ATI Med-Surge Proctored Exam 2026:
High-Yield Questions & Rationales to
Pass on Your First Attempt
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–
25)
Question 1
A nurse is caring for a client with heart failure who reports sudden weight gain, dyspnea,
and jugular vein distention. Which action should the nurse take FIRST?
A) Administer furosemide IV push
B) Place the client in high-Fowler's position
C) Increase oxygen to 4 L/min via nasal cannula
D) Notify the provider
Answer: B) Place the client in high-Fowler's position
Rationale: High-Fowler's position uses gravity to reduce venous return, decrease
preload, and improve ventilation, providing immediate relief of dyspnea. This is the
priority intervention before administering medications.
,Question 2
A client with heart failure is receiving furosemide (Lasix). Which laboratory value should
the nurse monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B) Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia is
a common and potentially dangerous adverse effect that can lead to cardiac
dysrhythmias.
Question 3
A client prescribed furosemide complains of muscle weakness and cramps. Which
laboratory value requires immediate attention?
A) Sodium 140 mEq/L
B) Potassium 2.8 mEq/L
C) Calcium 9.2 mg/dL
D) Magnesium 2.0 mEq/L
Answer: B) Potassium 2.8 mEq/L
Rationale: A potassium level of 2.8 mEq/L is severely low (normal 3.5–5.0 mEq/L) and
indicates hypokalemia. This can cause muscle cramps, weakness, and life-threatening
cardiac dysrhythmias.
,Question 4
A client with heart failure has a prescription for digoxin. Which finding indicates digoxin
toxicity?
A) Heart rate of 72 bpm
B) Nausea and yellow vision
C) Blood pressure of 140/90 mm Hg
D) Dry cough
Answer: B) Nausea and yellow vision
Rationale: Classic signs of digoxin toxicity include GI symptoms (nausea, vomiting,
anorexia) and visual disturbances (yellow or green halos, blurred vision). Bradycardia is
also a sign, but a heart rate of 72 bpm is normal.
Question 5
A nurse is assessing a client who is 6 hours postoperative following cardiac
catheterization via the femoral artery. Which finding requires immediate intervention?
A) Blood pressure 110/70 mm Hg
B) Heart rate 88 bpm
C) Pallor and coolness of the right foot
D) Small amount of serous drainage at the site
Answer: C) Pallor and coolness of the right foot
Rationale: Pallor and coolness of the extremity indicate arterial insufficiency, which
could be caused by a thrombus or hematoma at the catheterization site. This requires
immediate intervention to prevent tissue ischemia and loss of the limb.
, Question 6
A 68-year-old male with a history of hypertension and diabetes presents with substernal
chest pressure radiating to the left arm, diaphoresis, and nausea. What is the priority
nursing intervention?
A) Administer sublingual nitroglycerin
B) Obtain a 12-lead ECG
C) Administer aspirin 325 mg chewed
D) Prepare for percutaneous coronary intervention
Answer: C) Administer aspirin 325 mg chewed
Rationale: The patient is exhibiting signs of an acute myocardial infarction (MI). The
priority intervention is to administer aspirin 325 mg (chewed) as it reduces mortality by
inhibiting platelet aggregation. A 12-lead ECG is the next step to confirm diagnosis,
followed by nitroglycerin if not contraindicated. This order follows ACLS guidelines.
Question 7
A 72-year-old patient with chronic heart failure has worsening dyspnea on exertion,
orthopnea, and a cough with pink, frothy sputum. Which assessment finding is most
concerning?
A) Weight gain of 2 pounds in 24 hours
B) Jugular venous distension
C) Crackles in the lung bases
D) Oxygen saturation of 88% on room air
Answer: D) Oxygen saturation of 88% on room air
High-Yield Questions & Rationales to
Pass on Your First Attempt
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–
25)
Question 1
A nurse is caring for a client with heart failure who reports sudden weight gain, dyspnea,
and jugular vein distention. Which action should the nurse take FIRST?
A) Administer furosemide IV push
B) Place the client in high-Fowler's position
C) Increase oxygen to 4 L/min via nasal cannula
D) Notify the provider
Answer: B) Place the client in high-Fowler's position
Rationale: High-Fowler's position uses gravity to reduce venous return, decrease
preload, and improve ventilation, providing immediate relief of dyspnea. This is the
priority intervention before administering medications.
,Question 2
A client with heart failure is receiving furosemide (Lasix). Which laboratory value should
the nurse monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B) Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia is
a common and potentially dangerous adverse effect that can lead to cardiac
dysrhythmias.
Question 3
A client prescribed furosemide complains of muscle weakness and cramps. Which
laboratory value requires immediate attention?
A) Sodium 140 mEq/L
B) Potassium 2.8 mEq/L
C) Calcium 9.2 mg/dL
D) Magnesium 2.0 mEq/L
Answer: B) Potassium 2.8 mEq/L
Rationale: A potassium level of 2.8 mEq/L is severely low (normal 3.5–5.0 mEq/L) and
indicates hypokalemia. This can cause muscle cramps, weakness, and life-threatening
cardiac dysrhythmias.
,Question 4
A client with heart failure has a prescription for digoxin. Which finding indicates digoxin
toxicity?
A) Heart rate of 72 bpm
B) Nausea and yellow vision
C) Blood pressure of 140/90 mm Hg
D) Dry cough
Answer: B) Nausea and yellow vision
Rationale: Classic signs of digoxin toxicity include GI symptoms (nausea, vomiting,
anorexia) and visual disturbances (yellow or green halos, blurred vision). Bradycardia is
also a sign, but a heart rate of 72 bpm is normal.
Question 5
A nurse is assessing a client who is 6 hours postoperative following cardiac
catheterization via the femoral artery. Which finding requires immediate intervention?
A) Blood pressure 110/70 mm Hg
B) Heart rate 88 bpm
C) Pallor and coolness of the right foot
D) Small amount of serous drainage at the site
Answer: C) Pallor and coolness of the right foot
Rationale: Pallor and coolness of the extremity indicate arterial insufficiency, which
could be caused by a thrombus or hematoma at the catheterization site. This requires
immediate intervention to prevent tissue ischemia and loss of the limb.
, Question 6
A 68-year-old male with a history of hypertension and diabetes presents with substernal
chest pressure radiating to the left arm, diaphoresis, and nausea. What is the priority
nursing intervention?
A) Administer sublingual nitroglycerin
B) Obtain a 12-lead ECG
C) Administer aspirin 325 mg chewed
D) Prepare for percutaneous coronary intervention
Answer: C) Administer aspirin 325 mg chewed
Rationale: The patient is exhibiting signs of an acute myocardial infarction (MI). The
priority intervention is to administer aspirin 325 mg (chewed) as it reduces mortality by
inhibiting platelet aggregation. A 12-lead ECG is the next step to confirm diagnosis,
followed by nitroglycerin if not contraindicated. This order follows ACLS guidelines.
Question 7
A 72-year-old patient with chronic heart failure has worsening dyspnea on exertion,
orthopnea, and a cough with pink, frothy sputum. Which assessment finding is most
concerning?
A) Weight gain of 2 pounds in 24 hours
B) Jugular venous distension
C) Crackles in the lung bases
D) Oxygen saturation of 88% on room air
Answer: D) Oxygen saturation of 88% on room air
