ATI PN Adult Medical-Surgical CMS: Question
Section 1: Cardiovascular & Hematologic Disorders (Q1–Q25)
Q1. A nurse is caring for a client who is 24 hours postoperative
following a right hemicolectomy. Which finding should the nurse
report to the RN immediately?
A. Serosanguineous drainage on the dressing
B. Pain rated 4 on a scale of 0–10
C. Temperature 101.8°F (38.8°C)
D. Client requesting pain medication
Answer: C
Rationale: Elevated temperature postoperatively may indicate infection or
sepsis and requires immediate notification of the RN. Serosanguineous
drainage, moderate pain, and requesting pain medication are expected
findings.
Q2. A client with heart failure is prescribed furosemide. Which finding
indicates the medication is effective?
A. Decreased peripheral edema
B. Weight gain of 1 kg in 24 hours
C. Increased blood pressure
D. Jugular venous distention
Answer: A
Rationale: Furosemide reduces fluid volume, leading to decreased edema,
weight loss, and decreased JVD.
Q3. A nurse is reinforcing teaching with a client prescribed warfarin.
Which statement indicates understanding?
A. "I should increase my intake of green leafy vegetables."
B. "I should avoid all foods containing vitamin K."
C. "I should maintain consistent intake of vitamin K."
D. "I should take aspirin for headaches."
,Answer: C
Rationale: Clients on warfarin should maintain consistent vitamin K intake.
Increasing or decreasing intake can affect INR. Aspirin increases bleeding
risk.
Q4. A client with left-sided heart failure. Which finding is expected?
A. Jugular venous distention
B. Crackles in the lungs
C. Dependent edema
D. Hepatomegaly
Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion,
manifested by crackles, dyspnea, and orthopnea. Right-sided failure
causes JVD, edema, and hepatomegaly.
Q5. A client with heart failure is prescribed digoxin. Which finding
indicates digoxin toxicity?
A. Heart rate 72/min
B. Nausea and yellow-tinged vision
C. Blood pressure 120/80 mm Hg
D. Weight loss
Answer: B
Rationale: Digoxin toxicity causes nausea, vomiting, visual disturbances
(yellow-green halos), bradycardia, and arrhythmias.
Q6. A client is prescribed nitroglycerin sublingual. Which instruction
should the nurse provide?
A. "Swallow the tablet with water."
B. "Call 911 if chest pain persists after 3 tablets."
C. "Take up to 5 tablets."
D. "Lie down after taking the tablet."
,Answer: B
Rationale: If chest pain persists after 3 sublingual nitroglycerin tablets
(taken 5 minutes apart), the client should call 911.
Q7. A client on warfarin has an INR of 5.5. Which action should the
nurse take?
A. Continue current dose
B. Hold warfarin and consider vitamin K
C. Increase warfarin dose
D. Administer heparin
Answer: B
Rationale: INR >5 requires holding warfarin; vitamin K may be given if
bleeding.
Q8. Which adverse effect is associated with ACE inhibitors?
A. Dry cough
B. Peripheral edema
C. Bradycardia
D. Hyperkalemia
Answer: A
Rationale: ACE inhibitors cause dry cough due to bradykinin accumulation.
ARBs are alternatives.
Q9. A client on furosemide should be monitored for:
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Answer: B
Rationale: Loop diuretics cause potassium loss. Monitor K+ and replace
as needed.
, Q10. A client is prescribed metoprolol. Which finding requires holding
the dose?
A. Heart rate 56/min
B. Blood pressure 128/78 mm Hg
C. Respiratory rate 18/min
D. Temperature 37.0°C
Answer: A
Rationale: Hold beta-blockers if heart rate <60/min or systolic BP <90 mm
Hg.
Q11. A client is prescribed atorvastatin. Which instruction should the
nurse provide?
A. "Report muscle pain."
B. "Take with grapefruit juice."
C. "Stop the medication if you feel better."
D. "Take at bedtime only."
Answer: A
Rationale: Statins can cause myopathy/rhabdomyolysis. Report
unexplained muscle pain.
Q12. A client with atrial fibrillation is prescribed apixaban. The nurse
knows this drug:
A. Requires frequent INR monitoring
B. Is a factor Xa inhibitor
C. Is a vitamin K antagonist
D. Is an antiplatelet
Answer: B
Rationale: Apixaban is a factor Xa inhibitor (DOAC). No routine INR
monitoring.
Section 1: Cardiovascular & Hematologic Disorders (Q1–Q25)
Q1. A nurse is caring for a client who is 24 hours postoperative
following a right hemicolectomy. Which finding should the nurse
report to the RN immediately?
A. Serosanguineous drainage on the dressing
B. Pain rated 4 on a scale of 0–10
C. Temperature 101.8°F (38.8°C)
D. Client requesting pain medication
Answer: C
Rationale: Elevated temperature postoperatively may indicate infection or
sepsis and requires immediate notification of the RN. Serosanguineous
drainage, moderate pain, and requesting pain medication are expected
findings.
Q2. A client with heart failure is prescribed furosemide. Which finding
indicates the medication is effective?
A. Decreased peripheral edema
B. Weight gain of 1 kg in 24 hours
C. Increased blood pressure
D. Jugular venous distention
Answer: A
Rationale: Furosemide reduces fluid volume, leading to decreased edema,
weight loss, and decreased JVD.
Q3. A nurse is reinforcing teaching with a client prescribed warfarin.
Which statement indicates understanding?
A. "I should increase my intake of green leafy vegetables."
B. "I should avoid all foods containing vitamin K."
C. "I should maintain consistent intake of vitamin K."
D. "I should take aspirin for headaches."
,Answer: C
Rationale: Clients on warfarin should maintain consistent vitamin K intake.
Increasing or decreasing intake can affect INR. Aspirin increases bleeding
risk.
Q4. A client with left-sided heart failure. Which finding is expected?
A. Jugular venous distention
B. Crackles in the lungs
C. Dependent edema
D. Hepatomegaly
Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion,
manifested by crackles, dyspnea, and orthopnea. Right-sided failure
causes JVD, edema, and hepatomegaly.
Q5. A client with heart failure is prescribed digoxin. Which finding
indicates digoxin toxicity?
A. Heart rate 72/min
B. Nausea and yellow-tinged vision
C. Blood pressure 120/80 mm Hg
D. Weight loss
Answer: B
Rationale: Digoxin toxicity causes nausea, vomiting, visual disturbances
(yellow-green halos), bradycardia, and arrhythmias.
Q6. A client is prescribed nitroglycerin sublingual. Which instruction
should the nurse provide?
A. "Swallow the tablet with water."
B. "Call 911 if chest pain persists after 3 tablets."
C. "Take up to 5 tablets."
D. "Lie down after taking the tablet."
,Answer: B
Rationale: If chest pain persists after 3 sublingual nitroglycerin tablets
(taken 5 minutes apart), the client should call 911.
Q7. A client on warfarin has an INR of 5.5. Which action should the
nurse take?
A. Continue current dose
B. Hold warfarin and consider vitamin K
C. Increase warfarin dose
D. Administer heparin
Answer: B
Rationale: INR >5 requires holding warfarin; vitamin K may be given if
bleeding.
Q8. Which adverse effect is associated with ACE inhibitors?
A. Dry cough
B. Peripheral edema
C. Bradycardia
D. Hyperkalemia
Answer: A
Rationale: ACE inhibitors cause dry cough due to bradykinin accumulation.
ARBs are alternatives.
Q9. A client on furosemide should be monitored for:
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Answer: B
Rationale: Loop diuretics cause potassium loss. Monitor K+ and replace
as needed.
, Q10. A client is prescribed metoprolol. Which finding requires holding
the dose?
A. Heart rate 56/min
B. Blood pressure 128/78 mm Hg
C. Respiratory rate 18/min
D. Temperature 37.0°C
Answer: A
Rationale: Hold beta-blockers if heart rate <60/min or systolic BP <90 mm
Hg.
Q11. A client is prescribed atorvastatin. Which instruction should the
nurse provide?
A. "Report muscle pain."
B. "Take with grapefruit juice."
C. "Stop the medication if you feel better."
D. "Take at bedtime only."
Answer: A
Rationale: Statins can cause myopathy/rhabdomyolysis. Report
unexplained muscle pain.
Q12. A client with atrial fibrillation is prescribed apixaban. The nurse
knows this drug:
A. Requires frequent INR monitoring
B. Is a factor Xa inhibitor
C. Is a vitamin K antagonist
D. Is an antiplatelet
Answer: B
Rationale: Apixaban is a factor Xa inhibitor (DOAC). No routine INR
monitoring.
