ATI RN Med-Surg Proctored Exam 2025–2026 |
300 NGN Questions + Rationales | A+ Test Bank
& Study Guide | HealthStudyPro
SECTION 1: CARDIOVASCULAR SYSTEM
Question 1
A nurse is caring for a client with heart failure who is receiving furosemide (Lasix).
Which assessment finding requires immediate intervention?
A. Urine output of 50 mL/hr
B. Serum potassium of 2.8 mEq/L
C. Weight loss of 1 kg in 24 hours
D. Blood pressure of 118/72 mm Hg
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss. A serum
potassium of 2.8 mEq/L indicates severe hypokalemia, which can precipitate life-
threatening dysrhythmias, including ventricular tachycardia and fibrillation.
Normal potassium range is 3.5–5.0 mEq/L. The nurse must notify the provider
immediately and anticipate potassium replacement. Options A, C, and D represent
expected therapeutic responses to diuretic therapy.
Question 2
A nurse is assessing a client with suspected myocardial infarction. Which
laboratory value is most specific for myocardial damage?
A. CK-MB
B. Troponin I
C. Myoglobin
D. LDH
, Correct Answer: B
Rationale: Troponin I is highly specific to cardiac muscle and is the preferred
biomarker for diagnosing myocardial infarction. It rises within 3–6 hours of injury,
peaks at 14–20 hours, and remains elevated for 7–10 days. CK-MB is cardiac-
specific but less so than troponin. Myoglobin rises earliest but is not cardiac-
specific. LDH is neither sensitive nor specific for cardiac damage.
Question 3
A client is prescribed digoxin (Lanoxin) for atrial fibrillation. Which finding
indicates possible digoxin toxicity?
A. Heart rate of 88 bpm
B. Blood pressure of 128/80 mm Hg
C. Visual disturbances with yellow-green halos
D. Serum digoxin level of 1.2 ng/mL
Correct Answer: C
Rationale: Visual disturbances, particularly yellow-green halos or blurred
vision, are classic signs of digoxin toxicity. Other signs include nausea, vomiting,
anorexia, bradycardia, and dysrhythmias. The therapeutic range for digoxin is 0.5–
2.0 ng/mL, so 1.2 ng/mL is therapeutic. A heart rate of 88 and BP of 128/80 are
within normal limits.
Question 4 (SATA)
A nurse is teaching a client about lifestyle modifications to manage hypertension.
Which statements indicate correct understanding? Select all that apply.
A. "I should limit my sodium intake to less than 2,300 mg per day."
B. "I can continue my current exercise routine of running marathons."
C. "I should monitor my blood pressure at home regularly."
D. "Drinking 3–4 alcoholic beverages daily is acceptable."
,E. "I should maintain a healthy weight and follow the DASH diet."
F. "I can stop taking my medication once my blood pressure normalizes."
Correct Answers: A, C, E
Rationale: Sodium restriction (<2,300 mg/day, ideally <1,500 mg/day), home
BP monitoring, and weight management with the DASH diet are all appropriate
lifestyle modifications for hypertension. Option B is incorrect because strenuous
exercise may need modification based on cardiovascular status and should be
discussed with a provider. Option D is incorrect as alcohol should be limited to ≤2
drinks/day for men and ≤1 for women. Option F is incorrect because
antihypertensive medications are typically lifelong, and stopping them can cause
rebound hypertension.
Question 5
A nurse is caring for a client immediately following cardiac catheterization. Which
finding should be reported to the provider immediately?
A. Small bruise at the insertion site
B. Client reports feeling warm
C. Absent pedal pulse on the affected extremity
D. Blood pressure of 110/70 mm Hg
Correct Answer: C
Rationale: An absent pedal pulse distal to the catheterization site indicates
possible arterial occlusion or hematoma formation, which is a medical emergency
requiring immediate intervention. A small bruise is expected. Feeling warm is a
common sensation from contrast dye. A BP of 110/70 is within normal limits.
Question 6
A client with atrial fibrillation is prescribed warfarin (Coumadin). Which laboratory
value should the nurse monitor to evaluate therapeutic effectiveness?
, A. aPTT
B. INR
C. Platelet count
D. Hemoglobin
Correct Answer: B
Rationale: Warfarin therapy is monitored using the INR (International
Normalized Ratio), with a therapeutic goal of 2.0–3.0 for atrial fibrillation. The
aPTT is used to monitor heparin therapy. Platelet count and hemoglobin are not
used to evaluate warfarin's anticoagulant effectiveness, though they may be
monitored for complications.
Question 7
A nurse is assessing a client with peripheral arterial disease (PAD). Which finding is
most consistent with this condition?
A. Dependent rubor and cool extremities
B. Warm, swollen extremities
C. Bilateral pitting edema
D. Shiny, brown-pigmented skin
Correct Answer: A
Rationale: PAD results from decreased arterial blood flow, causing cool
extremities, dependent rubor (redness when the extremity is lowered), pallor on
elevation, diminished pulses, and intermittent claudication. Warm, swollen
extremities suggest infection or DVT. Bilateral pitting edema is more consistent
with venous insufficiency or heart failure. Shiny, brown-pigmented skin
(hemosiderin staining) is characteristic of venous insufficiency.
300 NGN Questions + Rationales | A+ Test Bank
& Study Guide | HealthStudyPro
SECTION 1: CARDIOVASCULAR SYSTEM
Question 1
A nurse is caring for a client with heart failure who is receiving furosemide (Lasix).
Which assessment finding requires immediate intervention?
A. Urine output of 50 mL/hr
B. Serum potassium of 2.8 mEq/L
C. Weight loss of 1 kg in 24 hours
D. Blood pressure of 118/72 mm Hg
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss. A serum
potassium of 2.8 mEq/L indicates severe hypokalemia, which can precipitate life-
threatening dysrhythmias, including ventricular tachycardia and fibrillation.
Normal potassium range is 3.5–5.0 mEq/L. The nurse must notify the provider
immediately and anticipate potassium replacement. Options A, C, and D represent
expected therapeutic responses to diuretic therapy.
Question 2
A nurse is assessing a client with suspected myocardial infarction. Which
laboratory value is most specific for myocardial damage?
A. CK-MB
B. Troponin I
C. Myoglobin
D. LDH
, Correct Answer: B
Rationale: Troponin I is highly specific to cardiac muscle and is the preferred
biomarker for diagnosing myocardial infarction. It rises within 3–6 hours of injury,
peaks at 14–20 hours, and remains elevated for 7–10 days. CK-MB is cardiac-
specific but less so than troponin. Myoglobin rises earliest but is not cardiac-
specific. LDH is neither sensitive nor specific for cardiac damage.
Question 3
A client is prescribed digoxin (Lanoxin) for atrial fibrillation. Which finding
indicates possible digoxin toxicity?
A. Heart rate of 88 bpm
B. Blood pressure of 128/80 mm Hg
C. Visual disturbances with yellow-green halos
D. Serum digoxin level of 1.2 ng/mL
Correct Answer: C
Rationale: Visual disturbances, particularly yellow-green halos or blurred
vision, are classic signs of digoxin toxicity. Other signs include nausea, vomiting,
anorexia, bradycardia, and dysrhythmias. The therapeutic range for digoxin is 0.5–
2.0 ng/mL, so 1.2 ng/mL is therapeutic. A heart rate of 88 and BP of 128/80 are
within normal limits.
Question 4 (SATA)
A nurse is teaching a client about lifestyle modifications to manage hypertension.
Which statements indicate correct understanding? Select all that apply.
A. "I should limit my sodium intake to less than 2,300 mg per day."
B. "I can continue my current exercise routine of running marathons."
C. "I should monitor my blood pressure at home regularly."
D. "Drinking 3–4 alcoholic beverages daily is acceptable."
,E. "I should maintain a healthy weight and follow the DASH diet."
F. "I can stop taking my medication once my blood pressure normalizes."
Correct Answers: A, C, E
Rationale: Sodium restriction (<2,300 mg/day, ideally <1,500 mg/day), home
BP monitoring, and weight management with the DASH diet are all appropriate
lifestyle modifications for hypertension. Option B is incorrect because strenuous
exercise may need modification based on cardiovascular status and should be
discussed with a provider. Option D is incorrect as alcohol should be limited to ≤2
drinks/day for men and ≤1 for women. Option F is incorrect because
antihypertensive medications are typically lifelong, and stopping them can cause
rebound hypertension.
Question 5
A nurse is caring for a client immediately following cardiac catheterization. Which
finding should be reported to the provider immediately?
A. Small bruise at the insertion site
B. Client reports feeling warm
C. Absent pedal pulse on the affected extremity
D. Blood pressure of 110/70 mm Hg
Correct Answer: C
Rationale: An absent pedal pulse distal to the catheterization site indicates
possible arterial occlusion or hematoma formation, which is a medical emergency
requiring immediate intervention. A small bruise is expected. Feeling warm is a
common sensation from contrast dye. A BP of 110/70 is within normal limits.
Question 6
A client with atrial fibrillation is prescribed warfarin (Coumadin). Which laboratory
value should the nurse monitor to evaluate therapeutic effectiveness?
, A. aPTT
B. INR
C. Platelet count
D. Hemoglobin
Correct Answer: B
Rationale: Warfarin therapy is monitored using the INR (International
Normalized Ratio), with a therapeutic goal of 2.0–3.0 for atrial fibrillation. The
aPTT is used to monitor heparin therapy. Platelet count and hemoglobin are not
used to evaluate warfarin's anticoagulant effectiveness, though they may be
monitored for complications.
Question 7
A nurse is assessing a client with peripheral arterial disease (PAD). Which finding is
most consistent with this condition?
A. Dependent rubor and cool extremities
B. Warm, swollen extremities
C. Bilateral pitting edema
D. Shiny, brown-pigmented skin
Correct Answer: A
Rationale: PAD results from decreased arterial blood flow, causing cool
extremities, dependent rubor (redness when the extremity is lowered), pallor on
elevation, diminished pulses, and intermittent claudication. Warm, swollen
extremities suggest infection or DVT. Bilateral pitting edema is more consistent
with venous insufficiency or heart failure. Shiny, brown-pigmented skin
(hemosiderin staining) is characteristic of venous insufficiency.
