ATI RN Adult Medical-Surgical Proctored Exam
Questions with Correct Answers
(VerifiedAnswers) plus Rationales 2026 Q&A
Instant Download PDF
Question 1
A nurse is caring for a client who has acute heart failure. Which
finding requires immediate intervention?
A. 2+ bilateral ankle edema
B. Weight gain of 1 kg in 24 hr
C. Crackles throughout both lung fields
D. Fatigue with activity
Correct answer: C. Crackles throughout both lung fields
Crackles throughout the lungs indicate significant pulmonary
fluid accumulation and impaired gas exchange, which can
progress to acute pulmonary edema. The nurse should prioritize
airway and breathing, position the client upright, administer
oxygen as prescribed, and promptly notify the provider.
Peripheral edema and rapid weight gain indicate fluid retention
but are generally less immediately threatening than widespread
,pulmonary congestion. Fatigue is common with heart failure but
is not the priority finding.
Question 2
A client with chronic obstructive pulmonary disease is receiving
oxygen therapy. Which oxygen saturation should the nurse
generally expect as an appropriate target for a client at risk for
chronic carbon dioxide retention?
A. 100%
B. 98%
C. 95%
D. 88% to 92%
Correct answer: D. 88% to 92%
Many clients with COPD who are at risk for hypercapnia are
prescribed controlled oxygen therapy with a target saturation
around 88% to 92%. Excessive oxygen administration can
worsen ventilation-perfusion mismatch and contribute to
carbon dioxide retention in susceptible clients. The nurse should
follow the prescribed oxygen target rather than attempting to
normalize the saturation to 100%.
Question 3
,A nurse is assessing a client who suddenly develops dyspnea,
pleuritic chest pain, and tachycardia following surgery. Which
condition should the nurse suspect?
A. Pulmonary embolism
B. Atelectasis
C. Pneumonia
D. Pleural effusion
Correct answer: A. Pulmonary embolism
Sudden dyspnea, pleuritic chest pain, tachycardia, and
hypoxemia are classic warning findings for pulmonary
embolism, particularly in a postoperative client who may have
venous stasis. Pulmonary embolism is potentially life-
threatening because an obstructing clot can severely impair
pulmonary circulation and oxygenation. The nurse should treat
the sudden respiratory deterioration as an emergency and
initiate appropriate oxygenation and rapid evaluation.
Question 4
A client with a chest tube has continuous bubbling in the water-
seal chamber. What should the nurse do first?
A. Clamp the chest tube immediately
B. Increase wall suction
, C. Assess the system for an air leak
D. Remove the chest tube dressing
Correct answer: C. Assess the system for an air leak
Continuous bubbling in the water-seal chamber usually
indicates an air leak somewhere in the drainage system. The
nurse should systematically assess the tubing, connections,
insertion site, and drainage apparatus to identify the source.
Routine clamping can be dangerous because it can trap air in
the pleural space and contribute to a tension pneumothorax.
Question 5
A client is experiencing an acute myocardial infarction. Which
medication should the nurse anticipate administering unless
contraindicated?
A. Aspirin
B. Warfarin
C. Spironolactone
D. Acetazolamide
Correct answer: A. Aspirin
Aspirin inhibits platelet aggregation and is an important early
treatment in suspected acute coronary syndrome when there is
no contraindication such as a serious allergy or active bleeding.
Rapid antiplatelet therapy helps reduce further thrombus
Questions with Correct Answers
(VerifiedAnswers) plus Rationales 2026 Q&A
Instant Download PDF
Question 1
A nurse is caring for a client who has acute heart failure. Which
finding requires immediate intervention?
A. 2+ bilateral ankle edema
B. Weight gain of 1 kg in 24 hr
C. Crackles throughout both lung fields
D. Fatigue with activity
Correct answer: C. Crackles throughout both lung fields
Crackles throughout the lungs indicate significant pulmonary
fluid accumulation and impaired gas exchange, which can
progress to acute pulmonary edema. The nurse should prioritize
airway and breathing, position the client upright, administer
oxygen as prescribed, and promptly notify the provider.
Peripheral edema and rapid weight gain indicate fluid retention
but are generally less immediately threatening than widespread
,pulmonary congestion. Fatigue is common with heart failure but
is not the priority finding.
Question 2
A client with chronic obstructive pulmonary disease is receiving
oxygen therapy. Which oxygen saturation should the nurse
generally expect as an appropriate target for a client at risk for
chronic carbon dioxide retention?
A. 100%
B. 98%
C. 95%
D. 88% to 92%
Correct answer: D. 88% to 92%
Many clients with COPD who are at risk for hypercapnia are
prescribed controlled oxygen therapy with a target saturation
around 88% to 92%. Excessive oxygen administration can
worsen ventilation-perfusion mismatch and contribute to
carbon dioxide retention in susceptible clients. The nurse should
follow the prescribed oxygen target rather than attempting to
normalize the saturation to 100%.
Question 3
,A nurse is assessing a client who suddenly develops dyspnea,
pleuritic chest pain, and tachycardia following surgery. Which
condition should the nurse suspect?
A. Pulmonary embolism
B. Atelectasis
C. Pneumonia
D. Pleural effusion
Correct answer: A. Pulmonary embolism
Sudden dyspnea, pleuritic chest pain, tachycardia, and
hypoxemia are classic warning findings for pulmonary
embolism, particularly in a postoperative client who may have
venous stasis. Pulmonary embolism is potentially life-
threatening because an obstructing clot can severely impair
pulmonary circulation and oxygenation. The nurse should treat
the sudden respiratory deterioration as an emergency and
initiate appropriate oxygenation and rapid evaluation.
Question 4
A client with a chest tube has continuous bubbling in the water-
seal chamber. What should the nurse do first?
A. Clamp the chest tube immediately
B. Increase wall suction
, C. Assess the system for an air leak
D. Remove the chest tube dressing
Correct answer: C. Assess the system for an air leak
Continuous bubbling in the water-seal chamber usually
indicates an air leak somewhere in the drainage system. The
nurse should systematically assess the tubing, connections,
insertion site, and drainage apparatus to identify the source.
Routine clamping can be dangerous because it can trap air in
the pleural space and contribute to a tension pneumothorax.
Question 5
A client is experiencing an acute myocardial infarction. Which
medication should the nurse anticipate administering unless
contraindicated?
A. Aspirin
B. Warfarin
C. Spironolactone
D. Acetazolamide
Correct answer: A. Aspirin
Aspirin inhibits platelet aggregation and is an important early
treatment in suspected acute coronary syndrome when there is
no contraindication such as a serious allergy or active bleeding.
Rapid antiplatelet therapy helps reduce further thrombus
