ATI RN Adult Medical-Surgical Proctored Mock
Exam & Revision Guide 2026/2027 | Complete
Questions with Answers & Detailed Rationales
1.
A nurse is caring for a client who was admitted with acute
decompensated heart failure. Which finding requires the
nurse's immediate intervention?
A. Bilateral ankle edema
B. Weight gain of 2 kg over 3 days
C. New pink, frothy sputum
D. Fatigue when performing activities of daily living
Correct answer: C. New pink, frothy sputum
Rationale: Pink, frothy sputum is a classic finding associated
with acute pulmonary edema, indicating severe pulmonary
congestion and impaired gas exchange. This is an airway and
breathing priority requiring immediate intervention. Peripheral
edema, weight gain, and fatigue are important manifestations
of heart failure but are not as immediately life-threatening.
,2.
A client with sepsis-induced hypoperfusion is receiving
intravenous crystalloid therapy. Which assessment finding best
indicates that the initial fluid resuscitation is improving tissue
perfusion?
A. Urine output decreases from 35 mL/hr to 20 mL/hr
B. Capillary refill becomes prolonged
C. Mental status improves and urine output increases
D. Heart rate increases from 96/min to 124/min
Correct answer: C. Mental status improves and urine output
increases
Rationale: Improved mentation and increasing urine output are
clinically useful indicators of improving systemic perfusion.
Sepsis resuscitation requires frequent reassessment rather than
assuming that a predetermined fluid volume is sufficient.
Tachycardia, worsening capillary refill, and decreasing urine
output suggest persistent hypoperfusion.
3.
A client with type 2 diabetes is hospitalized for pneumonia and
is eating poorly. The client's blood glucose is persistently 220
mg/dL (12.2 mmol/L). Which insulin approach is most
appropriate?
,A. Use correction insulin alone for the entire admission
B. Use basal insulin with correction insulin as prescribed
C. Discontinue all insulin until oral intake improves
D. Administer only prandial insulin before each meal
Correct answer: B. Use basal insulin with correction insulin as
prescribed
Rationale: For noncritically ill hospitalized adults with poor or
no oral intake, basal insulin or basal insulin plus correction
insulin is preferred. Correction-only regimens without basal
insulin are generally discouraged for ongoing inpatient
management. Insulin requirements must still be individualized
according to nutritional intake, illness severity, and glucose
trends.
4.
A nurse is assessing a client 6 hours after a thyroidectomy.
Which finding requires immediate action?
A. Mild incisional discomfort
B. Hoarse voice
C. Tingling around the mouth and fingertips
D. Small amount of serosanguineous drainage
Correct answer: C. Tingling around the mouth and fingertips
, Rationale: Perioral and fingertip paresthesias may indicate
hypocalcemia caused by impaired parathyroid function
following thyroid surgery. Severe hypocalcemia can progress to
tetany, laryngospasm, and seizures. The nurse should promptly
assess the client and notify the provider because airway
compromise can occur.
5.
A client with chronic kidney disease has a serum potassium
level of 6.7 mEq/L (6.7 mmol/L). Which ECG finding should the
nurse anticipate?
A. Prominent U waves
B. Peaked T waves
C. Prolonged QT interval
D. ST-segment elevation caused by ventricular ischemia
Correct answer: B. Peaked T waves
Rationale: Hyperkalemia can produce tall, peaked T waves and
may progress to PR prolongation, QRS widening, conduction
abnormalities, ventricular dysrhythmias, and cardiac arrest. A
potassium level of 6.7 mEq/L represents a potentially life-
threatening abnormality requiring prompt evaluation and
treatment.
Exam & Revision Guide 2026/2027 | Complete
Questions with Answers & Detailed Rationales
1.
A nurse is caring for a client who was admitted with acute
decompensated heart failure. Which finding requires the
nurse's immediate intervention?
A. Bilateral ankle edema
B. Weight gain of 2 kg over 3 days
C. New pink, frothy sputum
D. Fatigue when performing activities of daily living
Correct answer: C. New pink, frothy sputum
Rationale: Pink, frothy sputum is a classic finding associated
with acute pulmonary edema, indicating severe pulmonary
congestion and impaired gas exchange. This is an airway and
breathing priority requiring immediate intervention. Peripheral
edema, weight gain, and fatigue are important manifestations
of heart failure but are not as immediately life-threatening.
,2.
A client with sepsis-induced hypoperfusion is receiving
intravenous crystalloid therapy. Which assessment finding best
indicates that the initial fluid resuscitation is improving tissue
perfusion?
A. Urine output decreases from 35 mL/hr to 20 mL/hr
B. Capillary refill becomes prolonged
C. Mental status improves and urine output increases
D. Heart rate increases from 96/min to 124/min
Correct answer: C. Mental status improves and urine output
increases
Rationale: Improved mentation and increasing urine output are
clinically useful indicators of improving systemic perfusion.
Sepsis resuscitation requires frequent reassessment rather than
assuming that a predetermined fluid volume is sufficient.
Tachycardia, worsening capillary refill, and decreasing urine
output suggest persistent hypoperfusion.
3.
A client with type 2 diabetes is hospitalized for pneumonia and
is eating poorly. The client's blood glucose is persistently 220
mg/dL (12.2 mmol/L). Which insulin approach is most
appropriate?
,A. Use correction insulin alone for the entire admission
B. Use basal insulin with correction insulin as prescribed
C. Discontinue all insulin until oral intake improves
D. Administer only prandial insulin before each meal
Correct answer: B. Use basal insulin with correction insulin as
prescribed
Rationale: For noncritically ill hospitalized adults with poor or
no oral intake, basal insulin or basal insulin plus correction
insulin is preferred. Correction-only regimens without basal
insulin are generally discouraged for ongoing inpatient
management. Insulin requirements must still be individualized
according to nutritional intake, illness severity, and glucose
trends.
4.
A nurse is assessing a client 6 hours after a thyroidectomy.
Which finding requires immediate action?
A. Mild incisional discomfort
B. Hoarse voice
C. Tingling around the mouth and fingertips
D. Small amount of serosanguineous drainage
Correct answer: C. Tingling around the mouth and fingertips
, Rationale: Perioral and fingertip paresthesias may indicate
hypocalcemia caused by impaired parathyroid function
following thyroid surgery. Severe hypocalcemia can progress to
tetany, laryngospasm, and seizures. The nurse should promptly
assess the client and notify the provider because airway
compromise can occur.
5.
A client with chronic kidney disease has a serum potassium
level of 6.7 mEq/L (6.7 mmol/L). Which ECG finding should the
nurse anticipate?
A. Prominent U waves
B. Peaked T waves
C. Prolonged QT interval
D. ST-segment elevation caused by ventricular ischemia
Correct answer: B. Peaked T waves
Rationale: Hyperkalemia can produce tall, peaked T waves and
may progress to PR prolongation, QRS widening, conduction
abnormalities, ventricular dysrhythmias, and cardiac arrest. A
potassium level of 6.7 mEq/L represents a potentially life-
threatening abnormality requiring prompt evaluation and
treatment.
