ATI RN MEDICAL-SURGICAL
PROCTORED RETAKE EXAM 2026
EDITION: COMPREHENSIVE 400-
QUESTION PRACTICE BANK WITH
VERIFIED ANSWERS PLUS
RATIONALES (VERSIONS 1, 2, & 3)
1. Post-Operative Hip Arthroplasty Instructions
A nurse is providing discharge teaching to an older adult client following a left total
hip arthroplasty. Which instruction should the nurse include?
• A) "You should use an incentive spirometer every 8 hours."
• B) "You can cross your legs at the ankles when sitting down."
• C) "Clean the incision daily with hydrogen peroxide."
• D) "Install a raised toilet seat in your bathroom."
Rationale: A raised toilet seat helps prevent hip flexion beyond 90 degrees, reducing
the risk of dislocation.
2. Calculating IV Infusion Rate
A nurse is preparing to administer lactated Ringer's via continuous IV infusion at 200
mL/hr. The IV tubing has a drip factor of 10 gtt/mL. How many gtts/min should the
nurse set the IV pump to administer? (Round to the nearest whole number.)
• A) 20 gtt/min
• B) 33 gtt/min
• C) 50 gtt/min
• D) 100 gtt/min
Rationale: To calculate the drip rate: (200 mL/hr * 10 gtt/mL) / 60 min/hr = 33.33
gtt/min, which rounds to 33 gtt/min.
3. Sublingual Nitroglycerin Teaching
A nurse is providing discharge teaching to a client with a new prescription for
sublingual nitroglycerin. Which statement by the client indicates understanding?
• A) "I should lie down when I take this medication."
• B) "I can keep my medication for 1 year before replacing it."
• C) "I should discontinue this medication if I develop a headache."
, • D) "I can take up to five tablets in 15 minutes before seeking medical
attention."
Rationale: Sublingual nitroglycerin can cause hypotension, so lying down minimizes
the risk of falling.
4. Contraindication for Acupuncture
A nurse is caring for a client receiving chemotherapy who requests information about
acupuncture. Which finding should the nurse identify as a contraindication?
• A) Urticaria
• B) Lymphedema
• C) Headaches
• D) Mouth sores
Rationale: Lymphedema can be exacerbated by acupuncture due to the risk of
increased swelling or infection.
5. Postoperative Colon Resection
A nurse is caring for a client who is 12 hours postoperative after a colon resection.
Which finding should the nurse report immediately to the surgeon?
• A) Heart rate 90/min
• B) Absent bowel sounds
• C) Hemoglobin 8.2 g/dL
• D) Gastric pH 3
Rationale: A hemoglobin of 8.2 g/dL suggests significant blood loss or anemia
requiring prompt attention.
6. Seizure Precautions
A nurse is caring for a client who begins to have a generalized tonic-clonic seizure
while lying in bed. Which action should the nurse take?
• A) Insert an oral airway
• B) Turn the client onto a side
• C) Restrict movement of the client's limbs
• D) Place a pillow under the client's head
Rationale: Turning the client onto their side helps maintain a patent airway and
prevent aspiration.
7. Post-Extubation Assessment
A nurse is caring for a client for whom the respiratory therapist has just removed the
endotracheal tube. Which action should the nurse take first?
• A) Instruct the client to cough
• B) Administer oxygen via face mask
• C) Evaluate the client for stridor
, • D) Keep the client in a semi- to high-Fowler's position
Rationale: The nurse should first evaluate for stridor, which indicates airway
obstruction.
8. Cardiac Catheterization Post-Procedure Care
A nurse is caring for a client immediately following a cardiac catheterization with a
femoral artery approach. Which action should the nurse take?
• A) Check pedal pulses every 15 min.
• B) Maintain the client in a supine position.
• C) Apply pressure to the insertion site.
Rationale: Assessing pedal pulses checks for distal perfusion and potential arterial
occlusion.
9. Diabetes Insipidus Management
A client diagnosed with diabetes insipidus reports excessive thirst and frequent
urination. Which medication should the nurse expect to administer?
• A) Desmopressin
• B) Regular insulin
• C) Furosemide
• D) Lithium carbonate
Rationale: Desmopressin, a synthetic ADH analog, reduces urine output by
promoting water reabsorption in the kidneys.
10. Chronic NSAID Use Monitoring
A client with chronic arthritis reports taking ibuprofen several times daily for 3 years.
Which test should the nurse prioritize in this client's monitoring?
• A) Fasting blood glucose
• B) Stool test for occult blood
• C) Urine analysis for white blood cells
• D) Serum calcium
Rationale: Long-term NSAID use increases the risk for gastrointestinal bleeding;
monitoring stool for occult blood detects early bleeding.
11. End of Life Care: Client Preference
A nurse is caring for a client near end of life who is on bed rest. The client states he
needs to have a bowel movement and refuses a bedpan, saying, "I've always used the
bathroom." What is the nurse's best response?
• A) "Tell me what concerns you have about using the bedpan."
• B) "Make sure to use nearby furniture to support yourself when walking to the
bathroom."
• C) "I will have the physical therapist ambulate you to the bathroom."
, • D) "You have to use the bedpan for your own safety."
Rationale: Exploring the client's feelings first promotes a trusting relationship and
patient-centered care.
12. Right-Sided Heart Failure Finding
A nurse is assessing a client who has left-sided heart failure. Which finding is
expected?
• A) Peripheral edema
• B) Jugular vein distention
• C) Bibasilar crackles
• D) Hepatomegaly
Rationale: Left-sided heart failure leads to pulmonary congestion and edema,
manifesting as crackles.
13. Acute Hemolytic Transfusion Reaction
Which manifestation indicates an acute hemolytic transfusion reaction?
• A) Severe lower back pain
• B) Acute hypertension
• C) Generalized chills
• D) Bradycardia
Rationale: Acute hemolytic reaction causes RBC destruction, which can manifest as
sudden, severe low back pain.
14. Diabetic Foot Care Teaching
A nurse is teaching a client with diabetes mellitus about routine foot care. Which
instruction should the nurse include?
• A) "Use a heating pad to keep your feet warm at night."
• B) "Wear loose-fitting slippers around the house at all times."
• C) "Wear clean cotton rather than synthetic nylon socks."
• D) "Wash your feet twice per day with antibacterial soap and hot water."
Rationale: Cotton socks absorb moisture more efficiently than nylon, keeping feet
dry and reducing infection risk.
15. DVT Risk Factor
Which finding should the nurse identify as a risk factor for DVT?
• A) Regular NSAID use
• B) Chronic hypertension
• C) Oral contraceptive use
• D) Hepatic cirrhosis
Rationale: Oral contraceptives containing estrogen increase clotting factor synthesis,
elevating DVT risk.
PROCTORED RETAKE EXAM 2026
EDITION: COMPREHENSIVE 400-
QUESTION PRACTICE BANK WITH
VERIFIED ANSWERS PLUS
RATIONALES (VERSIONS 1, 2, & 3)
1. Post-Operative Hip Arthroplasty Instructions
A nurse is providing discharge teaching to an older adult client following a left total
hip arthroplasty. Which instruction should the nurse include?
• A) "You should use an incentive spirometer every 8 hours."
• B) "You can cross your legs at the ankles when sitting down."
• C) "Clean the incision daily with hydrogen peroxide."
• D) "Install a raised toilet seat in your bathroom."
Rationale: A raised toilet seat helps prevent hip flexion beyond 90 degrees, reducing
the risk of dislocation.
2. Calculating IV Infusion Rate
A nurse is preparing to administer lactated Ringer's via continuous IV infusion at 200
mL/hr. The IV tubing has a drip factor of 10 gtt/mL. How many gtts/min should the
nurse set the IV pump to administer? (Round to the nearest whole number.)
• A) 20 gtt/min
• B) 33 gtt/min
• C) 50 gtt/min
• D) 100 gtt/min
Rationale: To calculate the drip rate: (200 mL/hr * 10 gtt/mL) / 60 min/hr = 33.33
gtt/min, which rounds to 33 gtt/min.
3. Sublingual Nitroglycerin Teaching
A nurse is providing discharge teaching to a client with a new prescription for
sublingual nitroglycerin. Which statement by the client indicates understanding?
• A) "I should lie down when I take this medication."
• B) "I can keep my medication for 1 year before replacing it."
• C) "I should discontinue this medication if I develop a headache."
, • D) "I can take up to five tablets in 15 minutes before seeking medical
attention."
Rationale: Sublingual nitroglycerin can cause hypotension, so lying down minimizes
the risk of falling.
4. Contraindication for Acupuncture
A nurse is caring for a client receiving chemotherapy who requests information about
acupuncture. Which finding should the nurse identify as a contraindication?
• A) Urticaria
• B) Lymphedema
• C) Headaches
• D) Mouth sores
Rationale: Lymphedema can be exacerbated by acupuncture due to the risk of
increased swelling or infection.
5. Postoperative Colon Resection
A nurse is caring for a client who is 12 hours postoperative after a colon resection.
Which finding should the nurse report immediately to the surgeon?
• A) Heart rate 90/min
• B) Absent bowel sounds
• C) Hemoglobin 8.2 g/dL
• D) Gastric pH 3
Rationale: A hemoglobin of 8.2 g/dL suggests significant blood loss or anemia
requiring prompt attention.
6. Seizure Precautions
A nurse is caring for a client who begins to have a generalized tonic-clonic seizure
while lying in bed. Which action should the nurse take?
• A) Insert an oral airway
• B) Turn the client onto a side
• C) Restrict movement of the client's limbs
• D) Place a pillow under the client's head
Rationale: Turning the client onto their side helps maintain a patent airway and
prevent aspiration.
7. Post-Extubation Assessment
A nurse is caring for a client for whom the respiratory therapist has just removed the
endotracheal tube. Which action should the nurse take first?
• A) Instruct the client to cough
• B) Administer oxygen via face mask
• C) Evaluate the client for stridor
, • D) Keep the client in a semi- to high-Fowler's position
Rationale: The nurse should first evaluate for stridor, which indicates airway
obstruction.
8. Cardiac Catheterization Post-Procedure Care
A nurse is caring for a client immediately following a cardiac catheterization with a
femoral artery approach. Which action should the nurse take?
• A) Check pedal pulses every 15 min.
• B) Maintain the client in a supine position.
• C) Apply pressure to the insertion site.
Rationale: Assessing pedal pulses checks for distal perfusion and potential arterial
occlusion.
9. Diabetes Insipidus Management
A client diagnosed with diabetes insipidus reports excessive thirst and frequent
urination. Which medication should the nurse expect to administer?
• A) Desmopressin
• B) Regular insulin
• C) Furosemide
• D) Lithium carbonate
Rationale: Desmopressin, a synthetic ADH analog, reduces urine output by
promoting water reabsorption in the kidneys.
10. Chronic NSAID Use Monitoring
A client with chronic arthritis reports taking ibuprofen several times daily for 3 years.
Which test should the nurse prioritize in this client's monitoring?
• A) Fasting blood glucose
• B) Stool test for occult blood
• C) Urine analysis for white blood cells
• D) Serum calcium
Rationale: Long-term NSAID use increases the risk for gastrointestinal bleeding;
monitoring stool for occult blood detects early bleeding.
11. End of Life Care: Client Preference
A nurse is caring for a client near end of life who is on bed rest. The client states he
needs to have a bowel movement and refuses a bedpan, saying, "I've always used the
bathroom." What is the nurse's best response?
• A) "Tell me what concerns you have about using the bedpan."
• B) "Make sure to use nearby furniture to support yourself when walking to the
bathroom."
• C) "I will have the physical therapist ambulate you to the bathroom."
, • D) "You have to use the bedpan for your own safety."
Rationale: Exploring the client's feelings first promotes a trusting relationship and
patient-centered care.
12. Right-Sided Heart Failure Finding
A nurse is assessing a client who has left-sided heart failure. Which finding is
expected?
• A) Peripheral edema
• B) Jugular vein distention
• C) Bibasilar crackles
• D) Hepatomegaly
Rationale: Left-sided heart failure leads to pulmonary congestion and edema,
manifesting as crackles.
13. Acute Hemolytic Transfusion Reaction
Which manifestation indicates an acute hemolytic transfusion reaction?
• A) Severe lower back pain
• B) Acute hypertension
• C) Generalized chills
• D) Bradycardia
Rationale: Acute hemolytic reaction causes RBC destruction, which can manifest as
sudden, severe low back pain.
14. Diabetic Foot Care Teaching
A nurse is teaching a client with diabetes mellitus about routine foot care. Which
instruction should the nurse include?
• A) "Use a heating pad to keep your feet warm at night."
• B) "Wear loose-fitting slippers around the house at all times."
• C) "Wear clean cotton rather than synthetic nylon socks."
• D) "Wash your feet twice per day with antibacterial soap and hot water."
Rationale: Cotton socks absorb moisture more efficiently than nylon, keeping feet
dry and reducing infection risk.
15. DVT Risk Factor
Which finding should the nurse identify as a risk factor for DVT?
• A) Regular NSAID use
• B) Chronic hypertension
• C) Oral contraceptive use
• D) Hepatic cirrhosis
Rationale: Oral contraceptives containing estrogen increase clotting factor synthesis,
elevating DVT risk.
