoarseness of the voice
C) Positive Chvostek's sign
D) Temperature 99.2°F (37.3°C)
Correct Answer: C
Rationale: A positive Chvostek's sign indicates hypocalcemia, a possible complication due to parathyroid
gland injury during thyroidectomy. This can cause tetany and requires immediate intervention. Pain (A)
and hoarseness (B) are expected; a mild temperature elevation (D) is common post-operatively.
5. A client is receiving a continuous heparin infusion. Which laboratory value should the nurse monitor to
evaluate the therapeutic effect?
A) Prothrombin time (PT)
B) International normalized ratio (INR)
,C) Activated partial thromboplastin time (aPTT)
D) Platelet count
Correct Answer: C
Rationale: Unfractionated heparin therapy is monitored using the aPTT. PT/INR (A, B) monitor warfarin
therapy; platelet count (D) is monitored for heparin-induced thrombocytopenia but not therapeutic effect.
6. A client with diabetes mellitus is found diaphoretic and confused. The blood glucose is 45 mg/dL.
Which action should the nurse take first?
A) Administer insulin lispro subcutaneously
B) Give 4 ounces of orange juice if the client is able to swallow
C) Administer 50% dextrose intravenously
D) Wait 15 minutes and recheck blood glucose
Correct Answer: B
Rationale: The client is hypoglycemic and conscious with an intact gag reflex; the first treatment is 15–20
grams of fast-acting carbohydrate such as orange juice. Insulin (A) would lower glucose further; IV
dextrose (C) is for unconscious or NPO clients; waiting (D) delays treatment.
7. A client is admitted with cirrhosis and ascites. Which diet should the nurse anticipate?
A) High protein, high sodium
B) Low sodium, moderate protein
C) High potassium, low carbohydrate
D) Low calcium, high fat
Correct Answer: B
Rationale: Sodium restriction reduces fluid retention and ascites; protein is moderated to prevent hepatic
encephalopathy. High protein (A) may precipitate encephalopathy; high potassium (C) is not indicated
unless the client is hypokalemic; low calcium/high fat (D) is not standard.
8. The nurse is performing an assessment on a client with peripheral arterial disease (PAD). Which
finding is expected?
, A) Brown discoloration of the lower legs
B) Diminished or absent pedal pulses
C) Large, weeping ulcers on the medial ankle
D) Edema in the lower extremities
Correct Answer: B
Rationale: PAD is characterized by decreased arterial blood flow, resulting in diminished or absent
pulses, shiny skin, and hair loss. Brown discoloration (A) and edema (D) are common in venous
insufficiency; medial ankle ulcers (C) are typical of venous stasis, not arterial disease.
9. A client is scheduled for a cardiac catheterization. Which pre-procedure intervention is most important?
A) Administer a sedative immediately
B) Assess for allergy to iodine or shellfish
C) Shave the groin area with a razor
D) Have the client sign a consent form after pre-medication
Correct Answer: B
Rationale: Assessing for contrast dye allergy is critical to prevent anaphylaxis. The consent form (D)
must be signed before sedation. Shaving (C) is no longer recommended due to infection risk. Sedation (A)
is given per order but not before allergy assessment.
10. A client with a chest tube to water seal drainage has continuous bubbling in the water seal chamber.
What should the nurse do first?
A) Clamp the chest tube
B) Notify the surgeon immediately
C) Check for air leaks in the system and at the insertion site
D) Add more sterile water to the chamber
Correct Answer: C
Rationale: Continuous bubbling indicates an air leak. The nurse should first check connections and the
