ATI Adult Medical Surgical Nursing (CMS)
Exam Actual Questions and Answers With
Expert Explanation (2026/2027 Update) |
Complete A+ Guide
Question 1
A client with heart failure has crackles in all lung fields, jugular venous distention,
and 3+ pitting edema. Which medication should the nurse expect to administer
first?
A. Digoxin
B. Furosemide
C. Enalapril
D. Carvedilol
Correct Answer: B. Furosemide
Rationale: Furosemide (loop diuretic) reduces preload by promoting fluid excretion,
relieving pulmonary congestion and edema. This is the priority intervention for fluid
overload .
Question 2
A client on digoxin reports nausea, vomiting, and sees yellow halos around lights.
What is the priority nursing action?
A. Administer an antiemetic
B. Hold the digoxin and check serum digoxin level
C. Give the digoxin with food to reduce GI upset
D. Reassure the client this is a normal side effect
Correct Answer: B. Hold the digoxin and check serum digoxin level
,Rationale: Nausea, vomiting, and visual disturbances (yellow-green halos) are classic
signs of digoxin toxicity. The medication should be held, and the provider notified .
Question 3
A client with chronic heart failure reports a weight gain of 5 lbs in 3 days and
increased dyspnea. Which action should the nurse take first?
A. Restrict fluids
B. Administer PRN furosemide and notify provider
C. Increase oxygen
D. Place in Trendelenburg position
Correct Answer: B. Administer PRN furosemide and notify provider
Rationale: Weight gain of 2-3 lbs/day or 5 lbs/week indicates fluid overload. Administer
diuretic as prescribed and notify provider .
Question 4
A client with heart failure is prescribed furosemide. Which assessment finding
indicates the medication is effective?
A. Weight gain of 2 lbs in 24 hours
B. Clear lung sounds
C. Blood pressure 150/90 mmHg
D. 2+ pitting edema in lower extremities
Correct Answer: B. Clear lung sounds
Rationale: Clear lung sounds indicate decreased pulmonary congestion. Weight loss
(not gain), reduced edema, and controlled BP are also signs of effectiveness .
Question 5
,A client with angina is prescribed nitroglycerin sublingual. The nurse instructs the
client to take one tablet every 5 minutes for up to 3 doses. If chest pain is not
relieved after 3 doses, the client should:
A. Take two more tablets
B. Call 911 immediately
C. Lie down and rest
D. Take a warm shower
Correct Answer: B. Call 911 immediately
Rationale: Unrelieved chest pain after 3 nitroglycerin doses (over 15 minutes) warrants
emergency medical attention as it may indicate a myocardial infarction .
Question 6
A client with a history of deep vein thrombosis (DVT) is prescribed enoxaparin.
The nurse should administer this medication via which route?
A. Intravenous push
B. Subcutaneous injection in the abdomen
C. Intramuscular injection
D. Oral
Correct Answer: B. Subcutaneous injection in the abdomen
Rationale: Enoxaparin (low-molecular-weight heparin) is given subcutaneously in the
abdomen. Rotate sites and do not expel the air bubble .
Question 7
A client is receiving heparin IV. Which laboratory value is most important to
monitor?
A. aPTT
B. PT/INR
C. Platelet count
D. Hemoglobin and hematocrit
, Correct Answer: A. aPTT
Rationale: aPTT monitors heparin therapy effectiveness. Platelet count monitors for
heparin-induced thrombocytopenia (HIT), but aPTT is the primary therapeutic
monitoring parameter .
Question 8
A client with a mechanical heart valve is prescribed warfarin. The nurse instructs
the client to avoid:
A. Aspirin and NSAIDs
B. Acetaminophen
C. Vitamin C supplements
D. Calcium supplements
Correct Answer: A. Aspirin and NSAIDs
Rationale: Aspirin and NSAIDs increase bleeding risk when combined with warfarin.
Clients should avoid these medications unless prescribed by their provider .
Question 9
A client with infective endocarditis has petechiae, splinter hemorrhages, and Osler
nodes. The nurse should prioritize:
A. Pain management
B. Obtaining blood cultures before antibiotics
C. Administering antipyretics
D. Restricting fluids
Correct Answer: B. Obtaining blood cultures before antibiotics
Rationale: Blood cultures are essential to identify the causative organism before
initiating antibiotics. Empiric antibiotics are started after cultures are obtained .
Question 10
Exam Actual Questions and Answers With
Expert Explanation (2026/2027 Update) |
Complete A+ Guide
Question 1
A client with heart failure has crackles in all lung fields, jugular venous distention,
and 3+ pitting edema. Which medication should the nurse expect to administer
first?
A. Digoxin
B. Furosemide
C. Enalapril
D. Carvedilol
Correct Answer: B. Furosemide
Rationale: Furosemide (loop diuretic) reduces preload by promoting fluid excretion,
relieving pulmonary congestion and edema. This is the priority intervention for fluid
overload .
Question 2
A client on digoxin reports nausea, vomiting, and sees yellow halos around lights.
What is the priority nursing action?
A. Administer an antiemetic
B. Hold the digoxin and check serum digoxin level
C. Give the digoxin with food to reduce GI upset
D. Reassure the client this is a normal side effect
Correct Answer: B. Hold the digoxin and check serum digoxin level
,Rationale: Nausea, vomiting, and visual disturbances (yellow-green halos) are classic
signs of digoxin toxicity. The medication should be held, and the provider notified .
Question 3
A client with chronic heart failure reports a weight gain of 5 lbs in 3 days and
increased dyspnea. Which action should the nurse take first?
A. Restrict fluids
B. Administer PRN furosemide and notify provider
C. Increase oxygen
D. Place in Trendelenburg position
Correct Answer: B. Administer PRN furosemide and notify provider
Rationale: Weight gain of 2-3 lbs/day or 5 lbs/week indicates fluid overload. Administer
diuretic as prescribed and notify provider .
Question 4
A client with heart failure is prescribed furosemide. Which assessment finding
indicates the medication is effective?
A. Weight gain of 2 lbs in 24 hours
B. Clear lung sounds
C. Blood pressure 150/90 mmHg
D. 2+ pitting edema in lower extremities
Correct Answer: B. Clear lung sounds
Rationale: Clear lung sounds indicate decreased pulmonary congestion. Weight loss
(not gain), reduced edema, and controlled BP are also signs of effectiveness .
Question 5
,A client with angina is prescribed nitroglycerin sublingual. The nurse instructs the
client to take one tablet every 5 minutes for up to 3 doses. If chest pain is not
relieved after 3 doses, the client should:
A. Take two more tablets
B. Call 911 immediately
C. Lie down and rest
D. Take a warm shower
Correct Answer: B. Call 911 immediately
Rationale: Unrelieved chest pain after 3 nitroglycerin doses (over 15 minutes) warrants
emergency medical attention as it may indicate a myocardial infarction .
Question 6
A client with a history of deep vein thrombosis (DVT) is prescribed enoxaparin.
The nurse should administer this medication via which route?
A. Intravenous push
B. Subcutaneous injection in the abdomen
C. Intramuscular injection
D. Oral
Correct Answer: B. Subcutaneous injection in the abdomen
Rationale: Enoxaparin (low-molecular-weight heparin) is given subcutaneously in the
abdomen. Rotate sites and do not expel the air bubble .
Question 7
A client is receiving heparin IV. Which laboratory value is most important to
monitor?
A. aPTT
B. PT/INR
C. Platelet count
D. Hemoglobin and hematocrit
, Correct Answer: A. aPTT
Rationale: aPTT monitors heparin therapy effectiveness. Platelet count monitors for
heparin-induced thrombocytopenia (HIT), but aPTT is the primary therapeutic
monitoring parameter .
Question 8
A client with a mechanical heart valve is prescribed warfarin. The nurse instructs
the client to avoid:
A. Aspirin and NSAIDs
B. Acetaminophen
C. Vitamin C supplements
D. Calcium supplements
Correct Answer: A. Aspirin and NSAIDs
Rationale: Aspirin and NSAIDs increase bleeding risk when combined with warfarin.
Clients should avoid these medications unless prescribed by their provider .
Question 9
A client with infective endocarditis has petechiae, splinter hemorrhages, and Osler
nodes. The nurse should prioritize:
A. Pain management
B. Obtaining blood cultures before antibiotics
C. Administering antipyretics
D. Restricting fluids
Correct Answer: B. Obtaining blood cultures before antibiotics
Rationale: Blood cultures are essential to identify the causative organism before
initiating antibiotics. Empiric antibiotics are started after cultures are obtained .
Question 10
