ATI RN ADULT MEDICAL SURGICAL ONLINE
PRACTICE 2026 A 100 NGN EXAM Q AND A WITH
DETAILED RATIONALES COMPREHENSIVE
REVIEW
1. A nurse is caring for a client who has homonymous
hemianopsia as a result of a cerebrovascular accident (CVA).
To maximize safety and reduce the risk of falls during
ambulation, which of the following instructions should the
nurse provide to the client?
A. "Keep your eyes fixed forward and rely on your peripheral
vision."
B. "Scan the environment by turning your head from side to
side."
C. "Wear an eye patch over the affected eye while walking."
D. "Lean slightly toward your unaffected side to compensate
for balance."
CORRECT ANSWER: B
RATiONAlE: Homonymous hemianopsia is the loss of
the same visual field in both eyes. Instructing the client to
actively scan the environment by turning their head from
side to side expands their visual field, allowing them to see
obstacles and significantly minimizing fall risks during
mobility and mealtimes.
2. A nurse in a provider's office is performing a follow-up
assessment on a client who has primary hypertension and
has been taking propranolol for three weeks. Which of the
, following findings should indicate to the nurse that the client
is experiencing an early adverse reaction to this medication?
A. A persistent night cough
B. An elevated serum bilirubin level
C. Reports of increased salivation
D. A localized macular rash on the chest
CORRECT ANSWER: A
RATiONAlE: Propranolol is a non-selective beta-
adrenergic blocker. A persistent night cough is an early
clinical indication of developing heart failure or
bronchoconstriction induced by beta-blockade, requiring
immediate reporting to the provider. Bilirubin elevation is
not an expected adverse effect of this medication.
3. A nurse in the emergency department is caring for a client
who has acute decompensated heart failure. The client
suddenly develops severe dyspnea, produces pink frothy
sputum, and has diffuse crackles throughout both lung fields.
Which of the following interventions should the nurse
implement first?
A. Administer intravenous furosemide via direct bolus
B. Place the client in a high-Fowler's position
C. Restrict the client's oral fluid intake to 1,000 mL/day
D. Obtain an accurate baseline daily body weight
CORRECT ANSWER: B
RATiONAlE: The client's manifestations indicate severe
acute pulmonary edema, a life-threatening emergency.
Following the airway-breathing-circulation (ABC) priority
framework, the immediate nursing action is to place the
, client in a high-Fowler's position to decrease venous return
(preload), lower the diaphragm, and maximize thoracic
expansion. IV diuretics are vital but should follow
immediate stabilization and positioning.
4. A nurse is assessing a client who was admitted with
suspected systemic sepsis. Which of the following clinical
clinical clusters should the nurse expect to find during the
hyperdynamic phase of sepsis?
A. Bradycardia and severe hypertension
B. Tachycardia and hypotension
C. Bradypnea and hypothermia
D. Oliguria and generalized vasoconstriction
CORRECT ANSWER: B
RATiONAlE: Sepsis triggers a profound systemic
inflammatory response that causes extensive arterial and
venous vasodilation, leading to systemic hypotension. In
response, the cardiovascular system attempts to maintain
cardiac output through catecholamine release, resulting in
compensatory tachycardia.
5. A nurse is planning care for a client who is being admitted
with a severe infection of Clostridium difficile. Which of the
following infection control interventions must the nurse
incorporate into the client's plan of care?
A. Ensure the client is placed in a negative airflow isolation
room
B. Initiate contact precautions and perform hand hygiene
using soap and water
C. Wear an N95 respirator mask whenever entering the
client's room
, D. Clean the client's bedside equipment exclusively with
alcohol-based solutions
CORRECT ANSWER: B
RATiONAlE: Clostridium difficile requires strict contact
precautions due to the high risk of environmental
transmission via spores. Because C. difficile spores are
resistant to alcohol, mechanical handwashing with soap
and water is mandatory to physically remove the spores
from the hands.
6. A nurse is providing preoperative teaching to a client
scheduled for a perineal prostatectomy. Which of the
following postoperative preventative measures should the
nurse emphasize during instruction?
A. Restricting all fluids for the first 48 hours post-surgery
B. Performing calf pump and foot circle exercises hourly
while in bed
C. Straining during defecation to avoid pelvic floor pressure
D. Maintaining a strict flat supine position for 5 days
CORRECT ANSWER: B
RATiONAlE: Deep vein thrombosis (DVT) is a significant
risk following major pelvic surgeries. Performing active
foot and calf exercises stimulates venous return and
mitigates stagnation. Antispasmodics help manage bladder
spasms, and preventing constipation with stool softeners
avoids straining.
7. A nurse is reviewing the laboratory results of a client who has
chronic kidney disease (CKD) and is scheduled for an
outpatient hemodialysis session. The client's potassium level
PRACTICE 2026 A 100 NGN EXAM Q AND A WITH
DETAILED RATIONALES COMPREHENSIVE
REVIEW
1. A nurse is caring for a client who has homonymous
hemianopsia as a result of a cerebrovascular accident (CVA).
To maximize safety and reduce the risk of falls during
ambulation, which of the following instructions should the
nurse provide to the client?
A. "Keep your eyes fixed forward and rely on your peripheral
vision."
B. "Scan the environment by turning your head from side to
side."
C. "Wear an eye patch over the affected eye while walking."
D. "Lean slightly toward your unaffected side to compensate
for balance."
CORRECT ANSWER: B
RATiONAlE: Homonymous hemianopsia is the loss of
the same visual field in both eyes. Instructing the client to
actively scan the environment by turning their head from
side to side expands their visual field, allowing them to see
obstacles and significantly minimizing fall risks during
mobility and mealtimes.
2. A nurse in a provider's office is performing a follow-up
assessment on a client who has primary hypertension and
has been taking propranolol for three weeks. Which of the
, following findings should indicate to the nurse that the client
is experiencing an early adverse reaction to this medication?
A. A persistent night cough
B. An elevated serum bilirubin level
C. Reports of increased salivation
D. A localized macular rash on the chest
CORRECT ANSWER: A
RATiONAlE: Propranolol is a non-selective beta-
adrenergic blocker. A persistent night cough is an early
clinical indication of developing heart failure or
bronchoconstriction induced by beta-blockade, requiring
immediate reporting to the provider. Bilirubin elevation is
not an expected adverse effect of this medication.
3. A nurse in the emergency department is caring for a client
who has acute decompensated heart failure. The client
suddenly develops severe dyspnea, produces pink frothy
sputum, and has diffuse crackles throughout both lung fields.
Which of the following interventions should the nurse
implement first?
A. Administer intravenous furosemide via direct bolus
B. Place the client in a high-Fowler's position
C. Restrict the client's oral fluid intake to 1,000 mL/day
D. Obtain an accurate baseline daily body weight
CORRECT ANSWER: B
RATiONAlE: The client's manifestations indicate severe
acute pulmonary edema, a life-threatening emergency.
Following the airway-breathing-circulation (ABC) priority
framework, the immediate nursing action is to place the
, client in a high-Fowler's position to decrease venous return
(preload), lower the diaphragm, and maximize thoracic
expansion. IV diuretics are vital but should follow
immediate stabilization and positioning.
4. A nurse is assessing a client who was admitted with
suspected systemic sepsis. Which of the following clinical
clinical clusters should the nurse expect to find during the
hyperdynamic phase of sepsis?
A. Bradycardia and severe hypertension
B. Tachycardia and hypotension
C. Bradypnea and hypothermia
D. Oliguria and generalized vasoconstriction
CORRECT ANSWER: B
RATiONAlE: Sepsis triggers a profound systemic
inflammatory response that causes extensive arterial and
venous vasodilation, leading to systemic hypotension. In
response, the cardiovascular system attempts to maintain
cardiac output through catecholamine release, resulting in
compensatory tachycardia.
5. A nurse is planning care for a client who is being admitted
with a severe infection of Clostridium difficile. Which of the
following infection control interventions must the nurse
incorporate into the client's plan of care?
A. Ensure the client is placed in a negative airflow isolation
room
B. Initiate contact precautions and perform hand hygiene
using soap and water
C. Wear an N95 respirator mask whenever entering the
client's room
, D. Clean the client's bedside equipment exclusively with
alcohol-based solutions
CORRECT ANSWER: B
RATiONAlE: Clostridium difficile requires strict contact
precautions due to the high risk of environmental
transmission via spores. Because C. difficile spores are
resistant to alcohol, mechanical handwashing with soap
and water is mandatory to physically remove the spores
from the hands.
6. A nurse is providing preoperative teaching to a client
scheduled for a perineal prostatectomy. Which of the
following postoperative preventative measures should the
nurse emphasize during instruction?
A. Restricting all fluids for the first 48 hours post-surgery
B. Performing calf pump and foot circle exercises hourly
while in bed
C. Straining during defecation to avoid pelvic floor pressure
D. Maintaining a strict flat supine position for 5 days
CORRECT ANSWER: B
RATiONAlE: Deep vein thrombosis (DVT) is a significant
risk following major pelvic surgeries. Performing active
foot and calf exercises stimulates venous return and
mitigates stagnation. Antispasmodics help manage bladder
spasms, and preventing constipation with stool softeners
avoids straining.
7. A nurse is reviewing the laboratory results of a client who has
chronic kidney disease (CKD) and is scheduled for an
outpatient hemodialysis session. The client's potassium level
