ATI RN Medical-Surgical Retake Exam 2026/2027
– Complete Practice Questions & Rationales (1-
200)
Welcome to this comprehensive ATI RN Medical-Surgical Retake Exam
practice bank, featuring 200 questions covering Versions 1, 2, and
3 with NGN-style questions and detailed rationales. This guide is
designed to mirror the actual ATI proctored exam experience and help you
achieve a passing score guarantee .
The exam consists of 100 questions per version with a passing score
guarantee, incorporating Next Generation NCLEX (NGN) format including
multiple-choice, select-all-that-apply (SATA), prioritization, and case-
scenario items. Content covers cardiovascular, respiratory, endocrine, renal,
gastrointestinal, neurological, hematologic, immune, infection control,
fluid/electrolyte imbalances, pharmacology integration, and priority nursing
interventions.
Section 1: Cardiovascular Disorders (Questions 1-30)
Question 1
A nurse is caring for a client who is 12 hours postoperative after a colon
resection. The nurse assesses the following vital signs and laboratory values:
Heart rate: 90/min, Absent bowel sounds, Hemoglobin: 8.2 g/dL, Gastric pH:
3.0. 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 3.0
*Correct Answer: C. Hemoglobin 8.2 g/dL. *
,Rationale: A hemoglobin of 8.2 g/dL suggests significant blood loss or anemia
requiring prompt attention. Heart rate 90/min is within normal limits,
absence of bowel sounds can be normal early post-op, and gastric pH of 3 is
normal gastric acidity. Immediate notification is required for low hemoglobin.
Question 2
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."
*Correct Answer: D. "Install a raised toilet seat in your bathroom." *
Rationale: Using a raised toilet seat helps prevent hip flexion beyond the
recommended angle following surgery, reducing the risk of dislocation and
promoting safe mobility. Incentive spirometer is used postoperatively but is
not specific to hip precautions. Crossing legs is contraindicated after hip
arthroplasty.
Question 3
A client reports chest pain and the nurse reviews the telemetry monitor
tracing. Which ECG component is most indicative of myocardial infarction?
A. PR interval
B. ST-segment elevation
C. QRS complex
D. T wave inversion
,*Correct Answer: B. ST-segment elevation. *
Rationale: ST-segment elevation in multiple contiguous leads is a key
indicator of acute ST-elevation myocardial infarction (STEMI) and requires
immediate medical attention. PR interval changes indicate AV block, and T
wave inversion may indicate ischemia but is less specific than ST elevation.
Question 4
A client receiving IV heparin has a platelet count of 80,000/mm³. What is
the priority nursing action?
A. Continue the heparin infusion as ordered
B. Notify the provider immediately
C. Increase the heparin drip rate
D. Administer platelets
*Correct Answer: B. Notify the provider immediately. *
Rationale: A platelet count drop to 80,000/mm³ in a client receiving heparin
is concerning for heparin-induced thrombocytopenia (HIT), a serious
immune-mediated reaction that increases the risk of thrombosis. The heparin
should be stopped and the provider notified immediately.
Question 5
A client with heart failure is prescribed furosemide. Which electrolyte
imbalance should the nurse monitor for?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
, *Correct Answer: B. Hypokalemia. *
Rationale: Loop diuretics such as furosemide cause potassium loss in the
urine, leading to hypokalemia. Serum potassium should be monitored closely,
especially in patients also taking digoxin. Hypokalemia can precipitate
cardiac arrhythmias.
Question 6
Which finding is consistent with right-sided heart failure?
A. Crackles in the lungs
B. Jugular vein distention
C. Orthopnea
D. Paroxysmal nocturnal dyspnea
*Correct Answer: B. Jugular vein distention. *
Rationale: Jugular vein distention (JVD) is a hallmark sign of right-sided heart
failure due to systemic venous congestion. Crackles, orthopnea, and
paroxysmal nocturnal dyspnea are signs of left-sided heart failure.
Question 7
A client with peripheral vascular disease is being assessed. Which finding
indicates a venous vascular disorder?
A. An ulcer at the tip of a toe
B. Hair loss distal to the client's calves
C. Leg pain at rest
D. Edema of the ankle
*Correct Answer: D. Edema of the ankle. *
– Complete Practice Questions & Rationales (1-
200)
Welcome to this comprehensive ATI RN Medical-Surgical Retake Exam
practice bank, featuring 200 questions covering Versions 1, 2, and
3 with NGN-style questions and detailed rationales. This guide is
designed to mirror the actual ATI proctored exam experience and help you
achieve a passing score guarantee .
The exam consists of 100 questions per version with a passing score
guarantee, incorporating Next Generation NCLEX (NGN) format including
multiple-choice, select-all-that-apply (SATA), prioritization, and case-
scenario items. Content covers cardiovascular, respiratory, endocrine, renal,
gastrointestinal, neurological, hematologic, immune, infection control,
fluid/electrolyte imbalances, pharmacology integration, and priority nursing
interventions.
Section 1: Cardiovascular Disorders (Questions 1-30)
Question 1
A nurse is caring for a client who is 12 hours postoperative after a colon
resection. The nurse assesses the following vital signs and laboratory values:
Heart rate: 90/min, Absent bowel sounds, Hemoglobin: 8.2 g/dL, Gastric pH:
3.0. 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 3.0
*Correct Answer: C. Hemoglobin 8.2 g/dL. *
,Rationale: A hemoglobin of 8.2 g/dL suggests significant blood loss or anemia
requiring prompt attention. Heart rate 90/min is within normal limits,
absence of bowel sounds can be normal early post-op, and gastric pH of 3 is
normal gastric acidity. Immediate notification is required for low hemoglobin.
Question 2
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."
*Correct Answer: D. "Install a raised toilet seat in your bathroom." *
Rationale: Using a raised toilet seat helps prevent hip flexion beyond the
recommended angle following surgery, reducing the risk of dislocation and
promoting safe mobility. Incentive spirometer is used postoperatively but is
not specific to hip precautions. Crossing legs is contraindicated after hip
arthroplasty.
Question 3
A client reports chest pain and the nurse reviews the telemetry monitor
tracing. Which ECG component is most indicative of myocardial infarction?
A. PR interval
B. ST-segment elevation
C. QRS complex
D. T wave inversion
,*Correct Answer: B. ST-segment elevation. *
Rationale: ST-segment elevation in multiple contiguous leads is a key
indicator of acute ST-elevation myocardial infarction (STEMI) and requires
immediate medical attention. PR interval changes indicate AV block, and T
wave inversion may indicate ischemia but is less specific than ST elevation.
Question 4
A client receiving IV heparin has a platelet count of 80,000/mm³. What is
the priority nursing action?
A. Continue the heparin infusion as ordered
B. Notify the provider immediately
C. Increase the heparin drip rate
D. Administer platelets
*Correct Answer: B. Notify the provider immediately. *
Rationale: A platelet count drop to 80,000/mm³ in a client receiving heparin
is concerning for heparin-induced thrombocytopenia (HIT), a serious
immune-mediated reaction that increases the risk of thrombosis. The heparin
should be stopped and the provider notified immediately.
Question 5
A client with heart failure is prescribed furosemide. Which electrolyte
imbalance should the nurse monitor for?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
, *Correct Answer: B. Hypokalemia. *
Rationale: Loop diuretics such as furosemide cause potassium loss in the
urine, leading to hypokalemia. Serum potassium should be monitored closely,
especially in patients also taking digoxin. Hypokalemia can precipitate
cardiac arrhythmias.
Question 6
Which finding is consistent with right-sided heart failure?
A. Crackles in the lungs
B. Jugular vein distention
C. Orthopnea
D. Paroxysmal nocturnal dyspnea
*Correct Answer: B. Jugular vein distention. *
Rationale: Jugular vein distention (JVD) is a hallmark sign of right-sided heart
failure due to systemic venous congestion. Crackles, orthopnea, and
paroxysmal nocturnal dyspnea are signs of left-sided heart failure.
Question 7
A client with peripheral vascular disease is being assessed. Which finding
indicates a venous vascular disorder?
A. An ulcer at the tip of a toe
B. Hair loss distal to the client's calves
C. Leg pain at rest
D. Edema of the ankle
*Correct Answer: D. Edema of the ankle. *
