RN VATI ADULT MEDICAL
SURGICAL ASSESSMENT EXAM
ACTUAL 2026/2027 - COMPLETE
LATEST MOCK PRACTICE SET
183 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
RN VATI ADULT MEDICAL SURGICAL ASSESSMENT EXAM ACTUAL 2026/2027 - COMPLETE EXAM-STYLE
QUESTIONS | 100% VERIFIED - PASS GUARANTEED - A+ GRADED. It contains 183 carefully selected
questions that reflect the most current exam content and testing strategies. Each question is accompanied by a
correct answer and a detailed rationale that explains the underlying pathophysiology, pharmacology, or clinical
reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 183 Questions
Foundations - Application - RN VATI Adult Medical Surgical Assessment Actual 2026/2027 Complete -style
100 PASS Guaranteed A Adult Medical-surgical Nursing Undergraduate YEAR 4 / Graduate Rn-bsn OR
Entry-level Master S
All answers with rationales
,Table of Contents
Section A - Acute Section B - Finding
Questions 1 to 46 Questions 47 to 92
Section C - Appropriate Section D - Intervention
Questions 93 to 138 Questions 139 to 183
,Section A - Acute
Q1.
A patient with septic shock has a mean arterial pressure (MAP) of 58 mm Hg despite fluid
resuscitation. The provider orders norepinephrine and dobutamine. The nurse notes a
cardiac index (CI) of 2.1 L/min/m² and a systemic vascular resistance (SVR) of 900
dynes-sec-cm. Which hemodynamic profile is consistent with these findings, and what is
the primary rationale for combining these agents?
A. Hyperdynamic sepsis with high CI and B. Hypodynamic sepsis with low CI and low
low SVR; norepinephrine increases SVR SVR; norepinephrine improves contractility
while dobutamine reduces afterload. while dobutamine raises SVR.
C. Hypodynamic sepsis with low CI and D. Cardiogenic shock with low CI and high
relatively low SVR; norepinephrine raises SVR; norepinephrine reduces afterload
SVR while dobutamine augments cardiac while dobutamine increases contractility.
output.
Correct: C - Hypodynamic sepsis with low CI and relatively low SVR; norepinephrine
raises SVR while dobutamine augments cardiac output.
Rationale:The patient has low CI and low/normal SVR, indicating distributive shock with
myocardial depression. Norepinephrine primarily increases SVR (vasopressor), while
dobutamine increases cardiac contractility (inotrope), so the combination addresses both
hypotension and low cardiac output. Option A describes hyperdynamic sepsis, which is not
present. Option B reverses the actions of the drugs. Option D describes cardiogenic shock
with high SVR, which is not the profile.
Q2.
A patient with chronic kidney disease (CKD) stage 4 is scheduled for an elective coronary
angiography. The provider orders intravenous sodium bicarbonate, N-acetylcysteine, and
holds metformin. Which pathophysiological mechanism best explains the rationale for
these orders?
A. To prevent contrast-induced nephropathy B. To correct pre-existing metabolic alkalosis
by reducing reactive oxygen species and and enhance renal excretion of contrast
renal vasoconstriction. media.
C. To reduce the risk of lactic acidosis from D. To increase renal blood flow by inhibiting
metformin and alkalinize urine to prevent tubuloglomerular feedback and dilating
contrast precipitation. afferent arterioles.
Correct: A - To prevent contrast-induced nephropathy by reducing reactive oxygen
species and renal vasoconstriction.
Page 3
, Section A - Acute
Rationale: Contrast-induced nephropathy (CIN) is a major risk in CKD. N-acetylcysteine acts
as an antioxidant and vasodilator, while sodium bicarbonate reduces oxidative stress and
tubular injury; both aim to prevent CIN. Metformin is withheld due to risk of lactic acidosis if
renal function deteriorates. Option B is incorrect because CKD typically causes metabolic
acidosis, not alkalosis. Option C mischaracterizes the role of sodium bicarbonate (it does not
prevent precipitation). Option D is not the primary mechanism of these agents.
Q3.
A patient in the intensive care unit develops acute respiratory distress syndrome (ARDS).
The provider sets a tidal volume of 6 mL/kg of predicted body weight and a plateau
pressure limit of 30 cm HO. The nurse notes a plateau pressure of 34 cm HO. Which action
is most appropriate?
A. Increase the respiratory rate to maintain B. Decrease tidal volume by 1 mL/kg
minute ventilation and accept the elevated increments to achieve plateau pressure 30
plateau pressure. cm HO.
C. Switch to pressure-controlled ventilation D. Administer a neuromuscular blocking
to reduce plateau pressure without changing agent to improve chest wall compliance and
tidal volume. reduce plateau pressure.
Correct: B - Decrease tidal volume by 1 mL/kg increments to achieve plateau pressure 30
cm HO.
Rationale:Lung-protective ventilation in ARDS mandates limiting plateau pressure to "d30 cm
HO to prevent ventilator-induced lung injury. If plateau pressure exceeds this, the priority is to
reduce tidal volume (even to 4-6 mL/kg PBW) per ARDSNet protocols. Increasing respiratory
rate may help minute ventilation but does not address the high plateau pressure.
Pressure-controlled ventilation may or may not reduce plateau pressure depending on
compliance. Neuromuscular blockers can improve oxygenation but are not the first-line
response to elevated plateau pressure.
Q4.
A patient with acute pancreatitis develops sudden worsening of respiratory distress,
jugular venous distension, and muffled heart sounds. Blood pressure drops to 80/50 mm
Hg. Which intervention is the priority?
A. Immediate pericardiocentesis or B. Rapid infusion of isotonic crystalloids to
pericardial window. maintain preload.
C. Administration of inotropic support with D. Endotracheal intubation and mechanical
norepinephrine. ventilation.
Correct: A - Immediate pericardiocentesis or pericardial window.
Page 4
SURGICAL ASSESSMENT EXAM
ACTUAL 2026/2027 - COMPLETE
LATEST MOCK PRACTICE SET
183 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
RN VATI ADULT MEDICAL SURGICAL ASSESSMENT EXAM ACTUAL 2026/2027 - COMPLETE EXAM-STYLE
QUESTIONS | 100% VERIFIED - PASS GUARANTEED - A+ GRADED. It contains 183 carefully selected
questions that reflect the most current exam content and testing strategies. Each question is accompanied by a
correct answer and a detailed rationale that explains the underlying pathophysiology, pharmacology, or clinical
reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 183 Questions
Foundations - Application - RN VATI Adult Medical Surgical Assessment Actual 2026/2027 Complete -style
100 PASS Guaranteed A Adult Medical-surgical Nursing Undergraduate YEAR 4 / Graduate Rn-bsn OR
Entry-level Master S
All answers with rationales
,Table of Contents
Section A - Acute Section B - Finding
Questions 1 to 46 Questions 47 to 92
Section C - Appropriate Section D - Intervention
Questions 93 to 138 Questions 139 to 183
,Section A - Acute
Q1.
A patient with septic shock has a mean arterial pressure (MAP) of 58 mm Hg despite fluid
resuscitation. The provider orders norepinephrine and dobutamine. The nurse notes a
cardiac index (CI) of 2.1 L/min/m² and a systemic vascular resistance (SVR) of 900
dynes-sec-cm. Which hemodynamic profile is consistent with these findings, and what is
the primary rationale for combining these agents?
A. Hyperdynamic sepsis with high CI and B. Hypodynamic sepsis with low CI and low
low SVR; norepinephrine increases SVR SVR; norepinephrine improves contractility
while dobutamine reduces afterload. while dobutamine raises SVR.
C. Hypodynamic sepsis with low CI and D. Cardiogenic shock with low CI and high
relatively low SVR; norepinephrine raises SVR; norepinephrine reduces afterload
SVR while dobutamine augments cardiac while dobutamine increases contractility.
output.
Correct: C - Hypodynamic sepsis with low CI and relatively low SVR; norepinephrine
raises SVR while dobutamine augments cardiac output.
Rationale:The patient has low CI and low/normal SVR, indicating distributive shock with
myocardial depression. Norepinephrine primarily increases SVR (vasopressor), while
dobutamine increases cardiac contractility (inotrope), so the combination addresses both
hypotension and low cardiac output. Option A describes hyperdynamic sepsis, which is not
present. Option B reverses the actions of the drugs. Option D describes cardiogenic shock
with high SVR, which is not the profile.
Q2.
A patient with chronic kidney disease (CKD) stage 4 is scheduled for an elective coronary
angiography. The provider orders intravenous sodium bicarbonate, N-acetylcysteine, and
holds metformin. Which pathophysiological mechanism best explains the rationale for
these orders?
A. To prevent contrast-induced nephropathy B. To correct pre-existing metabolic alkalosis
by reducing reactive oxygen species and and enhance renal excretion of contrast
renal vasoconstriction. media.
C. To reduce the risk of lactic acidosis from D. To increase renal blood flow by inhibiting
metformin and alkalinize urine to prevent tubuloglomerular feedback and dilating
contrast precipitation. afferent arterioles.
Correct: A - To prevent contrast-induced nephropathy by reducing reactive oxygen
species and renal vasoconstriction.
Page 3
, Section A - Acute
Rationale: Contrast-induced nephropathy (CIN) is a major risk in CKD. N-acetylcysteine acts
as an antioxidant and vasodilator, while sodium bicarbonate reduces oxidative stress and
tubular injury; both aim to prevent CIN. Metformin is withheld due to risk of lactic acidosis if
renal function deteriorates. Option B is incorrect because CKD typically causes metabolic
acidosis, not alkalosis. Option C mischaracterizes the role of sodium bicarbonate (it does not
prevent precipitation). Option D is not the primary mechanism of these agents.
Q3.
A patient in the intensive care unit develops acute respiratory distress syndrome (ARDS).
The provider sets a tidal volume of 6 mL/kg of predicted body weight and a plateau
pressure limit of 30 cm HO. The nurse notes a plateau pressure of 34 cm HO. Which action
is most appropriate?
A. Increase the respiratory rate to maintain B. Decrease tidal volume by 1 mL/kg
minute ventilation and accept the elevated increments to achieve plateau pressure 30
plateau pressure. cm HO.
C. Switch to pressure-controlled ventilation D. Administer a neuromuscular blocking
to reduce plateau pressure without changing agent to improve chest wall compliance and
tidal volume. reduce plateau pressure.
Correct: B - Decrease tidal volume by 1 mL/kg increments to achieve plateau pressure 30
cm HO.
Rationale:Lung-protective ventilation in ARDS mandates limiting plateau pressure to "d30 cm
HO to prevent ventilator-induced lung injury. If plateau pressure exceeds this, the priority is to
reduce tidal volume (even to 4-6 mL/kg PBW) per ARDSNet protocols. Increasing respiratory
rate may help minute ventilation but does not address the high plateau pressure.
Pressure-controlled ventilation may or may not reduce plateau pressure depending on
compliance. Neuromuscular blockers can improve oxygenation but are not the first-line
response to elevated plateau pressure.
Q4.
A patient with acute pancreatitis develops sudden worsening of respiratory distress,
jugular venous distension, and muffled heart sounds. Blood pressure drops to 80/50 mm
Hg. Which intervention is the priority?
A. Immediate pericardiocentesis or B. Rapid infusion of isotonic crystalloids to
pericardial window. maintain preload.
C. Administration of inotropic support with D. Endotracheal intubation and mechanical
norepinephrine. ventilation.
Correct: A - Immediate pericardiocentesis or pericardial window.
Page 4
