ATI RN MEDICAL SURGICAL RETAKE LATEST 2026
ACTUAL EXAM | RN MED-SURG PROCTORED
ASSESSMENT II (RETAKE) WITH COMPLETE REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS |
ALREADY GRADED A+]
Core Domains
• Cardiovascular and Hematologic Disorders
• Respiratory Disorders and Oxygen Therapy
• Gastrointestinal and Hepatic Disorders
• Endocrine and Metabolic Disorders
• Renal and Urinary System Disorders
• Musculoskeletal and Neurological Disorders
• Perioperative and Postoperative Nursing Care
• Pharmacology and Medication Safety
• Fluid, Electrolyte, and Acid-Base Balance
• Infection Control and Patient Safety
Introduction
This comprehensive examination is designed to evaluate the nursing knowledge
required for the ATI RN Medical-Surgical Proctored Assessment II Retake. It
assesses competencies across cardiovascular, respiratory, gastrointestinal,
endocrine, renal, musculoskeletal, and neurological systems, as well as
perioperative care, pharmacology, and fluid and electrolyte balance. The exam
utilizes a multiple-choice and scenario-based structure to simulate clinical
encounters in adult medical-surgical nursing. Emphasis is placed on the
application of clinical judgment, prioritization, and evidence-based practice to
,real-world patient presentations, requiring candidates to analyze clinical data,
identify complications, and select the most appropriate nursing interventions. This
exam mirrors the rigor and content coverage of the ATI RN Med-Surg Proctored
Assessment II Retake.
SECTION ONE: QUESTIONS 1–100
1. A nurse is assessing a client who has heart failure. Which finding should the
nurse recognize as an indication of worsening left-sided heart failure?
A. Dependent peripheral edema
B. Jugular venous distention
C. Crackles in the lung bases
D. Enlarged liver
Correct answer: C
RATIONALE: Left-sided heart failure causes pulmonary congestion because
the left ventricle cannot effectively pump blood into systemic circulation.
Crackles, dyspnea, and pulmonary edema are common findings. Dependent
edema, JVD, and hepatomegaly are signs of right-sided heart failure.
2. A nurse is caring for a client receiving a continuous IV infusion of heparin.
Which laboratory value should the nurse monitor to evaluate the therapeutic
effect?
A. INR
B. aPTT
C. Platelet count only
D. Hemoglobin A1c
Correct answer: B
RATIONALE: The activated partial thromboplastin time (aPTT) is commonly
monitored to evaluate the therapeutic effect of unfractionated heparin. INR is
used for warfarin monitoring. Platelet count is monitored for heparin-induced
thrombocytopenia, not therapeutic effect.
3. A client with COPD is receiving oxygen via nasal cannula. Which finding
requires immediate intervention?
A. Oxygen saturation 91%
,B. Respiratory rate 22/min
C. Increased drowsiness and confusion
D. Productive cough
Correct answer: C
RATIONALE: COPD clients can develop CO₂ retention. Drowsiness and
confusion may indicate worsening hypercapnia requiring prompt assessment. An
SpO₂ of 91%, RR of 22, and productive cough are expected findings in COPD.
4. A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which
laboratory finding should the nurse expect?
A. Blood glucose 450 mg/dL
B. Blood pH 7.45
C. Serum potassium 2.8 mEq/L only
D. Blood glucose 90 mg/dL
Correct answer: A
RATIONALE: DKA is characterized by severe hyperglycemia (typically >250
mg/dL), ketosis, and metabolic acidosis (pH <7.35). Blood glucose of 450 mg/dL is
consistent with DKA. pH 7.45 indicates alkalosis. Potassium levels can be normal,
high, or low initially.
5. A client reports crushing chest pain radiating to the left arm. Which action
should the nurse perform first?
A. Administer morphine
B. Obtain a 12-lead ECG
C. Assess vital signs
D. Draw cardiac enzymes
Correct answer: C
RATIONALE: Assessment comes first. Vital signs determine hemodynamic
stability before implementing further interventions. The nurse should assess the
client's vital signs and pain characteristics before administering medications or
obtaining diagnostic tests.
6. A nurse is caring for a client receiving furosemide. Which laboratory value
requires immediate reporting?
A. Sodium 138 mEq/L
, B. Potassium 2.9 mEq/L
C. Chloride 101 mEq/L
D. Calcium 9.2 mg/dL
Correct answer: B
RATIONALE: Furosemide is a loop diuretic that causes potassium loss. Severe
hypokalemia (potassium <3.0 mEq/L) increases the risk for dysrhythmias and
requires immediate reporting. Normal potassium is 3.5-5.0 mEq/L.
7. A nurse is teaching a client who has heart failure. Which instructions should
the nurse include? (Select all that apply.)
A. Weigh yourself daily
B. Restrict sodium intake
C. Report sudden weight gain
D. Drink unlimited fluids
E. Take medications as prescribed
Correct answer: A, B, C, E
RATIONALE: Daily weights, sodium restriction, medication adherence, and
reporting weight gain help prevent exacerbations. Fluid restriction, not unlimited
fluids, is typically recommended for heart failure clients.
8. A client with a pulmonary embolism suddenly becomes short of breath.
Which assessment finding is expected?
A. Bradycardia
B. Hypertension
C. Tachycardia
D. Hypothermia
Correct answer: C
RATIONALE: Pulmonary embolism causes impaired gas exchange and right
ventricular strain. Tachycardia is a common compensatory response. Bradycardia,
hypertension, and hypothermia are not typical findings.
9. A nurse is caring for a client who is 12 hours postoperative following a colon
resection. The nurse assesses the following: HR 90/min, absent bowel sounds,
hemoglobin 8.2 g/dL, gastric pH 3.0. Which finding should the nurse report to
the surgeon?
ACTUAL EXAM | RN MED-SURG PROCTORED
ASSESSMENT II (RETAKE) WITH COMPLETE REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS |
ALREADY GRADED A+]
Core Domains
• Cardiovascular and Hematologic Disorders
• Respiratory Disorders and Oxygen Therapy
• Gastrointestinal and Hepatic Disorders
• Endocrine and Metabolic Disorders
• Renal and Urinary System Disorders
• Musculoskeletal and Neurological Disorders
• Perioperative and Postoperative Nursing Care
• Pharmacology and Medication Safety
• Fluid, Electrolyte, and Acid-Base Balance
• Infection Control and Patient Safety
Introduction
This comprehensive examination is designed to evaluate the nursing knowledge
required for the ATI RN Medical-Surgical Proctored Assessment II Retake. It
assesses competencies across cardiovascular, respiratory, gastrointestinal,
endocrine, renal, musculoskeletal, and neurological systems, as well as
perioperative care, pharmacology, and fluid and electrolyte balance. The exam
utilizes a multiple-choice and scenario-based structure to simulate clinical
encounters in adult medical-surgical nursing. Emphasis is placed on the
application of clinical judgment, prioritization, and evidence-based practice to
,real-world patient presentations, requiring candidates to analyze clinical data,
identify complications, and select the most appropriate nursing interventions. This
exam mirrors the rigor and content coverage of the ATI RN Med-Surg Proctored
Assessment II Retake.
SECTION ONE: QUESTIONS 1–100
1. A nurse is assessing a client who has heart failure. Which finding should the
nurse recognize as an indication of worsening left-sided heart failure?
A. Dependent peripheral edema
B. Jugular venous distention
C. Crackles in the lung bases
D. Enlarged liver
Correct answer: C
RATIONALE: Left-sided heart failure causes pulmonary congestion because
the left ventricle cannot effectively pump blood into systemic circulation.
Crackles, dyspnea, and pulmonary edema are common findings. Dependent
edema, JVD, and hepatomegaly are signs of right-sided heart failure.
2. A nurse is caring for a client receiving a continuous IV infusion of heparin.
Which laboratory value should the nurse monitor to evaluate the therapeutic
effect?
A. INR
B. aPTT
C. Platelet count only
D. Hemoglobin A1c
Correct answer: B
RATIONALE: The activated partial thromboplastin time (aPTT) is commonly
monitored to evaluate the therapeutic effect of unfractionated heparin. INR is
used for warfarin monitoring. Platelet count is monitored for heparin-induced
thrombocytopenia, not therapeutic effect.
3. A client with COPD is receiving oxygen via nasal cannula. Which finding
requires immediate intervention?
A. Oxygen saturation 91%
,B. Respiratory rate 22/min
C. Increased drowsiness and confusion
D. Productive cough
Correct answer: C
RATIONALE: COPD clients can develop CO₂ retention. Drowsiness and
confusion may indicate worsening hypercapnia requiring prompt assessment. An
SpO₂ of 91%, RR of 22, and productive cough are expected findings in COPD.
4. A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which
laboratory finding should the nurse expect?
A. Blood glucose 450 mg/dL
B. Blood pH 7.45
C. Serum potassium 2.8 mEq/L only
D. Blood glucose 90 mg/dL
Correct answer: A
RATIONALE: DKA is characterized by severe hyperglycemia (typically >250
mg/dL), ketosis, and metabolic acidosis (pH <7.35). Blood glucose of 450 mg/dL is
consistent with DKA. pH 7.45 indicates alkalosis. Potassium levels can be normal,
high, or low initially.
5. A client reports crushing chest pain radiating to the left arm. Which action
should the nurse perform first?
A. Administer morphine
B. Obtain a 12-lead ECG
C. Assess vital signs
D. Draw cardiac enzymes
Correct answer: C
RATIONALE: Assessment comes first. Vital signs determine hemodynamic
stability before implementing further interventions. The nurse should assess the
client's vital signs and pain characteristics before administering medications or
obtaining diagnostic tests.
6. A nurse is caring for a client receiving furosemide. Which laboratory value
requires immediate reporting?
A. Sodium 138 mEq/L
, B. Potassium 2.9 mEq/L
C. Chloride 101 mEq/L
D. Calcium 9.2 mg/dL
Correct answer: B
RATIONALE: Furosemide is a loop diuretic that causes potassium loss. Severe
hypokalemia (potassium <3.0 mEq/L) increases the risk for dysrhythmias and
requires immediate reporting. Normal potassium is 3.5-5.0 mEq/L.
7. A nurse is teaching a client who has heart failure. Which instructions should
the nurse include? (Select all that apply.)
A. Weigh yourself daily
B. Restrict sodium intake
C. Report sudden weight gain
D. Drink unlimited fluids
E. Take medications as prescribed
Correct answer: A, B, C, E
RATIONALE: Daily weights, sodium restriction, medication adherence, and
reporting weight gain help prevent exacerbations. Fluid restriction, not unlimited
fluids, is typically recommended for heart failure clients.
8. A client with a pulmonary embolism suddenly becomes short of breath.
Which assessment finding is expected?
A. Bradycardia
B. Hypertension
C. Tachycardia
D. Hypothermia
Correct answer: C
RATIONALE: Pulmonary embolism causes impaired gas exchange and right
ventricular strain. Tachycardia is a common compensatory response. Bradycardia,
hypertension, and hypothermia are not typical findings.
9. A nurse is caring for a client who is 12 hours postoperative following a colon
resection. The nurse assesses the following: HR 90/min, absent bowel sounds,
hemoglobin 8.2 g/dL, gastric pH 3.0. Which finding should the nurse report to
the surgeon?
