ATI Adult Medical-Surgical Nursing (CMS)
Practice Exam Questions and Answers
with Rationales Latest Version
Question 1
A nurse is caring for a client admitted with heart failure who reports
increasing shortness of breath. Which assessment finding requires
immediate intervention?
A. Bilateral ankle edema 2+
B. Weight gain of 1 kg (2.2 lb) in 24 hr
C. Oxygen saturation of 86% on room air
D. Jugular vein distention at 45 degrees
Correct Answer: C. Oxygen saturation of 86% on room air
Expert Explanation
An oxygen saturation of 86% indicates significant hypoxemia requiring
immediate intervention. The priority is to improve oxygenation by
administering oxygen, positioning the client in High Fowler's position,
and notifying the provider if necessary.
Why the other answers are incorrect:
• A: Peripheral edema is expected in heart failure but is not
immediately life-threatening.
• B: Rapid weight gain indicates fluid retention but is less urgent
than hypoxemia.
• D: Jugular venous distention reflects fluid overload but is not the
highest priority.
ATI Tip: Apply ABCs (Airway, Breathing, Circulation). Impaired
oxygenation always takes priority.
,Question 2
A client with diabetic ketoacidosis (DKA) is receiving regular insulin by
continuous IV infusion. Which laboratory value indicates the treatment
is effective?
A. Serum glucose decreases from 520 mg/dL to 210 mg/dL
B. Urine specific gravity increases
C. Serum potassium rises to 6.0 mEq/L
D. Arterial pH decreases to 7.18
Correct Answer: A. Serum glucose decreases from 520 mg/dL to 210
mg/dL
Expert Explanation
A decreasing blood glucose level is an expected therapeutic response to
insulin therapy. Improvement should also include correction of acidosis
and normalization of electrolytes.
Incorrect Answers
• B: Increased urine concentration suggests dehydration.
• C: Hyperkalemia is dangerous and not a desired outcome.
• D: Worsening acidosis indicates ineffective treatment.
Question 3
A nurse is caring for a client receiving heparin therapy. Which
laboratory test should the nurse monitor?
A. INR
B. Platelet count and aPTT
,C. Hemoglobin A1C
D. Creatinine kinase
Correct Answer: B. Platelet count and aPTT
Expert Explanation
Heparin effectiveness is monitored using the activated partial
thromboplastin time (aPTT). Platelet counts should also be monitored
because heparin can cause heparin-induced thrombocytopenia (HIT).
Question 4
A nurse is teaching a client with chronic kidney disease about dietary
restrictions. Which food should the nurse instruct the client to avoid?
A. Apples
B. White rice
C. Bananas
D. Cauliflower
Correct Answer: C. Bananas
Expert Explanation
Bananas are high in potassium. Clients with chronic kidney disease often
have impaired potassium excretion, placing them at risk for life-
threatening hyperkalemia.
Question 5
A nurse is caring for a client 12 hours after thyroidectomy. Which
assessment finding requires immediate intervention?
, A. Hoarseness
B. Pain rated 5/10
C. Tingling around the mouth
D. Mild incisional swelling
Correct Answer: C. Tingling around the mouth
Expert Explanation
Perioral tingling is an early sign of hypocalcemia caused by accidental
removal or injury to the parathyroid glands. Untreated hypocalcemia can
progress to tetany and airway compromise.
Question 6
A nurse is assessing a client with suspected pulmonary embolism.
Which finding is most characteristic?
A. Bradycardia
B. Sudden dyspnea and pleuritic chest pain
C. Productive cough with thick sputum
D. Bilateral leg paralysis
Correct Answer: B. Sudden dyspnea and pleuritic chest pain
Expert Explanation
Pulmonary embolism typically presents with sudden shortness of breath,
pleuritic chest pain, tachycardia, anxiety, and hypoxemia.
Question 7
A client with liver cirrhosis develops confusion and asterixis. Which
medication should the nurse anticipate administering?
Practice Exam Questions and Answers
with Rationales Latest Version
Question 1
A nurse is caring for a client admitted with heart failure who reports
increasing shortness of breath. Which assessment finding requires
immediate intervention?
A. Bilateral ankle edema 2+
B. Weight gain of 1 kg (2.2 lb) in 24 hr
C. Oxygen saturation of 86% on room air
D. Jugular vein distention at 45 degrees
Correct Answer: C. Oxygen saturation of 86% on room air
Expert Explanation
An oxygen saturation of 86% indicates significant hypoxemia requiring
immediate intervention. The priority is to improve oxygenation by
administering oxygen, positioning the client in High Fowler's position,
and notifying the provider if necessary.
Why the other answers are incorrect:
• A: Peripheral edema is expected in heart failure but is not
immediately life-threatening.
• B: Rapid weight gain indicates fluid retention but is less urgent
than hypoxemia.
• D: Jugular venous distention reflects fluid overload but is not the
highest priority.
ATI Tip: Apply ABCs (Airway, Breathing, Circulation). Impaired
oxygenation always takes priority.
,Question 2
A client with diabetic ketoacidosis (DKA) is receiving regular insulin by
continuous IV infusion. Which laboratory value indicates the treatment
is effective?
A. Serum glucose decreases from 520 mg/dL to 210 mg/dL
B. Urine specific gravity increases
C. Serum potassium rises to 6.0 mEq/L
D. Arterial pH decreases to 7.18
Correct Answer: A. Serum glucose decreases from 520 mg/dL to 210
mg/dL
Expert Explanation
A decreasing blood glucose level is an expected therapeutic response to
insulin therapy. Improvement should also include correction of acidosis
and normalization of electrolytes.
Incorrect Answers
• B: Increased urine concentration suggests dehydration.
• C: Hyperkalemia is dangerous and not a desired outcome.
• D: Worsening acidosis indicates ineffective treatment.
Question 3
A nurse is caring for a client receiving heparin therapy. Which
laboratory test should the nurse monitor?
A. INR
B. Platelet count and aPTT
,C. Hemoglobin A1C
D. Creatinine kinase
Correct Answer: B. Platelet count and aPTT
Expert Explanation
Heparin effectiveness is monitored using the activated partial
thromboplastin time (aPTT). Platelet counts should also be monitored
because heparin can cause heparin-induced thrombocytopenia (HIT).
Question 4
A nurse is teaching a client with chronic kidney disease about dietary
restrictions. Which food should the nurse instruct the client to avoid?
A. Apples
B. White rice
C. Bananas
D. Cauliflower
Correct Answer: C. Bananas
Expert Explanation
Bananas are high in potassium. Clients with chronic kidney disease often
have impaired potassium excretion, placing them at risk for life-
threatening hyperkalemia.
Question 5
A nurse is caring for a client 12 hours after thyroidectomy. Which
assessment finding requires immediate intervention?
, A. Hoarseness
B. Pain rated 5/10
C. Tingling around the mouth
D. Mild incisional swelling
Correct Answer: C. Tingling around the mouth
Expert Explanation
Perioral tingling is an early sign of hypocalcemia caused by accidental
removal or injury to the parathyroid glands. Untreated hypocalcemia can
progress to tetany and airway compromise.
Question 6
A nurse is assessing a client with suspected pulmonary embolism.
Which finding is most characteristic?
A. Bradycardia
B. Sudden dyspnea and pleuritic chest pain
C. Productive cough with thick sputum
D. Bilateral leg paralysis
Correct Answer: B. Sudden dyspnea and pleuritic chest pain
Expert Explanation
Pulmonary embolism typically presents with sudden shortness of breath,
pleuritic chest pain, tachycardia, anxiety, and hypoxemia.
Question 7
A client with liver cirrhosis develops confusion and asterixis. Which
medication should the nurse anticipate administering?
