ATI RN Adult Medical-Surgical Nursing 2026 (Med-Surg) NGN
Comprehensive Practice Examination | 190 Questions &
Answers | RN Nursing Exam Prep, Next Generation NCLEX-
Style Practice Test, Detailed Rationales, Complete Study
Guide, Clinical Judgment Review & Latest Updated Exam
Preparation
Question 1
A nurse is assessing a client with heart failure who reports increased shortness of
breath when lying flat. Which clinical manifestation should the nurse document?
A. Orthopnea
B. Paroxysmal nocturnal dyspnea
C. Dyspnea on exertion
D. Platypnea
Correct Answer: A
Explanation: Orthopnea is difficulty breathing when supine, relieved by sitting upright. It
indicates worsening heart failure and pulmonary congestion. Paroxysmal nocturnal
dyspnea occurs at night after sleeping. Dyspnea on exertion occurs with activity.
Question 2
,A client with atrial fibrillation is prescribed warfarin. Which laboratory value should the
nurse monitor to evaluate therapeutic effectiveness?
A. aPTT
B. INR
C. Platelet count
D. Bleeding time
Correct Answer: B
Explanation: INR monitors warfarin therapy with target 2-3 for atrial fibrillation. aPTT
monitors heparin. Platelet count assesses thrombocytopenia risk. Bleeding time
evaluates platelet function, not anticoagulation.
Question 3
A nurse is caring for a client following coronary artery bypass graft surgery. Which
finding requires immediate intervention?
A. Chest tube drainage of 50 mL in the first hour
B. Temperature of 100.2°F (37.9°C)
C. Sudden cessation of chest tube drainage
D. Incisional pain rated 5/10
Correct Answer: C
Explanation: Sudden cessation of chest tube drainage may indicate tube occlusion or
cardiac tamponade, requiring immediate intervention. Drainage of 50 mL/hour is
acceptable initially. Low-grade fever and incisional pain are expected postoperatively.
Question 4
,A client with hypertension is prescribed lisinopril. Which adverse effect should the
nurse include in teaching?
A. Dry cough
B. Bradycardia
C. Hyperkalemia
D. Peripheral edema
Correct Answer: A
Explanation: ACE inhibitors like lisinopril commonly cause dry cough due to bradykinin
accumulation. Bradycardia is associated with beta-blockers. Hyperkalemia can occur
but cough is more common. Peripheral edema is not typical.
Question 5
A nurse is assessing a client with peripheral arterial disease. Which finding is
expected?
A. Dependent rubor
B. Pitting edema
C. Warm extremities
D. Strong pedal pulses
Correct Answer: A
Explanation: Dependent rubor occurs in PAD due to reactive hyperemia when legs are
dependent. PAD causes cool extremities, diminished pulses, and no edema. Venous
insufficiency causes edema and warm extremities.
Question 6
, A client develops pulseless electrical activity. Which intervention should the nurse
anticipate first?
A. Defibrillation
B. Epinephrine administration
C. Synchronized cardioversion
D. Atropine administration
Correct Answer: B
Explanation: PEA treatment begins with high-quality CPR and epinephrine 1 mg IV every
3-5 minutes. Defibrillation is for VF/pulseless VT. Cardioversion is for unstable
tachycardias with pulses. Atropine is for symptomatic bradycardia.
Question 7
A nurse is teaching a client about digoxin therapy. Which statement indicates
understanding?
A. "I should take this medication with food."
B. "I will report visual disturbances immediately."
C. "I can stop taking this when I feel better."
D. "I should increase my potassium intake."
Correct Answer: B
Explanation: Visual disturbances like yellow-green halos indicate digoxin toxicity and
require immediate reporting. Digoxin is taken on empty stomach. Never stop abruptly.
Potassium should be monitored, not increased without prescription.
Question 8
Comprehensive Practice Examination | 190 Questions &
Answers | RN Nursing Exam Prep, Next Generation NCLEX-
Style Practice Test, Detailed Rationales, Complete Study
Guide, Clinical Judgment Review & Latest Updated Exam
Preparation
Question 1
A nurse is assessing a client with heart failure who reports increased shortness of
breath when lying flat. Which clinical manifestation should the nurse document?
A. Orthopnea
B. Paroxysmal nocturnal dyspnea
C. Dyspnea on exertion
D. Platypnea
Correct Answer: A
Explanation: Orthopnea is difficulty breathing when supine, relieved by sitting upright. It
indicates worsening heart failure and pulmonary congestion. Paroxysmal nocturnal
dyspnea occurs at night after sleeping. Dyspnea on exertion occurs with activity.
Question 2
,A client with atrial fibrillation is prescribed warfarin. Which laboratory value should the
nurse monitor to evaluate therapeutic effectiveness?
A. aPTT
B. INR
C. Platelet count
D. Bleeding time
Correct Answer: B
Explanation: INR monitors warfarin therapy with target 2-3 for atrial fibrillation. aPTT
monitors heparin. Platelet count assesses thrombocytopenia risk. Bleeding time
evaluates platelet function, not anticoagulation.
Question 3
A nurse is caring for a client following coronary artery bypass graft surgery. Which
finding requires immediate intervention?
A. Chest tube drainage of 50 mL in the first hour
B. Temperature of 100.2°F (37.9°C)
C. Sudden cessation of chest tube drainage
D. Incisional pain rated 5/10
Correct Answer: C
Explanation: Sudden cessation of chest tube drainage may indicate tube occlusion or
cardiac tamponade, requiring immediate intervention. Drainage of 50 mL/hour is
acceptable initially. Low-grade fever and incisional pain are expected postoperatively.
Question 4
,A client with hypertension is prescribed lisinopril. Which adverse effect should the
nurse include in teaching?
A. Dry cough
B. Bradycardia
C. Hyperkalemia
D. Peripheral edema
Correct Answer: A
Explanation: ACE inhibitors like lisinopril commonly cause dry cough due to bradykinin
accumulation. Bradycardia is associated with beta-blockers. Hyperkalemia can occur
but cough is more common. Peripheral edema is not typical.
Question 5
A nurse is assessing a client with peripheral arterial disease. Which finding is
expected?
A. Dependent rubor
B. Pitting edema
C. Warm extremities
D. Strong pedal pulses
Correct Answer: A
Explanation: Dependent rubor occurs in PAD due to reactive hyperemia when legs are
dependent. PAD causes cool extremities, diminished pulses, and no edema. Venous
insufficiency causes edema and warm extremities.
Question 6
, A client develops pulseless electrical activity. Which intervention should the nurse
anticipate first?
A. Defibrillation
B. Epinephrine administration
C. Synchronized cardioversion
D. Atropine administration
Correct Answer: B
Explanation: PEA treatment begins with high-quality CPR and epinephrine 1 mg IV every
3-5 minutes. Defibrillation is for VF/pulseless VT. Cardioversion is for unstable
tachycardias with pulses. Atropine is for symptomatic bradycardia.
Question 7
A nurse is teaching a client about digoxin therapy. Which statement indicates
understanding?
A. "I should take this medication with food."
B. "I will report visual disturbances immediately."
C. "I can stop taking this when I feel better."
D. "I should increase my potassium intake."
Correct Answer: B
Explanation: Visual disturbances like yellow-green halos indicate digoxin toxicity and
require immediate reporting. Digoxin is taken on empty stomach. Never stop abruptly.
Potassium should be monitored, not increased without prescription.
Question 8
