MEDSURG ATI FINAL EXAM
COMPREHENSIVE PRACTICE (2026/2027 EDITION)
150 Multiple-Choice Questions - Complete Practice Exam
Independent-Study Disclaimer
This practice examination is an independent study aid and is not affiliated with, endorsed by, or sponsored by ATI
Testing or any other organization. It is provided for educational and self-assessment purposes only and is not a
substitute for official nursing curricula, the NCLEX-RN test plan, or professional guidance. Standards are subject
to change; always consult current ATI, guideline, and clinical best-practice references.
, Section 1: Cardiovascular Disorders – CAD, MI, Heart Failure,
Hypertension, Dysrhythmias (25 questions)
Q1: Which of the following ECG findings is most characteristic of an acute STEMI?
A. PR-interval prolongation
B. Peaked T waves only
C. ST-segment depression in all leads
D. ST-segment elevation in contiguous leads [CORRECT]
Correct Answer: D
Rationale: STEMI is characterized by ST-segment elevation in leads representing a coronary territory. The
others are not STEMI findings.
Q2: Which of the following is the priority for a patient with an acute STEMI?
A. Delaying treatment
B. Giving oral glucose
C. Early reperfusion (PCI or thrombolytics) per protocol [CORRECT]
D. Wait and observe
Correct Answer: C
Rationale: Early reperfusion is the priority for STEMI. The others delay definitive treatment.
Q3: Which of the following is a classic finding of left-sided heart failure?
A. Peripheral edema only
B. Pulmonary congestion with dyspnea and crackles [CORRECT]
C. Hepatomegaly only
D. JVD only
Correct Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion. The others are right-sided findings.
Q4: Which of the following is a finding of right-sided heart failure?
A. Pulmonary crackles
B. Peripheral edema, JVD, and hepatomegaly [CORRECT]
C. Dyspnea only
D. Frothy sputum
Correct Answer: B
Rationale: Right-sided heart failure causes peripheral edema, JVD, and hepatomegaly. The others are
left-sided.
Q5: Which of the following is the priority for a patient with acute pulmonary edema?
A. Position upright, provide oxygen, and administer diuretics per protocol [CORRECT]
B. Lay flat
C. Give oral fluids
D. Do nothing
Correct Answer: A
Rationale: Pulmonary edema is managed with upright positioning, oxygen, and diuretics. The others are
incorrect.
MedSurg ATI Final Exam - 2026/2027 Edition Page 2
, Q6: Which of the following is a finding of cardiogenic shock?
A. Hypertension with warm skin
B. Hypotension, cool extremities, and poor perfusion despite adequate volume [CORRECT]
C. Bounding pulses
D. Normal urine output
Correct Answer: B
Rationale: Cardiogenic shock causes hypotension and poor perfusion despite adequate volume. The others
are not cardiogenic shock.
Q7: Which of the following is the initial treatment for a pulseless ventricular tachycardia?
A. Defibrillation [CORRECT]
B. Synchronized cardioversion
C. Atropine
D. Adenosine
Correct Answer: A
Rationale: Pulseless VT is treated with defibrillation. Synchronized cardioversion is for stable VT. The others
differ.
Q8: Which of the following is the treatment for an unstable patient with a tachyarrhythmia?
A. Adenosine for all
B. Defibrillation
C. Atropine
D. Synchronized cardioversion [CORRECT]
Correct Answer: D
Rationale: Unstable tachyarrhythmias are treated with synchronized cardioversion. The others are incorrect.
Q9: Which of the following is TRUE about atrial fibrillation?
A. It is a regular rhythm
B. It has clear P waves
C. It is an irregularly irregular rhythm without discernible P waves [CORRECT]
D. It is a bradycardia
Correct Answer: C
Rationale: AF is irregularly irregular without P waves. The others are incorrect.
Q10: Which of the following is a risk for a patient with atrial fibrillation?
A. No stroke risk
B. Hyperglycemia
C. Thromboembolism (stroke) [CORRECT]
D. Hypotension always
Correct Answer: C
Rationale: AF increases thromboembolism risk. The others are incorrect.
MedSurg ATI Final Exam - 2026/2027 Edition Page 3
, Q11: Which of the following is a finding of hypertensive crisis?
A. Severely elevated blood pressure with end-organ dysfunction [CORRECT]
B. Mildly elevated BP with no symptoms
C. Normal BP
D. Hypotension
Correct Answer: A
Rationale: Hypertensive crisis involves severe BP elevation with end-organ dysfunction. The others are
incorrect.
Q12: Which of the following is a classic finding of cardiac tamponade?
A. Muffled heart sounds, hypotension, and distended neck veins (Beck's triad) [CORRECT]
B. Widened pulse pressure
C. Pulsus alternans
D. Bounding pulses
Correct Answer: A
Rationale: Beck's triad (muffled heart sounds, hypotension, JVD) characterizes tamponade. The others are
not.
Q13: Which of the following is the priority for a patient with cardiac tamponade?
A. Give oral fluids
B. Apply a tourniquet
C. Prepare for pericardiocentesis and provide hemodynamic support [CORRECT]
D. Do nothing
Correct Answer: C
Rationale: Tamponade requires pericardiocentesis and hemodynamic support. The others are incorrect.
Q14: Which of the following is a finding of a dissecting aortic aneurysm?
A. Mild pain
B. No pain
C. A rash
D. Sudden, severe 'tearing' pain [CORRECT]
Correct Answer: D
Rationale: Aortic dissection causes sudden tearing pain. The others are incorrect.
Q15: Which of the following is TRUE about peripheral vascular disease?
A. It affects only the heart
B. It may cause claudication, decreased pulses, and skin changes in the extremities [CORRECT]
C. It causes hypertension only
D. It is not serious
Correct Answer: B
Rationale: PVD causes claudication, decreased pulses, and skin changes. The others are incorrect.
MedSurg ATI Final Exam - 2026/2027 Edition Page 4
COMPREHENSIVE PRACTICE (2026/2027 EDITION)
150 Multiple-Choice Questions - Complete Practice Exam
Independent-Study Disclaimer
This practice examination is an independent study aid and is not affiliated with, endorsed by, or sponsored by ATI
Testing or any other organization. It is provided for educational and self-assessment purposes only and is not a
substitute for official nursing curricula, the NCLEX-RN test plan, or professional guidance. Standards are subject
to change; always consult current ATI, guideline, and clinical best-practice references.
, Section 1: Cardiovascular Disorders – CAD, MI, Heart Failure,
Hypertension, Dysrhythmias (25 questions)
Q1: Which of the following ECG findings is most characteristic of an acute STEMI?
A. PR-interval prolongation
B. Peaked T waves only
C. ST-segment depression in all leads
D. ST-segment elevation in contiguous leads [CORRECT]
Correct Answer: D
Rationale: STEMI is characterized by ST-segment elevation in leads representing a coronary territory. The
others are not STEMI findings.
Q2: Which of the following is the priority for a patient with an acute STEMI?
A. Delaying treatment
B. Giving oral glucose
C. Early reperfusion (PCI or thrombolytics) per protocol [CORRECT]
D. Wait and observe
Correct Answer: C
Rationale: Early reperfusion is the priority for STEMI. The others delay definitive treatment.
Q3: Which of the following is a classic finding of left-sided heart failure?
A. Peripheral edema only
B. Pulmonary congestion with dyspnea and crackles [CORRECT]
C. Hepatomegaly only
D. JVD only
Correct Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion. The others are right-sided findings.
Q4: Which of the following is a finding of right-sided heart failure?
A. Pulmonary crackles
B. Peripheral edema, JVD, and hepatomegaly [CORRECT]
C. Dyspnea only
D. Frothy sputum
Correct Answer: B
Rationale: Right-sided heart failure causes peripheral edema, JVD, and hepatomegaly. The others are
left-sided.
Q5: Which of the following is the priority for a patient with acute pulmonary edema?
A. Position upright, provide oxygen, and administer diuretics per protocol [CORRECT]
B. Lay flat
C. Give oral fluids
D. Do nothing
Correct Answer: A
Rationale: Pulmonary edema is managed with upright positioning, oxygen, and diuretics. The others are
incorrect.
MedSurg ATI Final Exam - 2026/2027 Edition Page 2
, Q6: Which of the following is a finding of cardiogenic shock?
A. Hypertension with warm skin
B. Hypotension, cool extremities, and poor perfusion despite adequate volume [CORRECT]
C. Bounding pulses
D. Normal urine output
Correct Answer: B
Rationale: Cardiogenic shock causes hypotension and poor perfusion despite adequate volume. The others
are not cardiogenic shock.
Q7: Which of the following is the initial treatment for a pulseless ventricular tachycardia?
A. Defibrillation [CORRECT]
B. Synchronized cardioversion
C. Atropine
D. Adenosine
Correct Answer: A
Rationale: Pulseless VT is treated with defibrillation. Synchronized cardioversion is for stable VT. The others
differ.
Q8: Which of the following is the treatment for an unstable patient with a tachyarrhythmia?
A. Adenosine for all
B. Defibrillation
C. Atropine
D. Synchronized cardioversion [CORRECT]
Correct Answer: D
Rationale: Unstable tachyarrhythmias are treated with synchronized cardioversion. The others are incorrect.
Q9: Which of the following is TRUE about atrial fibrillation?
A. It is a regular rhythm
B. It has clear P waves
C. It is an irregularly irregular rhythm without discernible P waves [CORRECT]
D. It is a bradycardia
Correct Answer: C
Rationale: AF is irregularly irregular without P waves. The others are incorrect.
Q10: Which of the following is a risk for a patient with atrial fibrillation?
A. No stroke risk
B. Hyperglycemia
C. Thromboembolism (stroke) [CORRECT]
D. Hypotension always
Correct Answer: C
Rationale: AF increases thromboembolism risk. The others are incorrect.
MedSurg ATI Final Exam - 2026/2027 Edition Page 3
, Q11: Which of the following is a finding of hypertensive crisis?
A. Severely elevated blood pressure with end-organ dysfunction [CORRECT]
B. Mildly elevated BP with no symptoms
C. Normal BP
D. Hypotension
Correct Answer: A
Rationale: Hypertensive crisis involves severe BP elevation with end-organ dysfunction. The others are
incorrect.
Q12: Which of the following is a classic finding of cardiac tamponade?
A. Muffled heart sounds, hypotension, and distended neck veins (Beck's triad) [CORRECT]
B. Widened pulse pressure
C. Pulsus alternans
D. Bounding pulses
Correct Answer: A
Rationale: Beck's triad (muffled heart sounds, hypotension, JVD) characterizes tamponade. The others are
not.
Q13: Which of the following is the priority for a patient with cardiac tamponade?
A. Give oral fluids
B. Apply a tourniquet
C. Prepare for pericardiocentesis and provide hemodynamic support [CORRECT]
D. Do nothing
Correct Answer: C
Rationale: Tamponade requires pericardiocentesis and hemodynamic support. The others are incorrect.
Q14: Which of the following is a finding of a dissecting aortic aneurysm?
A. Mild pain
B. No pain
C. A rash
D. Sudden, severe 'tearing' pain [CORRECT]
Correct Answer: D
Rationale: Aortic dissection causes sudden tearing pain. The others are incorrect.
Q15: Which of the following is TRUE about peripheral vascular disease?
A. It affects only the heart
B. It may cause claudication, decreased pulses, and skin changes in the extremities [CORRECT]
C. It causes hypertension only
D. It is not serious
Correct Answer: B
Rationale: PVD causes claudication, decreased pulses, and skin changes. The others are incorrect.
MedSurg ATI Final Exam - 2026/2027 Edition Page 4
