ATI Med-Surg Proctored Exam —
Comprehensive Test Bank
1,000+ High-Yield Questions Covering All Body Systems
Aligned to ATI RN Adult Medical-Surgical Proctored Exam Blueprint
Versions A, B, C & D | Complete Chapters with Verified Answers &
Detailed Rationales
Table of Contents
Chapter Content Area Questions
1 Foundations of Medical-Surgical Nursing & Perioperative Care 1–80
2 Cardiovascular Disorders 81–180
3 Respiratory Disorders 181–270
4 Gastrointestinal & Hepatic Disorders 271–360
5 Renal & Urinary Disorders 361–440
6 Neurological Disorders 441–530
7 Musculoskeletal & Integumentary Disorders 531–610
8 Endocrine & Metabolic Disorders 611–690
9 Hematologic & Oncologic Disorders 691–760
,Chapter Content Area Questions
10 Fluid, Electrolyte & Acid-Base Imbalances 761–830
11 Infectious Diseases & Infection Control 831–900
12 Emergency & Critical Care Nursing 901–970
13 Pharmacology & Medication Safety 971–1040
CHAPTER 1: FOUNDATIONS OF MEDICAL-
SURGICAL NURSING & PERIOPERATIVE CARE
Question 1
A 68-year-old patient is scheduled for an elective total knee replacement.
During the preoperative assessment, the nurse notes the patient takes
warfarin 5 mg daily for atrial fibrillation. Which action by the nurse is most
appropriate?
A. Hold the warfarin on the morning of surgery and administer vitamin K as
ordered
B. Continue the warfarin through the morning of surgery to prevent stroke
C. Hold the warfarin 5 days prior to surgery per the surgeon's protocol and
document the last dose taken
D. Switch the patient to aspirin 81 mg daily until the day of surgery
Answer: C
Rationale: Warfarin has a long half-life and requires approximately 5 days
to clear from the system. Holding it before surgery reduces bleeding risk
during the procedure. This aligns with standard of care which states that
anticoagulants must be managed preoperatively to balance thromboembolic
risk against surgical bleeding risk. The nurse's role is to verify the last dose,
,document it, and communicate with the surgical team about bridging
therapy if needed.
Question 2
During the immediate postoperative period, a patient who had abdominal
surgery reports severe pain at the incision site rated 9/10. The nurse notes
the patient is guarding the abdomen and has shallow respirations. Which
nursing intervention takes priority?
A. Encourage the patient to use the incentive spirometer every hour
B. Administer the prescribed PRN opioid analgesic and reassess in 30
minutes
C. Apply a warm compress to the incision site to promote comfort
D. Reposition the patient to a side-lying position to reduce tension on the
incision
Answer: B
Rationale: Uncontrolled postoperative pain leads to shallow breathing,
which increases the risk of atelectasis and pneumonia. Pain management is
a priority in the immediate post-op period. Once pain is controlled, the other
interventions become much more feasible.
Question 3
A nurse is caring for a postoperative patient on the second day after a
laparoscopic cholecystectomy. The patient has not had a bowel movement
since before surgery and reports mild abdominal bloating. The patient's vital
signs are stable, and bowel sounds are present in all four quadrants. What is
, the nurse's best initial action?
A. Administer a Fleet enema to stimulate peristalsis
B. Encourage ambulation and increase oral fluid intake
C. Contact the provider to request an abdominal X-ray
D. Place the patient on NPO status until bowel function returns
Answer: B
Rationale: Postoperative ileus is common after abdominal surgery and
typically resolves with conservative measures like early ambulation and
adequate hydration. This choice addresses the underlying cause—decreased
peristalsis from anesthesia and immobility—without introducing unnecessary
interventions.
Question 4
A patient is recovering from spinal surgery and is on strict bed rest with a flat
bed position as ordered. The nurse is performing a skin assessment and
notes a reddened area on the patient's sacrum that blanches with fingertip
pressure. How should the nurse document this finding?
A. Stage 1 pressure injury
B. Stage 2 pressure injury
C. Deep tissue injury
D. Moisture-associated skin damage
Answer: A
Rationale: A reddened area that blanches with fingertip pressure is
characteristic of a Stage 1 pressure injury. This indicates intact skin with
non-blanchable erythema in darker skin tones, but in lighter skin tones, it
may appear as a defined area of persistent redness.
Comprehensive Test Bank
1,000+ High-Yield Questions Covering All Body Systems
Aligned to ATI RN Adult Medical-Surgical Proctored Exam Blueprint
Versions A, B, C & D | Complete Chapters with Verified Answers &
Detailed Rationales
Table of Contents
Chapter Content Area Questions
1 Foundations of Medical-Surgical Nursing & Perioperative Care 1–80
2 Cardiovascular Disorders 81–180
3 Respiratory Disorders 181–270
4 Gastrointestinal & Hepatic Disorders 271–360
5 Renal & Urinary Disorders 361–440
6 Neurological Disorders 441–530
7 Musculoskeletal & Integumentary Disorders 531–610
8 Endocrine & Metabolic Disorders 611–690
9 Hematologic & Oncologic Disorders 691–760
,Chapter Content Area Questions
10 Fluid, Electrolyte & Acid-Base Imbalances 761–830
11 Infectious Diseases & Infection Control 831–900
12 Emergency & Critical Care Nursing 901–970
13 Pharmacology & Medication Safety 971–1040
CHAPTER 1: FOUNDATIONS OF MEDICAL-
SURGICAL NURSING & PERIOPERATIVE CARE
Question 1
A 68-year-old patient is scheduled for an elective total knee replacement.
During the preoperative assessment, the nurse notes the patient takes
warfarin 5 mg daily for atrial fibrillation. Which action by the nurse is most
appropriate?
A. Hold the warfarin on the morning of surgery and administer vitamin K as
ordered
B. Continue the warfarin through the morning of surgery to prevent stroke
C. Hold the warfarin 5 days prior to surgery per the surgeon's protocol and
document the last dose taken
D. Switch the patient to aspirin 81 mg daily until the day of surgery
Answer: C
Rationale: Warfarin has a long half-life and requires approximately 5 days
to clear from the system. Holding it before surgery reduces bleeding risk
during the procedure. This aligns with standard of care which states that
anticoagulants must be managed preoperatively to balance thromboembolic
risk against surgical bleeding risk. The nurse's role is to verify the last dose,
,document it, and communicate with the surgical team about bridging
therapy if needed.
Question 2
During the immediate postoperative period, a patient who had abdominal
surgery reports severe pain at the incision site rated 9/10. The nurse notes
the patient is guarding the abdomen and has shallow respirations. Which
nursing intervention takes priority?
A. Encourage the patient to use the incentive spirometer every hour
B. Administer the prescribed PRN opioid analgesic and reassess in 30
minutes
C. Apply a warm compress to the incision site to promote comfort
D. Reposition the patient to a side-lying position to reduce tension on the
incision
Answer: B
Rationale: Uncontrolled postoperative pain leads to shallow breathing,
which increases the risk of atelectasis and pneumonia. Pain management is
a priority in the immediate post-op period. Once pain is controlled, the other
interventions become much more feasible.
Question 3
A nurse is caring for a postoperative patient on the second day after a
laparoscopic cholecystectomy. The patient has not had a bowel movement
since before surgery and reports mild abdominal bloating. The patient's vital
signs are stable, and bowel sounds are present in all four quadrants. What is
, the nurse's best initial action?
A. Administer a Fleet enema to stimulate peristalsis
B. Encourage ambulation and increase oral fluid intake
C. Contact the provider to request an abdominal X-ray
D. Place the patient on NPO status until bowel function returns
Answer: B
Rationale: Postoperative ileus is common after abdominal surgery and
typically resolves with conservative measures like early ambulation and
adequate hydration. This choice addresses the underlying cause—decreased
peristalsis from anesthesia and immobility—without introducing unnecessary
interventions.
Question 4
A patient is recovering from spinal surgery and is on strict bed rest with a flat
bed position as ordered. The nurse is performing a skin assessment and
notes a reddened area on the patient's sacrum that blanches with fingertip
pressure. How should the nurse document this finding?
A. Stage 1 pressure injury
B. Stage 2 pressure injury
C. Deep tissue injury
D. Moisture-associated skin damage
Answer: A
Rationale: A reddened area that blanches with fingertip pressure is
characteristic of a Stage 1 pressure injury. This indicates intact skin with
non-blanchable erythema in darker skin tones, but in lighter skin tones, it
may appear as a defined area of persistent redness.
