ATI RN Adult Medical-Surgical Proctored Exam — 200
Practice Questions with Answers and Rationales
Exam: ATI RN Adult Medical-Surgical Proctored Exam
Assessment Technologies Institute (ATI) Nursing Education
Format: Multiple-choice, Select-All-That-Apply (SATA), Ordered Response, Fill-in-the-Blank, and
Next Generation NCLEX (NGN) style questions
Key Content Areas: Cardiovascular, Respiratory, Gastrointestinal, Renal/Urinary, Neurological,
Endocrine, Musculoskeletal, Hematological, Immunological, Integumentary, Perioperative, Fluid
& Electrolyte, and Pharmacology
SECTION 1: CARDIOVASCULAR SYSTEM (Questions 1–35)
1. A nurse is assessing a client with heart failure. Which finding is an early indication of
left-sided heart failure?
- A) Peripheral edema
- B) Jugular venous distention
- C) Crackles in the lung bases
- D) Hepatomegaly
Answer: C
Rationale: Left-sided heart failure results in pulmonary congestion due to the backup of blood
into the lungs. Crackles (rales) in the lung bases are an early sign of fluid accumulation.
Peripheral edema, JVD, and hepatomegaly are signs of right-sided heart failure.
2. A client with heart failure is prescribed furosemide. Which laboratory value should the nurse
monitor most closely?
- A) Serum sodium
- B) Serum potassium
- C) Serum calcium
- D) Serum magnesium
Answer: B
,Rationale: Furosemide is a loop diuretic that causes excretion of potassium, leading to
hypokalemia. The nurse should monitor serum potassium levels closely and assess for signs of
hypokalemia (muscle weakness, cardiac dysrhythmias).
3. A client is prescribed digoxin for heart failure. Which finding indicates digoxin toxicity?
- A) Tachycardia
- B) Hypertension
- C) Visual disturbances (yellow-green halos)
- D) Hyperkalemia
Answer: C
Rationale: Digoxin toxicity can cause visual disturbances such as yellow-green halos around
lights, as well as nausea, vomiting, and cardiac dysrhythmias. Digoxin levels should be
monitored (therapeutic range 0.8–2.0 ng/mL).
4. A nurse is caring for a client with unstable angina. Which medication should the nurse
administer first?
- A) Morphine
- B) Nitroglycerin
- C) Aspirin
- D) Oxygen
Answer: C
Rationale: Aspirin should be administered immediately for unstable angina to prevent further
platelet aggregation and clot formation. Oxygen, nitroglycerin, and morphine are also important
but aspirin is the priority.
5. A client is scheduled for a cardiac catheterization via the femoral artery. Which
post-procedure nursing action is most important?
- A) Encourage ambulation immediately
- B) Perform neurovascular checks with vital signs
- C) Apply heat to the insertion site
- D) Position the client in high-Fowler's position
Answer: B
Rationale: After femoral cardiac catheterization, the client should be on bed rest with the
affected leg straight. The nurse should perform neurovascular checks (pulses, sensation, motor
,function, color, temperature) to monitor for complications such as bleeding, hematoma, or
arterial occlusion.
6. A client reports chest pain that is relieved by rest and sublingual nitroglycerin. This type of
pain is most consistent with:
- A) Unstable angina
- B) Stable angina
- C) Myocardial infarction
- D) Pericarditis
Answer: B
Rationale: Stable angina is predictable chest pain that occurs with exertion or stress and is
relieved by rest and/or nitroglycerin. Unstable angina occurs at rest or with minimal exertion and
is not easily relieved.
7. A client with a history of hypertension is prescribed a beta-blocker. Which side effect should
the nurse monitor for?
- A) Tachycardia
- B) Hypotension and bradycardia
- C) Hypertension
- D) Hyperglycemia
Answer: B
Rationale: Beta-blockers decrease heart rate and cardiac output, leading to hypotension and
bradycardia. The nurse should monitor vital signs and assess for signs of decreased cardiac
output.
8. A client with atrial fibrillation is prescribed warfarin. Which laboratory test should the nurse
monitor to evaluate the effectiveness of therapy?
- A) aPTT
- B) INR
- C) Platelet count
- D) Hemoglobin
Answer: B
Rationale: The International Normalized Ratio (INR) is used to monitor warfarin therapy. The
therapeutic INR range for atrial fibrillation is typically 2.0–3.0. aPTT is used to monitor heparin
therapy.
, 9. The nurse is providing discharge teaching to a client with a new diagnosis of hypertension.
Which lifestyle modification is most effective for lowering blood pressure?
- A) Increasing sodium intake
- B) Decreasing physical activity
- C) Following the DASH diet
- D) Increasing caffeine intake
Answer: C
Rationale: The DASH diet (Dietary Approaches to Stop Hypertension), which is rich in fruits,
vegetables, whole grains, and low-fat dairy and low in sodium and saturated fat, is an effective
lifestyle modification for lowering blood pressure.
10. Which electrocardiogram (ECG) finding is most indicative of a myocardial infarction?
- A) ST-segment depression
- B) ST-segment elevation
- C) T-wave inversion
- D) Prolonged PR interval
Answer: B
Rationale: ST-segment elevation is indicative of an ST-elevation myocardial infarction (STEMI),
which is a complete occlusion of a coronary artery requiring immediate reperfusion therapy.
11. A client with peripheral artery disease (PAD) reports leg pain when walking that is relieved
by rest. The nurse documents this as:
- A) Rest pain
- B) Intermittent claudication
- C) Neuropathic pain
- D) Venous insufficiency
Answer: B
Rationale: Intermittent claudication is muscle pain (cramping, aching) in the legs that occurs
with exercise and is relieved by rest. It is a classic symptom of peripheral artery disease due to
inadequate blood flow.
Practice Questions with Answers and Rationales
Exam: ATI RN Adult Medical-Surgical Proctored Exam
Assessment Technologies Institute (ATI) Nursing Education
Format: Multiple-choice, Select-All-That-Apply (SATA), Ordered Response, Fill-in-the-Blank, and
Next Generation NCLEX (NGN) style questions
Key Content Areas: Cardiovascular, Respiratory, Gastrointestinal, Renal/Urinary, Neurological,
Endocrine, Musculoskeletal, Hematological, Immunological, Integumentary, Perioperative, Fluid
& Electrolyte, and Pharmacology
SECTION 1: CARDIOVASCULAR SYSTEM (Questions 1–35)
1. A nurse is assessing a client with heart failure. Which finding is an early indication of
left-sided heart failure?
- A) Peripheral edema
- B) Jugular venous distention
- C) Crackles in the lung bases
- D) Hepatomegaly
Answer: C
Rationale: Left-sided heart failure results in pulmonary congestion due to the backup of blood
into the lungs. Crackles (rales) in the lung bases are an early sign of fluid accumulation.
Peripheral edema, JVD, and hepatomegaly are signs of right-sided heart failure.
2. A client with heart failure is prescribed furosemide. Which laboratory value should the nurse
monitor most closely?
- A) Serum sodium
- B) Serum potassium
- C) Serum calcium
- D) Serum magnesium
Answer: B
,Rationale: Furosemide is a loop diuretic that causes excretion of potassium, leading to
hypokalemia. The nurse should monitor serum potassium levels closely and assess for signs of
hypokalemia (muscle weakness, cardiac dysrhythmias).
3. A client is prescribed digoxin for heart failure. Which finding indicates digoxin toxicity?
- A) Tachycardia
- B) Hypertension
- C) Visual disturbances (yellow-green halos)
- D) Hyperkalemia
Answer: C
Rationale: Digoxin toxicity can cause visual disturbances such as yellow-green halos around
lights, as well as nausea, vomiting, and cardiac dysrhythmias. Digoxin levels should be
monitored (therapeutic range 0.8–2.0 ng/mL).
4. A nurse is caring for a client with unstable angina. Which medication should the nurse
administer first?
- A) Morphine
- B) Nitroglycerin
- C) Aspirin
- D) Oxygen
Answer: C
Rationale: Aspirin should be administered immediately for unstable angina to prevent further
platelet aggregation and clot formation. Oxygen, nitroglycerin, and morphine are also important
but aspirin is the priority.
5. A client is scheduled for a cardiac catheterization via the femoral artery. Which
post-procedure nursing action is most important?
- A) Encourage ambulation immediately
- B) Perform neurovascular checks with vital signs
- C) Apply heat to the insertion site
- D) Position the client in high-Fowler's position
Answer: B
Rationale: After femoral cardiac catheterization, the client should be on bed rest with the
affected leg straight. The nurse should perform neurovascular checks (pulses, sensation, motor
,function, color, temperature) to monitor for complications such as bleeding, hematoma, or
arterial occlusion.
6. A client reports chest pain that is relieved by rest and sublingual nitroglycerin. This type of
pain is most consistent with:
- A) Unstable angina
- B) Stable angina
- C) Myocardial infarction
- D) Pericarditis
Answer: B
Rationale: Stable angina is predictable chest pain that occurs with exertion or stress and is
relieved by rest and/or nitroglycerin. Unstable angina occurs at rest or with minimal exertion and
is not easily relieved.
7. A client with a history of hypertension is prescribed a beta-blocker. Which side effect should
the nurse monitor for?
- A) Tachycardia
- B) Hypotension and bradycardia
- C) Hypertension
- D) Hyperglycemia
Answer: B
Rationale: Beta-blockers decrease heart rate and cardiac output, leading to hypotension and
bradycardia. The nurse should monitor vital signs and assess for signs of decreased cardiac
output.
8. A client with atrial fibrillation is prescribed warfarin. Which laboratory test should the nurse
monitor to evaluate the effectiveness of therapy?
- A) aPTT
- B) INR
- C) Platelet count
- D) Hemoglobin
Answer: B
Rationale: The International Normalized Ratio (INR) is used to monitor warfarin therapy. The
therapeutic INR range for atrial fibrillation is typically 2.0–3.0. aPTT is used to monitor heparin
therapy.
, 9. The nurse is providing discharge teaching to a client with a new diagnosis of hypertension.
Which lifestyle modification is most effective for lowering blood pressure?
- A) Increasing sodium intake
- B) Decreasing physical activity
- C) Following the DASH diet
- D) Increasing caffeine intake
Answer: C
Rationale: The DASH diet (Dietary Approaches to Stop Hypertension), which is rich in fruits,
vegetables, whole grains, and low-fat dairy and low in sodium and saturated fat, is an effective
lifestyle modification for lowering blood pressure.
10. Which electrocardiogram (ECG) finding is most indicative of a myocardial infarction?
- A) ST-segment depression
- B) ST-segment elevation
- C) T-wave inversion
- D) Prolonged PR interval
Answer: B
Rationale: ST-segment elevation is indicative of an ST-elevation myocardial infarction (STEMI),
which is a complete occlusion of a coronary artery requiring immediate reperfusion therapy.
11. A client with peripheral artery disease (PAD) reports leg pain when walking that is relieved
by rest. The nurse documents this as:
- A) Rest pain
- B) Intermittent claudication
- C) Neuropathic pain
- D) Venous insufficiency
Answer: B
Rationale: Intermittent claudication is muscle pain (cramping, aching) in the legs that occurs
with exercise and is relieved by rest. It is a classic symptom of peripheral artery disease due to
inadequate blood flow.
