Legit ATI RN Adult Medical-Surgical 2026 Proctored
Exam | NGN | Level 3 Score | 100 Screenshot
Questions, Answers and Rationales
1. A nurse is caring for a client with heart failure who has been prescribed furosemide. Which
assessment finding indicates a therapeutic response?
A. Weight loss of 1 kg (2.2 lb) in 24 hours
B. Heart rate of 110/min
C. Urine output of 20 mL/hr
D. Crackles audible at the lung bases
Correct Answer: A
Rationale: A weight loss of 0.5–1 kg (1–2 lb) per day indicates effective diuresis and fluid
removal in heart failure. Tachycardia, oliguria, and persistent crackles indicate worsening fluid
overload or inadequate diuresis.
2. A nurse is assessing a client who reports chest pain. Which finding most suggests an acute
myocardial infarction rather than angina?
A. Pain relieved by rest
B. Pain lasting 5 minutes
C. Pain unrelieved by nitroglycerin
D. Pain described as sharp with inspiration
Correct Answer: C
Rationale: MI pain is typically unrelieved by rest or nitroglycerin and lasts longer than 20
minutes. Angina is usually relieved by rest or nitroglycerin within 5 minutes. Sharp, inspiratory
pain suggests pericarditis or pleuritic pain.
3. A client is prescribed digoxin. Which finding should the nurse report immediately?
A. Heart rate 58/min with nausea and visual halos
B. Blood pressure 118/76 mm Hg
C. Potassium 4.2 mEq/L
D. Digoxin level 1.2 ng/mL
, Correct Answer: A
Rationale: Bradycardia, nausea, and visual disturbances (halos, yellow-green vision) are
classic signs of digoxin toxicity. Therapeutic digoxin level is 0.5–2.0 ng/mL; 1.2 is therapeutic.
4. SATA: A nurse is teaching a client about a low-sodium diet for hypertension. Which foods
should the client limit? (Select all that apply.)
A. Canned soup
B. Fresh apples
C. Deli meats
D. Frozen pizza
E. Brown rice
Correct Answer: A, C, D
Rationale: Canned soup, deli meats, and frozen pizza are high in sodium due to processing
and preservatives. Fresh apples and plain brown rice are naturally low in sodium.
5. A nurse is caring for a client following cardiac catheterization. Which assessment is the
priority?
A. Monitor the insertion site for bleeding and check distal pulses
B. Encourage ambulation
C. Assess for hunger
D. Administer oral fluids
Correct Answer: A
Rationale: Post-catheterization priority is monitoring for bleeding, hematoma, and
compromised circulation distal to the insertion site. Ambulation is restricted initially.
6. A client with atrial fibrillation is prescribed warfarin. Which lab value should the nurse
monitor?
A. aPTT
B. INR
C. Platelet count
D. Hemoglobin
, Correct Answer: B
Rationale: Warfarin therapy is monitored with INR (therapeutic 2–3 for most indications).
aPTT monitors heparin. Platelets and hemoglobin are monitored but do not reflect
anticoagulation effectiveness.
7. A nurse is assessing a client with peripheral arterial disease (PAD). Which finding is expected?
A. Dependent rubor and cool extremities
B. Warm, edematous extremities
C. Bounding pulses
D. Brown discoloration of the ankles
Correct Answer: A
Rationale: PAD causes decreased arterial blood flow, resulting in cool extremities, pallor
with elevation, dependent rubor, and diminished pulses. Warm edema and brown ankle
discoloration suggest venous insufficiency.
8. A client is receiving heparin IV. Which finding indicates a possible complication?
A. INR 2.5
B. Platelets 90,000/mm³
C. aPTT 60 seconds
D. Blood pressure 130/80 mm Hg
Correct Answer: B
Rationale: Heparin-induced thrombocytopenia (HIT) is a serious complication; platelets
<150,000/mm³ should be reported. Therapeutic aPTT is 1.5–2.5 times control (typically 60–80
seconds).
9. SATA: A nurse is teaching a client about heart failure self-management. Which instructions
should be included? (Select all that apply.)
A. Weigh yourself daily at the same time
B. Report a weight gain of 2–3 lb in 24 hours
C. Lie flat to improve breathing
D. Limit sodium intake
E. Take diuretics in the evening
, Correct Answer: A, B, D
Rationale: Daily weights, reporting rapid weight gain, and sodium restriction are key HF
management strategies. Clients should sleep with the head elevated, and diuretics should be
taken in the morning to avoid nocturia.
10. A nurse is caring for a client with a new pacemaker. Which instruction is priority?
A. Avoid MRI unless approved
B. Resume vigorous exercise immediately
C. Avoid all electrical devices
D. Sleep on the pacemaker site
Correct Answer: A
Rationale: MRI is generally contraindicated with traditional pacemakers unless the device is
MRI-conditional. Vigorous exercise, sleeping on the site, and avoiding all electronics are not
appropriate instructions.
11. A client with chest pain is prescribed nitroglycerin sublingual. Which instruction is correct?
A. Take one tablet every 5 minutes up to 3 doses, then call 911
B. Take 3 tablets at once
C. Swallow the tablet whole
D. Take with a full glass of water
Correct Answer: A
Rationale: Sublingual nitroglycerin is taken every 5 minutes for up to 3 doses; if pain
persists, activate emergency services. Tablets are dissolved under the tongue, not swallowed.
12. A nurse is assessing a client with an abdominal aortic aneurysm. Which finding is most
concerning?
A. Pulsatile abdominal mass with sudden severe back pain
B. Blood pressure 150/90 mm Hg
C. Bruit over the abdomen
D. Mild constipation
Exam | NGN | Level 3 Score | 100 Screenshot
Questions, Answers and Rationales
1. A nurse is caring for a client with heart failure who has been prescribed furosemide. Which
assessment finding indicates a therapeutic response?
A. Weight loss of 1 kg (2.2 lb) in 24 hours
B. Heart rate of 110/min
C. Urine output of 20 mL/hr
D. Crackles audible at the lung bases
Correct Answer: A
Rationale: A weight loss of 0.5–1 kg (1–2 lb) per day indicates effective diuresis and fluid
removal in heart failure. Tachycardia, oliguria, and persistent crackles indicate worsening fluid
overload or inadequate diuresis.
2. A nurse is assessing a client who reports chest pain. Which finding most suggests an acute
myocardial infarction rather than angina?
A. Pain relieved by rest
B. Pain lasting 5 minutes
C. Pain unrelieved by nitroglycerin
D. Pain described as sharp with inspiration
Correct Answer: C
Rationale: MI pain is typically unrelieved by rest or nitroglycerin and lasts longer than 20
minutes. Angina is usually relieved by rest or nitroglycerin within 5 minutes. Sharp, inspiratory
pain suggests pericarditis or pleuritic pain.
3. A client is prescribed digoxin. Which finding should the nurse report immediately?
A. Heart rate 58/min with nausea and visual halos
B. Blood pressure 118/76 mm Hg
C. Potassium 4.2 mEq/L
D. Digoxin level 1.2 ng/mL
, Correct Answer: A
Rationale: Bradycardia, nausea, and visual disturbances (halos, yellow-green vision) are
classic signs of digoxin toxicity. Therapeutic digoxin level is 0.5–2.0 ng/mL; 1.2 is therapeutic.
4. SATA: A nurse is teaching a client about a low-sodium diet for hypertension. Which foods
should the client limit? (Select all that apply.)
A. Canned soup
B. Fresh apples
C. Deli meats
D. Frozen pizza
E. Brown rice
Correct Answer: A, C, D
Rationale: Canned soup, deli meats, and frozen pizza are high in sodium due to processing
and preservatives. Fresh apples and plain brown rice are naturally low in sodium.
5. A nurse is caring for a client following cardiac catheterization. Which assessment is the
priority?
A. Monitor the insertion site for bleeding and check distal pulses
B. Encourage ambulation
C. Assess for hunger
D. Administer oral fluids
Correct Answer: A
Rationale: Post-catheterization priority is monitoring for bleeding, hematoma, and
compromised circulation distal to the insertion site. Ambulation is restricted initially.
6. A client with atrial fibrillation is prescribed warfarin. Which lab value should the nurse
monitor?
A. aPTT
B. INR
C. Platelet count
D. Hemoglobin
, Correct Answer: B
Rationale: Warfarin therapy is monitored with INR (therapeutic 2–3 for most indications).
aPTT monitors heparin. Platelets and hemoglobin are monitored but do not reflect
anticoagulation effectiveness.
7. A nurse is assessing a client with peripheral arterial disease (PAD). Which finding is expected?
A. Dependent rubor and cool extremities
B. Warm, edematous extremities
C. Bounding pulses
D. Brown discoloration of the ankles
Correct Answer: A
Rationale: PAD causes decreased arterial blood flow, resulting in cool extremities, pallor
with elevation, dependent rubor, and diminished pulses. Warm edema and brown ankle
discoloration suggest venous insufficiency.
8. A client is receiving heparin IV. Which finding indicates a possible complication?
A. INR 2.5
B. Platelets 90,000/mm³
C. aPTT 60 seconds
D. Blood pressure 130/80 mm Hg
Correct Answer: B
Rationale: Heparin-induced thrombocytopenia (HIT) is a serious complication; platelets
<150,000/mm³ should be reported. Therapeutic aPTT is 1.5–2.5 times control (typically 60–80
seconds).
9. SATA: A nurse is teaching a client about heart failure self-management. Which instructions
should be included? (Select all that apply.)
A. Weigh yourself daily at the same time
B. Report a weight gain of 2–3 lb in 24 hours
C. Lie flat to improve breathing
D. Limit sodium intake
E. Take diuretics in the evening
, Correct Answer: A, B, D
Rationale: Daily weights, reporting rapid weight gain, and sodium restriction are key HF
management strategies. Clients should sleep with the head elevated, and diuretics should be
taken in the morning to avoid nocturia.
10. A nurse is caring for a client with a new pacemaker. Which instruction is priority?
A. Avoid MRI unless approved
B. Resume vigorous exercise immediately
C. Avoid all electrical devices
D. Sleep on the pacemaker site
Correct Answer: A
Rationale: MRI is generally contraindicated with traditional pacemakers unless the device is
MRI-conditional. Vigorous exercise, sleeping on the site, and avoiding all electronics are not
appropriate instructions.
11. A client with chest pain is prescribed nitroglycerin sublingual. Which instruction is correct?
A. Take one tablet every 5 minutes up to 3 doses, then call 911
B. Take 3 tablets at once
C. Swallow the tablet whole
D. Take with a full glass of water
Correct Answer: A
Rationale: Sublingual nitroglycerin is taken every 5 minutes for up to 3 doses; if pain
persists, activate emergency services. Tablets are dissolved under the tongue, not swallowed.
12. A nurse is assessing a client with an abdominal aortic aneurysm. Which finding is most
concerning?
A. Pulsatile abdominal mass with sudden severe back pain
B. Blood pressure 150/90 mm Hg
C. Bruit over the abdomen
D. Mild constipation
