ATI Med-Surg Midterm Practice Exam
Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
1. A nurse is assessing a client with heart failure. Which
finding should the nurse identify as an indication of worsening
left-sided heart failure?
A. Dependent peripheral edema
B. Crackles in the lung bases
C. Jugular venous distention
D. Enlarged liver
Rationale: Left-sided heart failure causes blood to back up into
the pulmonary circulation, resulting in pulmonary congestion.
Crackles, dyspnea, orthopnea, and decreased oxygen saturation
are common findings. Peripheral edema, jugular venous
distention, and hepatomegaly are more characteristic of
systemic venous congestion associated with right-sided heart
failure.
,2. A nurse is caring for a client who has chronic obstructive
pulmonary disease (COPD). Which oxygen prescription should
the nurse anticipate?
A. Oxygen at 15 L/min via nonrebreather mask
B. Oxygen at 10 L/min via simple face mask
C. Low-flow oxygen at 1 to 2 L/min via nasal cannula
D. Oxygen at 8 L/min via face tent
Rationale: Clients with COPD commonly require carefully
titrated supplemental oxygen. Low-flow oxygen delivered by
nasal cannula is frequently prescribed, with the goal of
maintaining adequate oxygenation while avoiding excessive
oxygen administration. The nurse should monitor respiratory
status and oxygen saturation and follow the prescribed target
range.
3. A client with diabetes mellitus reports sweating, tremors,
palpitations, and confusion. Which condition should the nurse
suspect?
A. Hyperglycemia
B. Diabetic ketoacidosis
C. Hypoglycemia
D. Hyperosmolar hyperglycemic state
,Rationale: Sweating, tremors, tachycardia, palpitations, hunger,
anxiety, and confusion are classic manifestations of
hypoglycemia. If the client is conscious and able to swallow, a
rapid source of glucose should be administered according to
facility protocol. Severe hypoglycemia can progress to seizures,
loss of consciousness, and coma.
4. A nurse is caring for a client who has a potassium level of
6.4 mEq/L. Which finding requires immediate attention?
A. Muscle weakness
B. Nausea
C. Fatigue
D. Peaked T waves on the ECG
Rationale: Hyperkalemia can cause potentially fatal cardiac
dysrhythmias. Peaked T waves are an early ECG manifestation
of elevated potassium and indicate an increased risk for cardiac
complications. Although muscle weakness and gastrointestinal
symptoms can occur with hyperkalemia, ECG changes require
immediate intervention and cardiac monitoring.
5. A nurse is assessing a client who has pneumonia. Which
finding is most concerning?
, A. Productive cough
B. Temperature of 38.2°C (100.8°F)
C. Crackles
D. Oxygen saturation of 86%
Rationale: An oxygen saturation of 86% indicates significant
hypoxemia and requires prompt intervention. Pneumonia
commonly causes fever, cough, sputum production, and
abnormal breath sounds, but inadequate oxygenation is the
most immediate concern because impaired gas exchange can
rapidly become life-threatening.
6. A client is receiving a blood transfusion and develops chills,
fever, and low back pain. What should the nurse do first?
A. Administer acetaminophen
B. Slow the transfusion
C. Notify the provider
D. Stop the blood transfusion
Rationale: Fever, chills, and low back pain can indicate an acute
hemolytic transfusion reaction, which is a medical emergency.
The nurse should immediately stop the transfusion and
maintain IV access with normal saline using new tubing
according to facility policy. The blood product and tubing are
generally preserved for evaluation, and the provider and blood
bank are notified.
Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
1. A nurse is assessing a client with heart failure. Which
finding should the nurse identify as an indication of worsening
left-sided heart failure?
A. Dependent peripheral edema
B. Crackles in the lung bases
C. Jugular venous distention
D. Enlarged liver
Rationale: Left-sided heart failure causes blood to back up into
the pulmonary circulation, resulting in pulmonary congestion.
Crackles, dyspnea, orthopnea, and decreased oxygen saturation
are common findings. Peripheral edema, jugular venous
distention, and hepatomegaly are more characteristic of
systemic venous congestion associated with right-sided heart
failure.
,2. A nurse is caring for a client who has chronic obstructive
pulmonary disease (COPD). Which oxygen prescription should
the nurse anticipate?
A. Oxygen at 15 L/min via nonrebreather mask
B. Oxygen at 10 L/min via simple face mask
C. Low-flow oxygen at 1 to 2 L/min via nasal cannula
D. Oxygen at 8 L/min via face tent
Rationale: Clients with COPD commonly require carefully
titrated supplemental oxygen. Low-flow oxygen delivered by
nasal cannula is frequently prescribed, with the goal of
maintaining adequate oxygenation while avoiding excessive
oxygen administration. The nurse should monitor respiratory
status and oxygen saturation and follow the prescribed target
range.
3. A client with diabetes mellitus reports sweating, tremors,
palpitations, and confusion. Which condition should the nurse
suspect?
A. Hyperglycemia
B. Diabetic ketoacidosis
C. Hypoglycemia
D. Hyperosmolar hyperglycemic state
,Rationale: Sweating, tremors, tachycardia, palpitations, hunger,
anxiety, and confusion are classic manifestations of
hypoglycemia. If the client is conscious and able to swallow, a
rapid source of glucose should be administered according to
facility protocol. Severe hypoglycemia can progress to seizures,
loss of consciousness, and coma.
4. A nurse is caring for a client who has a potassium level of
6.4 mEq/L. Which finding requires immediate attention?
A. Muscle weakness
B. Nausea
C. Fatigue
D. Peaked T waves on the ECG
Rationale: Hyperkalemia can cause potentially fatal cardiac
dysrhythmias. Peaked T waves are an early ECG manifestation
of elevated potassium and indicate an increased risk for cardiac
complications. Although muscle weakness and gastrointestinal
symptoms can occur with hyperkalemia, ECG changes require
immediate intervention and cardiac monitoring.
5. A nurse is assessing a client who has pneumonia. Which
finding is most concerning?
, A. Productive cough
B. Temperature of 38.2°C (100.8°F)
C. Crackles
D. Oxygen saturation of 86%
Rationale: An oxygen saturation of 86% indicates significant
hypoxemia and requires prompt intervention. Pneumonia
commonly causes fever, cough, sputum production, and
abnormal breath sounds, but inadequate oxygenation is the
most immediate concern because impaired gas exchange can
rapidly become life-threatening.
6. A client is receiving a blood transfusion and develops chills,
fever, and low back pain. What should the nurse do first?
A. Administer acetaminophen
B. Slow the transfusion
C. Notify the provider
D. Stop the blood transfusion
Rationale: Fever, chills, and low back pain can indicate an acute
hemolytic transfusion reaction, which is a medical emergency.
The nurse should immediately stop the transfusion and
maintain IV access with normal saline using new tubing
according to facility policy. The blood product and tubing are
generally preserved for evaluation, and the provider and blood
bank are notified.
