ATI MED-SURG PROCTORED EXAM TEST
BANK 2026/2027 COMPLETE 250
QUESTIONS AND ANSWERS WITH VERIFIED
RATIONALES | GRADED A+ | 2026 UPDATE |
100% VERIFIED SOLUTIONS
EXAM STRUCTURE OVERVIEW
Content Area Approximate Percentage
Cardiovascular 16%
Respiratory 14%
Gastrointestinal 12%
Renal/Urinary 10%
Endocrine 10%
Neurological 8%
Musculoskeletal 8%
Immune/Oncology 6%
Perioperative 6%
,Content Area Approximate Percentage
Fluids/Electrolytes 5%
Other (Pain, Safety, CMS) 5%
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–40)
Question 1
A 68-year-old male with a history of hypertension and diabetes presents with substernal
chest pressure radiating to the left arm, accompanied by 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
Correct 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 the diagnosis,
followed by nitroglycerin if not contraindicated. This order follows ACLS guidelines .
Question 2
A 72-year-old patient with chronic heart failure is experiencing 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
Correct Answer: D) Oxygen saturation of 88% on room air
Rationale: An oxygen saturation of 88% indicates significant hypoxemia and is the most
concerning finding, requiring immediate intervention. While weight gain, JVD, and
crackles are signs of fluid overload, hypoxemia represents an immediate threat to tissue
perfusion .
Question 3
A client with acute heart failure presents with severe dyspnea, pink frothy sputum, and
crackles bilaterally throughout all lung fields. Which initial nursing action is the priority?
A) Place the client in a high-Fowler's position with legs dangling
B) Encourage incentive spirometry to expand lung volume
C) Administer oral beta-blockers as prescribed
D) Prepare the client for immediate continuous ambulatory peritoneal dialysis
Correct Answer: A) Place the client in a high-Fowler's position with legs dangling
Rationale: Acute decompensated heart failure with pulmonary edema requires immediate
measures to reduce venous return (preload) to the heart. Placing the client in a high-
Fowler's position with legs dependent decreases venous return from the lower extremities,
lessening pulmonary congestion and improving oxygenation .
Question 4
A patient with hypertension is prescribed lisinopril (Prinivil, Zestril). Which adverse effect
should the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Tachycardia
D) Weight gain
Correct Answer: A) Hyperkalemia
, Rationale: ACE inhibitors (lisinopril, enalapril) can cause hyperkalemia by reducing
aldosterone secretion. Serum potassium should be monitored, especially in patients with
renal impairment or those taking potassium supplements or potassium-sparing diuretics .
Question 5
A patient with chronic heart failure is prescribed furosemide (Lasix). Which laboratory
value should the nurse monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: B) Serum potassium
Rationale: Furosemide is a potent loop diuretic that inhibits sodium and chloride
reabsorption in the ascending loop of Henle, leading to significant excretion of water,
sodium, and potassium. Hypokalemia is a common adverse effect requiring close
monitoring .
Question 6
A patient with deep vein thrombosis (DVT) is started on heparin therapy. Which
laboratory value is critical to monitor?
A) PT (Prothrombin Time)
B) aPTT (Activated Partial Thromboplastin Time)
C) INR (International Normalized Ratio)
D) Platelet count
Correct Answer: B) aPTT
Rationale: Heparin therapy is monitored via aPTT to prevent bleeding complications. The
therapeutic range is typically 1.5–2.5 times the control value. PT/INR is used to monitor
warfarin therapy .
BANK 2026/2027 COMPLETE 250
QUESTIONS AND ANSWERS WITH VERIFIED
RATIONALES | GRADED A+ | 2026 UPDATE |
100% VERIFIED SOLUTIONS
EXAM STRUCTURE OVERVIEW
Content Area Approximate Percentage
Cardiovascular 16%
Respiratory 14%
Gastrointestinal 12%
Renal/Urinary 10%
Endocrine 10%
Neurological 8%
Musculoskeletal 8%
Immune/Oncology 6%
Perioperative 6%
,Content Area Approximate Percentage
Fluids/Electrolytes 5%
Other (Pain, Safety, CMS) 5%
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1–40)
Question 1
A 68-year-old male with a history of hypertension and diabetes presents with substernal
chest pressure radiating to the left arm, accompanied by 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
Correct 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 the diagnosis,
followed by nitroglycerin if not contraindicated. This order follows ACLS guidelines .
Question 2
A 72-year-old patient with chronic heart failure is experiencing 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
Correct Answer: D) Oxygen saturation of 88% on room air
Rationale: An oxygen saturation of 88% indicates significant hypoxemia and is the most
concerning finding, requiring immediate intervention. While weight gain, JVD, and
crackles are signs of fluid overload, hypoxemia represents an immediate threat to tissue
perfusion .
Question 3
A client with acute heart failure presents with severe dyspnea, pink frothy sputum, and
crackles bilaterally throughout all lung fields. Which initial nursing action is the priority?
A) Place the client in a high-Fowler's position with legs dangling
B) Encourage incentive spirometry to expand lung volume
C) Administer oral beta-blockers as prescribed
D) Prepare the client for immediate continuous ambulatory peritoneal dialysis
Correct Answer: A) Place the client in a high-Fowler's position with legs dangling
Rationale: Acute decompensated heart failure with pulmonary edema requires immediate
measures to reduce venous return (preload) to the heart. Placing the client in a high-
Fowler's position with legs dependent decreases venous return from the lower extremities,
lessening pulmonary congestion and improving oxygenation .
Question 4
A patient with hypertension is prescribed lisinopril (Prinivil, Zestril). Which adverse effect
should the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Tachycardia
D) Weight gain
Correct Answer: A) Hyperkalemia
, Rationale: ACE inhibitors (lisinopril, enalapril) can cause hyperkalemia by reducing
aldosterone secretion. Serum potassium should be monitored, especially in patients with
renal impairment or those taking potassium supplements or potassium-sparing diuretics .
Question 5
A patient with chronic heart failure is prescribed furosemide (Lasix). Which laboratory
value should the nurse monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: B) Serum potassium
Rationale: Furosemide is a potent loop diuretic that inhibits sodium and chloride
reabsorption in the ascending loop of Henle, leading to significant excretion of water,
sodium, and potassium. Hypokalemia is a common adverse effect requiring close
monitoring .
Question 6
A patient with deep vein thrombosis (DVT) is started on heparin therapy. Which
laboratory value is critical to monitor?
A) PT (Prothrombin Time)
B) aPTT (Activated Partial Thromboplastin Time)
C) INR (International Normalized Ratio)
D) Platelet count
Correct Answer: B) aPTT
Rationale: Heparin therapy is monitored via aPTT to prevent bleeding complications. The
therapeutic range is typically 1.5–2.5 times the control value. PT/INR is used to monitor
warfarin therapy .
