ATI RN ADULT MEDICAL-SURGICAL
CMS EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF. The
assessment underscores critical
thinking, collaboration, and ethical
practice in adult medical-surgical
nursing.
________________________________________
Core Domains
• Cardiovascular Disorders
• Respiratory Disorders
• Neurological Disorders
• Gastrointestinal Disorders
• Renal and Urinary Disorders
• Endocrine and Metabolic Disorders
• Musculoskeletal Disorders
• Perioperative Nursing and Emergency Care
Introduction
,The ATI RN Adult Medical-Surgical CMS Exam assesses the
knowledge and clinical judgment required for safe, effective
nursing care of adult clients with acute and chronic health
conditions. The examination evaluates cardiovascular, respiratory,
neurological, gastrointestinal, renal, endocrine, and
musculoskeletal disorders, along with perioperative care and
emergency management. Questions incorporate multiple-choice
and Next Generation NCLEX (NGN) formats emphasizing
prioritization, clinical decision-making, and evidence-based
interventions. Candidates must demonstrate competency in
pathophysiology, medication administration, patient safety, and
therapeutic communication. The assessment underscores critical
thinking, collaboration, and ethical practice in adult medical-
surgical nursing.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client who has chronic
obstructive pulmonary disease (COPD) and is receiving
oxygen at 2 L/min via nasal cannula. The client reports
increased shortness of breath. Which of the following
actions should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min
B. Obtain a pulse oximetry reading
C. Assess the client's respiratory rate, depth, and pattern
D. Instruct the client to purse-lip breathe
C. Assess the client's respiratory rate, depth, and pattern
RATIONALE: The nurse should first assess the client's
respiratory status before making any changes to oxygen therapy.
Clients with COPD rely on hypoxic drive to breathe; increasing
,oxygen flow rate can suppress ventilation and cause respiratory
acidosis .
2. A nurse is teaching a client who has asthma about
proper use of a metered-dose inhaler (MDI) with a spacer.
Which statement indicates understanding?
A. "I will shake the inhaler, attach the spacer, exhale fully, then
inhale slowly and deeply."
B. "I will take two quick breaths after pressing the inhaler to get
the full dose."
C. "I will hold my breath for 5 seconds after inhaling the
medication."
D. "I will rinse my mouth with water before using the inhaler to
moisten my airway."
A. "I will shake the inhaler, attach the spacer, exhale fully,
then inhale slowly and deeply."
RATIONALE: Correct MDI technique includes shaking, exhaling
fully, pressing the inhaler, and inhaling slowly and deeply over 3-5
seconds, then holding breath for 10 seconds. Rinsing after
corticosteroid inhalers prevents oral candidiasis .
3. A nurse reviews ABG results for a client with
pneumonia: pH 7.30, PaCO2 50 mm Hg, HCO3- 24 mEq/L.
How should the nurse interpret these findings?
A. Respiratory alkalosis with partial compensation
B. Respiratory acidosis without compensation
C. Metabolic acidosis with respiratory compensation
D. Metabolic alkalosis without compensation
B. Respiratory acidosis without compensation
RATIONALE: pH 7.30 indicates acidosis; elevated PaCO2 of 50
mm Hg indicates respiratory origin; normal HCO3- indicates
, kidneys have not compensated. This is uncompensated
respiratory acidosis, common in pneumonia due to alveolar
hypoventilation .
4. A client who is postoperative following total knee
replacement develops sudden dyspnea, chest pain, and
tachycardia. Which action should the nurse take?
A. Administer prescribed pain medication to relieve chest
discomfort
B. Elevate the client's legs to promote venous return
C. Apply oxygen and notify the provider immediately
D. Encourage the client to cough and deep breathe
C. Apply oxygen and notify the provider immediately
RATIONALE: The client exhibits signs of pulmonary embolism,
a life-threatening complication after orthopedic surgery. Applying
oxygen addresses hypoxemia and provider notification is
immediate priority .
5. A nurse is admitting a client who reports chest pain and
has been placed on telemetry. Which finding should the
nurse analyze to determine myocardial infarction?
A. PR interval
B. QRS duration
C. T wave
D. ST segment
D. ST segment
RATIONALE: ST elevation indicates myocardial infarction; ST
depression indicates ischemia. PR interval relates to first-degree
heart block; QRS duration indicates ventricular conduction delay .
CMS EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF. The
assessment underscores critical
thinking, collaboration, and ethical
practice in adult medical-surgical
nursing.
________________________________________
Core Domains
• Cardiovascular Disorders
• Respiratory Disorders
• Neurological Disorders
• Gastrointestinal Disorders
• Renal and Urinary Disorders
• Endocrine and Metabolic Disorders
• Musculoskeletal Disorders
• Perioperative Nursing and Emergency Care
Introduction
,The ATI RN Adult Medical-Surgical CMS Exam assesses the
knowledge and clinical judgment required for safe, effective
nursing care of adult clients with acute and chronic health
conditions. The examination evaluates cardiovascular, respiratory,
neurological, gastrointestinal, renal, endocrine, and
musculoskeletal disorders, along with perioperative care and
emergency management. Questions incorporate multiple-choice
and Next Generation NCLEX (NGN) formats emphasizing
prioritization, clinical decision-making, and evidence-based
interventions. Candidates must demonstrate competency in
pathophysiology, medication administration, patient safety, and
therapeutic communication. The assessment underscores critical
thinking, collaboration, and ethical practice in adult medical-
surgical nursing.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client who has chronic
obstructive pulmonary disease (COPD) and is receiving
oxygen at 2 L/min via nasal cannula. The client reports
increased shortness of breath. Which of the following
actions should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min
B. Obtain a pulse oximetry reading
C. Assess the client's respiratory rate, depth, and pattern
D. Instruct the client to purse-lip breathe
C. Assess the client's respiratory rate, depth, and pattern
RATIONALE: The nurse should first assess the client's
respiratory status before making any changes to oxygen therapy.
Clients with COPD rely on hypoxic drive to breathe; increasing
,oxygen flow rate can suppress ventilation and cause respiratory
acidosis .
2. A nurse is teaching a client who has asthma about
proper use of a metered-dose inhaler (MDI) with a spacer.
Which statement indicates understanding?
A. "I will shake the inhaler, attach the spacer, exhale fully, then
inhale slowly and deeply."
B. "I will take two quick breaths after pressing the inhaler to get
the full dose."
C. "I will hold my breath for 5 seconds after inhaling the
medication."
D. "I will rinse my mouth with water before using the inhaler to
moisten my airway."
A. "I will shake the inhaler, attach the spacer, exhale fully,
then inhale slowly and deeply."
RATIONALE: Correct MDI technique includes shaking, exhaling
fully, pressing the inhaler, and inhaling slowly and deeply over 3-5
seconds, then holding breath for 10 seconds. Rinsing after
corticosteroid inhalers prevents oral candidiasis .
3. A nurse reviews ABG results for a client with
pneumonia: pH 7.30, PaCO2 50 mm Hg, HCO3- 24 mEq/L.
How should the nurse interpret these findings?
A. Respiratory alkalosis with partial compensation
B. Respiratory acidosis without compensation
C. Metabolic acidosis with respiratory compensation
D. Metabolic alkalosis without compensation
B. Respiratory acidosis without compensation
RATIONALE: pH 7.30 indicates acidosis; elevated PaCO2 of 50
mm Hg indicates respiratory origin; normal HCO3- indicates
, kidneys have not compensated. This is uncompensated
respiratory acidosis, common in pneumonia due to alveolar
hypoventilation .
4. A client who is postoperative following total knee
replacement develops sudden dyspnea, chest pain, and
tachycardia. Which action should the nurse take?
A. Administer prescribed pain medication to relieve chest
discomfort
B. Elevate the client's legs to promote venous return
C. Apply oxygen and notify the provider immediately
D. Encourage the client to cough and deep breathe
C. Apply oxygen and notify the provider immediately
RATIONALE: The client exhibits signs of pulmonary embolism,
a life-threatening complication after orthopedic surgery. Applying
oxygen addresses hypoxemia and provider notification is
immediate priority .
5. A nurse is admitting a client who reports chest pain and
has been placed on telemetry. Which finding should the
nurse analyze to determine myocardial infarction?
A. PR interval
B. QRS duration
C. T wave
D. ST segment
D. ST segment
RATIONALE: ST elevation indicates myocardial infarction; ST
depression indicates ischemia. PR interval relates to first-degree
heart block; QRS duration indicates ventricular conduction delay .
