ATI Medical-Surgical Nursing Exam Study Guide 2026 PDF for
PN and RN Students | Adult Health Disorders, Nursing
Assessment and Interventions, Patient Safety Principles,
Medication Administration, Clinical Decision-Making, Nursing
Process Application | A+ Graded
1. A nurse is caring for a postoperative client who develops acute respiratory
distress. Which action should the nurse take first?
• A. Notify the provider
• B. Administer oxygen
• C. Position the client in high Fowler's position
• D. Assess the client's oxygen saturation level
Answer: D
Rationale: The first step in the nursing process is assessment. The nurse must assess the
client's oxygen saturation and respiratory status before implementing interventions.
High Fowler's position may be appropriate but should follow assessment .
2. A client is admitted with suspected tuberculosis (TB). Which type of precaution
should the nurse implement?
• A. Contact precautions
• B. Droplet precautions
• C. Airborne precautions
• D. Standard precautions only
Answer: C
Rationale: TB is transmitted via airborne particles, requiring airborne precautions
including a negative pressure room and N95 respirator. Clients are no longer contagious
after 2-3 consecutive sputum cultures negative and taking medication consistently for 2-
3 weeks .
,3. A client with HIV/AIDS is being discharged. Which instruction should the nurse
include in teaching?
• A. "You may drink fluids that have been left out for 2 hours."
• B. "Clean your toothbrush in the dishwasher weekly."
• C. "Avoid fresh fruits and vegetables completely."
• D. "Monitor your viral load as a positive response to treatment."
Answer: D
Rationale: Positive response to HIV treatment is monitored by viral load. Clients should
NOT drink fluids left out longer than 60 minutes, clean toothbrushes in the dishwasher
weekly, and avoid fresh produce due to infection risk .
4. A nurse is preparing to administer a blood transfusion. Which action is most
important?
• A. Prime the IV line with dextrose solution
• B. Infuse the blood over 30 minutes
• C. Verify the client's identity with another nurse
• D. Monitor for allergic reaction within the first hour
Answer: C
Rationale: Two nurses must verify the client identity and blood product compatibility.
Blood should be infused over 2-4 hours, primed with normal saline (not dextrose), and
reactions can occur at any time .
5. A client develops hemolytic reaction during a blood transfusion. Which finding
should the nurse expect?
• A. Urticaria and bronchospasm
• B. Back pain and feeling of impending doom
, • C. Fever and chills only
• D. Hypotension and tachycardia
Answer: B
Rationale: Hemolytic reactions present with back/chest pain, apprehension, and a
feeling of impending doom. Allergic reactions present with urticaria, bronchospasm, and
anaphylaxis. The transfusion should be stopped immediately and the line changed to
normal saline .
6. A client is receiving oxygen via Venturi mask. Which statement about this device
is correct?
• A. It delivers 80-95% oxygen concentration
• B. It delivers an exact oxygen flow (24-50%)
• C. It is used for short-term therapy only
• D. It has a high risk for skin breakdown
Answer: B
Rationale: The Venturi mask delivers an exact oxygen concentration (24-50%) and is
ideal for clients with COPD who require precise oxygen delivery. Nonrebreather masks
deliver 80-95% oxygen .
7. A client with a spinal cord injury above T6 develops sudden severe headache,
diaphoresis, and hypertension. Which condition should the nurse suspect?
• A. Autonomic dysreflexia
• B. Spinal shock
• C. Neurogenic shock
• D. Septic shock
Answer: A
Rationale: Autonomic dysreflexia is an exaggerated sympathetic response to stimuli in
clients with spinal cord injuries at T6 or above. Manifestations include sudden significant
, rise in BP, bradycardia, severe headache, flushing, and diaphoresis. Complications
include stroke and organ damage .
8. A client is prescribed digoxin for heart failure. Which finding indicates toxicity?
• A. Visual disturbances and nausea
• B. Increased urine output
• C. Bradycardia with normal vision
• D. Weight gain
Answer: A
Rationale: Digoxin toxicity presents with anorexia, nausea, vomiting, visual disturbances
(yellow-green halos), and dysrhythmias. Therapeutic range is 0.5-0.8/2.0 ng/mL.
Potassium levels should be monitored as hypokalemia increases toxicity risk .
9. A nurse is caring for a client who has left-sided heart failure. Which assessment
finding is most consistent with this condition?
• A. Peripheral edema and ascites
• B. Jugular venous distention
• C. Dyspnea and pulmonary congestion
• D. Hepatomegaly
Answer: C
Rationale: Left-sided heart failure leads to pulmonary congestion, dyspnea, and
crackles. Right-sided failure results in peripheral edema, JVD, hepatomegaly, and ascites
(fluid backs up behind the failure—left in lungs, right in body) .
10. A client with diabetes mellitus is sick and unable to eat. Which instruction
should the nurse provide?
• A. "Hold your insulin until you can eat normally."
PN and RN Students | Adult Health Disorders, Nursing
Assessment and Interventions, Patient Safety Principles,
Medication Administration, Clinical Decision-Making, Nursing
Process Application | A+ Graded
1. A nurse is caring for a postoperative client who develops acute respiratory
distress. Which action should the nurse take first?
• A. Notify the provider
• B. Administer oxygen
• C. Position the client in high Fowler's position
• D. Assess the client's oxygen saturation level
Answer: D
Rationale: The first step in the nursing process is assessment. The nurse must assess the
client's oxygen saturation and respiratory status before implementing interventions.
High Fowler's position may be appropriate but should follow assessment .
2. A client is admitted with suspected tuberculosis (TB). Which type of precaution
should the nurse implement?
• A. Contact precautions
• B. Droplet precautions
• C. Airborne precautions
• D. Standard precautions only
Answer: C
Rationale: TB is transmitted via airborne particles, requiring airborne precautions
including a negative pressure room and N95 respirator. Clients are no longer contagious
after 2-3 consecutive sputum cultures negative and taking medication consistently for 2-
3 weeks .
,3. A client with HIV/AIDS is being discharged. Which instruction should the nurse
include in teaching?
• A. "You may drink fluids that have been left out for 2 hours."
• B. "Clean your toothbrush in the dishwasher weekly."
• C. "Avoid fresh fruits and vegetables completely."
• D. "Monitor your viral load as a positive response to treatment."
Answer: D
Rationale: Positive response to HIV treatment is monitored by viral load. Clients should
NOT drink fluids left out longer than 60 minutes, clean toothbrushes in the dishwasher
weekly, and avoid fresh produce due to infection risk .
4. A nurse is preparing to administer a blood transfusion. Which action is most
important?
• A. Prime the IV line with dextrose solution
• B. Infuse the blood over 30 minutes
• C. Verify the client's identity with another nurse
• D. Monitor for allergic reaction within the first hour
Answer: C
Rationale: Two nurses must verify the client identity and blood product compatibility.
Blood should be infused over 2-4 hours, primed with normal saline (not dextrose), and
reactions can occur at any time .
5. A client develops hemolytic reaction during a blood transfusion. Which finding
should the nurse expect?
• A. Urticaria and bronchospasm
• B. Back pain and feeling of impending doom
, • C. Fever and chills only
• D. Hypotension and tachycardia
Answer: B
Rationale: Hemolytic reactions present with back/chest pain, apprehension, and a
feeling of impending doom. Allergic reactions present with urticaria, bronchospasm, and
anaphylaxis. The transfusion should be stopped immediately and the line changed to
normal saline .
6. A client is receiving oxygen via Venturi mask. Which statement about this device
is correct?
• A. It delivers 80-95% oxygen concentration
• B. It delivers an exact oxygen flow (24-50%)
• C. It is used for short-term therapy only
• D. It has a high risk for skin breakdown
Answer: B
Rationale: The Venturi mask delivers an exact oxygen concentration (24-50%) and is
ideal for clients with COPD who require precise oxygen delivery. Nonrebreather masks
deliver 80-95% oxygen .
7. A client with a spinal cord injury above T6 develops sudden severe headache,
diaphoresis, and hypertension. Which condition should the nurse suspect?
• A. Autonomic dysreflexia
• B. Spinal shock
• C. Neurogenic shock
• D. Septic shock
Answer: A
Rationale: Autonomic dysreflexia is an exaggerated sympathetic response to stimuli in
clients with spinal cord injuries at T6 or above. Manifestations include sudden significant
, rise in BP, bradycardia, severe headache, flushing, and diaphoresis. Complications
include stroke and organ damage .
8. A client is prescribed digoxin for heart failure. Which finding indicates toxicity?
• A. Visual disturbances and nausea
• B. Increased urine output
• C. Bradycardia with normal vision
• D. Weight gain
Answer: A
Rationale: Digoxin toxicity presents with anorexia, nausea, vomiting, visual disturbances
(yellow-green halos), and dysrhythmias. Therapeutic range is 0.5-0.8/2.0 ng/mL.
Potassium levels should be monitored as hypokalemia increases toxicity risk .
9. A nurse is caring for a client who has left-sided heart failure. Which assessment
finding is most consistent with this condition?
• A. Peripheral edema and ascites
• B. Jugular venous distention
• C. Dyspnea and pulmonary congestion
• D. Hepatomegaly
Answer: C
Rationale: Left-sided heart failure leads to pulmonary congestion, dyspnea, and
crackles. Right-sided failure results in peripheral edema, JVD, hepatomegaly, and ascites
(fluid backs up behind the failure—left in lungs, right in body) .
10. A client with diabetes mellitus is sick and unable to eat. Which instruction
should the nurse provide?
• A. "Hold your insulin until you can eat normally."
