• Mental Health Care 09/15/2026
ATI RN Adult Medical-Surgical 2026 Proctored Exam
Most Tested Practice Questions with Answers &
Rationales Exam Format: 250 questions | Multiple
Choice, SATA, NGN Case Studies | Answers with detailed
rationales | Level 3 proficiency focus Content
The nurse is caring for a critically ill client with cirrhosis of the liver who has a nasogastric tube draining bright red
blood. The nurse notes that the client's serum hemoglobin and hematocrit levels are decreased. Which
additional change in laboratory data should the nurse expect?
A.
Increased serum albumin level
P 1
, • Mental Health Care 09/15/2026
B.
Decreased serum creatinine
C.
Decreased serum ammonia level
D.
Increased liver function test results –
Correct Answer :C.
Decreased serum ammonia level
Rationale:
The breakdown of glutamine in the intestine and the increased activity of colonic bacteria from the digestion of
proteins increase ammonia levels in clients with advanced liver disease, so removal of blood, a protein source,
from the intestine results in a reduced level of ammonia (C). (A, B, and D) will not be significantly affected by the
removal of blood.
A client with a nasogastric tube attached to low suction states that she is nauseated. The nurse assesses that
there has been no drainage through the nasogastric tube in the last 2 hours. Which action should the nurse take
first?
A.
Irrigate the nasogastric tube with sterile normal saline.
B.
Reposition the client on her side.
C.
P 2
, • Mental Health Care 09/15/2026
Advance the nasogastric tube 5 cm.
D.
Administer an intravenous antiemetic as prescribed.
- Correct Answer :B
Rationale:The immediate priority is to determine if the tube is functioning correctly, which would then relieve the
client's nausea. The least invasive intervention, repositioning the client, should be attempted first, followed by
options A and C, unless either of these interventions is contraindicated. If these measures are unsuccessful, the
client may require option D.
The nurse is conducting an osteoporosis screening clinic at a health fair. What information should the nurse
provide to individuals who are at risk for osteoporosis? (Select all that apply.)
A.
Encourage alcohol and smoking cessation.
B.
Suggest supplementing diet with vitamin E.
C.
Promote regular weight-bearing exercises.
D.
Implement a home safety plan to prevent falls.
E.
Propose a regular sleep pattern of 8 hours nightly. –
Correct Answer :A, C, D
Rationale:Options A, C, and D are factors that decrease the risk for developing osteoporosis. Vitamin D and
calcium are important supplements to aid in the decrease of bone loss. Regular sleep patterns are important to
overall health but are not identified with a decreasing risk for osteoporosis.
Which nursing action would be appropriate for a client who is newly diagnosed with Cushing syndrome?
A.
Monitor blood glucose levels daily.
P 3
, • Mental Health Care 09/15/2026
B.
Increase intake of fluids high in potassium.
C.
Encourage adequate rest between activities.
D.
Offer the client a sodium-enriched menu.
- Correct Answer :A
Rationale:Cushing syndrome results from a hypersecretion of glucocorticoids in the adrenal cortex. Clients with
Cushing syndrome often develop diabetes mellitus. Monitoring of serum glucose levels assesses for increased
blood glucose levels so that treatment can begin early. A common finding in Cushing syndrome is generalized
edema. Although potassium is needed, it is generally obtained from food intake, not by offering potassium-
enhanced fluids. Fatigue is usually not an overwhelming factor in Cushing syndrome, so an emphasis on the need
for rest is not indicated. A low-calorie, low-carbohydrate, low-sodium diet is not recommended.
A 58-year-old client who has no health problems asks the nurse about receiving the pneumococcal vaccine.
Which statement given by the nurse would offer the client accurate information about this vaccine?
A.
The vaccine is given annually before the flu season to those older than 50 years.
B.
The immunization is administered once to older adults or those at risk for illness.
C.
The vaccine is for all ages and is given primarily to those persons traveling overseas to areas of infection.
D.
The vaccine will prevent the occurrence of pneumococcal pneumonia for up to 5 years. –
Correct Answer :B
Rationale:It is usually recommended that persons older than 65 years and those with a history of chronic illness
should receive the vaccine once in their lifetime. Some recommend receiving the vaccine at 50 years of age. The
influenza vaccine is given once a year. Although the vaccine might be given to a person traveling overseas, that
is not the main rationale for administering the vaccine. The vaccine is usually given once in a lifetime, but with
immunosuppressed clients or clients with a history of pneumonia, revaccination is sometimes required.
P 4
ATI RN Adult Medical-Surgical 2026 Proctored Exam
Most Tested Practice Questions with Answers &
Rationales Exam Format: 250 questions | Multiple
Choice, SATA, NGN Case Studies | Answers with detailed
rationales | Level 3 proficiency focus Content
The nurse is caring for a critically ill client with cirrhosis of the liver who has a nasogastric tube draining bright red
blood. The nurse notes that the client's serum hemoglobin and hematocrit levels are decreased. Which
additional change in laboratory data should the nurse expect?
A.
Increased serum albumin level
P 1
, • Mental Health Care 09/15/2026
B.
Decreased serum creatinine
C.
Decreased serum ammonia level
D.
Increased liver function test results –
Correct Answer :C.
Decreased serum ammonia level
Rationale:
The breakdown of glutamine in the intestine and the increased activity of colonic bacteria from the digestion of
proteins increase ammonia levels in clients with advanced liver disease, so removal of blood, a protein source,
from the intestine results in a reduced level of ammonia (C). (A, B, and D) will not be significantly affected by the
removal of blood.
A client with a nasogastric tube attached to low suction states that she is nauseated. The nurse assesses that
there has been no drainage through the nasogastric tube in the last 2 hours. Which action should the nurse take
first?
A.
Irrigate the nasogastric tube with sterile normal saline.
B.
Reposition the client on her side.
C.
P 2
, • Mental Health Care 09/15/2026
Advance the nasogastric tube 5 cm.
D.
Administer an intravenous antiemetic as prescribed.
- Correct Answer :B
Rationale:The immediate priority is to determine if the tube is functioning correctly, which would then relieve the
client's nausea. The least invasive intervention, repositioning the client, should be attempted first, followed by
options A and C, unless either of these interventions is contraindicated. If these measures are unsuccessful, the
client may require option D.
The nurse is conducting an osteoporosis screening clinic at a health fair. What information should the nurse
provide to individuals who are at risk for osteoporosis? (Select all that apply.)
A.
Encourage alcohol and smoking cessation.
B.
Suggest supplementing diet with vitamin E.
C.
Promote regular weight-bearing exercises.
D.
Implement a home safety plan to prevent falls.
E.
Propose a regular sleep pattern of 8 hours nightly. –
Correct Answer :A, C, D
Rationale:Options A, C, and D are factors that decrease the risk for developing osteoporosis. Vitamin D and
calcium are important supplements to aid in the decrease of bone loss. Regular sleep patterns are important to
overall health but are not identified with a decreasing risk for osteoporosis.
Which nursing action would be appropriate for a client who is newly diagnosed with Cushing syndrome?
A.
Monitor blood glucose levels daily.
P 3
, • Mental Health Care 09/15/2026
B.
Increase intake of fluids high in potassium.
C.
Encourage adequate rest between activities.
D.
Offer the client a sodium-enriched menu.
- Correct Answer :A
Rationale:Cushing syndrome results from a hypersecretion of glucocorticoids in the adrenal cortex. Clients with
Cushing syndrome often develop diabetes mellitus. Monitoring of serum glucose levels assesses for increased
blood glucose levels so that treatment can begin early. A common finding in Cushing syndrome is generalized
edema. Although potassium is needed, it is generally obtained from food intake, not by offering potassium-
enhanced fluids. Fatigue is usually not an overwhelming factor in Cushing syndrome, so an emphasis on the need
for rest is not indicated. A low-calorie, low-carbohydrate, low-sodium diet is not recommended.
A 58-year-old client who has no health problems asks the nurse about receiving the pneumococcal vaccine.
Which statement given by the nurse would offer the client accurate information about this vaccine?
A.
The vaccine is given annually before the flu season to those older than 50 years.
B.
The immunization is administered once to older adults or those at risk for illness.
C.
The vaccine is for all ages and is given primarily to those persons traveling overseas to areas of infection.
D.
The vaccine will prevent the occurrence of pneumococcal pneumonia for up to 5 years. –
Correct Answer :B
Rationale:It is usually recommended that persons older than 65 years and those with a history of chronic illness
should receive the vaccine once in their lifetime. Some recommend receiving the vaccine at 50 years of age. The
influenza vaccine is given once a year. Although the vaccine might be given to a person traveling overseas, that
is not the main rationale for administering the vaccine. The vaccine is usually given once in a lifetime, but with
immunosuppressed clients or clients with a history of pneumonia, revaccination is sometimes required.
P 4
