ATI MED SURG PROCTORED EXAM 2026 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% VERIFIED
SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+...
Core Domains
Cardiovascular and Hematological Disorders
Respiratory Disorders and Acid-Base Imbalances
Neurological and Sensory Disorders
Gastrointestinal, Hepatic, and Renal Disorders
Endocrine and Metabolic Disorders
Musculoskeletal and Integumentary Disorders
Perioperative Nursing Care and Emergency Nursing
Oncology and Immunology
Fluid, Electrolyte, and Hemodynamic Monitoring
Professional Practice, Ethical-Legal Principles, and Patient Safety
Introduction
This comprehensive assessment evaluates the clinical judgment and foundational nursing knowledge required for
the ATI Medical-Surgical Nursing Proctored Examination. The test assesses the candidate's ability to provide safe,
competent, and evidence-based care to adult clients experiencing complex acute and chronic health conditions.
Using a rigorous multiple-choice and scenario-based format, this examination challenges the learner to apply the
nursing process, prioritize interventions, delegate tasks appropriately, and evaluate client outcomes. Success
requires proficiency in critical thinking, pathophysiology, pharmacology, and therapeutic communication, ensuring
,readiness to meet the demands of professional medical-surgical nursing practice in a dynamic clinical
environment.
SECTION ONE: Questions 1–100
Question 1
A nurse is caring for a client who is 1 day postoperative following a total hip arthroplasty. The client has a
closed-wound suction drain (Jackson-Pratt) in place. Which action should the nurse take to maintain proper
drain function?
A. Keep the drain tubing straight and avoid coiling it.
B. Empty the drain bulb when it is half full and re-establish the negative pressure by compressing the bulb and
closing the port.
C. Irrigate the drain with 10 mL of normal saline every shift to keep it patent.
D. Milk clots from the tubing toward the insertion site.
🟢 Correct Answer:
B
🔴 RATIONALE:
A Jackson-Pratt (JP) drain operates on negative pressure (suction). To function correctly, the compressible bulb
must be maintained in a collapsed state. The nurse should empty the bulb when it is approximately half full,
cleanse the port, fully compress the bulb, and then recap the port to re-establish the closed suction system.
Coiling the tubing does not affect suction. Nurses do not routinely irrigate closed-wound surgical drains
without a specific provider order, as it introduces an infection risk. Milking clots should be done gently away
from the insertion site, not toward it.
,Question 2
A nurse in a telemetry unit is reviewing the monitor strip of a client. The rhythm shows a P wave preceding
every QRS complex, a consistent PR interval of 0.20 seconds, and a QRS duration of 0.08 seconds. The rate is 45
bpm. How should the nurse document this rhythm?
A. Normal sinus rhythm
B. Sinus bradycardia
C. First-degree atrioventricular block
D. Sinus arrhythmia
🟢 Correct Answer:
B
🔴 RATIONALE:
The defining characteristics of this rhythm are a regular rate of 45 beats per minute with a normal P wave for
every QRS complex and a normal PR interval and QRS duration. Sinus bradycardia is defined as a sinus rhythm
with a rate of less than 60 bpm. A first-degree AV block would show a prolonged, constant PR interval greater
than 0.20 seconds. The PR interval here is 0.20 seconds, which is the upper limit of normal but not prolonged,
making bradycardia the primary finding.
Question 3
A client admitted with deep vein thrombosis (DVT) is receiving a continuous intravenous heparin infusion. The
nurse notes the client's latest aPTT result is 95 seconds. The control aPTT is 30 seconds. What is the priority
nursing action?
A. Increase the heparin infusion rate as per the facility protocol.
B. Stop the heparin infusion immediately and notify the healthcare provider.
C. Continue the infusion at the current rate and recheck the aPTT in 4 hours.
D. Administer protamine sulfate intravenously.
, 🟢 Correct Answer:
B
🔴 RATIONALE:
The therapeutic range for aPTT in heparin therapy is typically 1.5 to 2.5 times the control value. The control is 30
seconds, making the therapeutic range 45 to 75 seconds. An aPTT of 95 seconds is significantly
supratherapeutic and places the client at high risk for spontaneous bleeding. The priority action is to stop the
infusion to prevent further administration of heparin. The nurse should then notify the provider immediately.
Protamine sulfate is the antidote for heparin, but stopping the infusion is the immediate nursing action before
administering an antidote, which requires a provider order.
Question 4
A nurse is providing discharge teaching to a client who has a new diagnosis of Meniere's disease. Which
instruction should the nurse include to help the client manage the symptoms?
A. "Drink at least 3 liters of fluid daily."
B. "Limit your intake of foods high in sodium."
C. "Perform the Valsalva maneuver daily."
D. "Increase your dietary protein intake."
🟢 Correct Answer:
B
🔴 RATIONALE:
Meniere's disease is an inner ear disorder characterized by episodes of vertigo, tinnitus, and sensorineural
hearing loss. The pathophysiology involves an excess of endolymphatic fluid (endolymphatic hydrops).
Management focuses on reducing this fluid volume. A low-sodium diet is the cornerstone of nonpharmacologic
treatment because decreasing sodium intake helps reduce fluid retention in the inner ear. High fluid intake is
SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+...
Core Domains
Cardiovascular and Hematological Disorders
Respiratory Disorders and Acid-Base Imbalances
Neurological and Sensory Disorders
Gastrointestinal, Hepatic, and Renal Disorders
Endocrine and Metabolic Disorders
Musculoskeletal and Integumentary Disorders
Perioperative Nursing Care and Emergency Nursing
Oncology and Immunology
Fluid, Electrolyte, and Hemodynamic Monitoring
Professional Practice, Ethical-Legal Principles, and Patient Safety
Introduction
This comprehensive assessment evaluates the clinical judgment and foundational nursing knowledge required for
the ATI Medical-Surgical Nursing Proctored Examination. The test assesses the candidate's ability to provide safe,
competent, and evidence-based care to adult clients experiencing complex acute and chronic health conditions.
Using a rigorous multiple-choice and scenario-based format, this examination challenges the learner to apply the
nursing process, prioritize interventions, delegate tasks appropriately, and evaluate client outcomes. Success
requires proficiency in critical thinking, pathophysiology, pharmacology, and therapeutic communication, ensuring
,readiness to meet the demands of professional medical-surgical nursing practice in a dynamic clinical
environment.
SECTION ONE: Questions 1–100
Question 1
A nurse is caring for a client who is 1 day postoperative following a total hip arthroplasty. The client has a
closed-wound suction drain (Jackson-Pratt) in place. Which action should the nurse take to maintain proper
drain function?
A. Keep the drain tubing straight and avoid coiling it.
B. Empty the drain bulb when it is half full and re-establish the negative pressure by compressing the bulb and
closing the port.
C. Irrigate the drain with 10 mL of normal saline every shift to keep it patent.
D. Milk clots from the tubing toward the insertion site.
🟢 Correct Answer:
B
🔴 RATIONALE:
A Jackson-Pratt (JP) drain operates on negative pressure (suction). To function correctly, the compressible bulb
must be maintained in a collapsed state. The nurse should empty the bulb when it is approximately half full,
cleanse the port, fully compress the bulb, and then recap the port to re-establish the closed suction system.
Coiling the tubing does not affect suction. Nurses do not routinely irrigate closed-wound surgical drains
without a specific provider order, as it introduces an infection risk. Milking clots should be done gently away
from the insertion site, not toward it.
,Question 2
A nurse in a telemetry unit is reviewing the monitor strip of a client. The rhythm shows a P wave preceding
every QRS complex, a consistent PR interval of 0.20 seconds, and a QRS duration of 0.08 seconds. The rate is 45
bpm. How should the nurse document this rhythm?
A. Normal sinus rhythm
B. Sinus bradycardia
C. First-degree atrioventricular block
D. Sinus arrhythmia
🟢 Correct Answer:
B
🔴 RATIONALE:
The defining characteristics of this rhythm are a regular rate of 45 beats per minute with a normal P wave for
every QRS complex and a normal PR interval and QRS duration. Sinus bradycardia is defined as a sinus rhythm
with a rate of less than 60 bpm. A first-degree AV block would show a prolonged, constant PR interval greater
than 0.20 seconds. The PR interval here is 0.20 seconds, which is the upper limit of normal but not prolonged,
making bradycardia the primary finding.
Question 3
A client admitted with deep vein thrombosis (DVT) is receiving a continuous intravenous heparin infusion. The
nurse notes the client's latest aPTT result is 95 seconds. The control aPTT is 30 seconds. What is the priority
nursing action?
A. Increase the heparin infusion rate as per the facility protocol.
B. Stop the heparin infusion immediately and notify the healthcare provider.
C. Continue the infusion at the current rate and recheck the aPTT in 4 hours.
D. Administer protamine sulfate intravenously.
, 🟢 Correct Answer:
B
🔴 RATIONALE:
The therapeutic range for aPTT in heparin therapy is typically 1.5 to 2.5 times the control value. The control is 30
seconds, making the therapeutic range 45 to 75 seconds. An aPTT of 95 seconds is significantly
supratherapeutic and places the client at high risk for spontaneous bleeding. The priority action is to stop the
infusion to prevent further administration of heparin. The nurse should then notify the provider immediately.
Protamine sulfate is the antidote for heparin, but stopping the infusion is the immediate nursing action before
administering an antidote, which requires a provider order.
Question 4
A nurse is providing discharge teaching to a client who has a new diagnosis of Meniere's disease. Which
instruction should the nurse include to help the client manage the symptoms?
A. "Drink at least 3 liters of fluid daily."
B. "Limit your intake of foods high in sodium."
C. "Perform the Valsalva maneuver daily."
D. "Increase your dietary protein intake."
🟢 Correct Answer:
B
🔴 RATIONALE:
Meniere's disease is an inner ear disorder characterized by episodes of vertigo, tinnitus, and sensorineural
hearing loss. The pathophysiology involves an excess of endolymphatic fluid (endolymphatic hydrops).
Management focuses on reducing this fluid volume. A low-sodium diet is the cornerstone of nonpharmacologic
treatment because decreasing sodium intake helps reduce fluid retention in the inner ear. High fluid intake is
