ATI MED SURG CMS PROCTORED EXAM 2026 | VERSIONS A, B AND C

ATI MED SURG CMS PROCTORED EXAM 2026 | VERSIONS A, B AND C COMPLETE 300 ORIGINAL PRACTICE QUESTIONS & RATIONALES QUESTION 1 A nurse is assessing a client who has been diagnosed with heart failure. Which of the following findings is an early manifestation of left-sided heart failure? A. Jugular venous distension B. Peripheral edema C. Dyspnea on exertion D. Crackles in the lung bases Correct Answer: D. Crackles in the lung bases Rationale: Left-sided heart failure leads to pulmonary congestion. Crackles (rales) in the lung bases are an early sign of fluid backing up into the lungs, indicating decreased cardiac output and increased pulmonary pressure. --- QUESTION 2 A nurse is reviewing the laboratory results for a client who is taking furosemide. Which of the following findings indicates an adverse effect of the medication? A. Serum sodium of 145 mEq/L B. Serum potassium of 3.2 mEq/L C. Serum potassium of 3.0 mEq/L D. Serum calcium of 10.2 mg/dL Correct Answer: C. Serum potassium of 3.0 mEq/L Rationale: Furosemide is a loop diuretic that inhibits sodium and water reabsorption in the loop of Henle, also leading to significant potassium excretion. A potassium level of 3.0 mEq/L is below the normal range (3.5-5.0 mEq/L), indicating hypokalemia, a common adverse effect. --- QUESTION 3 A nurse is assessing a client who is 6 hours post-operative from a total hip arthroplasty. Which of the following findings requires immediate intervention? A. Pain rated as 4 on a scale of 0 to 10 B. Slight serosanguineous drainage on the dressing C. Toes on the operative extremity are pale and cool to the touch D. Toes on the operative extremity are pale and cool to the touch Correct Answer: C. Toes on the operative extremity are pale and cool to the touch Rationale: Pale, cool toes on the operative extremity indicate compromised circulation, potentially from a thromboembolism or arterial occlusion. This is a medical emergency requiring immediate assessment and intervention to prevent tissue necrosis. --- QUESTION 4 A nurse is planning care for a client with cirrhosis of the liver. Which of the following interventions should be included to manage the client's ascites? A. Restrict dietary protein B. Encourage a high-sodium diet C. Administer lactulose as prescribed D. Measure abdominal girth daily Correct Answer: D. Measure abdominal girth daily Rationale: Daily measurement of abdominal girth is a key nursing intervention to monitor the progression or resolution of ascites. It provides objective data to assess the effectiveness of treatments like diuretics and paracentesis. --- QUESTION 5 A nurse is providing discharge teaching to a client with a new diagnosis of type 2 diabetes. Which of the following statements by the client indicates a need for further teaching? A. "I will need to check my blood sugar before each meal." B. "I should carry a source of sugar with me at all times." C. "I can stop my medication once my blood sugar is normal." D. "I can stop my medication once my blood sugar is normal." Correct Answer: C. "I can stop my medication once my blood sugar is normal." Rationale: Type 2 diabetes is a chronic condition. Medications, along with diet and exercise, are needed to maintain blood glucose control. Stopping medication without a provider's guidance can lead to dangerous hyperglycemia. The client needs to understand that management is lifelong. --- QUESTION 6 A nurse is caring for a client who has a pulmonary embolism. Which of the following interventions should the nurse anticipate? A. Administering thrombolytic therapy B. Placing the client in a high-Fowler's position C. Monitoring arterial blood gases (ABGs) D. Administering thrombolytic therapy Correct Answer: A. Administering thrombolytic therapy Rationale: For a massive pulmonary embolism, thrombolytic therapy (e.g., alteplase) is the treatment of choice to dissolve the clot and restore pulmonary blood flow. While monitoring ABGs and oxygen therapy are important, thrombolytics are a specific, definitive intervention. --- QUESTION 7 A nurse is assessing a client who has chronic kidney disease. Which of the following laboratory findings would the nurse expect? A. Decreased serum creatinine B. Increased GFR C. Decreased BUN D. Elevated serum phosphorus Correct Answer: D. Elevated serum phosphorus Rationale: In chronic kidney disease, the kidneys fail to excrete phosphorus, leading to hyperphosphatemia. This is a common electrolyte imbalance that contributes to renal osteodystrophy and cardiovascular complications. --- QUESTION 8 A nurse is preparing to administer an enteral feeding via a nasogastric tube. Which of the following actions should the nurse take first? A. Flush the tube with 30 mL of water B. Elevate the head of the bed to 45 degrees C. Verify tube placement by checking the pH of gastric aspirate D. Verify tube placement by checking the pH of gastric aspirate Correct Answer: C. Verify tube placement by checking the pH of gastric aspirate Rationale: Before administering anything through an NG tube, the nurse must verify correct placement to prevent aspiration. Checking the pH of the aspirate (should be ≤ 5.0) is an appropriate method to confirm placement. --- QUESTION 9 A nurse is caring for a client with pneumonia. Which of the following positions should the nurse encourage to help mobilize secretions? A. Supine B. Prone C. Semi-Fowler's D. High-Fowler's Correct Answer: D. High-Fowler's Rationale: High-Fowler's position promotes maximal lung expansion and facilitates drainage of secretions, making it easier for the client to cough and clear the airway. --- QUESTION 10 A client is prescribed warfarin for atrial fibrillation. Which of the following laboratory values is most important for the nurse to monitor? A. Activated partial thromboplastin time (aPTT) B. Platelet count C. International normalized ratio (INR) D. International normalized ratio (INR) Correct Answer: C. International normalized ratio (INR) Rationale: Warfarin affects the extrinsic pathway of the coagulation cascade. The INR is the standard test used to monitor the therapeutic effect of warfarin and to adjust the dose to maintain a target range (typically 2.0-3.0 for atrial fibrillation). --- QUESTION 11 A nurse is reinforcing teaching about a low-sodium diet for a client with hypertension. Which of the following statements indicates the client understands the teaching? A. "I can season my food with garlic powder instead of salt." B. "I can season my food with garlic powder instead of salt." C. "I should choose canned vegetables because they are cheaper." D. "I can have a sandwich with turkey and processed cheese." Correct Answer: B. "I can season my food with garlic powder instead of salt." Rationale: Garlic powder is a sodium-free seasoning that adds flavor without increasing sodium intake. This indicates the client understands an alternative to using salt. --- QUESTION 12 A nurse is assessing a client who is post-operative from a bowel resection and has a nasogastric tube attached to low intermittent suction. Which of the following findings indicates a potential complication? A. Abdominal cramping B. Nausea C. Hypoactive bowel sounds D. Absent bowel sounds Correct Answer: D. Absent bowel sounds Rationale: While hypoactive bowel sounds are expected post-operatively, absent bowel sounds can indicate a paralytic ileus, which is a serious complication. This finding warrants immediate notification of the provider. --- QUESTION 13 A nurse is caring for a client who has type 1 diabetes mellitus. The client is sweating, tremulous, and reports feeling dizzy. Which of the following actions should the nurse take first? A. Check the client's blood glucose level B. Check the client's blood glucose level C. Administer 50% dextrose IV push D. Give the client a glass of orange juice Correct Answer: B. Check the client's blood glucose level Rationale: The client is exhibiting signs of hypoglycemia. The first action is to check the blood glucose level to confirm the suspicion and determine the appropriate treatment. --- QUESTION 14 A client with heart failure is prescribed digoxin. Which of the following findings is a sign of digoxin toxicity? A. Tachycardia B. Hypertension C. Anorexia and nausea D. Anorexia and nausea Correct Answer: C. Anorexia and nausea Rationale: Early signs of digoxin toxicity include gastrointestinal symptoms such as anorexia, nausea, and vomiting. Visual disturbances (yellow-green halos) and cardiac dysrhythmias (bradycardia) are also common. --- QUESTION 15 A nurse is caring for a client with cirrhosis who has developed hepatic encephalopathy. Which of the following medications does the nurse anticipate administering? A. Spironolactone B. Furosemide C. Lactulose D. Lactulose Correct Answer: C. Lactulose Rationale: Lactulose is administered to reduce serum ammonia levels in clients with hepatic encephalopathy. It works by acidifying the colon, trapping ammonia and promoting its excretion in the stool. --- QUESTION 16 A nurse is assessing a client for signs of deep vein thrombosis (DVT). Which of the following findings is a classic sign? A. Coolness and pallor of the extremity B. Pitting edema and erythema C. Sharp pain in the calf with dorsiflexion of the foot D. Sharp pain in the calf with dorsiflexion of the foot Correct Answer: C. Sharp pain in the calf with dorsiflexion of the foot Rationale: Homans' sign (pain in the calf with dorsiflexion) is an indicator of DVT, though not always reliable. The classic signs of a DVT are unilateral swelling, warmth, redness, and pain in the affected extremity. --- QUESTION 17 The nurse is caring for a client post-hip arthroplasty. Which of the following instructions should be given to the nursing assistant? A. "You may help the client bend over to pick up an object." B. "It's okay for the client to sit in a low chair." C. "Place a pillow between the client's legs when turning." D. "Place a pillow between the client's legs when turning." Correct Answer: C. "Place a pillow between the client's legs when turning." Rationale: Maintaining abduction of the hip is crucial post-hip arthroplasty to prevent dislocation. A pillow between the legs helps maintain this position. --- QUESTION 18 A nurse is assessing a client who has a urinary tract infection (UTI). Which of the following findings would the nurse expect in an older adult? A. Fever and chills B. Dysuria C. Confusion and altered mental status D. Confusion and altered mental status Correct Answer: C. Confusion and altered mental status Rationale: In older adults, classic UTI symptoms like dysuria and frequency may be absent. Instead, the first presenting sign can be a sudden change in cognition, such as confusion, delirium, or lethargy. --- QUESTION 19 A nurse is preparing to insert a Foley catheter. Which of the following actions is correct? A. Use sterile technique and a sterile field B. Use sterile technique and a sterile field C. Use clean gloves for the entire procedure D. Advance the catheter until resistance is met Correct Answer: B. Use sterile technique and a sterile field Rationale: Foley catheter insertion is a sterile procedure to prevent introducing microorganisms into the urinary tract. Maintaining a sterile field and using sterile equipment is essential. --- QUESTION 20 A nurse is teaching a client about managing asthma. Which of the following should be included in the teaching? A. Use a peak flow meter to monitor breathing status B. Use a peak flow meter to monitor breathing status C. Take a rescue inhaler daily to prevent symptoms D. Avoid all exercise to prevent attacks Correct Answer: B. Use a peak flow meter to monitor breathing status Rationale: A peak flow meter is a key tool for asthma self-management. It helps clients monitor their airway obstruction and can give them advance warning of an impending asthma exacerbation.