ATI RN Medical-Surgical Practice Exam
Questions and Correct Answers
(Verified Answers) Plus Rationales |
2026 /2027 Q&A | Instant Download
Pdf.
1. A nurse is caring for a client who has heart failure and is receiving
furosemide. Which finding should the nurse identify as an
indication that the medication is effective?
A. Increased peripheral edema
B. Increased dyspnea
C. Decreased daily weight
D. Decreased urine output
Answer: C. Decreased daily weight
Rationale: Furosemide is a loop diuretic that promotes sodium and
water excretion. A decrease in daily weight indicates a reduction in fluid
retention and is an expected therapeutic response in a client with heart
failure. The nurse should monitor daily weights, intake and output, lung
sounds, and peripheral edema to evaluate fluid status.
2. A nurse is assessing a client who has chronic obstructive
pulmonary disease (COPD). Which finding should the nurse
expect?
,A. Respiratory alkalosis
B. Barrel-shaped chest
C. Decreased anterior-posterior chest diameter
D. Bradycardia
Answer: B. Barrel-shaped chest
Rationale: Chronic air trapping in COPD, particularly emphysema,
causes an increased anterior-posterior diameter of the chest, producing
a barrel-shaped appearance. Clients can also have prolonged expiration,
diminished breath sounds, dyspnea, and use of accessory muscles.
Chronic carbon dioxide retention can contribute to respiratory acidosis
rather than respiratory alkalosis.
3. A nurse is caring for a client who has a myocardial infarction.
Which laboratory value is most specific for myocardial injury?
A. Myoglobin
B. Creatine kinase-MB
C. Troponin I
D. Lactate dehydrogenase
Answer: C. Troponin I
Rationale: Cardiac troponins, particularly troponin I and troponin T, are
highly specific markers of myocardial injury. Troponin levels typically rise
within several hours after myocardial injury and remain elevated for an
extended period. Myoglobin rises earlier but is less specific, while CK-MB
is less specific than troponin.
, 4. A nurse is caring for a client who has pneumonia. Which
assessment finding requires immediate intervention?
A. Temperature of 38.1°C (100.6°F)
B. Productive cough with yellow sputum
C. Respiratory rate of 30/min
D. Oxygen saturation of 89%
Answer: D. Oxygen saturation of 89%
Rationale: An oxygen saturation of 89% indicates impaired oxygenation
and requires prompt intervention. The nurse should assess respiratory
status and administer oxygen as prescribed while investigating the
cause of hypoxemia. Fever, productive cough, and tachypnea are
common findings with pneumonia, but significant hypoxemia represents
the most immediate threat to airway and breathing.
5. A nurse is teaching a client who has diabetes mellitus about
recognizing hypoglycemia. Which manifestation should the nurse
include?
A. Warm, dry skin
B. Fruity breath
C. Tremors and diaphoresis
D. Deep, rapid respirations
Answer: C. Tremors and diaphoresis
Rationale: Hypoglycemia activates the sympathetic nervous system,
producing manifestations such as tremors, sweating, palpitations,
anxiety, hunger, and tachycardia. Fruity breath and deep, rapid
, respirations are associated with diabetic ketoacidosis. Warm, dry skin is
more consistent with hyperglycemia-related dehydration than acute
hypoglycemia.
6. A nurse is caring for a client who has a potassium level of 2.9
mEq/L (2.9 mmol/L). Which finding should the nurse expect?
A. Muscle weakness
B. Hyperactive reflexes
C. Peaked T waves
D. Facial twitching
Answer: A. Muscle weakness
Rationale: Hypokalemia can cause muscle weakness, fatigue,
constipation, decreased bowel motility, and cardiac dysrhythmias. ECG
changes can include flattened or inverted T waves and the presence of U
waves. Peaked T waves are associated with hyperkalemia, while
neuromuscular irritability and facial twitching are more characteristic of
hypocalcemia.
7. A nurse is caring for a client who has a chest tube connected to a
water-seal drainage system. Which finding requires immediate
action?
A. Tidaling in the water-seal chamber
B. Drainage of 50 mL during the first hour
C. Continuous bubbling in the water-seal chamber
D. Mild discomfort at the insertion site
Questions and Correct Answers
(Verified Answers) Plus Rationales |
2026 /2027 Q&A | Instant Download
Pdf.
1. A nurse is caring for a client who has heart failure and is receiving
furosemide. Which finding should the nurse identify as an
indication that the medication is effective?
A. Increased peripheral edema
B. Increased dyspnea
C. Decreased daily weight
D. Decreased urine output
Answer: C. Decreased daily weight
Rationale: Furosemide is a loop diuretic that promotes sodium and
water excretion. A decrease in daily weight indicates a reduction in fluid
retention and is an expected therapeutic response in a client with heart
failure. The nurse should monitor daily weights, intake and output, lung
sounds, and peripheral edema to evaluate fluid status.
2. A nurse is assessing a client who has chronic obstructive
pulmonary disease (COPD). Which finding should the nurse
expect?
,A. Respiratory alkalosis
B. Barrel-shaped chest
C. Decreased anterior-posterior chest diameter
D. Bradycardia
Answer: B. Barrel-shaped chest
Rationale: Chronic air trapping in COPD, particularly emphysema,
causes an increased anterior-posterior diameter of the chest, producing
a barrel-shaped appearance. Clients can also have prolonged expiration,
diminished breath sounds, dyspnea, and use of accessory muscles.
Chronic carbon dioxide retention can contribute to respiratory acidosis
rather than respiratory alkalosis.
3. A nurse is caring for a client who has a myocardial infarction.
Which laboratory value is most specific for myocardial injury?
A. Myoglobin
B. Creatine kinase-MB
C. Troponin I
D. Lactate dehydrogenase
Answer: C. Troponin I
Rationale: Cardiac troponins, particularly troponin I and troponin T, are
highly specific markers of myocardial injury. Troponin levels typically rise
within several hours after myocardial injury and remain elevated for an
extended period. Myoglobin rises earlier but is less specific, while CK-MB
is less specific than troponin.
, 4. A nurse is caring for a client who has pneumonia. Which
assessment finding requires immediate intervention?
A. Temperature of 38.1°C (100.6°F)
B. Productive cough with yellow sputum
C. Respiratory rate of 30/min
D. Oxygen saturation of 89%
Answer: D. Oxygen saturation of 89%
Rationale: An oxygen saturation of 89% indicates impaired oxygenation
and requires prompt intervention. The nurse should assess respiratory
status and administer oxygen as prescribed while investigating the
cause of hypoxemia. Fever, productive cough, and tachypnea are
common findings with pneumonia, but significant hypoxemia represents
the most immediate threat to airway and breathing.
5. A nurse is teaching a client who has diabetes mellitus about
recognizing hypoglycemia. Which manifestation should the nurse
include?
A. Warm, dry skin
B. Fruity breath
C. Tremors and diaphoresis
D. Deep, rapid respirations
Answer: C. Tremors and diaphoresis
Rationale: Hypoglycemia activates the sympathetic nervous system,
producing manifestations such as tremors, sweating, palpitations,
anxiety, hunger, and tachycardia. Fruity breath and deep, rapid
, respirations are associated with diabetic ketoacidosis. Warm, dry skin is
more consistent with hyperglycemia-related dehydration than acute
hypoglycemia.
6. A nurse is caring for a client who has a potassium level of 2.9
mEq/L (2.9 mmol/L). Which finding should the nurse expect?
A. Muscle weakness
B. Hyperactive reflexes
C. Peaked T waves
D. Facial twitching
Answer: A. Muscle weakness
Rationale: Hypokalemia can cause muscle weakness, fatigue,
constipation, decreased bowel motility, and cardiac dysrhythmias. ECG
changes can include flattened or inverted T waves and the presence of U
waves. Peaked T waves are associated with hyperkalemia, while
neuromuscular irritability and facial twitching are more characteristic of
hypocalcemia.
7. A nurse is caring for a client who has a chest tube connected to a
water-seal drainage system. Which finding requires immediate
action?
A. Tidaling in the water-seal chamber
B. Drainage of 50 mL during the first hour
C. Continuous bubbling in the water-seal chamber
D. Mild discomfort at the insertion site
