Exam Format: Multiple Choice, NGN-Style Items
Total Questions: 150 Practice Questions
Target Audience: ATI RN Adult Medical-Surgical Nursing CMS Proctored Exam
Candidates
SECTION 1: PRIORITIZATION & EMERGENCY CARE (Questions
1–25)
1. A nurse in the emergency department is assessing a client with suspected
tuberculosis. Which action should the nurse take FIRST?
A) Obtain a sputum sample for culture
B) Administer ondansetron for nausea
C) Initiate airborne precautions
D) Prepare the client for a chest x-ray
Answer: C
2. A nurse is caring for a postoperative client who has a prescription for fentanyl
PRN. The client develops respiratory depression. Which medication should the
nurse ensure is available?
A) Naloxone
B) Atropine
C) Flumazenil
D) Acetylcysteine
,Answer: A
3. A nurse in the emergency department is assessing a client with a suspected
tension pneumothorax. Which finding suggests this diagnosis?
A) Absent breath sounds on the affected side with tracheal deviation
B) Rhonchi throughout all lung fields
C) Crackles in bilateral lung bases
D) Wheezing on expiration
Answer: A
4. A nurse is caring for a client who has a central venous access device and notes
the tubing has become disconnected. The client develops dyspnea and
tachycardia. Which action should the nurse take FIRST?
A) Perform an ECG
B) Obtain ABG values
C) Turn the client to the left side
D) Clamp the catheter
Answer: D
5. A nurse is reviewing laboratory results for a client. Which value requires the
most immediate action?
,A) Serum potassium 5.8 mEq/L
B) Serum sodium 134 mEq/L
C) Hemoglobin 10.5 g/dL
D) Blood glucose 180 mg/dL
Answer: A
6. A client with salicylate (aspirin) toxicity initially presents with what acid-base
imbalance?
A) Metabolic alkalosis
B) Respiratory acidosis
C) Metabolic acidosis
D) Respiratory alkalosis
Answer: D
7. A client reports chest pain. After administering sublingual nitroglycerin, which
vital sign change requires immediate intervention?
A) Heart rate from 80 to 90 bpm
B) Blood pressure from 120/80 to 90/60 mm Hg
C) Respiratory rate from 16 to 20/min
D) Temperature from 37.0°C to 37.2°C
Answer: B
, 8. A nurse is caring for a client who had a left lower lobectomy for lung cancer.
Which factor will have the most significant impact on the plan of care?
A) Lung cancer usually metastasizes before the client presents with symptoms
B) The client will require lifelong oxygen therapy
C) The client will be unable to ambulate independently
D) Pain management is rarely needed after thoracic surgery
Answer: A
9. A nurse is preparing to administer a unit of packed RBCs. Identify the correct
sequence of steps.
A) Obtain venous access → Obtain blood from bank → Verify compatibility → Initiate
transfusion → Remain with client for first 15-30 minutes
B) Verify compatibility → Obtain venous access → Obtain blood → Initiate transfusion →
Remain with client
C) Obtain blood → Verify compatibility → Obtain venous access → Initiate transfusion →
Remain with client
D) Obtain venous access → Verify compatibility → Obtain blood → Initiate transfusion →
Remain with client
Answer: A
10. A nurse is caring for a client with an acute myocardial infarction. Which pain
medication is used for pain relief AND has a mortality benefit?
A) Morphine
B) Fentanyl
C) Oxygen
D) Nitroglycerin
Total Questions: 150 Practice Questions
Target Audience: ATI RN Adult Medical-Surgical Nursing CMS Proctored Exam
Candidates
SECTION 1: PRIORITIZATION & EMERGENCY CARE (Questions
1–25)
1. A nurse in the emergency department is assessing a client with suspected
tuberculosis. Which action should the nurse take FIRST?
A) Obtain a sputum sample for culture
B) Administer ondansetron for nausea
C) Initiate airborne precautions
D) Prepare the client for a chest x-ray
Answer: C
2. A nurse is caring for a postoperative client who has a prescription for fentanyl
PRN. The client develops respiratory depression. Which medication should the
nurse ensure is available?
A) Naloxone
B) Atropine
C) Flumazenil
D) Acetylcysteine
,Answer: A
3. A nurse in the emergency department is assessing a client with a suspected
tension pneumothorax. Which finding suggests this diagnosis?
A) Absent breath sounds on the affected side with tracheal deviation
B) Rhonchi throughout all lung fields
C) Crackles in bilateral lung bases
D) Wheezing on expiration
Answer: A
4. A nurse is caring for a client who has a central venous access device and notes
the tubing has become disconnected. The client develops dyspnea and
tachycardia. Which action should the nurse take FIRST?
A) Perform an ECG
B) Obtain ABG values
C) Turn the client to the left side
D) Clamp the catheter
Answer: D
5. A nurse is reviewing laboratory results for a client. Which value requires the
most immediate action?
,A) Serum potassium 5.8 mEq/L
B) Serum sodium 134 mEq/L
C) Hemoglobin 10.5 g/dL
D) Blood glucose 180 mg/dL
Answer: A
6. A client with salicylate (aspirin) toxicity initially presents with what acid-base
imbalance?
A) Metabolic alkalosis
B) Respiratory acidosis
C) Metabolic acidosis
D) Respiratory alkalosis
Answer: D
7. A client reports chest pain. After administering sublingual nitroglycerin, which
vital sign change requires immediate intervention?
A) Heart rate from 80 to 90 bpm
B) Blood pressure from 120/80 to 90/60 mm Hg
C) Respiratory rate from 16 to 20/min
D) Temperature from 37.0°C to 37.2°C
Answer: B
, 8. A nurse is caring for a client who had a left lower lobectomy for lung cancer.
Which factor will have the most significant impact on the plan of care?
A) Lung cancer usually metastasizes before the client presents with symptoms
B) The client will require lifelong oxygen therapy
C) The client will be unable to ambulate independently
D) Pain management is rarely needed after thoracic surgery
Answer: A
9. A nurse is preparing to administer a unit of packed RBCs. Identify the correct
sequence of steps.
A) Obtain venous access → Obtain blood from bank → Verify compatibility → Initiate
transfusion → Remain with client for first 15-30 minutes
B) Verify compatibility → Obtain venous access → Obtain blood → Initiate transfusion →
Remain with client
C) Obtain blood → Verify compatibility → Obtain venous access → Initiate transfusion →
Remain with client
D) Obtain venous access → Verify compatibility → Obtain blood → Initiate transfusion →
Remain with client
Answer: A
10. A nurse is caring for a client with an acute myocardial infarction. Which pain
medication is used for pain relief AND has a mortality benefit?
A) Morphine
B) Fentanyl
C) Oxygen
D) Nitroglycerin
