ATI Medical-Surgical Nursing Part A 2026/2027
Comprehensive Exam | 150 Latest MCQs with
Correct Answers & Detailed Rationales
Section 1: Cardiovascular System
1. A nurse is caring for a client with left-sided heart failure. Which of the following
findings should the nurse expect?
a) Jugular vein distension
b) Peripheral edema
c) Crackles in the lung bases
d) Hepatomegaly
Correct answer: c) Crackles in the lung bases
Rationale: Left-sided heart failure leads to pulmonary congestion, which causes crackles in
the lungs. Right-sided heart failure typically causes systemic congestion (JVD, edema,
hepatomegaly).
2. A nurse is teaching a client about sublingual nitroglycerin. Which statement
indicates understanding?
a) "I can keep my medication for 1 year before replacing it."
b) "I should lie down when I take this medication."
c) "I should discontinue this medication if I develop a headache."
d) "I can take up to five tablets in 15 minutes before seeking help."
Correct answer: b) "I should lie down when I take this medication."
Rationale: Lying down prevents dizziness and hypotension from vasodilation. Nitroglycerin
should be replaced every 6 months, headache is a common side effect, and the correct
dosing is up to 3 tablets every 5 minutes.
,3. A nurse is providing discharge teaching to a client with a new prescription for
sublingual nitroglycerin. Which statement indicates a need for further teaching?
a) "I will take my pulse before each dose."
b) "I can take an antacid at the same time as my nitroglycerin."
c) "I will report nausea, visual changes, or fatigue to my provider."
d) "I will have my potassium level checked periodically."
Correct answer: b) "I can take an antacid at the same time as my nitroglycerin."
Rationale: Antacids can interfere with the absorption of sublingual nitroglycerin. The other
statements are correct for monitoring digoxin, not nitroglycerin.
4. A nurse is caring for a client with chronic heart failure who is prescribed
furosemide. Which finding indicates a potential adverse effect?
a) Serum potassium 3.0 mEq/L
b) Blood pressure 130/80 mm Hg
c) Serum sodium 140 mEq/L
d) Heart rate 80/min
Correct answer: a) Serum potassium 3.0 mEq/L
Rationale: Furosemide is a loop diuretic that can cause hypokalemia. A serum potassium
of 3.0 mEq/L is below the expected reference range (3.5–5.0 mEq/L) and indicates a
potential adverse effect.
5. A nurse is assessing a client admitted with acute decompensated heart failure.
Which assessment finding requires immediate intervention?
a) Bilateral 2+ pitting edema in the lower extremities
b) Oxygen saturation of 88% on room air
c) Weight gain of 3 lbs over the past 3 days
d) Fine crackles heard in the bilateral lower lung bases
Correct answer: b) Oxygen saturation of 88% on room air
Rationale: An oxygen saturation of 88% indicates severe hypoxia and potential respiratory
failure, which is a life-threatening emergency requiring immediate oxygen therapy. Edema,
weight gain, and crackles are expected findings in fluid volume overload but are not as
immediately life-threatening.
, 6. A nurse is caring for a client who has left-sided heart failure. Which of the
following manifestations should the nurse expect?
a) Pedal edema
b) Neck vein distention
c) Daytime oliguria
d) Enlarged liver
Correct answer: c) Daytime oliguria
Rationale: Left-sided heart failure reduces renal perfusion, leading to decreased urine
output during the day. Pedal edema, neck vein distention, and enlarged liver are
manifestations of right-sided heart failure.
7. A nurse is assessing a client who has heart failure and is taking digoxin. Which of
the following findings should the nurse report to the provider?
a) Heart rate 72/min
b) Increased urinary output
c) Nausea and visual disturbances
d) Blood pressure 120/70 mm Hg
Correct answer: c) Nausea and visual disturbances
Rationale: Nausea and visual disturbances (such as yellow-green halos) are signs of
digoxin toxicity. The nurse should withhold the medication and notify the provider.
8. A nurse is teaching a client who has a new prescription for warfarin. Which of the
following foods should the nurse instruct the client to avoid?
a) Spinach
b) Apples
c) Chicken
d) Rice
Correct answer: a) Spinach
Rationale: Spinach is high in vitamin K, which can interfere with warfarin's effectiveness.
Clients should maintain consistent intake of vitamin K-rich foods.
9. A patient with a deep vein thrombosis (DVT) reports sudden chest pain. What
should the nurse suspect?
a) Pulmonary embolism
Comprehensive Exam | 150 Latest MCQs with
Correct Answers & Detailed Rationales
Section 1: Cardiovascular System
1. A nurse is caring for a client with left-sided heart failure. Which of the following
findings should the nurse expect?
a) Jugular vein distension
b) Peripheral edema
c) Crackles in the lung bases
d) Hepatomegaly
Correct answer: c) Crackles in the lung bases
Rationale: Left-sided heart failure leads to pulmonary congestion, which causes crackles in
the lungs. Right-sided heart failure typically causes systemic congestion (JVD, edema,
hepatomegaly).
2. A nurse is teaching a client about sublingual nitroglycerin. Which statement
indicates understanding?
a) "I can keep my medication for 1 year before replacing it."
b) "I should lie down when I take this medication."
c) "I should discontinue this medication if I develop a headache."
d) "I can take up to five tablets in 15 minutes before seeking help."
Correct answer: b) "I should lie down when I take this medication."
Rationale: Lying down prevents dizziness and hypotension from vasodilation. Nitroglycerin
should be replaced every 6 months, headache is a common side effect, and the correct
dosing is up to 3 tablets every 5 minutes.
,3. A nurse is providing discharge teaching to a client with a new prescription for
sublingual nitroglycerin. Which statement indicates a need for further teaching?
a) "I will take my pulse before each dose."
b) "I can take an antacid at the same time as my nitroglycerin."
c) "I will report nausea, visual changes, or fatigue to my provider."
d) "I will have my potassium level checked periodically."
Correct answer: b) "I can take an antacid at the same time as my nitroglycerin."
Rationale: Antacids can interfere with the absorption of sublingual nitroglycerin. The other
statements are correct for monitoring digoxin, not nitroglycerin.
4. A nurse is caring for a client with chronic heart failure who is prescribed
furosemide. Which finding indicates a potential adverse effect?
a) Serum potassium 3.0 mEq/L
b) Blood pressure 130/80 mm Hg
c) Serum sodium 140 mEq/L
d) Heart rate 80/min
Correct answer: a) Serum potassium 3.0 mEq/L
Rationale: Furosemide is a loop diuretic that can cause hypokalemia. A serum potassium
of 3.0 mEq/L is below the expected reference range (3.5–5.0 mEq/L) and indicates a
potential adverse effect.
5. A nurse is assessing a client admitted with acute decompensated heart failure.
Which assessment finding requires immediate intervention?
a) Bilateral 2+ pitting edema in the lower extremities
b) Oxygen saturation of 88% on room air
c) Weight gain of 3 lbs over the past 3 days
d) Fine crackles heard in the bilateral lower lung bases
Correct answer: b) Oxygen saturation of 88% on room air
Rationale: An oxygen saturation of 88% indicates severe hypoxia and potential respiratory
failure, which is a life-threatening emergency requiring immediate oxygen therapy. Edema,
weight gain, and crackles are expected findings in fluid volume overload but are not as
immediately life-threatening.
, 6. A nurse is caring for a client who has left-sided heart failure. Which of the
following manifestations should the nurse expect?
a) Pedal edema
b) Neck vein distention
c) Daytime oliguria
d) Enlarged liver
Correct answer: c) Daytime oliguria
Rationale: Left-sided heart failure reduces renal perfusion, leading to decreased urine
output during the day. Pedal edema, neck vein distention, and enlarged liver are
manifestations of right-sided heart failure.
7. A nurse is assessing a client who has heart failure and is taking digoxin. Which of
the following findings should the nurse report to the provider?
a) Heart rate 72/min
b) Increased urinary output
c) Nausea and visual disturbances
d) Blood pressure 120/70 mm Hg
Correct answer: c) Nausea and visual disturbances
Rationale: Nausea and visual disturbances (such as yellow-green halos) are signs of
digoxin toxicity. The nurse should withhold the medication and notify the provider.
8. A nurse is teaching a client who has a new prescription for warfarin. Which of the
following foods should the nurse instruct the client to avoid?
a) Spinach
b) Apples
c) Chicken
d) Rice
Correct answer: a) Spinach
Rationale: Spinach is high in vitamin K, which can interfere with warfarin's effectiveness.
Clients should maintain consistent intake of vitamin K-rich foods.
9. A patient with a deep vein thrombosis (DVT) reports sudden chest pain. What
should the nurse suspect?
a) Pulmonary embolism
