ATI RN Adult Medical-Surgical (Med-Surg) Proctored
Exam with NGN 2026–2027 | Versions A, B & C |
Comprehensive Practice Questions with Detailed
Answer Rationales | Complete Nursing Study Guide
RN ADULT MED SURG VERSION A
1. A nurse in an acute care facility is caring for a client who is at risk for seizures. Which
of the following precautions should the nurse implement? a. Place a padded tongue
blade at the client's bedside.
b. Keep the side rails lowered on the client's bed.
c. Maintain the client's bed at hip level or above.
d. Ensure that the client has a patent IV.
Correct Answer - d. Ensure that the client has a patent IV.
The nurse should ensure the client has IV access in the event that the client requires
medication to stop seizure activity.
2. A nurse is caring for a client who has portal hypertension. The client is vomiting blood
mixed with food after a meal. Which of the following actions should the nurse take first?
a. Check laboratory values for recent hemoglobin and hematocrit levels.
b. Establish a peripheral IV line for possible transfusion.
pg. 1
,c. Call the laboratory to obtain a stat platelet count.
d. Obtain vital signs.
Correct Answer - d. Obtain vital signs.
The first action the nurse should take using the nursing process is to assess the client's
vital signs. A client who has portal hypertension can develop esophageal varices, which
are fragile and can rupture, resulting in large amounts of blood loss and shock.
Obtaining vital signs provides information about the client's condition that can contribute
to decision making.
3. A nurse is caring for a client who has a potassium level of 3 mEq/L (3.5 to 5 mEq/L).
Which of the following assessment findings should the nurse expect?
a. Positive Trousseau's sign
b. 4+ deep tendon reflexes
c. Deep respirations
d. Hypoactive bowel sounds
Correct Answer - d. Hypoactive bowel sounds
Hypokalemia decreases smooth muscle contraction in the gastrointestinal tract leading
to decreased peristalsis.
4. A nurse in an emergency department is assessing an older adult client who has a
fractured wrist following a fall. During the assessment, the client states, "Last week I
crashed my car because my vision suddenly became blurry." Which of the following
actions is the nurse's priority?
a. Check the client's neurologic status.
b. Document the client's statements.
c. Prepare the client for a CT scan.
pg. 2
,d. Teach the client about using safety precautions for falls.
Correct Answer - a. Check the client's neurologic status.
The first action the nurse should take using the nursing process is to assess the client.
Therefore, the nurse should first check the neurologic status of the client.
5. A nurse is performing a dressing change for a client who is recovering from a
hemicolectomy. When removing the dressing, the nurse notes that a large part of the
bowel is protruding through the abdomen. Which of the following actions should the
nurse take first?
a. Place the client in a supine position.
b. Measure vital signs.
c. Cover the wound with a sterile, saline-moistened dressing.
d. Call for help.
Correct Answer - d. Call for help.
Evidence-based practice indicates that the nurse should first stay with the client and call
for assistance. The client will require emergency surgery and is at risk for shock.
Therefore, the nurse should obtain immediate assistance.
6. A nurse is assessing a client who had extracorporeal shock wave lithotripsy (ESWL)
6 hr ago. Which of the following findings should the nurse expect?
a. Stone fragments in the urine
b. Fever
c. Decreased urine output
d. Bruising on the lower abdomen
Correct Answer - a. Stone fragments in the urine
pg. 3
, ESWL is an effort to break the calculi so that the fragments pass down the ureter, into
the bladder, and through the urethra during voiding. Following the procedure, the nurse
should strain the client's urine to confirm the passage of stones.
7. A nurse is reviewing the laboratory results of a client who has a history of aplastic
anemia. Which of the following findings indicates that the client is experiencing
pancytopenia?
a. RBC count 6.3 million/mm3 (4.7 to 6.1 million/mm3 male)
b. WBC count 2,000/mm3 (5000 to 10,000/mm3)
c. Platelets 450,000/mm3 (150,000 to 400,000/mm3)
d. Potassium 3.3 mEq/L (3.5 to 5 mEq/L)
Correct Answer - b. WBC count 2,000/mm3 (5000 to 10,000/mm3)
A decreased WBC, or leukopenia, is a manifestation of pancytopenia. Pancytopenia
occurs when there is a decreased RBC count, decreased WBC count, and decreased
platelets.
8. A nurse in a provider's office is assessing a client who has hypertension and takes
propranolol. Which of the following findings should indicate to the nurse that the client is
experiencing an adverse reaction to this medication? a. Report of a night cough
b. Report of tinnitus
c. Report of excessive tearing
d. Report of increased salivation
Correct Answer - a. Report of a night cough
The nurse should recognize that a night cough is an early indication of heart failure and
report this adverse reaction to the provider.
pg. 4
Exam with NGN 2026–2027 | Versions A, B & C |
Comprehensive Practice Questions with Detailed
Answer Rationales | Complete Nursing Study Guide
RN ADULT MED SURG VERSION A
1. A nurse in an acute care facility is caring for a client who is at risk for seizures. Which
of the following precautions should the nurse implement? a. Place a padded tongue
blade at the client's bedside.
b. Keep the side rails lowered on the client's bed.
c. Maintain the client's bed at hip level or above.
d. Ensure that the client has a patent IV.
Correct Answer - d. Ensure that the client has a patent IV.
The nurse should ensure the client has IV access in the event that the client requires
medication to stop seizure activity.
2. A nurse is caring for a client who has portal hypertension. The client is vomiting blood
mixed with food after a meal. Which of the following actions should the nurse take first?
a. Check laboratory values for recent hemoglobin and hematocrit levels.
b. Establish a peripheral IV line for possible transfusion.
pg. 1
,c. Call the laboratory to obtain a stat platelet count.
d. Obtain vital signs.
Correct Answer - d. Obtain vital signs.
The first action the nurse should take using the nursing process is to assess the client's
vital signs. A client who has portal hypertension can develop esophageal varices, which
are fragile and can rupture, resulting in large amounts of blood loss and shock.
Obtaining vital signs provides information about the client's condition that can contribute
to decision making.
3. A nurse is caring for a client who has a potassium level of 3 mEq/L (3.5 to 5 mEq/L).
Which of the following assessment findings should the nurse expect?
a. Positive Trousseau's sign
b. 4+ deep tendon reflexes
c. Deep respirations
d. Hypoactive bowel sounds
Correct Answer - d. Hypoactive bowel sounds
Hypokalemia decreases smooth muscle contraction in the gastrointestinal tract leading
to decreased peristalsis.
4. A nurse in an emergency department is assessing an older adult client who has a
fractured wrist following a fall. During the assessment, the client states, "Last week I
crashed my car because my vision suddenly became blurry." Which of the following
actions is the nurse's priority?
a. Check the client's neurologic status.
b. Document the client's statements.
c. Prepare the client for a CT scan.
pg. 2
,d. Teach the client about using safety precautions for falls.
Correct Answer - a. Check the client's neurologic status.
The first action the nurse should take using the nursing process is to assess the client.
Therefore, the nurse should first check the neurologic status of the client.
5. A nurse is performing a dressing change for a client who is recovering from a
hemicolectomy. When removing the dressing, the nurse notes that a large part of the
bowel is protruding through the abdomen. Which of the following actions should the
nurse take first?
a. Place the client in a supine position.
b. Measure vital signs.
c. Cover the wound with a sterile, saline-moistened dressing.
d. Call for help.
Correct Answer - d. Call for help.
Evidence-based practice indicates that the nurse should first stay with the client and call
for assistance. The client will require emergency surgery and is at risk for shock.
Therefore, the nurse should obtain immediate assistance.
6. A nurse is assessing a client who had extracorporeal shock wave lithotripsy (ESWL)
6 hr ago. Which of the following findings should the nurse expect?
a. Stone fragments in the urine
b. Fever
c. Decreased urine output
d. Bruising on the lower abdomen
Correct Answer - a. Stone fragments in the urine
pg. 3
, ESWL is an effort to break the calculi so that the fragments pass down the ureter, into
the bladder, and through the urethra during voiding. Following the procedure, the nurse
should strain the client's urine to confirm the passage of stones.
7. A nurse is reviewing the laboratory results of a client who has a history of aplastic
anemia. Which of the following findings indicates that the client is experiencing
pancytopenia?
a. RBC count 6.3 million/mm3 (4.7 to 6.1 million/mm3 male)
b. WBC count 2,000/mm3 (5000 to 10,000/mm3)
c. Platelets 450,000/mm3 (150,000 to 400,000/mm3)
d. Potassium 3.3 mEq/L (3.5 to 5 mEq/L)
Correct Answer - b. WBC count 2,000/mm3 (5000 to 10,000/mm3)
A decreased WBC, or leukopenia, is a manifestation of pancytopenia. Pancytopenia
occurs when there is a decreased RBC count, decreased WBC count, and decreased
platelets.
8. A nurse in a provider's office is assessing a client who has hypertension and takes
propranolol. Which of the following findings should indicate to the nurse that the client is
experiencing an adverse reaction to this medication? a. Report of a night cough
b. Report of tinnitus
c. Report of excessive tearing
d. Report of increased salivation
Correct Answer - a. Report of a night cough
The nurse should recognize that a night cough is an early indication of heart failure and
report this adverse reaction to the provider.
pg. 4
