ATI Med-Surg Proctored Exam 2026 Practice Questions and Answers
with Rationales – Medical-Surgical Nursing Review
1. A client with acute pulmonary edema has which finding that requires immediate
intervention?
A. Mild ankle edema
B. Pink, frothy sputum
C. Heart rate of 88/min
D. Blood pressure of 138/84 mm Hg
Answer: B. Pink, frothy sputum
Rationale: Pink, frothy sputum is associated with pulmonary edema and indicates fluid
accumulation in the alveoli, which can severely impair oxygenation.
2. A nurse is caring for a client with COPD who has a prescription for oxygen. Which action is
appropriate?
A. Administer oxygen at the highest possible flow rate
B. Administer oxygen as prescribed and titrate according to the client’s target saturation
C. Withhold oxygen because oxygen is contraindicated in COPD
D. Administer oxygen only when the client is asleep
Answer: B. Administer oxygen as prescribed and titrate according to the client’s target
saturation
Rationale: Clients with COPD can require supplemental oxygen. Oxygen should be administered
carefully according to the prescription and prescribed oxygenation target.
3. Which finding is consistent with hypokalemia?
A. Muscle weakness
B. Peaked T waves
C. Severe flushing
D. Hyperactive bowel sounds
Answer: A. Muscle weakness
,Rationale: Low potassium can cause muscle weakness, fatigue, dysrhythmias, and decreased
gastrointestinal motility. Peaked T waves are associated with hyperkalemia.
4. A client is suspected of having a deep-vein thrombosis (DVT). Which finding supports this
diagnosis?
A. Bilateral ankle swelling
B. Unilateral calf swelling and tenderness
C. Bounding peripheral pulses
D. Cool hands
Answer: B. Unilateral calf swelling and tenderness
Rationale: Unilateral swelling, warmth, tenderness, and sometimes redness are common
findings associated with DVT.
5. A conscious client with diabetes has a blood glucose level of 54 mg/dL. What should the
nurse do first?
A. Administer regular insulin
B. Give a rapid-acting carbohydrate
C. Encourage exercise
D. Administer a high-protein meal only
Answer: B. Give a rapid-acting carbohydrate
Rationale: An alert client who can safely swallow should receive a rapidly absorbed
carbohydrate to correct hypoglycemia.
6. A client with heart failure develops severe dyspnea and bilateral crackles. Which action
should the nurse take first?
A. Place the client in high-Fowler’s position
B. Encourage the client to lie flat
C. Encourage ambulation
D. Increase oral fluid intake
Answer: A. Place the client in high-Fowler’s position
,Rationale: Sitting upright improves lung expansion and can decrease venous return, helping
reduce pulmonary congestion.
7. Which finding is commonly associated with iron-deficiency anemia?
A. Fatigue and pallor
B. Increased exercise tolerance
C. Severe hypertension
D. Facial flushing
Answer: A. Fatigue and pallor
Rationale: Reduced hemoglobin decreases oxygen-carrying capacity, commonly resulting in
fatigue, weakness, pallor, and decreased exercise tolerance.
8. A client with a nasogastric tube develops abdominal distention and nausea. What should the
nurse do first?
A. Assess the tube for patency
B. Remove the tube immediately
C. Encourage oral fluids
D. Clamp the tube permanently
Answer: A. Assess the tube for patency
Rationale: A blocked or malfunctioning NG tube can prevent gastric decompression and
contribute to nausea and abdominal distention.
9. Which finding is an early indicator of increased intracranial pressure?
A. Decreased level of consciousness
B. Increased appetite
C. Increased bowel sounds
D. Warm skin
Answer: A. Decreased level of consciousness
Rationale: Changes in level of consciousness are important indicators of neurological
deterioration and possible increased intracranial pressure.
, 10. Which food should a nurse identify as high in potassium for a client with hyperkalemia?
A. Banana
B. White rice
C. Applesauce
D. White bread
Answer: A. Banana
Rationale: Bananas contain significant potassium. Clients with hyperkalemia may be prescribed
a potassium-restricted diet.
11. Which instruction is appropriate for a client receiving anticoagulant therapy?
A. Use a soft-bristled toothbrush
B. Use a hard-bristled toothbrush
C. Take aspirin routinely
D. Use a sharp razor
Answer: A. Use a soft-bristled toothbrush
Rationale: Anticoagulants increase bleeding risk. A soft toothbrush reduces trauma to the gums.
12. Which finding is most consistent with hypoglycemia?
A. Diaphoresis and tremors
B. Fruity breath
C. Deep, rapid respirations
D. Warm, dry skin
Answer: A. Diaphoresis and tremors
Rationale: Hypoglycemia activates the sympathetic nervous system, producing sweating,
tremors, palpitations, hunger, and anxiety.
13. A client with pneumonia has an oxygen saturation of 88% and respiratory distress. Which
action is the priority?
A. Apply prescribed oxygen
B. Offer food
with Rationales – Medical-Surgical Nursing Review
1. A client with acute pulmonary edema has which finding that requires immediate
intervention?
A. Mild ankle edema
B. Pink, frothy sputum
C. Heart rate of 88/min
D. Blood pressure of 138/84 mm Hg
Answer: B. Pink, frothy sputum
Rationale: Pink, frothy sputum is associated with pulmonary edema and indicates fluid
accumulation in the alveoli, which can severely impair oxygenation.
2. A nurse is caring for a client with COPD who has a prescription for oxygen. Which action is
appropriate?
A. Administer oxygen at the highest possible flow rate
B. Administer oxygen as prescribed and titrate according to the client’s target saturation
C. Withhold oxygen because oxygen is contraindicated in COPD
D. Administer oxygen only when the client is asleep
Answer: B. Administer oxygen as prescribed and titrate according to the client’s target
saturation
Rationale: Clients with COPD can require supplemental oxygen. Oxygen should be administered
carefully according to the prescription and prescribed oxygenation target.
3. Which finding is consistent with hypokalemia?
A. Muscle weakness
B. Peaked T waves
C. Severe flushing
D. Hyperactive bowel sounds
Answer: A. Muscle weakness
,Rationale: Low potassium can cause muscle weakness, fatigue, dysrhythmias, and decreased
gastrointestinal motility. Peaked T waves are associated with hyperkalemia.
4. A client is suspected of having a deep-vein thrombosis (DVT). Which finding supports this
diagnosis?
A. Bilateral ankle swelling
B. Unilateral calf swelling and tenderness
C. Bounding peripheral pulses
D. Cool hands
Answer: B. Unilateral calf swelling and tenderness
Rationale: Unilateral swelling, warmth, tenderness, and sometimes redness are common
findings associated with DVT.
5. A conscious client with diabetes has a blood glucose level of 54 mg/dL. What should the
nurse do first?
A. Administer regular insulin
B. Give a rapid-acting carbohydrate
C. Encourage exercise
D. Administer a high-protein meal only
Answer: B. Give a rapid-acting carbohydrate
Rationale: An alert client who can safely swallow should receive a rapidly absorbed
carbohydrate to correct hypoglycemia.
6. A client with heart failure develops severe dyspnea and bilateral crackles. Which action
should the nurse take first?
A. Place the client in high-Fowler’s position
B. Encourage the client to lie flat
C. Encourage ambulation
D. Increase oral fluid intake
Answer: A. Place the client in high-Fowler’s position
,Rationale: Sitting upright improves lung expansion and can decrease venous return, helping
reduce pulmonary congestion.
7. Which finding is commonly associated with iron-deficiency anemia?
A. Fatigue and pallor
B. Increased exercise tolerance
C. Severe hypertension
D. Facial flushing
Answer: A. Fatigue and pallor
Rationale: Reduced hemoglobin decreases oxygen-carrying capacity, commonly resulting in
fatigue, weakness, pallor, and decreased exercise tolerance.
8. A client with a nasogastric tube develops abdominal distention and nausea. What should the
nurse do first?
A. Assess the tube for patency
B. Remove the tube immediately
C. Encourage oral fluids
D. Clamp the tube permanently
Answer: A. Assess the tube for patency
Rationale: A blocked or malfunctioning NG tube can prevent gastric decompression and
contribute to nausea and abdominal distention.
9. Which finding is an early indicator of increased intracranial pressure?
A. Decreased level of consciousness
B. Increased appetite
C. Increased bowel sounds
D. Warm skin
Answer: A. Decreased level of consciousness
Rationale: Changes in level of consciousness are important indicators of neurological
deterioration and possible increased intracranial pressure.
, 10. Which food should a nurse identify as high in potassium for a client with hyperkalemia?
A. Banana
B. White rice
C. Applesauce
D. White bread
Answer: A. Banana
Rationale: Bananas contain significant potassium. Clients with hyperkalemia may be prescribed
a potassium-restricted diet.
11. Which instruction is appropriate for a client receiving anticoagulant therapy?
A. Use a soft-bristled toothbrush
B. Use a hard-bristled toothbrush
C. Take aspirin routinely
D. Use a sharp razor
Answer: A. Use a soft-bristled toothbrush
Rationale: Anticoagulants increase bleeding risk. A soft toothbrush reduces trauma to the gums.
12. Which finding is most consistent with hypoglycemia?
A. Diaphoresis and tremors
B. Fruity breath
C. Deep, rapid respirations
D. Warm, dry skin
Answer: A. Diaphoresis and tremors
Rationale: Hypoglycemia activates the sympathetic nervous system, producing sweating,
tremors, palpitations, hunger, and anxiety.
13. A client with pneumonia has an oxygen saturation of 88% and respiratory distress. Which
action is the priority?
A. Apply prescribed oxygen
B. Offer food
