ATI PN Adult Medical-Surgical Nursing Exam
2026 | 150 Questions with Correct Answers &
Rationales | Latest Updated Study Guide |
Proctored Exam Prep | Grade A
Section 1: Cardiovascular Disorders
Question 1
A nurse is assessing a client who has heart failure. Which finding is an early manifestation
of fluid volume overload?
A. Jugular vein distention
B. Crackles auscultated in the lung bases
C. Weight gain of 2 pounds in 24 hours
D. Peripheral edema (2+ pitting)
Correct Answer: C
Rationale: Weight gain is the earliest indicator of fluid volume overload because 1 kg (2.2 lb)
of weight gain equals approximately 1 liter of retained fluid. Daily weights are the most
sensitive indicator of fluid status changes. Jugular vein distention, crackles, and peripheral
edema are later signs that develop after significant fluid accumulation has occurred. Clients
,with heart failure should weigh themselves daily and report any weight gain of more than 2-
3 pounds in 24 hours or 5 pounds in a week to their healthcare provider .
Question 2
A nurse is reinforcing teaching with a client who has angina pectoris and a new prescription
for sublingual nitroglycerin. Which statement by the client indicates an understanding of the
teaching?
A. "I will take one tablet and if the pain is not relieved in 10 minutes, I will call 911."
B. "I will place the tablet under my tongue and allow it to dissolve completely."
C. "I will swallow the tablet with a full glass of water."
D. "I will take the medication with food to prevent stomach upset."
Correct Answer: B
Rationale: Sublingual nitroglycerin should be placed under the tongue and allowed to
dissolve completely for rapid absorption through the oral mucosa. Swallowing the tablet
renders it ineffective because it is destroyed by first-pass metabolism in the liver. The
correct regimen is to take one tablet at the onset of chest pain, then every 5 minutes for up
to three doses. If pain is not relieved after the first tablet, the client should call 911
immediately (not wait 10 minutes) .
Question 3
,A nurse is caring for a client who is receiving IV heparin for treatment of a deep vein
thrombosis (DVT). The client's activated partial thromboplastin time (aPTT) is 110 seconds
(normal 25-35 seconds). Which action should the nurse take?
A. Continue the infusion at the current rate
B. Increase the infusion rate as prescribed
C. Stop the infusion and notify the healthcare provider
D. Decrease the infusion rate by 50%
Correct Answer: C
Rationale: The therapeutic range for aPTT during heparin therapy is 1.5 to 2.5 times the
normal control value, which is approximately 60-80 seconds. An aPTT of 110 seconds is
significantly elevated and indicates the client is at high risk for bleeding. The infusion should
be stopped immediately and the provider notified for further orders. Continuing, increasing,
or decreasing the rate without a provider's order could result in serious bleeding
complications .
Question 4
A client with heart failure is receiving furosemide and digoxin. Which laboratory value
requires priority intervention?
A. Potassium 3.2 mEq/L
B. Sodium 138 mEq/L
C. Calcium 9.0 mg/dL
D. Magnesium 2.0 mEq/L
, Correct Answer: A
Rationale: Furosemide is a loop diuretic that causes significant potassium loss through the
kidneys, leading to hypokalemia (normal 3.5-5.0 mEq/L). Hypokalemia increases the risk of
dysrhythmias, especially in patients on digoxin. The PN should monitor potassium closely
and report values <3.5 mEq/L. Sodium, calcium, and magnesium are also monitored but
potassium is the priority due to cardiac risk .
Question 5
A patient receiving digoxin for heart failure reports nausea, vomiting, and visual
disturbances (yellow halos). The PN should recognize these as signs of:
A. Expected side effects
B. Digoxin toxicity
C. Allergic reaction
D. Gastric ulcer
Correct Answer: B
Rationale: Nausea, vomiting, anorexia, visual disturbances (yellow/green halos, blurred
vision), bradycardia, and dysrhythmias are classic signs of digoxin toxicity. Therapeutic
digoxin level is 0.5-2.0 ng/mL. The PN should hold the dose, notify the provider, check
serum digoxin and potassium levels (hypokalemia potentiates toxicity), and monitor for
dysrhythmias. Digoxin immune Fab (Digibind) may be given for severe toxicity .
2026 | 150 Questions with Correct Answers &
Rationales | Latest Updated Study Guide |
Proctored Exam Prep | Grade A
Section 1: Cardiovascular Disorders
Question 1
A nurse is assessing a client who has heart failure. Which finding is an early manifestation
of fluid volume overload?
A. Jugular vein distention
B. Crackles auscultated in the lung bases
C. Weight gain of 2 pounds in 24 hours
D. Peripheral edema (2+ pitting)
Correct Answer: C
Rationale: Weight gain is the earliest indicator of fluid volume overload because 1 kg (2.2 lb)
of weight gain equals approximately 1 liter of retained fluid. Daily weights are the most
sensitive indicator of fluid status changes. Jugular vein distention, crackles, and peripheral
edema are later signs that develop after significant fluid accumulation has occurred. Clients
,with heart failure should weigh themselves daily and report any weight gain of more than 2-
3 pounds in 24 hours or 5 pounds in a week to their healthcare provider .
Question 2
A nurse is reinforcing teaching with a client who has angina pectoris and a new prescription
for sublingual nitroglycerin. Which statement by the client indicates an understanding of the
teaching?
A. "I will take one tablet and if the pain is not relieved in 10 minutes, I will call 911."
B. "I will place the tablet under my tongue and allow it to dissolve completely."
C. "I will swallow the tablet with a full glass of water."
D. "I will take the medication with food to prevent stomach upset."
Correct Answer: B
Rationale: Sublingual nitroglycerin should be placed under the tongue and allowed to
dissolve completely for rapid absorption through the oral mucosa. Swallowing the tablet
renders it ineffective because it is destroyed by first-pass metabolism in the liver. The
correct regimen is to take one tablet at the onset of chest pain, then every 5 minutes for up
to three doses. If pain is not relieved after the first tablet, the client should call 911
immediately (not wait 10 minutes) .
Question 3
,A nurse is caring for a client who is receiving IV heparin for treatment of a deep vein
thrombosis (DVT). The client's activated partial thromboplastin time (aPTT) is 110 seconds
(normal 25-35 seconds). Which action should the nurse take?
A. Continue the infusion at the current rate
B. Increase the infusion rate as prescribed
C. Stop the infusion and notify the healthcare provider
D. Decrease the infusion rate by 50%
Correct Answer: C
Rationale: The therapeutic range for aPTT during heparin therapy is 1.5 to 2.5 times the
normal control value, which is approximately 60-80 seconds. An aPTT of 110 seconds is
significantly elevated and indicates the client is at high risk for bleeding. The infusion should
be stopped immediately and the provider notified for further orders. Continuing, increasing,
or decreasing the rate without a provider's order could result in serious bleeding
complications .
Question 4
A client with heart failure is receiving furosemide and digoxin. Which laboratory value
requires priority intervention?
A. Potassium 3.2 mEq/L
B. Sodium 138 mEq/L
C. Calcium 9.0 mg/dL
D. Magnesium 2.0 mEq/L
, Correct Answer: A
Rationale: Furosemide is a loop diuretic that causes significant potassium loss through the
kidneys, leading to hypokalemia (normal 3.5-5.0 mEq/L). Hypokalemia increases the risk of
dysrhythmias, especially in patients on digoxin. The PN should monitor potassium closely
and report values <3.5 mEq/L. Sodium, calcium, and magnesium are also monitored but
potassium is the priority due to cardiac risk .
Question 5
A patient receiving digoxin for heart failure reports nausea, vomiting, and visual
disturbances (yellow halos). The PN should recognize these as signs of:
A. Expected side effects
B. Digoxin toxicity
C. Allergic reaction
D. Gastric ulcer
Correct Answer: B
Rationale: Nausea, vomiting, anorexia, visual disturbances (yellow/green halos, blurred
vision), bradycardia, and dysrhythmias are classic signs of digoxin toxicity. Therapeutic
digoxin level is 0.5-2.0 ng/mL. The PN should hold the dose, notify the provider, check
serum digoxin and potassium levels (hypokalemia potentiates toxicity), and monitor for
dysrhythmias. Digoxin immune Fab (Digibind) may be given for severe toxicity .
