ATI RN Adult Medical-Surgical Nursing – Original Practice
Exam with correct answers and rationales 2026/2027 version
Question 1
A nurse is caring for a client admitted with heart failure who reports increasing shortness of
breath. Which assessment finding requires immediate intervention?
A. Bilateral ankle edema
B. Weight gain of 1 lb (0.45 kg) in 24 hours
C. Oxygen saturation of 86% on room air
D. Fatigue with activity
Correct Answer: C. Oxygen saturation of 86% on room air.
Rationale: An oxygen saturation of 86% indicates significant hypoxemia and requires
immediate intervention to improve oxygenation.
Question 2
A client with type 1 diabetes mellitus becomes confused, diaphoretic, and shaky. Which action
should the nurse take first?
A. Administer rapid-acting insulin.
B. Check the client's blood glucose level.
C. Encourage exercise.
D. Restrict fluids.
Correct Answer: B. Check the client's blood glucose level.
Rationale: These findings suggest hypoglycemia. Confirming the blood glucose helps guide
prompt treatment.
,Question 3
A nurse is caring for a client with chronic obstructive pulmonary disease (COPD). Which
intervention promotes optimal oxygenation?
A. Place the client in a high-Fowler's position.
B. Encourage the client to lie flat.
C. Restrict fluid intake.
D. Administer high-flow oxygen to all clients.
Correct Answer: A. Place the client in a high-Fowler's position.
Rationale: Upright positioning improves lung expansion and eases breathing in clients with
COPD.
Question 4
A client reports chest pain rated 8/10. What is the nurse's priority action?
A. Document the pain.
B. Assess the client's vital signs and characteristics of the pain.
C. Encourage the client to rest.
D. Notify dietary services.
Correct Answer: B. Assess the client's vital signs and characteristics of the pain.
Rationale: Immediate assessment helps determine the severity and possible cause of the chest
pain.
Question 5
Which laboratory value is most concerning for a client receiving potassium-wasting diuretics?
A. Potassium 2.9 mEq/L
,B. Sodium 138 mEq/L
C. Glucose 96 mg/dL
D. Calcium 9.2 mg/dL
Correct Answer: A. Potassium 2.9 mEq/L.
Rationale: Hypokalemia increases the risk for cardiac dysrhythmias and muscle weakness.
Question 6
A nurse is assessing a client who has bacterial meningitis. Which finding should the nurse
expect?
A. Nuchal rigidity
B. Bradycardia without symptoms
C. Bilateral ankle edema
D. Polyuria
Correct Answer: A. Nuchal rigidity.
Rationale: Neck stiffness is a classic sign of meningeal irritation.
Question 7
A client with pneumonia is producing thick secretions. Which nursing intervention helps
mobilize secretions?
A. Encourage adequate fluid intake if not contraindicated.
B. Restrict oral fluids.
C. Limit coughing.
D. Maintain bed rest continuously.
Correct Answer: A. Encourage adequate fluid intake if not contraindicated.
, Rationale: Hydration helps thin respiratory secretions, making them easier to expectorate.
Question 8
A nurse is caring for a client following thyroidectomy. Which assessment finding requires
immediate notification of the provider?
A. Hoarseness with stridor
B. Mild incisional discomfort
C. Blood pressure 132/78 mm Hg
D. Temperature 37.2°C (99°F)
Correct Answer: A. Hoarseness with stridor.
Rationale: Stridor may indicate airway obstruction, which is a postoperative emergency.
Question 9
A client has a serum sodium level of 124 mEq/L. Which manifestation should the nurse
anticipate?
A. Confusion
B. Increased alertness
C. Hypertension only
D. Polyuria without other symptoms
Correct Answer: A. Confusion.
Rationale: Hyponatremia commonly affects neurological function, causing confusion and
altered mental status.
Question 10
Exam with correct answers and rationales 2026/2027 version
Question 1
A nurse is caring for a client admitted with heart failure who reports increasing shortness of
breath. Which assessment finding requires immediate intervention?
A. Bilateral ankle edema
B. Weight gain of 1 lb (0.45 kg) in 24 hours
C. Oxygen saturation of 86% on room air
D. Fatigue with activity
Correct Answer: C. Oxygen saturation of 86% on room air.
Rationale: An oxygen saturation of 86% indicates significant hypoxemia and requires
immediate intervention to improve oxygenation.
Question 2
A client with type 1 diabetes mellitus becomes confused, diaphoretic, and shaky. Which action
should the nurse take first?
A. Administer rapid-acting insulin.
B. Check the client's blood glucose level.
C. Encourage exercise.
D. Restrict fluids.
Correct Answer: B. Check the client's blood glucose level.
Rationale: These findings suggest hypoglycemia. Confirming the blood glucose helps guide
prompt treatment.
,Question 3
A nurse is caring for a client with chronic obstructive pulmonary disease (COPD). Which
intervention promotes optimal oxygenation?
A. Place the client in a high-Fowler's position.
B. Encourage the client to lie flat.
C. Restrict fluid intake.
D. Administer high-flow oxygen to all clients.
Correct Answer: A. Place the client in a high-Fowler's position.
Rationale: Upright positioning improves lung expansion and eases breathing in clients with
COPD.
Question 4
A client reports chest pain rated 8/10. What is the nurse's priority action?
A. Document the pain.
B. Assess the client's vital signs and characteristics of the pain.
C. Encourage the client to rest.
D. Notify dietary services.
Correct Answer: B. Assess the client's vital signs and characteristics of the pain.
Rationale: Immediate assessment helps determine the severity and possible cause of the chest
pain.
Question 5
Which laboratory value is most concerning for a client receiving potassium-wasting diuretics?
A. Potassium 2.9 mEq/L
,B. Sodium 138 mEq/L
C. Glucose 96 mg/dL
D. Calcium 9.2 mg/dL
Correct Answer: A. Potassium 2.9 mEq/L.
Rationale: Hypokalemia increases the risk for cardiac dysrhythmias and muscle weakness.
Question 6
A nurse is assessing a client who has bacterial meningitis. Which finding should the nurse
expect?
A. Nuchal rigidity
B. Bradycardia without symptoms
C. Bilateral ankle edema
D. Polyuria
Correct Answer: A. Nuchal rigidity.
Rationale: Neck stiffness is a classic sign of meningeal irritation.
Question 7
A client with pneumonia is producing thick secretions. Which nursing intervention helps
mobilize secretions?
A. Encourage adequate fluid intake if not contraindicated.
B. Restrict oral fluids.
C. Limit coughing.
D. Maintain bed rest continuously.
Correct Answer: A. Encourage adequate fluid intake if not contraindicated.
, Rationale: Hydration helps thin respiratory secretions, making them easier to expectorate.
Question 8
A nurse is caring for a client following thyroidectomy. Which assessment finding requires
immediate notification of the provider?
A. Hoarseness with stridor
B. Mild incisional discomfort
C. Blood pressure 132/78 mm Hg
D. Temperature 37.2°C (99°F)
Correct Answer: A. Hoarseness with stridor.
Rationale: Stridor may indicate airway obstruction, which is a postoperative emergency.
Question 9
A client has a serum sodium level of 124 mEq/L. Which manifestation should the nurse
anticipate?
A. Confusion
B. Increased alertness
C. Hypertension only
D. Polyuria without other symptoms
Correct Answer: A. Confusion.
Rationale: Hyponatremia commonly affects neurological function, causing confusion and
altered mental status.
Question 10
