ATI Med-Surg Proctored Exam Questions with
Correct Answers (VerifiedAnswers) Plus
Rationales 2026 Q&A Instant Download PDF —
Adult Medical-Surgical Nursing Practice Exam
Question 1 — Acute Coronary Syndrome
A nurse is caring for a client who reports crushing substernal
chest pain radiating to the left arm. The client is diaphoretic and
nauseated. Which action should the nurse take first?
A. Obtain a 12-lead ECG after administering prescribed
analgesia
B. Encourage the client to ambulate to improve circulation
C. Place the client in a supine position and provide oral fluids
D. Obtain a 12-lead ECG and assess vital signs promptly
Answer: D. Obtain a 12-lead ECG and assess vital signs
promptly
Rationale: Acute crushing chest pain with diaphoresis and
nausea is highly concerning for acute coronary syndrome. Rapid
assessment, including vital signs and a 12-lead ECG, helps
identify myocardial ischemia or infarction and guides time-
sensitive treatment. The client should be placed at rest,
,generally in a position that supports breathing and comfort.
Oral fluids and ambulation are inappropriate during suspected
acute myocardial ischemia.
Question 2 — Heart Failure
A client with heart failure suddenly develops severe dyspnea,
bilateral crackles, and pink, frothy sputum. Which action is the
priority?
A. Encourage oral fluid intake
B. Place the client flat in bed
C. Place the client in high-Fowler's position and administer
oxygen as prescribed
D. Obtain the client's weight
Answer: C. Place the client in high-Fowler's position and
administer oxygen as prescribed
Rationale: Pink, frothy sputum and severe dyspnea suggest
acute pulmonary edema, a life-threatening complication of
heart failure. High-Fowler's positioning improves lung expansion
and decreases venous return to the heart. Supplemental oxygen
supports oxygenation while additional emergency interventions
are initiated. Weight monitoring is important for chronic heart
failure management but is not the immediate priority during
acute respiratory compromise.
,Question 3 — Atrial Fibrillation
A client with atrial fibrillation is prescribed warfarin. Which
laboratory value should the nurse monitor to evaluate
therapeutic anticoagulation?
A. Troponin
B. Serum potassium
C. Hemoglobin A1c
D. INR
Answer: D. INR
Rationale: Warfarin therapy is monitored using the
international normalized ratio (INR). The INR reflects the effect
of warfarin on the extrinsic coagulation pathway and helps
balance prevention of thromboembolism against excessive
bleeding. Troponin evaluates myocardial injury, potassium
evaluates electrolyte status, and hemoglobin A1c evaluates
long-term glucose control.
Question 4 — Myocardial Infarction
A client is experiencing an acute myocardial infarction. Which
laboratory marker is most specific for myocardial injury?
, A. Amylase
B. Creatinine
C. Cardiac troponin
D. Bilirubin
Answer: C. Cardiac troponin
Rationale: Cardiac troponins are highly sensitive and specific
biomarkers for myocardial injury. An elevated troponin level
supports the diagnosis of myocardial infarction when
interpreted with the client's symptoms, ECG findings, and
clinical presentation. Other laboratory values may be abnormal
for unrelated reasons but are not as specific for myocardial
injury.
Question 5 — COPD
A client with COPD has increasing dyspnea and an oxygen
saturation of 84%. Which intervention should the nurse
anticipate?
A. Withhold oxygen because oxygen is contraindicated in COPD
B. Administer oxygen at the highest possible flow rate without
reassessment
C. Administer prescribed supplemental oxygen and monitor
respiratory status closely
D. Place the client in Trendelenburg position
Correct Answers (VerifiedAnswers) Plus
Rationales 2026 Q&A Instant Download PDF —
Adult Medical-Surgical Nursing Practice Exam
Question 1 — Acute Coronary Syndrome
A nurse is caring for a client who reports crushing substernal
chest pain radiating to the left arm. The client is diaphoretic and
nauseated. Which action should the nurse take first?
A. Obtain a 12-lead ECG after administering prescribed
analgesia
B. Encourage the client to ambulate to improve circulation
C. Place the client in a supine position and provide oral fluids
D. Obtain a 12-lead ECG and assess vital signs promptly
Answer: D. Obtain a 12-lead ECG and assess vital signs
promptly
Rationale: Acute crushing chest pain with diaphoresis and
nausea is highly concerning for acute coronary syndrome. Rapid
assessment, including vital signs and a 12-lead ECG, helps
identify myocardial ischemia or infarction and guides time-
sensitive treatment. The client should be placed at rest,
,generally in a position that supports breathing and comfort.
Oral fluids and ambulation are inappropriate during suspected
acute myocardial ischemia.
Question 2 — Heart Failure
A client with heart failure suddenly develops severe dyspnea,
bilateral crackles, and pink, frothy sputum. Which action is the
priority?
A. Encourage oral fluid intake
B. Place the client flat in bed
C. Place the client in high-Fowler's position and administer
oxygen as prescribed
D. Obtain the client's weight
Answer: C. Place the client in high-Fowler's position and
administer oxygen as prescribed
Rationale: Pink, frothy sputum and severe dyspnea suggest
acute pulmonary edema, a life-threatening complication of
heart failure. High-Fowler's positioning improves lung expansion
and decreases venous return to the heart. Supplemental oxygen
supports oxygenation while additional emergency interventions
are initiated. Weight monitoring is important for chronic heart
failure management but is not the immediate priority during
acute respiratory compromise.
,Question 3 — Atrial Fibrillation
A client with atrial fibrillation is prescribed warfarin. Which
laboratory value should the nurse monitor to evaluate
therapeutic anticoagulation?
A. Troponin
B. Serum potassium
C. Hemoglobin A1c
D. INR
Answer: D. INR
Rationale: Warfarin therapy is monitored using the
international normalized ratio (INR). The INR reflects the effect
of warfarin on the extrinsic coagulation pathway and helps
balance prevention of thromboembolism against excessive
bleeding. Troponin evaluates myocardial injury, potassium
evaluates electrolyte status, and hemoglobin A1c evaluates
long-term glucose control.
Question 4 — Myocardial Infarction
A client is experiencing an acute myocardial infarction. Which
laboratory marker is most specific for myocardial injury?
, A. Amylase
B. Creatinine
C. Cardiac troponin
D. Bilirubin
Answer: C. Cardiac troponin
Rationale: Cardiac troponins are highly sensitive and specific
biomarkers for myocardial injury. An elevated troponin level
supports the diagnosis of myocardial infarction when
interpreted with the client's symptoms, ECG findings, and
clinical presentation. Other laboratory values may be abnormal
for unrelated reasons but are not as specific for myocardial
injury.
Question 5 — COPD
A client with COPD has increasing dyspnea and an oxygen
saturation of 84%. Which intervention should the nurse
anticipate?
A. Withhold oxygen because oxygen is contraindicated in COPD
B. Administer oxygen at the highest possible flow rate without
reassessment
C. Administer prescribed supplemental oxygen and monitor
respiratory status closely
D. Place the client in Trendelenburg position
