Legit ATI RN Adult Medical-Surgical 2026 Proctored
Exam | NGN | Level 3 Score | 100 Screenshot
Questions, Answers and Rationales
Q1. A client with heart failure has a new order for furosemide 40 mg IV. Which assessment
finding requires the nurse to hold the dose and notify the provider?
A. Potassium 3.1 mEq/L
B. Blood pressure 118/72 mm Hg
C. Urine output 40 mL/hr
D. Weight loss of 0.5 kg since yesterday
Correct: A
Loop diuretics like furosemide cause potassium loss. A K+ of 3.1 mEq/L is below normal
(3.5–5.0) and increases risk of dysrhythmias; the dose should be held and the provider notified.
Q2. Which client is at highest risk for developing infective endocarditis?
A. A 24-year-old with a repaired atrial septal defect
B. A 38-year-old who uses IV heroin
C. A 55-year-old with well-controlled hypertension
D. A 62-year-old with type 2 diabetes
Correct: B
IV drug use is a major risk factor for infective endocarditis, especially right-sided (tricuspid)
involvement, due to direct inoculation of organisms into the bloodstream.
Q3. A nurse is caring for a client 6 hours after a femoral cardiac catheterization. Which finding
should be reported immediately?
A. Small bruise at the puncture site
B. Client reports mild back discomfort
C. Pedal pulse 1+ with cool, pale foot
D. Groin pain relieved by repositioning
Correct: C
A diminished pulse with a cool, pale extremity suggests arterial compromise (hematoma,
thrombosis, or pseudoaneurysm) and requires immediate intervention.
,Q4. SATA. Which findings are expected in a client with left-sided heart failure? (Select all that
apply.)
A. Crackles in the lung bases
B. Peripheral edema
C. Orthopnea
D. Jugular venous distention
E. Paroxysmal nocturnal dyspnea
Correct: A, C, E
Left-sided failure causes pulmonary congestion: crackles, orthopnea, and PND. Peripheral
edema and JVD are right-sided findings.
Q5. A client with atrial fibrillation is prescribed warfarin. Which instruction is most important?
A. "Increase leafy green vegetables."
B. "Keep your vitamin K intake consistent."
C. "Take aspirin for headaches."
D. "Double the dose if you miss one."
Correct: B
Vitamin K antagonizes warfarin. Consistent (not increased or decreased) intake keeps INR
stable. Aspirin increases bleeding risk.
Q6. Which ECG change indicates myocardial injury (not ischemia or infarction)?
A. ST elevation
B. T-wave inversion
C. Pathologic Q waves
D. ST depression
Correct: B
T-wave inversion indicates ischemia/injury. ST elevation = injury/infarction; Q waves =
necrosis. In many frameworks T-wave inversion reflects ischemia; the key distractor is Q waves
(necrosis).
,Q7. A client is in pulseless ventricular tachycardia. What is the priority action?
A. Administer epinephrine 1 mg IV
B. Begin CPR and defibrillate
C. Give amiodarone 150 mg IV
D. Perform synchronized cardioversion
Correct: B
Pulseless VT is a shockable rhythm. Immediate high-quality CPR and defibrillation are
priority; epinephrine and amiodarone follow.
Q8. A client with an abdominal aortic aneurysm reports sudden severe back pain. What is the
priority nursing action?
A. Administer pain medication
B. Assess vital signs and prepare for emergency surgery
C. Apply a heating pad
D. Encourage ambulation
Correct: B
Sudden severe back pain may indicate rupture. Assess for hypotension/tachycardia and
prepare for immediate surgical intervention.
Q9. Which lab value is most concerning in a client on heparin infusion?
A. aPTT 45 seconds
B. Platelets 90,000/mm³
C. Hemoglobin 13 g/dL
D. INR 1.1
Correct: B
Heparin-induced thrombocytopenia (HIT) is a serious complication. A falling platelet count
requires immediate notification and possible discontinuation.
Q10. A nurse is teaching a client about nitroglycerin. Which statement shows understanding?
A. "I'll take it with my erectile dysfunction medication."
B. "I'll sit down before taking it."
C. "I'll take three at once if I have chest pain."
D. "I'll store it in the bathroom."
, Correct: B
Nitroglycerin causes hypotension; sitting prevents falls. It is contraindicated with PDE-5
inhibitors and should be stored away from heat/moisture.
Q11. Which client requires the most immediate assessment?
A. Client with pericarditis reporting sharp chest pain
B. Client post-CABG with 250 mL chest tube output in 1 hour
C. Client with hypertension reporting a headache
D. Client with varicose veins reporting leg heaviness
Correct: B
Chest tube output >200 mL/hr may indicate hemorrhage and requires immediate
intervention.
Q12. A client with DVT is started on enoxaparin. Which assessment is priority?
A. Renal function
B. Visual acuity
C. Hearing
D. Pupil response
Correct: A
Enoxaparin is renally cleared; impaired renal function increases bleeding risk and requires
dose adjustment.
Q13. SATA. Which are modifiable risk factors for coronary artery disease? (Select all that apply.)
A. Smoking
B. Family history
C. Hypertension
D. Age
E. Obesity
Correct: A, C, E
Smoking, hypertension, and obesity are modifiable. Family history and age are
nonmodifiable.
Exam | NGN | Level 3 Score | 100 Screenshot
Questions, Answers and Rationales
Q1. A client with heart failure has a new order for furosemide 40 mg IV. Which assessment
finding requires the nurse to hold the dose and notify the provider?
A. Potassium 3.1 mEq/L
B. Blood pressure 118/72 mm Hg
C. Urine output 40 mL/hr
D. Weight loss of 0.5 kg since yesterday
Correct: A
Loop diuretics like furosemide cause potassium loss. A K+ of 3.1 mEq/L is below normal
(3.5–5.0) and increases risk of dysrhythmias; the dose should be held and the provider notified.
Q2. Which client is at highest risk for developing infective endocarditis?
A. A 24-year-old with a repaired atrial septal defect
B. A 38-year-old who uses IV heroin
C. A 55-year-old with well-controlled hypertension
D. A 62-year-old with type 2 diabetes
Correct: B
IV drug use is a major risk factor for infective endocarditis, especially right-sided (tricuspid)
involvement, due to direct inoculation of organisms into the bloodstream.
Q3. A nurse is caring for a client 6 hours after a femoral cardiac catheterization. Which finding
should be reported immediately?
A. Small bruise at the puncture site
B. Client reports mild back discomfort
C. Pedal pulse 1+ with cool, pale foot
D. Groin pain relieved by repositioning
Correct: C
A diminished pulse with a cool, pale extremity suggests arterial compromise (hematoma,
thrombosis, or pseudoaneurysm) and requires immediate intervention.
,Q4. SATA. Which findings are expected in a client with left-sided heart failure? (Select all that
apply.)
A. Crackles in the lung bases
B. Peripheral edema
C. Orthopnea
D. Jugular venous distention
E. Paroxysmal nocturnal dyspnea
Correct: A, C, E
Left-sided failure causes pulmonary congestion: crackles, orthopnea, and PND. Peripheral
edema and JVD are right-sided findings.
Q5. A client with atrial fibrillation is prescribed warfarin. Which instruction is most important?
A. "Increase leafy green vegetables."
B. "Keep your vitamin K intake consistent."
C. "Take aspirin for headaches."
D. "Double the dose if you miss one."
Correct: B
Vitamin K antagonizes warfarin. Consistent (not increased or decreased) intake keeps INR
stable. Aspirin increases bleeding risk.
Q6. Which ECG change indicates myocardial injury (not ischemia or infarction)?
A. ST elevation
B. T-wave inversion
C. Pathologic Q waves
D. ST depression
Correct: B
T-wave inversion indicates ischemia/injury. ST elevation = injury/infarction; Q waves =
necrosis. In many frameworks T-wave inversion reflects ischemia; the key distractor is Q waves
(necrosis).
,Q7. A client is in pulseless ventricular tachycardia. What is the priority action?
A. Administer epinephrine 1 mg IV
B. Begin CPR and defibrillate
C. Give amiodarone 150 mg IV
D. Perform synchronized cardioversion
Correct: B
Pulseless VT is a shockable rhythm. Immediate high-quality CPR and defibrillation are
priority; epinephrine and amiodarone follow.
Q8. A client with an abdominal aortic aneurysm reports sudden severe back pain. What is the
priority nursing action?
A. Administer pain medication
B. Assess vital signs and prepare for emergency surgery
C. Apply a heating pad
D. Encourage ambulation
Correct: B
Sudden severe back pain may indicate rupture. Assess for hypotension/tachycardia and
prepare for immediate surgical intervention.
Q9. Which lab value is most concerning in a client on heparin infusion?
A. aPTT 45 seconds
B. Platelets 90,000/mm³
C. Hemoglobin 13 g/dL
D. INR 1.1
Correct: B
Heparin-induced thrombocytopenia (HIT) is a serious complication. A falling platelet count
requires immediate notification and possible discontinuation.
Q10. A nurse is teaching a client about nitroglycerin. Which statement shows understanding?
A. "I'll take it with my erectile dysfunction medication."
B. "I'll sit down before taking it."
C. "I'll take three at once if I have chest pain."
D. "I'll store it in the bathroom."
, Correct: B
Nitroglycerin causes hypotension; sitting prevents falls. It is contraindicated with PDE-5
inhibitors and should be stored away from heat/moisture.
Q11. Which client requires the most immediate assessment?
A. Client with pericarditis reporting sharp chest pain
B. Client post-CABG with 250 mL chest tube output in 1 hour
C. Client with hypertension reporting a headache
D. Client with varicose veins reporting leg heaviness
Correct: B
Chest tube output >200 mL/hr may indicate hemorrhage and requires immediate
intervention.
Q12. A client with DVT is started on enoxaparin. Which assessment is priority?
A. Renal function
B. Visual acuity
C. Hearing
D. Pupil response
Correct: A
Enoxaparin is renally cleared; impaired renal function increases bleeding risk and requires
dose adjustment.
Q13. SATA. Which are modifiable risk factors for coronary artery disease? (Select all that apply.)
A. Smoking
B. Family history
C. Hypertension
D. Age
E. Obesity
Correct: A, C, E
Smoking, hypertension, and obesity are modifiable. Family history and age are
nonmodifiable.
