ATI RN Adult Medical-Surgical
2026 NGN-Aligned Proctored Exam
100 Multiple-Choice Questions with
answer key
Practice Examination for Nursing
Students
,Examination Instructions
This practice examination consists of 100 multiple-choice questions designed to assess
your clinical knowledge and judgment in adult medical-surgical nursing. The questions
are aligned with the 2026 Next Generation NCLEX (NGN) format and test clinical
reasoning, prioritization, and safe nursing care.
• This examination contains 100 questions. Choose the single best answer for each
question, unless the question format specifies otherwise.
• The recommended time limit for this practice examination is 3 hours.
• Some questions use NGN-aligned formats including clinical judgment scenarios,
ordered response elements, and multiple-response (select all that apply) styles
presented as combination choices.
• Readeach question carefully, including the clinical scenario provided, before selecting your
answer.
• There is no penalty for guessing. Answer every question.
• An answer key with detailed rationales is provided at the end of the examination.
• Use the rationales to understand the correct answer and the reasoning for why the other
options are incorrect.
• Record your answers on a separate sheet of paper before checking the answer key.
Page 1
,"A nurse is caring for a client who is 2 hours postoperative following a coronary artery
bypass graft (CABG) surgery. The client's chest tube drainage has increased from 50
mL to 200 mL in the past hour, and the drainage is now bright red."
1. Which of the following actions should the nurse take first?
A. Check the client's blood pressure and heart rate
B. Prepare to administer a unit of packed red blood cells
C. Increase the IV fluid rate to maintain perfusion
D. Clamp the chest tube to stop the bleeding
"A nurse is providing discharge teaching to a client who has heart failure and a new
prescription for furosemide. The client's current weight is 198 lbs."
2. Whichof the following statements by the client indicates an understanding of the
teaching?
A. I will weigh myself once a week and call my provider if I gain 5 pounds.
B. I will eat foods rich in potassium, such as bananas and oranges.
C. I will take this medication at bedtime to avoid dizziness during the day.
D. I will limit my fluid intake to 3 liters per day.
"A nurse is assessing a client who has left-sided heart failure. The client reports
increasing shortness of breath when lying flat and has 2+ pitting edema in the lower
extremities."
3. Which of the following findings should the nurse expect?
A. Jugularvein distention
B. Crackles in the lung fields
C. Hepatomegaly
D. Dependent sacral edema
"A nurse is caring for a client who has atrial fibrillation with a heart rate of 150 bpm.
The provider prescribes diltiazem IV."
4. Which
of the following findings should the nurse monitor for as an adverse effect of this
medication?
A. Hypertension
B. Bradycardia
Page 2
, C. Hyperreflexia
D. Tinnitus
"A nurse is reviewing the laboratory results of a client who has chronic heart failure
and is receiving digoxin. The client's serum potassium level is 3.0 mEq/L."
5. Which of the following actions should the nurse anticipate?
A. The provider will increase the digoxin dose.
B. The provider will prescribe a potassium supplement.
C. The provider will discontinue the digoxin.
D. The provider will switch to a different antiarrhythmic.
Page 3
2026 NGN-Aligned Proctored Exam
100 Multiple-Choice Questions with
answer key
Practice Examination for Nursing
Students
,Examination Instructions
This practice examination consists of 100 multiple-choice questions designed to assess
your clinical knowledge and judgment in adult medical-surgical nursing. The questions
are aligned with the 2026 Next Generation NCLEX (NGN) format and test clinical
reasoning, prioritization, and safe nursing care.
• This examination contains 100 questions. Choose the single best answer for each
question, unless the question format specifies otherwise.
• The recommended time limit for this practice examination is 3 hours.
• Some questions use NGN-aligned formats including clinical judgment scenarios,
ordered response elements, and multiple-response (select all that apply) styles
presented as combination choices.
• Readeach question carefully, including the clinical scenario provided, before selecting your
answer.
• There is no penalty for guessing. Answer every question.
• An answer key with detailed rationales is provided at the end of the examination.
• Use the rationales to understand the correct answer and the reasoning for why the other
options are incorrect.
• Record your answers on a separate sheet of paper before checking the answer key.
Page 1
,"A nurse is caring for a client who is 2 hours postoperative following a coronary artery
bypass graft (CABG) surgery. The client's chest tube drainage has increased from 50
mL to 200 mL in the past hour, and the drainage is now bright red."
1. Which of the following actions should the nurse take first?
A. Check the client's blood pressure and heart rate
B. Prepare to administer a unit of packed red blood cells
C. Increase the IV fluid rate to maintain perfusion
D. Clamp the chest tube to stop the bleeding
"A nurse is providing discharge teaching to a client who has heart failure and a new
prescription for furosemide. The client's current weight is 198 lbs."
2. Whichof the following statements by the client indicates an understanding of the
teaching?
A. I will weigh myself once a week and call my provider if I gain 5 pounds.
B. I will eat foods rich in potassium, such as bananas and oranges.
C. I will take this medication at bedtime to avoid dizziness during the day.
D. I will limit my fluid intake to 3 liters per day.
"A nurse is assessing a client who has left-sided heart failure. The client reports
increasing shortness of breath when lying flat and has 2+ pitting edema in the lower
extremities."
3. Which of the following findings should the nurse expect?
A. Jugularvein distention
B. Crackles in the lung fields
C. Hepatomegaly
D. Dependent sacral edema
"A nurse is caring for a client who has atrial fibrillation with a heart rate of 150 bpm.
The provider prescribes diltiazem IV."
4. Which
of the following findings should the nurse monitor for as an adverse effect of this
medication?
A. Hypertension
B. Bradycardia
Page 2
, C. Hyperreflexia
D. Tinnitus
"A nurse is reviewing the laboratory results of a client who has chronic heart failure
and is receiving digoxin. The client's serum potassium level is 3.0 mEq/L."
5. Which of the following actions should the nurse anticipate?
A. The provider will increase the digoxin dose.
B. The provider will prescribe a potassium supplement.
C. The provider will discontinue the digoxin.
D. The provider will switch to a different antiarrhythmic.
Page 3
