ATI Adult Medical-Surgical
Practice Assessment A -
Version
3.1 well written one year
2025 /2026 updated
graded A+ Comprehensive 150-Question
Practice Examination
Instructions
This comprehensive practice examination contains 150 multiple-choice questions designed to
assess advanced clinical judgment in adult medical-surgical nursing. Each question includes
one correct answer with a detailed rationale. Select the best answer for each question.
,Cardiovascular Disorders (Questions 1-20)
1. A nurse is caring for a client with heart failure who reports sudden shortness of
breathand coughing up pink, frothy sputum. Which of the following actions should
the nurse take first?
A. Place the client in high-Fowler's position
B. Administer furosemide IV push
C. Apply oxygen at 2 L/min via nasal cannula
D. Notify the provider immediately
- detailed answer 100% correct:_A. Place the client in high-Fowler's position
Rationale: Pink, frothy sputum indicates acute pulmonary edema, a life-threatening
emergency. The priority action is to position the client in high-Fowler's to promote
oxygenation and reduce venous return to the heart. Oxygen should be applied, but positioning
is the immediate priority.
2. A client with heart failure is prescribed furosemide. Which electrolyte imbalance
shouldthe nurse monitor most closely?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
- detailed answer 100% correct:_B. Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss through the urine.
Hypokalemia can lead to cardiac dysrhythmias and is the most significant electrolyte
imbalance to monitor.
,3. A nurse is reviewing the medication record of a client who is taking digoxin. Which of
thefollowing medications should the nurse identify as increasing the risk for digoxin
toxicity?
A. Potassium chloride
B. Famotidine
C. Levothyroxine
D. Furosemide
- detailed answer 100% correct:_D. Furosemide
Rationale: Loop diuretics such as furosemide increase urinary excretion of potassium, leading
to hypokalemia. Hypokalemia increases the risk for digoxin toxicity.
4. A client who is postoperative suddenly develops shortness of breath and chest pain.
Whatis the nurse's priority action?
A. Administer pain medication
B. Encourage deep breathing
C. Apply oxygen
D. Check blood pressure
- detailed answer 100% correct:_C. Apply oxygen
Rationale: Sudden dyspnea and chest pain in a postoperative client suggest pulmonary
embolism. Airway and oxygenation come first; applying oxygen is the priority action.
5. A client has a serum potassium level of 6.5 mEq/L. Which of the following ECG
changesshould the nurse expect?
, A. Flattened T waves
B. Peaked T waves
C. ST segment elevation
D. Presence of U waves
- detailed answer 100% correct:_B. Peaked T waves
Rationale: Hyperkalemia (potassium >5.0 mEq/L) causes peaked (tall, tented) T waves on ECG.
This is a critical finding that can progress to life-threatening dysrhythmias.
6. A client with heart failure is prescribed digoxin. Which of the following findings
indicatesdigoxin toxicity?
A. Heart rate 62 beats/min
B. Visual disturbances (yellow-green halos)
C. Blood pressure 138/86 mmHg
D. Serum digoxin level 1.2 ng/mL
- detailed answer 100% correct:_B. Visual disturbances (yellow-green halos)
Rationale: Visual disturbances such as yellow-green halos, blurred vision, and photophobia
are classic signs of digoxin toxicity. A serum digoxin level of 1.2 ng/mL is within therapeutic
range (0.8-2.0 ng/mL).
7. A client with peripheral arterial disease (PAD) has an arterial ulcer on the left foot.
Whichof the following characteristics should the nurse expect?
A. Shallow, irregular borders with pink granulation tissue
B. Deep, punched-out appearance with pale base
C. Surrounding skin with brown discoloration
D. Located on the medial malleolus
Practice Assessment A -
Version
3.1 well written one year
2025 /2026 updated
graded A+ Comprehensive 150-Question
Practice Examination
Instructions
This comprehensive practice examination contains 150 multiple-choice questions designed to
assess advanced clinical judgment in adult medical-surgical nursing. Each question includes
one correct answer with a detailed rationale. Select the best answer for each question.
,Cardiovascular Disorders (Questions 1-20)
1. A nurse is caring for a client with heart failure who reports sudden shortness of
breathand coughing up pink, frothy sputum. Which of the following actions should
the nurse take first?
A. Place the client in high-Fowler's position
B. Administer furosemide IV push
C. Apply oxygen at 2 L/min via nasal cannula
D. Notify the provider immediately
- detailed answer 100% correct:_A. Place the client in high-Fowler's position
Rationale: Pink, frothy sputum indicates acute pulmonary edema, a life-threatening
emergency. The priority action is to position the client in high-Fowler's to promote
oxygenation and reduce venous return to the heart. Oxygen should be applied, but positioning
is the immediate priority.
2. A client with heart failure is prescribed furosemide. Which electrolyte imbalance
shouldthe nurse monitor most closely?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
- detailed answer 100% correct:_B. Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss through the urine.
Hypokalemia can lead to cardiac dysrhythmias and is the most significant electrolyte
imbalance to monitor.
,3. A nurse is reviewing the medication record of a client who is taking digoxin. Which of
thefollowing medications should the nurse identify as increasing the risk for digoxin
toxicity?
A. Potassium chloride
B. Famotidine
C. Levothyroxine
D. Furosemide
- detailed answer 100% correct:_D. Furosemide
Rationale: Loop diuretics such as furosemide increase urinary excretion of potassium, leading
to hypokalemia. Hypokalemia increases the risk for digoxin toxicity.
4. A client who is postoperative suddenly develops shortness of breath and chest pain.
Whatis the nurse's priority action?
A. Administer pain medication
B. Encourage deep breathing
C. Apply oxygen
D. Check blood pressure
- detailed answer 100% correct:_C. Apply oxygen
Rationale: Sudden dyspnea and chest pain in a postoperative client suggest pulmonary
embolism. Airway and oxygenation come first; applying oxygen is the priority action.
5. A client has a serum potassium level of 6.5 mEq/L. Which of the following ECG
changesshould the nurse expect?
, A. Flattened T waves
B. Peaked T waves
C. ST segment elevation
D. Presence of U waves
- detailed answer 100% correct:_B. Peaked T waves
Rationale: Hyperkalemia (potassium >5.0 mEq/L) causes peaked (tall, tented) T waves on ECG.
This is a critical finding that can progress to life-threatening dysrhythmias.
6. A client with heart failure is prescribed digoxin. Which of the following findings
indicatesdigoxin toxicity?
A. Heart rate 62 beats/min
B. Visual disturbances (yellow-green halos)
C. Blood pressure 138/86 mmHg
D. Serum digoxin level 1.2 ng/mL
- detailed answer 100% correct:_B. Visual disturbances (yellow-green halos)
Rationale: Visual disturbances such as yellow-green halos, blurred vision, and photophobia
are classic signs of digoxin toxicity. A serum digoxin level of 1.2 ng/mL is within therapeutic
range (0.8-2.0 ng/mL).
7. A client with peripheral arterial disease (PAD) has an arterial ulcer on the left foot.
Whichof the following characteristics should the nurse expect?
A. Shallow, irregular borders with pink granulation tissue
B. Deep, punched-out appearance with pale base
C. Surrounding skin with brown discoloration
D. Located on the medial malleolus
