Updated ATI RN Adult Medical-Surgical (Medsurg) 2026
Proctored Exam with NGN 100 Screenshot Questions and
Answers Per ATI Marking Scheme for Level 3 RN ATI Adult
Medical Surgical Proctored
1. A nurse is caring for a client who has heart failure and is receiving furosemide. Which of the
following findings should the nurse identify as an adverse effect of this medication?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Correct Answer: B. Hypokalemia
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in
the ascending loop of Henle, leading to increased excretion of potassium. Hypokalemia is a
common adverse effect. The nurse should monitor serum potassium levels and teach the client
to consume potassium-rich foods. Options A, C, and D are incorrect because furosemide causes
potassium loss, not retention, and does not typically cause hypernatremia or hypercalcemia.
2. A nurse is assessing a client who has been taking digoxin for heart failure. Which of the
following findings should the nurse report immediately?
A. Heart rate of 58/min
B. Serum potassium of 3.2 mEq/L
C. Nausea and visual disturbances
D. Blood pressure of 110/70 mm Hg
Correct Answer: C. Nausea and visual disturbances
Rationale: Nausea, vomiting, and visual disturbances (such as yellow-green halos) are
classic early signs of digoxin toxicity. The nurse should withhold the medication and notify the
provider immediately. While a heart rate of 58/min and potassium of 3.2 mEq/L warrant
monitoring, they are not immediate indicators of toxicity. Digoxin toxicity is potentiated by
hypokalemia, so the nurse should also monitor potassium levels closely.
,3. A nurse is teaching a client who has a new prescription for warfarin. Which of the following
statements by the client indicates understanding of the teaching?
A. "I will increase my intake of leafy green vegetables."
B. "I will use a soft toothbrush and electric razor."
C. "I will take aspirin for headaches."
D. "I will double my dose if I miss one."
Correct Answer: B. "I will use a soft toothbrush and electric razor."
Rationale: Warfarin is an anticoagulant that increases bleeding risk. Using a soft toothbrush
and electric razor helps prevent bleeding. Clients should maintain consistent (not increased)
intake of vitamin K–rich foods (leafy greens). Aspirin increases bleeding risk and should be
avoided unless prescribed. Clients should never double doses of warfarin.
4. A nurse is caring for a client who has just returned from cardiac catheterization. Which of
the following findings requires immediate intervention?
A. Small hematoma at the insertion site
B. Blood pressure of 100/60 mm Hg
C. Oozing blood from the access site with a dropping blood pressure
D. Client reports mild back discomfort
Correct Answer: C. Oozing blood from the access site with a dropping blood pressure
Rationale: Active bleeding from the access site combined with a dropping blood pressure
indicates possible hemorrhage or retroperitoneal bleeding, which requires immediate
intervention. A small hematoma may be expected. Mild back discomfort may be related to lying
flat. A BP of 100/60 may be baseline for some clients but should be monitored.
5. A nurse is reviewing the ECG rhythm strip of a client and notes a heart rate of 48/min,
regular P waves before each QRS, and a PR interval of 0.16 seconds. The client is
asymptomatic. Which of the following actions should the nurse take first?
A. Administer atropine 0.5 mg IV
B. Continue to monitor the client
C. Prepare for transcutaneous pacing
D. Initiate CPR
Correct Answer: B. Continue to monitor the client
, Rationale: This rhythm describes sinus bradycardia. Asymptomatic sinus bradycardia does
not require immediate treatment. The nurse should continue to monitor. Atropine is indicated
for symptomatic bradycardia. Pacing and CPR are not indicated for an asymptomatic client.
6. A nurse is caring for a client who has atrial fibrillation and a new prescription for apixaban.
Which of the following laboratory values should the nurse monitor?
A. INR
B. aPTT
C. Hemoglobin and hematocrit
D. Platelet count only
Correct Answer: C. Hemoglobin and hematocrit
Rationale: Apixaban is a direct oral anticoagulant (DOAC) that does not require routine INR
or aPTT monitoring. However, the nurse should monitor hemoglobin and hematocrit to assess
for bleeding. While platelet count is important, H&H is the priority for detecting occult bleeding.
7. A nurse is assessing a client who has peripheral arterial disease (PAD). Which of the
following findings should the nurse expect? (Select all that apply.)
A. Intermittent claudication
B. Bounding pedal pulses
C. Cool extremities
D. Dependent rubor
E. Shiny, hairless skin on lower legs
Correct Answers: A, C, D, E
Rationale: PAD results from decreased arterial blood flow. Expected findings include
intermittent claudication (A), cool extremities (C), dependent rubor (D), and shiny, hairless skin
(E). Bounding pedal pulses (B) are associated with venous insufficiency, not arterial insufficiency.
Pulses in PAD are typically diminished or absent.
8. A nurse is teaching a client who has hypertension about lifestyle modifications. Which of
the following instructions should the nurse include?
, A. "Limit your sodium intake to 4,000 mg per day."
B. "Exercise for at least 150 minutes of moderate activity per week."
C. "Drink 3 to 4 alcoholic beverages per day."
D. "Stop taking your medication when your blood pressure is normal."
Correct Answer: B. "Exercise for at least 150 minutes of moderate activity per week."
Rationale: The American Heart Association recommends at least 150 minutes of moderate-
intensity aerobic activity per week for hypertension management. Sodium should be limited to
1,500–2,300 mg/day. Alcohol should be limited. Antihypertensive medications should be
continued even when BP normalizes.
9. A nurse is caring for a client who is receiving a blood transfusion and develops fever, chills,
and low back pain. Which of the following actions should the nurse take first?
A. Administer acetaminophen
B. Stop the transfusion
C. Obtain a urine specimen
D. Notify the provider
Correct Answer: B. Stop the transfusion
Rationale: Fever, chills, and low back pain during transfusion suggest an acute hemolytic
reaction, which is life-threatening. The first action is to stop the transfusion immediately, then
maintain IV access with normal saline, notify the provider, and obtain specimens.
Acetaminophen is not appropriate for hemolytic reactions.
10. A nurse is assessing a client who has left-sided heart failure. Which of the following
findings should the nurse expect?
A. Peripheral edema
B. Jugular vein distention
C. Crackles in the lungs
D. Hepatomegaly
Correct Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure causes pulmonary congestion, leading to crackles,
dyspnea, and orthopnea. Right-sided heart failure causes systemic congestion, including
peripheral edema (A), JVD (B), and hepatomegaly (D).
Proctored Exam with NGN 100 Screenshot Questions and
Answers Per ATI Marking Scheme for Level 3 RN ATI Adult
Medical Surgical Proctored
1. A nurse is caring for a client who has heart failure and is receiving furosemide. Which of the
following findings should the nurse identify as an adverse effect of this medication?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Correct Answer: B. Hypokalemia
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in
the ascending loop of Henle, leading to increased excretion of potassium. Hypokalemia is a
common adverse effect. The nurse should monitor serum potassium levels and teach the client
to consume potassium-rich foods. Options A, C, and D are incorrect because furosemide causes
potassium loss, not retention, and does not typically cause hypernatremia or hypercalcemia.
2. A nurse is assessing a client who has been taking digoxin for heart failure. Which of the
following findings should the nurse report immediately?
A. Heart rate of 58/min
B. Serum potassium of 3.2 mEq/L
C. Nausea and visual disturbances
D. Blood pressure of 110/70 mm Hg
Correct Answer: C. Nausea and visual disturbances
Rationale: Nausea, vomiting, and visual disturbances (such as yellow-green halos) are
classic early signs of digoxin toxicity. The nurse should withhold the medication and notify the
provider immediately. While a heart rate of 58/min and potassium of 3.2 mEq/L warrant
monitoring, they are not immediate indicators of toxicity. Digoxin toxicity is potentiated by
hypokalemia, so the nurse should also monitor potassium levels closely.
,3. A nurse is teaching a client who has a new prescription for warfarin. Which of the following
statements by the client indicates understanding of the teaching?
A. "I will increase my intake of leafy green vegetables."
B. "I will use a soft toothbrush and electric razor."
C. "I will take aspirin for headaches."
D. "I will double my dose if I miss one."
Correct Answer: B. "I will use a soft toothbrush and electric razor."
Rationale: Warfarin is an anticoagulant that increases bleeding risk. Using a soft toothbrush
and electric razor helps prevent bleeding. Clients should maintain consistent (not increased)
intake of vitamin K–rich foods (leafy greens). Aspirin increases bleeding risk and should be
avoided unless prescribed. Clients should never double doses of warfarin.
4. A nurse is caring for a client who has just returned from cardiac catheterization. Which of
the following findings requires immediate intervention?
A. Small hematoma at the insertion site
B. Blood pressure of 100/60 mm Hg
C. Oozing blood from the access site with a dropping blood pressure
D. Client reports mild back discomfort
Correct Answer: C. Oozing blood from the access site with a dropping blood pressure
Rationale: Active bleeding from the access site combined with a dropping blood pressure
indicates possible hemorrhage or retroperitoneal bleeding, which requires immediate
intervention. A small hematoma may be expected. Mild back discomfort may be related to lying
flat. A BP of 100/60 may be baseline for some clients but should be monitored.
5. A nurse is reviewing the ECG rhythm strip of a client and notes a heart rate of 48/min,
regular P waves before each QRS, and a PR interval of 0.16 seconds. The client is
asymptomatic. Which of the following actions should the nurse take first?
A. Administer atropine 0.5 mg IV
B. Continue to monitor the client
C. Prepare for transcutaneous pacing
D. Initiate CPR
Correct Answer: B. Continue to monitor the client
, Rationale: This rhythm describes sinus bradycardia. Asymptomatic sinus bradycardia does
not require immediate treatment. The nurse should continue to monitor. Atropine is indicated
for symptomatic bradycardia. Pacing and CPR are not indicated for an asymptomatic client.
6. A nurse is caring for a client who has atrial fibrillation and a new prescription for apixaban.
Which of the following laboratory values should the nurse monitor?
A. INR
B. aPTT
C. Hemoglobin and hematocrit
D. Platelet count only
Correct Answer: C. Hemoglobin and hematocrit
Rationale: Apixaban is a direct oral anticoagulant (DOAC) that does not require routine INR
or aPTT monitoring. However, the nurse should monitor hemoglobin and hematocrit to assess
for bleeding. While platelet count is important, H&H is the priority for detecting occult bleeding.
7. A nurse is assessing a client who has peripheral arterial disease (PAD). Which of the
following findings should the nurse expect? (Select all that apply.)
A. Intermittent claudication
B. Bounding pedal pulses
C. Cool extremities
D. Dependent rubor
E. Shiny, hairless skin on lower legs
Correct Answers: A, C, D, E
Rationale: PAD results from decreased arterial blood flow. Expected findings include
intermittent claudication (A), cool extremities (C), dependent rubor (D), and shiny, hairless skin
(E). Bounding pedal pulses (B) are associated with venous insufficiency, not arterial insufficiency.
Pulses in PAD are typically diminished or absent.
8. A nurse is teaching a client who has hypertension about lifestyle modifications. Which of
the following instructions should the nurse include?
, A. "Limit your sodium intake to 4,000 mg per day."
B. "Exercise for at least 150 minutes of moderate activity per week."
C. "Drink 3 to 4 alcoholic beverages per day."
D. "Stop taking your medication when your blood pressure is normal."
Correct Answer: B. "Exercise for at least 150 minutes of moderate activity per week."
Rationale: The American Heart Association recommends at least 150 minutes of moderate-
intensity aerobic activity per week for hypertension management. Sodium should be limited to
1,500–2,300 mg/day. Alcohol should be limited. Antihypertensive medications should be
continued even when BP normalizes.
9. A nurse is caring for a client who is receiving a blood transfusion and develops fever, chills,
and low back pain. Which of the following actions should the nurse take first?
A. Administer acetaminophen
B. Stop the transfusion
C. Obtain a urine specimen
D. Notify the provider
Correct Answer: B. Stop the transfusion
Rationale: Fever, chills, and low back pain during transfusion suggest an acute hemolytic
reaction, which is life-threatening. The first action is to stop the transfusion immediately, then
maintain IV access with normal saline, notify the provider, and obtain specimens.
Acetaminophen is not appropriate for hemolytic reactions.
10. A nurse is assessing a client who has left-sided heart failure. Which of the following
findings should the nurse expect?
A. Peripheral edema
B. Jugular vein distention
C. Crackles in the lungs
D. Hepatomegaly
Correct Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure causes pulmonary congestion, leading to crackles,
dyspnea, and orthopnea. Right-sided heart failure causes systemic congestion, including
peripheral edema (A), JVD (B), and hepatomegaly (D).
