ATI PN ADULT MEDICAL-SURGICAL PROCTORED
EXAM QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF.
Core Domains:
• Foundations of Adult Medical-Surgical Nursing
• Perioperative Nursing Care
• Cardiovascular System Disorders
• Respiratory System Disorders
• Neurological System Disorders
• Gastrointestinal System Disorders
• Renal and Urinary System Disorders
• Endocrine System Disorders
• Musculoskeletal and Integumentary Systems
• Hematologic and Immunologic Systems
• Fluid, Electrolyte, and Acid-Base Balance
• Emergency and Shock Management
• NGN Clinical Judgment and Case Studies
Introduction:
This examination assesses the core competencies
required for safe and effective practical nursing practice
in adult medical-surgical care. It evaluates knowledge of
acute and chronic medical conditions, perioperative
,management, pharmacological interventions, and fluid
and electrolyte balance. The assessment includes
multiple-choice and scenario-based questions designed to
test clinical judgment, prioritization, and evidence-based
decision-making. Emphasis is placed on the application of
the nursing process, the ATI Medical-Surgical Nursing
Content Mastery Series blueprint, and Next Generation
NCLEX (NGN) clinical judgment models to real-world
clinical scenarios involving adult clients.
SECTION ONE: QUESTIONS 1–100
1. A 68-year-old male patient is admitted with
community-acquired pneumonia. Vital signs:
temperature 38.9°C (102°F), heart rate 102 bpm,
respiratory rate 24/min, oxygen saturation 88% on
room air. He is confused and coughing productive
yellow sputum. Which findings require immediate
intervention?
A. Temperature 38.9°C (102°F)
B. Heart rate 102 bpm
C. Oxygen saturation 88%
D. Confusion
E. Productive cough
C, D
RATIONALE: Oxygen saturation of 88% indicates
hypoxemia requiring immediate oxygen therapy.
Confusion in an older adult may indicate hypoxia,
hypercapnia, or sepsis. These are life-threatening
,priorities. Fever, tachycardia, tachypnea, and productive
cough are important but not immediate priorities .
2. A nurse is assessing a client with heart failure
who 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
A
RATIONALE: Furosemide is a loop diuretic that causes
potassium wasting. Hypokalemia (K+ <3.5 mEq/L)
increases the risk of digoxin toxicity. The potassium level
of 3.2 mEq/L requires immediate intervention .
3. The provider orders an arterial blood gas for a
client with respiratory distress. Results: pH 7.30,
PaCO2 58 mm Hg, PaO2 70 mm Hg. Which acid-
base imbalance is present?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
C
RATIONALE: Respiratory acidosis is pH <7.35 with
PaCO2 >45 mm Hg. The pH is 7.30 (acidotic) and PaCO2
, is 58 mm Hg (elevated), indicating carbon dioxide
retention as the cause of acidosis .
4. A nurse is caring for a client who is 6 hours post-
operative following abdominal surgery. Which
assessment finding should the nurse recognize as
the priority cue?
A. Sudden onset of shortness of breath and chest pain
B. Pain rated 6/10 at the surgical site
C. Temperature 99.8°F (37.7°C)
D. Serosanguineous drainage on the dressing
A
RATIONALE: Sudden onset of shortness of breath and
chest pain in a postoperative client is a critical cue for
pulmonary embolism (PE), a life-threatening complication
requiring immediate assessment and intervention. Pain
6/10 is significant but not immediately life-threatening.
Low-grade fever may indicate inflammation or infection
but is less urgent. Serosanguineous drainage is expected
post-operatively .
5. A nurse is caring for a client with diabetic
ketoacidosis (DKA). Which assessment finding
should the nurse identify as a priority cue?
A. Polyuria and polydipsia
B. Kussmaul respirations
C. Fruity odor to breath
D. Blood glucose 350 mg/dL
EXAM QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF.
Core Domains:
• Foundations of Adult Medical-Surgical Nursing
• Perioperative Nursing Care
• Cardiovascular System Disorders
• Respiratory System Disorders
• Neurological System Disorders
• Gastrointestinal System Disorders
• Renal and Urinary System Disorders
• Endocrine System Disorders
• Musculoskeletal and Integumentary Systems
• Hematologic and Immunologic Systems
• Fluid, Electrolyte, and Acid-Base Balance
• Emergency and Shock Management
• NGN Clinical Judgment and Case Studies
Introduction:
This examination assesses the core competencies
required for safe and effective practical nursing practice
in adult medical-surgical care. It evaluates knowledge of
acute and chronic medical conditions, perioperative
,management, pharmacological interventions, and fluid
and electrolyte balance. The assessment includes
multiple-choice and scenario-based questions designed to
test clinical judgment, prioritization, and evidence-based
decision-making. Emphasis is placed on the application of
the nursing process, the ATI Medical-Surgical Nursing
Content Mastery Series blueprint, and Next Generation
NCLEX (NGN) clinical judgment models to real-world
clinical scenarios involving adult clients.
SECTION ONE: QUESTIONS 1–100
1. A 68-year-old male patient is admitted with
community-acquired pneumonia. Vital signs:
temperature 38.9°C (102°F), heart rate 102 bpm,
respiratory rate 24/min, oxygen saturation 88% on
room air. He is confused and coughing productive
yellow sputum. Which findings require immediate
intervention?
A. Temperature 38.9°C (102°F)
B. Heart rate 102 bpm
C. Oxygen saturation 88%
D. Confusion
E. Productive cough
C, D
RATIONALE: Oxygen saturation of 88% indicates
hypoxemia requiring immediate oxygen therapy.
Confusion in an older adult may indicate hypoxia,
hypercapnia, or sepsis. These are life-threatening
,priorities. Fever, tachycardia, tachypnea, and productive
cough are important but not immediate priorities .
2. A nurse is assessing a client with heart failure
who 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
A
RATIONALE: Furosemide is a loop diuretic that causes
potassium wasting. Hypokalemia (K+ <3.5 mEq/L)
increases the risk of digoxin toxicity. The potassium level
of 3.2 mEq/L requires immediate intervention .
3. The provider orders an arterial blood gas for a
client with respiratory distress. Results: pH 7.30,
PaCO2 58 mm Hg, PaO2 70 mm Hg. Which acid-
base imbalance is present?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
C
RATIONALE: Respiratory acidosis is pH <7.35 with
PaCO2 >45 mm Hg. The pH is 7.30 (acidotic) and PaCO2
, is 58 mm Hg (elevated), indicating carbon dioxide
retention as the cause of acidosis .
4. A nurse is caring for a client who is 6 hours post-
operative following abdominal surgery. Which
assessment finding should the nurse recognize as
the priority cue?
A. Sudden onset of shortness of breath and chest pain
B. Pain rated 6/10 at the surgical site
C. Temperature 99.8°F (37.7°C)
D. Serosanguineous drainage on the dressing
A
RATIONALE: Sudden onset of shortness of breath and
chest pain in a postoperative client is a critical cue for
pulmonary embolism (PE), a life-threatening complication
requiring immediate assessment and intervention. Pain
6/10 is significant but not immediately life-threatening.
Low-grade fever may indicate inflammation or infection
but is less urgent. Serosanguineous drainage is expected
post-operatively .
5. A nurse is caring for a client with diabetic
ketoacidosis (DKA). Which assessment finding
should the nurse identify as a priority cue?
A. Polyuria and polydipsia
B. Kussmaul respirations
C. Fruity odor to breath
D. Blood glucose 350 mg/dL
