ATI RN Adult Medical-Surgical
Comprehensive Practice Examination 2026 update
100 Multiple-Choice Questions with Answers and Rationales
Full Scope: Cardiovascular, Respiratory, Neurological,
Gastrointestinal, Endocrine, Musculoskeletal,
Renal/Urinary, Immune, Hematologic, Integumentary
Total Questions:
100 Format: Multiple
Choice (A-D)
Recommended Time: 2
hours
, ATI RN Adult Medical-Surgical Practice Exam
1. Aclient with heart failure is receiving furosemide (Lasix) 40 mg IV. Which
laboratory value should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum chloride
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes significant potassium loss through
increased urinary excretion. Hypokalemia can lead to dangerous cardiac
dysrhythmias, making serum potassium the priority lab value to monitor. While
sodium, calcium, and chloride may shift, potassium depletion poses the greatest
immediate risk to a cardiac client. The nurse should also assess for muscle weakness,
fatigue, and irregular pulse.
2. A
nurse is assessing a client with left-sided heart failure. Which finding is
most consistent with this condition?
A. Jugular vein distention
B. Hepatomegaly
C. Pulmonary crackles
D. Dependent edema
Correct Answer: C
Rationale: Left-sided heart failure impairs the left ventricle's ability to pump blood
forward, causing blood to back up into the pulmonary circulation. This results in
pulmonary congestion manifested as crackles on auscultation, dyspnea, orthopnea,
and a productive cough with pink frothy sputum. Jugular vein distention,
hepatomegaly, and dependent edema are signs of right-sided heart failure, where
Page 2
, ATI RN Adult Medical-Surgical Practice Exam
blood backs up into the systemic venous system.
3. Aclient diagnosed with atrial fibrillation has a ventricular rate of 156 bpm.
The nurse anticipates which medication as the first-line treatment for rate
control?
A. Amiodarone (Cordarone)
B. Diltiazem (Cardizem)
C. Heparin sodium
D. Digoxin (Lanoxin)
Correct Answer: B
Rationale: Diltiazem, a calcium channel blocker, is a first-line medication for rate
control in atrial fibrillation because it slows atrioventricular nodal conduction, thereby
reducing the ventricular rate. Amiodarone is used for rhythm control rather than acute
rate control. Heparin is used for anticoagulation to prevent stroke but does not control
heart rate. Digoxin may be added for rate control but is not the first-line agent due to
its narrow therapeutic index and slower onset of action.
Page 3
, ATI RN Adult Medical-Surgical Practice Exam
4. Thenurse is providing discharge teaching to a client who had a permanent
pacemaker inserted. Which statement by the client indicates a need for further
teaching?
A. "I should carry a pacemaker ID card with me at all times."
B. "I will avoid going through airport security detectors."
C. "I should avoid lifting my left arm above my shoulder for 4 to 6 weeks."
D. "I will check my pulse daily and report any unusual rates."
Correct Answer: B
Rationale: Clients with pacemakers can safely pass through airport security detectors;
these devices do not interfere with modern pacemakers. However, the client should
carry a pacemaker ID card and request a hand search if concerned. The other
statements are correct: carrying an ID card is essential, avoiding ipsilateral arm
elevation prevents lead dislodgement, and daily pulse checks help monitor pacemaker
function. Avoiding airport security is an unnecessary restriction that indicates a need
for further teaching.
5. Aclient with coronary artery disease (CAD) asks the nurse about modifiable
risk factors. Which response by the nurse is most appropriate?
A. "Your age and family history are the most important risk factors."
B. "Smoking, hypertension, and high cholesterol can be modified with
lifestyle changes."
C. "Only your diet contributes to coronary artery disease."
D. "Risk factors for CAD cannot be changed once plaque has formed."
Correct Answer: B
Rationale: Modifiable risk factors for CAD include smoking, hypertension,
hyperlipidemia, diabetes mellitus, obesity, sedentary lifestyle, and excessive alcohol
Page 4
Comprehensive Practice Examination 2026 update
100 Multiple-Choice Questions with Answers and Rationales
Full Scope: Cardiovascular, Respiratory, Neurological,
Gastrointestinal, Endocrine, Musculoskeletal,
Renal/Urinary, Immune, Hematologic, Integumentary
Total Questions:
100 Format: Multiple
Choice (A-D)
Recommended Time: 2
hours
, ATI RN Adult Medical-Surgical Practice Exam
1. Aclient with heart failure is receiving furosemide (Lasix) 40 mg IV. Which
laboratory value should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum chloride
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes significant potassium loss through
increased urinary excretion. Hypokalemia can lead to dangerous cardiac
dysrhythmias, making serum potassium the priority lab value to monitor. While
sodium, calcium, and chloride may shift, potassium depletion poses the greatest
immediate risk to a cardiac client. The nurse should also assess for muscle weakness,
fatigue, and irregular pulse.
2. A
nurse is assessing a client with left-sided heart failure. Which finding is
most consistent with this condition?
A. Jugular vein distention
B. Hepatomegaly
C. Pulmonary crackles
D. Dependent edema
Correct Answer: C
Rationale: Left-sided heart failure impairs the left ventricle's ability to pump blood
forward, causing blood to back up into the pulmonary circulation. This results in
pulmonary congestion manifested as crackles on auscultation, dyspnea, orthopnea,
and a productive cough with pink frothy sputum. Jugular vein distention,
hepatomegaly, and dependent edema are signs of right-sided heart failure, where
Page 2
, ATI RN Adult Medical-Surgical Practice Exam
blood backs up into the systemic venous system.
3. Aclient diagnosed with atrial fibrillation has a ventricular rate of 156 bpm.
The nurse anticipates which medication as the first-line treatment for rate
control?
A. Amiodarone (Cordarone)
B. Diltiazem (Cardizem)
C. Heparin sodium
D. Digoxin (Lanoxin)
Correct Answer: B
Rationale: Diltiazem, a calcium channel blocker, is a first-line medication for rate
control in atrial fibrillation because it slows atrioventricular nodal conduction, thereby
reducing the ventricular rate. Amiodarone is used for rhythm control rather than acute
rate control. Heparin is used for anticoagulation to prevent stroke but does not control
heart rate. Digoxin may be added for rate control but is not the first-line agent due to
its narrow therapeutic index and slower onset of action.
Page 3
, ATI RN Adult Medical-Surgical Practice Exam
4. Thenurse is providing discharge teaching to a client who had a permanent
pacemaker inserted. Which statement by the client indicates a need for further
teaching?
A. "I should carry a pacemaker ID card with me at all times."
B. "I will avoid going through airport security detectors."
C. "I should avoid lifting my left arm above my shoulder for 4 to 6 weeks."
D. "I will check my pulse daily and report any unusual rates."
Correct Answer: B
Rationale: Clients with pacemakers can safely pass through airport security detectors;
these devices do not interfere with modern pacemakers. However, the client should
carry a pacemaker ID card and request a hand search if concerned. The other
statements are correct: carrying an ID card is essential, avoiding ipsilateral arm
elevation prevents lead dislodgement, and daily pulse checks help monitor pacemaker
function. Avoiding airport security is an unnecessary restriction that indicates a need
for further teaching.
5. Aclient with coronary artery disease (CAD) asks the nurse about modifiable
risk factors. Which response by the nurse is most appropriate?
A. "Your age and family history are the most important risk factors."
B. "Smoking, hypertension, and high cholesterol can be modified with
lifestyle changes."
C. "Only your diet contributes to coronary artery disease."
D. "Risk factors for CAD cannot be changed once plaque has formed."
Correct Answer: B
Rationale: Modifiable risk factors for CAD include smoking, hypertension,
hyperlipidemia, diabetes mellitus, obesity, sedentary lifestyle, and excessive alcohol
Page 4
