ATI ADULT MEDICAL SURGICAL PROCTORED 2026 – EXAM-STYLE QUESTIONS
AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES
| GUARANTEED PASS | 2026/27 LATEST UPDATE | EXAM PREP | STUDY GUIDE |
PRACTICE TEST
1. A nurse is assessing a client who is 24 hours post-operative following a right-
sided thoracotomy. The client reports sharp pain that increases with inspiration
on the affected side. Which of the following findings should the nurse prioritize
for immediate intervention?
A. The client's oxygen saturation is 94% on 2 liters of oxygen via nasal cannula.
B. The client's respiratory rate is 18 breaths per minute and unlabored.
C. The client has decreased breath sounds on the right side and a tracheal shift to
the left.
D. The client is reluctant to deep breathe and cough due to pain.
Correct Answer: C. The client has decreased breath sounds on the right side and
a tracheal shift to the left.
Rationale: A tracheal shift away from the affected side (to the left in a right-sided
issue) combined with decreased breath sounds is a classic sign of a tension
pneumothorax. This is a life-threatening complication following thoracic surgery
that requires immediate needle decompression or chest tube insertion. Oxygen
saturation of 94% (A) is acceptable post-operatively but is not the priority over an
emergent, life-threatening finding. A respiratory rate of 18 (B) is within normal
limits and does not indicate immediate distress, though it is a positive sign. Pain
,with breathing (D) is an expected finding post-thoracotomy and, while important, is
a lower priority than addressing a potential tension pneumothorax.**
2. A nurse is providing discharge teaching to a client who has a new diagnosis
of heart failure. Which of the following statements by the client indicates an
understanding of the teaching?
A. "I should weigh myself once a week, in the morning after I eat."
B. "I can stop taking my diuretic if I feel dizzy."
C. "A 3-pound weight gain in a week is normal and not a concern."
D. "I will call my provider if I have a persistent cough that produces frothy
sputum."
Correct Answer: D. "I will call my provider if I have a persistent cough that
produces frothy sputum."
Rationale: A persistent cough with frothy sputum is a classic sign of acute
pulmonary edema, which can indicate worsening heart failure and requires
immediate medical attention. Clients with heart failure should weigh themselves
daily (A), not weekly, at the same time each morning before eating and after
voiding. Diuretics (B) are a cornerstone of heart failure management and should
not be stopped without a provider's instruction, even if dizziness is experienced, as
this could indicate electrolyte imbalance or dehydration. A weight gain of 3 pounds
in a week (C) is significant and indicates fluid retention; the provider should be
notified, as this can lead to worsening heart failure.**
,3. A nurse is caring for a client with acute pancreatitis. Which of the following
laboratory values should the nurse monitor as the best indicator of the client's
nutritional and metabolic status?
A. Serum amylase
B. Serum lipase
C. Blood glucose
D. Serum albumin
Correct Answer: D. Serum albumin
Rationale: Serum albumin is a key indicator of visceral protein status and
nutritional health. In acute pancreatitis, prolonged inflammation and catabolism
deplete protein stores, and a low albumin level correlates with increased morbidity
and mortality. Serum amylase (A) and lipase (B) are elevated in acute pancreatitis
but are diagnostic markers of pancreatic inflammation, not of ongoing nutritional
status. Blood glucose (C) is important to monitor due to the risk of pancreatic
endocrine dysfunction, but albumin is the more comprehensive indicator of
nutritional and metabolic status in this context.**
4. A nurse is preparing to administer a blood transfusion to a client who has
anemia. Which of the following actions should the nurse take first?
A. Verify the client's blood type and crossmatch with the blood unit.
B. Prime the administration set with 0.9% sodium chloride.
C. Obtain the client's vital signs.
D. Ask another nurse to confirm the client's identification.
, Correct Answer: A. Verify the client's blood type and crossmatch with the blood
unit.
Rationale: The first and most critical step in the blood transfusion process is to
verify that the blood product is compatible with the client. This involves a two-nurse
verification process checking the blood product against the client's identification
band and verifying the blood type and crossmatch compatibility. While priming the
tubing (B) and obtaining vital signs (C) are necessary steps, they occur after
verification. Asking another nurse (D) to confirm identification is part of the
verification process, but the primary action is to check the compatibility of the
blood product itself.**
5. A client with chronic obstructive pulmonary disease (COPD) is receiving
oxygen at 2 L/min via nasal cannula. The nurse observes the client's respiratory
rate has decreased to 8 breaths per minute. Which of the following actions
should the nurse take?
A. Increase the oxygen flow rate to 4 L/min.
B. Decrease the oxygen flow rate to 1 L/min.
C. Encourage the client to take deep breaths.
D. Place the client in the Trendelenburg position.
Correct Answer: B. Decrease the oxygen flow rate to 1 L/min.
Rationale: Clients with severe COPD often rely on a hypoxic drive to breathe. High
oxygen concentrations can suppress this drive, leading to respiratory depression
and carbon dioxide (CO2) retention. The nurse should decrease the oxygen flow rate
to maintain an oxygen saturation of 88-92% and address the respiratory
AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES
| GUARANTEED PASS | 2026/27 LATEST UPDATE | EXAM PREP | STUDY GUIDE |
PRACTICE TEST
1. A nurse is assessing a client who is 24 hours post-operative following a right-
sided thoracotomy. The client reports sharp pain that increases with inspiration
on the affected side. Which of the following findings should the nurse prioritize
for immediate intervention?
A. The client's oxygen saturation is 94% on 2 liters of oxygen via nasal cannula.
B. The client's respiratory rate is 18 breaths per minute and unlabored.
C. The client has decreased breath sounds on the right side and a tracheal shift to
the left.
D. The client is reluctant to deep breathe and cough due to pain.
Correct Answer: C. The client has decreased breath sounds on the right side and
a tracheal shift to the left.
Rationale: A tracheal shift away from the affected side (to the left in a right-sided
issue) combined with decreased breath sounds is a classic sign of a tension
pneumothorax. This is a life-threatening complication following thoracic surgery
that requires immediate needle decompression or chest tube insertion. Oxygen
saturation of 94% (A) is acceptable post-operatively but is not the priority over an
emergent, life-threatening finding. A respiratory rate of 18 (B) is within normal
limits and does not indicate immediate distress, though it is a positive sign. Pain
,with breathing (D) is an expected finding post-thoracotomy and, while important, is
a lower priority than addressing a potential tension pneumothorax.**
2. A nurse is providing discharge teaching to a client who has a new diagnosis
of heart failure. Which of the following statements by the client indicates an
understanding of the teaching?
A. "I should weigh myself once a week, in the morning after I eat."
B. "I can stop taking my diuretic if I feel dizzy."
C. "A 3-pound weight gain in a week is normal and not a concern."
D. "I will call my provider if I have a persistent cough that produces frothy
sputum."
Correct Answer: D. "I will call my provider if I have a persistent cough that
produces frothy sputum."
Rationale: A persistent cough with frothy sputum is a classic sign of acute
pulmonary edema, which can indicate worsening heart failure and requires
immediate medical attention. Clients with heart failure should weigh themselves
daily (A), not weekly, at the same time each morning before eating and after
voiding. Diuretics (B) are a cornerstone of heart failure management and should
not be stopped without a provider's instruction, even if dizziness is experienced, as
this could indicate electrolyte imbalance or dehydration. A weight gain of 3 pounds
in a week (C) is significant and indicates fluid retention; the provider should be
notified, as this can lead to worsening heart failure.**
,3. A nurse is caring for a client with acute pancreatitis. Which of the following
laboratory values should the nurse monitor as the best indicator of the client's
nutritional and metabolic status?
A. Serum amylase
B. Serum lipase
C. Blood glucose
D. Serum albumin
Correct Answer: D. Serum albumin
Rationale: Serum albumin is a key indicator of visceral protein status and
nutritional health. In acute pancreatitis, prolonged inflammation and catabolism
deplete protein stores, and a low albumin level correlates with increased morbidity
and mortality. Serum amylase (A) and lipase (B) are elevated in acute pancreatitis
but are diagnostic markers of pancreatic inflammation, not of ongoing nutritional
status. Blood glucose (C) is important to monitor due to the risk of pancreatic
endocrine dysfunction, but albumin is the more comprehensive indicator of
nutritional and metabolic status in this context.**
4. A nurse is preparing to administer a blood transfusion to a client who has
anemia. Which of the following actions should the nurse take first?
A. Verify the client's blood type and crossmatch with the blood unit.
B. Prime the administration set with 0.9% sodium chloride.
C. Obtain the client's vital signs.
D. Ask another nurse to confirm the client's identification.
, Correct Answer: A. Verify the client's blood type and crossmatch with the blood
unit.
Rationale: The first and most critical step in the blood transfusion process is to
verify that the blood product is compatible with the client. This involves a two-nurse
verification process checking the blood product against the client's identification
band and verifying the blood type and crossmatch compatibility. While priming the
tubing (B) and obtaining vital signs (C) are necessary steps, they occur after
verification. Asking another nurse (D) to confirm identification is part of the
verification process, but the primary action is to check the compatibility of the
blood product itself.**
5. A client with chronic obstructive pulmonary disease (COPD) is receiving
oxygen at 2 L/min via nasal cannula. The nurse observes the client's respiratory
rate has decreased to 8 breaths per minute. Which of the following actions
should the nurse take?
A. Increase the oxygen flow rate to 4 L/min.
B. Decrease the oxygen flow rate to 1 L/min.
C. Encourage the client to take deep breaths.
D. Place the client in the Trendelenburg position.
Correct Answer: B. Decrease the oxygen flow rate to 1 L/min.
Rationale: Clients with severe COPD often rely on a hypoxic drive to breathe. High
oxygen concentrations can suppress this drive, leading to respiratory depression
and carbon dioxide (CO2) retention. The nurse should decrease the oxygen flow rate
to maintain an oxygen saturation of 88-92% and address the respiratory
