2026 ATI RN ADULT MEDICAL SURGICAL
(MED-SURG) NGN PRACTICE EXAM
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
CORE DOMAINS
• Cardiovascular and Hematologic Disorders
• Respiratory and Oxygenation Management
• Neurological and Sensory Disorders
• Endocrine and Metabolic Disorders
• Gastrointestinal and Renal Disorders
• Perioperative Care and Surgical Complications
• Emergency and Critical Care Nursing
• Pharmacological and Parenteral Therapies
• Next Generation NCLEX (NGN) Clinical Judgment and Case Studies
INTRODUCTION
The ATI RN Adult Medical-Surgical (Med-Surg) NGN Practice Examination
assesses the clinical judgment, prioritization, and application-based
knowledge required for safe nursing practice in adult health settings. The
exam evaluates foundational medical-surgical concepts, perioperative care,
management of acute and chronic conditions, and clinical decision-making
through multiple-choice and Next Generation NCLEX (NGN)-style case
scenarios. Candidates must demonstrate competency in recognizing cues,
analyzing findings, generating solutions, and evaluating outcomes to ensure
patient safety and optimal care delivery across the adult lifespan.
,SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is assessing a client who has a short-leg fiberglass cast. Which of the
following findings should the nurse identify as an early manifestation of
compartment syndrome?
A. Erythema of the toes
B. Intense pain with passive movement
C. Bounding distal pulses
D. Capillary refill less than 2 seconds
B. Intense pain with passive movement
RATIONALE: Severe pain that worsens with passive movement is one of
the earliest and most significant signs of compartment syndrome. The
condition occurs when pressure within a closed muscle compartment
compromises circulation and tissue perfusion. Early intervention is critical to
prevent permanent nerve and muscle damage.
Question 2
A client receiving 2 units of packed red blood cells develops low back pain,
chills, and hypotension. Which complication should the nurse suspect?
A. Febrile non-hemolytic reaction
B. Acute hemolytic transfusion reaction
C. Allergic reaction
D. Circulatory overload
B. Acute hemolytic transfusion reaction
RATIONALE: Acute hemolytic transfusion reactions commonly present
with low back pain, flank pain, fever, chills, and hemoglobinuria. These
,reactions occur when donor red blood cells are destroyed by the recipient's
immune system. The nurse must stop the transfusion immediately and notify
the provider.
Question 3
A nurse is reviewing the laboratory results of a client who has chronic heart
failure and is receiving digoxin. The client's serum potassium level is 3.0
mEq/L. Which of the following actions should the nurse anticipate?
A. The provider will increase the digoxin dose
B. The provider will prescribe a potassium supplement
C. The provider will discontinue the digoxin
D. The provider will switch to a different antiarrhythmic
B. The provider will prescribe a potassium supplement
RATIONALE: Hypokalemia increases the risk of digoxin toxicity. A serum
potassium level of 3.0 mEq/L is below the therapeutic range (3.5–5.0 mEq/L),
and the provider will likely prescribe a potassium supplement to correct the
imbalance and reduce toxicity risk.
Question 4
A nurse is caring for a client who is being discharged after a myocardial
infarction. The client asks why they must take aspirin 81 mg daily. Which of
the following responses by the nurse is appropriate?
A. Aspirin reduces the inflammation in your heart muscle after a heart attack
B. Aspirin prevents platelets from clumping together, which reduces the risk
of another heart attack
C. Aspirin lowers your blood pressure to reduce stress on your heart
D. Aspirin dissolves any remaining clots in your coronary arteries
, B. Aspirin prevents platelets from clumping together, which reduces the
risk of another heart attack
RATIONALE: Low-dose aspirin is an antiplatelet agent that inhibits
platelet aggregation, reducing the risk of thrombus formation and
subsequent myocardial infarction. It does not dissolve existing clots or reduce
inflammation of the heart muscle.
Question 5
A nurse is assessing a client who has a history of hypertension and is
reporting a severe headache, nausea, and visual disturbances. The client's
blood pressure is 210/120 mm Hg. Which of the following actions is the
priority for the nurse to take?
A. Administer an analgesic for the headache
B. Place the client in a supine position with legs elevated
C. Notify the provider immediately
D. Recheck the blood pressure in 30 minutes
C. Notify the provider immediately
RATIONALE: A blood pressure of 210/120 mm Hg with signs of end-organ
damage (severe headache, nausea, visual disturbances) indicates a
hypertensive emergency. The nurse must notify the provider immediately for
urgent intervention to prevent stroke, organ damage, or death.
Question 6
A client uses a morphine PCA pump postoperatively. The nurse notes the
client is drowsy with a respiratory rate of 8 breaths/min. What is the nurse's
priority action?
A. Encourage deep breathing and coughing
B. Administer naloxone
(MED-SURG) NGN PRACTICE EXAM
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
CORE DOMAINS
• Cardiovascular and Hematologic Disorders
• Respiratory and Oxygenation Management
• Neurological and Sensory Disorders
• Endocrine and Metabolic Disorders
• Gastrointestinal and Renal Disorders
• Perioperative Care and Surgical Complications
• Emergency and Critical Care Nursing
• Pharmacological and Parenteral Therapies
• Next Generation NCLEX (NGN) Clinical Judgment and Case Studies
INTRODUCTION
The ATI RN Adult Medical-Surgical (Med-Surg) NGN Practice Examination
assesses the clinical judgment, prioritization, and application-based
knowledge required for safe nursing practice in adult health settings. The
exam evaluates foundational medical-surgical concepts, perioperative care,
management of acute and chronic conditions, and clinical decision-making
through multiple-choice and Next Generation NCLEX (NGN)-style case
scenarios. Candidates must demonstrate competency in recognizing cues,
analyzing findings, generating solutions, and evaluating outcomes to ensure
patient safety and optimal care delivery across the adult lifespan.
,SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is assessing a client who has a short-leg fiberglass cast. Which of the
following findings should the nurse identify as an early manifestation of
compartment syndrome?
A. Erythema of the toes
B. Intense pain with passive movement
C. Bounding distal pulses
D. Capillary refill less than 2 seconds
B. Intense pain with passive movement
RATIONALE: Severe pain that worsens with passive movement is one of
the earliest and most significant signs of compartment syndrome. The
condition occurs when pressure within a closed muscle compartment
compromises circulation and tissue perfusion. Early intervention is critical to
prevent permanent nerve and muscle damage.
Question 2
A client receiving 2 units of packed red blood cells develops low back pain,
chills, and hypotension. Which complication should the nurse suspect?
A. Febrile non-hemolytic reaction
B. Acute hemolytic transfusion reaction
C. Allergic reaction
D. Circulatory overload
B. Acute hemolytic transfusion reaction
RATIONALE: Acute hemolytic transfusion reactions commonly present
with low back pain, flank pain, fever, chills, and hemoglobinuria. These
,reactions occur when donor red blood cells are destroyed by the recipient's
immune system. The nurse must stop the transfusion immediately and notify
the provider.
Question 3
A nurse is reviewing the laboratory results of a client who has chronic heart
failure and is receiving digoxin. The client's serum potassium level is 3.0
mEq/L. Which of the following actions should the nurse anticipate?
A. The provider will increase the digoxin dose
B. The provider will prescribe a potassium supplement
C. The provider will discontinue the digoxin
D. The provider will switch to a different antiarrhythmic
B. The provider will prescribe a potassium supplement
RATIONALE: Hypokalemia increases the risk of digoxin toxicity. A serum
potassium level of 3.0 mEq/L is below the therapeutic range (3.5–5.0 mEq/L),
and the provider will likely prescribe a potassium supplement to correct the
imbalance and reduce toxicity risk.
Question 4
A nurse is caring for a client who is being discharged after a myocardial
infarction. The client asks why they must take aspirin 81 mg daily. Which of
the following responses by the nurse is appropriate?
A. Aspirin reduces the inflammation in your heart muscle after a heart attack
B. Aspirin prevents platelets from clumping together, which reduces the risk
of another heart attack
C. Aspirin lowers your blood pressure to reduce stress on your heart
D. Aspirin dissolves any remaining clots in your coronary arteries
, B. Aspirin prevents platelets from clumping together, which reduces the
risk of another heart attack
RATIONALE: Low-dose aspirin is an antiplatelet agent that inhibits
platelet aggregation, reducing the risk of thrombus formation and
subsequent myocardial infarction. It does not dissolve existing clots or reduce
inflammation of the heart muscle.
Question 5
A nurse is assessing a client who has a history of hypertension and is
reporting a severe headache, nausea, and visual disturbances. The client's
blood pressure is 210/120 mm Hg. Which of the following actions is the
priority for the nurse to take?
A. Administer an analgesic for the headache
B. Place the client in a supine position with legs elevated
C. Notify the provider immediately
D. Recheck the blood pressure in 30 minutes
C. Notify the provider immediately
RATIONALE: A blood pressure of 210/120 mm Hg with signs of end-organ
damage (severe headache, nausea, visual disturbances) indicates a
hypertensive emergency. The nurse must notify the provider immediately for
urgent intervention to prevent stroke, organ damage, or death.
Question 6
A client uses a morphine PCA pump postoperatively. The nurse notes the
client is drowsy with a respiratory rate of 8 breaths/min. What is the nurse's
priority action?
A. Encourage deep breathing and coughing
B. Administer naloxone
