ATI MED SURG / VATI MED SURG EXAM
Comprehensive Test Bank – 2026/2027 Edition
Aligned with the ATI/VATI Medical-Surgical Nursing Blueprint & NCLEX-RN Clinical Judgment Standards
250 Questions | 10 Content Domains | Multiple Choice (A–D)
Contents
Section 1: Cardiovascular Disorders – CAD, MI, Heart Failure, Hypertension, Dysrhythmias, Shock (40 questions)
Section 2: Respiratory Disorders – COPD, Asthma, Pneumonia, PE, ARDS, Mechanical Ventilation, TB (34 questions)
Section 3: Gastrointestinal & Hepatic Disorders – GERD, PUD, Liver Disease, Pancreatitis, IBD, GI Bleeds (28
questions)
Section 4: Neurological Disorders – Stroke, Seizures, Parkinson's, MS, Head Trauma, Spinal Cord Injury, Meningitis
(28 questions)
Section 5: Renal & Urinary Disorders – AKI, CKD, Dialysis, UTI, Fluid/Electrolytes, BPH (23 questions)
Section 6: Endocrine Disorders – Diabetes, DKA, HHS, Thyroid, Adrenal, SIADH (23 questions)
Section 7: Musculoskeletal & Integumentary Disorders – Fractures, Osteoporosis, Arthritis, Burns, Wound Care (19
questions)
Section 8: Hematological & Immunological Disorders – Anemia, Sickle Cell, HIV/AIDS, Blood Transfusions,
Immunizations (20 questions)
Section 9: Perioperative & Critical Care – Pre/Postoperative Care, Central Lines, TURP, Halo Traction (15 questions)
Section 10: Integrated Case Studies & Prioritization – Complex, Multi-System Scenarios (20 questions)
How to use this test bank: Work through each section sequentially. One answer choice per question is correct; the correct
answer and a rationale follow each question. Use the rationales to reinforce clinical judgment and core content. A reference
answer key is provided on the final page.
ATI Med Surg / VATI Med Surg Exam – Comprehensive Test Bank (2026/2027 Edition) Page 1
, Section 1: Cardiovascular Disorders – CAD, MI, Heart Failure, Hypertension,
Section 1
Dysrhythmias, Shock (40 questions)
Q1: A client with heart failure reports worsening dyspnea and orthopnea. Assessment reveals bilateral
crackles, distended neck veins, 3+ pitting edema of the lower extremities, and SpO2 of 89% on room air.
Which action should the nurse take FIRST?
A. Obtain the client's daily weight
B. Elevate the head of the bed and administer oxygen [CORRECT]
C. Administer furosemide 40 mg IV push
D. Restrict oral fluid intake
Correct Answer: B
Rationale: Airway and breathing are the priority: high-Fowler's positioning and oxygen improve oxygenation before
medications or other measures are initiated.
Q2: A client with heart failure is prescribed furosemide. Which food should the nurse encourage the client
to include in the diet?
A. Bananas [CORRECT]
B. Canned soup
C. Deli meat
D. Hard cheese
Correct Answer: A
Rationale: Loop diuretics such as furosemide waste potassium, so potassium-rich foods like bananas are encouraged.
Canned soup, deli meat, and cheese are high in sodium and should be limited.
Q3: A client is taking furosemide and digoxin. The nurse should monitor closely for which finding?
A. Muscle weakness related to hypokalemia, which increases the risk of digoxin toxicity [CORRECT]
B. Hyperkalemia, which decreases digoxin effectiveness
C. Hypermagnesemia, which potentiates furosemide
D. Hypernatremia, which worsens heart failure
Correct Answer: A
Rationale: Furosemide-induced hypokalemia causes muscle weakness and increases the risk of digoxin toxicity
because digoxin and potassium compete at the sodium-potassium pump.
Q4: A client in the emergency department reports crushing chest pain radiating to the left arm.
Assessment reveals cool, moist skin, bilateral crackles, and an elevated creatine kinase (CK-MB) level.
Which finding should the nurse report to the provider immediately?
A. Elevated CK-MB level
B. Radiation of pain to the left arm
C. Cool, moist skin
D. Crackles in the lung bases [CORRECT]
Correct Answer: D
Rationale: New-onset crackles indicate developing pulmonary congestion (left-sided heart failure), a potentially
life-threatening complication. Elevated enzymes, radiating pain, and diaphoresis are expected findings in acute coronary
syndrome.
ATI Med Surg / VATI Med Surg Exam – Comprehensive Test Bank (2026/2027 Edition) Page 2
, Q5: A client on telemetry has a heart rate of 40/min, is diaphoretic, and reports chest pain. Blood pressure
is 88/54 mm Hg. Which action should the nurse take FIRST?
A. Defibrillate the client immediately
B. Administer atropine as prescribed [CORRECT]
C. Administer sublingual nitroglycerin
D. Administer an additional dose of digoxin
Correct Answer: B
Rationale: Symptomatic bradycardia with hypotension and chest pain requires atropine to increase the heart rate.
Nitroglycerin and digoxin would worsen bradycardia and hypotension, and defibrillation is reserved for pulseless
ventricular rhythms.
Q6: A client with hypertension is receiving dietary teaching. Which modification should the nurse
recommend?
A. Restrict sodium intake to 2,300 mg/day or less [CORRECT]
B. Increase intake of saturated fats
C. Add table salt to cooked foods
D. Consume caffeine with each meal
Correct Answer: A
Rationale: Limiting sodium (DASH-style eating) lowers blood pressure. Saturated fats, added salt, and caffeine raise or
do not improve blood pressure control.
Q7: A client with a family history of coronary artery disease asks how to reduce risk. Which
recommendation is MOST effective?
A. Smoking cessation [CORRECT]
B. Avoiding all physical activity
C. Consuming full-fat dairy products
D. Restricting fluid intake
Correct Answer: A
Rationale: Smoking cessation is the single most effective modifiable risk-reduction strategy for coronary artery disease.
Regular exercise is beneficial, and full-fat dairy increases saturated fat intake.
Q8: A client with peripheral arterial disease reports leg pain with walking that resolves with rest. Which
instruction should the nurse include?
A. Apply a heating pad to the legs to relieve pain
B. Elevate the legs above heart level when resting
C. Walk until pain occurs, rest, then resume walking [CORRECT]
D. Cross the legs when sitting to reduce edema
Correct Answer: C
Rationale: A graduated walking program promotes collateral circulation in peripheral arterial disease. Heat can burn
insensate skin, elevation worsens arterial perfusion, and leg crossing impedes blood flow.
Q9: A client presents to the emergency department with ST-segment elevation myocardial infarction
(STEMI). Which medication should the nurse anticipate administering FIRST per protocol?
A. Morphine sulfate IV
B. Chewable aspirin 325 mg [CORRECT]
C. Metoprolol IV
D. Atorvastatin 80 mg
Correct Answer: B
Rationale: Aspirin is administered first in acute MI to rapidly inhibit platelet aggregation and reduce mortality. Morphine,
beta blockers, and statins follow as indicated.
ATI Med Surg / VATI Med Surg Exam – Comprehensive Test Bank (2026/2027 Edition) Page 3
, Q10: Which assessment finding is characteristic of RIGHT-sided heart failure?
A. Distended neck veins [CORRECT]
B. Pulmonary crackles
C. Orthopnea
D. Pink, frothy sputum
Correct Answer: A
Rationale: Right-sided failure causes systemic venous congestion, including jugular venous distention, peripheral
edema, and hepatomegaly. Crackles, orthopnea, and frothy sputum reflect left-sided failure.
Q11: A client taking digoxin reports nausea and seeing yellow-green halos around lights. The nurse notes
an apical pulse of 52/min. Which action should the nurse take?
A. Administer the next dose of digoxin as scheduled
B. Hold the digoxin and notify the provider [CORRECT]
C. Encourage increased oral fluid intake
D. Administer potassium chloride without an order
Correct Answer: B
Rationale: Nausea, visual disturbances, and bradycardia suggest digoxin toxicity. The nurse should hold the dose and
notify the provider for a serum digoxin level and potassium evaluation.
Q12: A blood pressure of 146/92 mm Hg on two separate occasions is classified as:
A. Normal
B. Stage 1 hypertension
C. Stage 2 hypertension [CORRECT]
D. Hypotension
Correct Answer: C
Rationale: Stage 2 hypertension is defined as a systolic pressure of 140 mm Hg or higher or a diastolic pressure of 90
mm Hg or higher. Stage 1 is 130-139/80-89.
Q13: A client prescribed warfarin receives dietary teaching. Which instruction is correct?
A. Maintain a consistent intake of vitamin K-containing foods [CORRECT]
B. Eliminate all green leafy vegetables from the diet
C. Take a daily aspirin with warfarin
D. Consume large amounts of cranberry juice daily
Correct Answer: A
Rationale: Consistency, not elimination, of vitamin K foods keeps the INR stable. Aspirin increases bleeding risk unless
prescribed, and large amounts of cranberry juice can potentiate warfarin.
Q14: A client is receiving a continuous heparin infusion. Which monitoring and reversal information
should the nurse understand?
A. Monitor the INR; antidote is vitamin K
B. Monitor the aPTT; antidote is protamine sulfate [CORRECT]
C. Monitor the platelet count; antidote is aminocaproic acid
D. Monitor the prothrombin time; antidote is calcium gluconate
Correct Answer: B
Rationale: Heparin therapy is monitored with the aPTT, and protamine sulfate reverses its effect. INR and vitamin K are
used for warfarin.
ATI Med Surg / VATI Med Surg Exam – Comprehensive Test Bank (2026/2027 Edition) Page 4
Comprehensive Test Bank – 2026/2027 Edition
Aligned with the ATI/VATI Medical-Surgical Nursing Blueprint & NCLEX-RN Clinical Judgment Standards
250 Questions | 10 Content Domains | Multiple Choice (A–D)
Contents
Section 1: Cardiovascular Disorders – CAD, MI, Heart Failure, Hypertension, Dysrhythmias, Shock (40 questions)
Section 2: Respiratory Disorders – COPD, Asthma, Pneumonia, PE, ARDS, Mechanical Ventilation, TB (34 questions)
Section 3: Gastrointestinal & Hepatic Disorders – GERD, PUD, Liver Disease, Pancreatitis, IBD, GI Bleeds (28
questions)
Section 4: Neurological Disorders – Stroke, Seizures, Parkinson's, MS, Head Trauma, Spinal Cord Injury, Meningitis
(28 questions)
Section 5: Renal & Urinary Disorders – AKI, CKD, Dialysis, UTI, Fluid/Electrolytes, BPH (23 questions)
Section 6: Endocrine Disorders – Diabetes, DKA, HHS, Thyroid, Adrenal, SIADH (23 questions)
Section 7: Musculoskeletal & Integumentary Disorders – Fractures, Osteoporosis, Arthritis, Burns, Wound Care (19
questions)
Section 8: Hematological & Immunological Disorders – Anemia, Sickle Cell, HIV/AIDS, Blood Transfusions,
Immunizations (20 questions)
Section 9: Perioperative & Critical Care – Pre/Postoperative Care, Central Lines, TURP, Halo Traction (15 questions)
Section 10: Integrated Case Studies & Prioritization – Complex, Multi-System Scenarios (20 questions)
How to use this test bank: Work through each section sequentially. One answer choice per question is correct; the correct
answer and a rationale follow each question. Use the rationales to reinforce clinical judgment and core content. A reference
answer key is provided on the final page.
ATI Med Surg / VATI Med Surg Exam – Comprehensive Test Bank (2026/2027 Edition) Page 1
, Section 1: Cardiovascular Disorders – CAD, MI, Heart Failure, Hypertension,
Section 1
Dysrhythmias, Shock (40 questions)
Q1: A client with heart failure reports worsening dyspnea and orthopnea. Assessment reveals bilateral
crackles, distended neck veins, 3+ pitting edema of the lower extremities, and SpO2 of 89% on room air.
Which action should the nurse take FIRST?
A. Obtain the client's daily weight
B. Elevate the head of the bed and administer oxygen [CORRECT]
C. Administer furosemide 40 mg IV push
D. Restrict oral fluid intake
Correct Answer: B
Rationale: Airway and breathing are the priority: high-Fowler's positioning and oxygen improve oxygenation before
medications or other measures are initiated.
Q2: A client with heart failure is prescribed furosemide. Which food should the nurse encourage the client
to include in the diet?
A. Bananas [CORRECT]
B. Canned soup
C. Deli meat
D. Hard cheese
Correct Answer: A
Rationale: Loop diuretics such as furosemide waste potassium, so potassium-rich foods like bananas are encouraged.
Canned soup, deli meat, and cheese are high in sodium and should be limited.
Q3: A client is taking furosemide and digoxin. The nurse should monitor closely for which finding?
A. Muscle weakness related to hypokalemia, which increases the risk of digoxin toxicity [CORRECT]
B. Hyperkalemia, which decreases digoxin effectiveness
C. Hypermagnesemia, which potentiates furosemide
D. Hypernatremia, which worsens heart failure
Correct Answer: A
Rationale: Furosemide-induced hypokalemia causes muscle weakness and increases the risk of digoxin toxicity
because digoxin and potassium compete at the sodium-potassium pump.
Q4: A client in the emergency department reports crushing chest pain radiating to the left arm.
Assessment reveals cool, moist skin, bilateral crackles, and an elevated creatine kinase (CK-MB) level.
Which finding should the nurse report to the provider immediately?
A. Elevated CK-MB level
B. Radiation of pain to the left arm
C. Cool, moist skin
D. Crackles in the lung bases [CORRECT]
Correct Answer: D
Rationale: New-onset crackles indicate developing pulmonary congestion (left-sided heart failure), a potentially
life-threatening complication. Elevated enzymes, radiating pain, and diaphoresis are expected findings in acute coronary
syndrome.
ATI Med Surg / VATI Med Surg Exam – Comprehensive Test Bank (2026/2027 Edition) Page 2
, Q5: A client on telemetry has a heart rate of 40/min, is diaphoretic, and reports chest pain. Blood pressure
is 88/54 mm Hg. Which action should the nurse take FIRST?
A. Defibrillate the client immediately
B. Administer atropine as prescribed [CORRECT]
C. Administer sublingual nitroglycerin
D. Administer an additional dose of digoxin
Correct Answer: B
Rationale: Symptomatic bradycardia with hypotension and chest pain requires atropine to increase the heart rate.
Nitroglycerin and digoxin would worsen bradycardia and hypotension, and defibrillation is reserved for pulseless
ventricular rhythms.
Q6: A client with hypertension is receiving dietary teaching. Which modification should the nurse
recommend?
A. Restrict sodium intake to 2,300 mg/day or less [CORRECT]
B. Increase intake of saturated fats
C. Add table salt to cooked foods
D. Consume caffeine with each meal
Correct Answer: A
Rationale: Limiting sodium (DASH-style eating) lowers blood pressure. Saturated fats, added salt, and caffeine raise or
do not improve blood pressure control.
Q7: A client with a family history of coronary artery disease asks how to reduce risk. Which
recommendation is MOST effective?
A. Smoking cessation [CORRECT]
B. Avoiding all physical activity
C. Consuming full-fat dairy products
D. Restricting fluid intake
Correct Answer: A
Rationale: Smoking cessation is the single most effective modifiable risk-reduction strategy for coronary artery disease.
Regular exercise is beneficial, and full-fat dairy increases saturated fat intake.
Q8: A client with peripheral arterial disease reports leg pain with walking that resolves with rest. Which
instruction should the nurse include?
A. Apply a heating pad to the legs to relieve pain
B. Elevate the legs above heart level when resting
C. Walk until pain occurs, rest, then resume walking [CORRECT]
D. Cross the legs when sitting to reduce edema
Correct Answer: C
Rationale: A graduated walking program promotes collateral circulation in peripheral arterial disease. Heat can burn
insensate skin, elevation worsens arterial perfusion, and leg crossing impedes blood flow.
Q9: A client presents to the emergency department with ST-segment elevation myocardial infarction
(STEMI). Which medication should the nurse anticipate administering FIRST per protocol?
A. Morphine sulfate IV
B. Chewable aspirin 325 mg [CORRECT]
C. Metoprolol IV
D. Atorvastatin 80 mg
Correct Answer: B
Rationale: Aspirin is administered first in acute MI to rapidly inhibit platelet aggregation and reduce mortality. Morphine,
beta blockers, and statins follow as indicated.
ATI Med Surg / VATI Med Surg Exam – Comprehensive Test Bank (2026/2027 Edition) Page 3
, Q10: Which assessment finding is characteristic of RIGHT-sided heart failure?
A. Distended neck veins [CORRECT]
B. Pulmonary crackles
C. Orthopnea
D. Pink, frothy sputum
Correct Answer: A
Rationale: Right-sided failure causes systemic venous congestion, including jugular venous distention, peripheral
edema, and hepatomegaly. Crackles, orthopnea, and frothy sputum reflect left-sided failure.
Q11: A client taking digoxin reports nausea and seeing yellow-green halos around lights. The nurse notes
an apical pulse of 52/min. Which action should the nurse take?
A. Administer the next dose of digoxin as scheduled
B. Hold the digoxin and notify the provider [CORRECT]
C. Encourage increased oral fluid intake
D. Administer potassium chloride without an order
Correct Answer: B
Rationale: Nausea, visual disturbances, and bradycardia suggest digoxin toxicity. The nurse should hold the dose and
notify the provider for a serum digoxin level and potassium evaluation.
Q12: A blood pressure of 146/92 mm Hg on two separate occasions is classified as:
A. Normal
B. Stage 1 hypertension
C. Stage 2 hypertension [CORRECT]
D. Hypotension
Correct Answer: C
Rationale: Stage 2 hypertension is defined as a systolic pressure of 140 mm Hg or higher or a diastolic pressure of 90
mm Hg or higher. Stage 1 is 130-139/80-89.
Q13: A client prescribed warfarin receives dietary teaching. Which instruction is correct?
A. Maintain a consistent intake of vitamin K-containing foods [CORRECT]
B. Eliminate all green leafy vegetables from the diet
C. Take a daily aspirin with warfarin
D. Consume large amounts of cranberry juice daily
Correct Answer: A
Rationale: Consistency, not elimination, of vitamin K foods keeps the INR stable. Aspirin increases bleeding risk unless
prescribed, and large amounts of cranberry juice can potentiate warfarin.
Q14: A client is receiving a continuous heparin infusion. Which monitoring and reversal information
should the nurse understand?
A. Monitor the INR; antidote is vitamin K
B. Monitor the aPTT; antidote is protamine sulfate [CORRECT]
C. Monitor the platelet count; antidote is aminocaproic acid
D. Monitor the prothrombin time; antidote is calcium gluconate
Correct Answer: B
Rationale: Heparin therapy is monitored with the aPTT, and protamine sulfate reverses its effect. INR and vitamin K are
used for warfarin.
ATI Med Surg / VATI Med Surg Exam – Comprehensive Test Bank (2026/2027 Edition) Page 4
