Exam Title: ATI PN Adult Medical-Surgical 2026 Level 3
Proctored Exam – Complete Practice Test Bank
Total Questions: 600
Question Format: Multiple Choice (single best answer) with correct answer and detailed
rationale.
Content Alignment:
This practice exam is mapped to the ATI PN Adult Medical-Surgical 2026 blueprint and the
NCLEX-PN 2026 Client Needs categories. The distribution reflects the core domains tested
on the proctored assessment, with emphasis on Physiological Integrity (Basic Care and
Comfort, Pharmacological Therapies, Reduction of Risk Potential, Physiological
Adaptation) and Safe and Effective Care Environment (Coordinated Care, Safety and
Infection Prevention and Control). Questions are organized by body system and specialty
area to facilitate targeted remediation and mastery of medical-surgical nursing concepts
for practical nursing practice.
Core Domains and Approximate Question Distribution:
- Cardiovascular Disorders: 70 questions
- Gastrointestinal Disorders: 67 questions
- Endocrine Disorders: 60 questions
- Neurological Disorders: 57 questions
- Respiratory Disorders: 50 questions
- Renal and Urinary Disorders: 47 questions
- Musculoskeletal Disorders: 40 questions
- Fluid, Electrolyte, and Acid–Base Balance: 40 questions
,- Hematologic and Oncologic Disorders: 37 questions
- Immune Disorders: 23 questions
- Perioperative Nursing: 23 questions
- Integumentary Disorders and Burns: 20 questions
- Infection Control and Safety: 20 questions
- Sensory Disorders (Eye and Ear): 17 questions
- Reproductive and Breast Disorders: 13 questions
- Coordinated Care and Prioritization: 13 questions
- Health Promotion and Screening: 3 questions
How to Use This Resource:
Take the exam in timed blocks (e.g., 50–75 questions per session) to simulate proctored
conditions. Review the rationale for every question, including the distractors, as incorrect
options often represent common clinical misconceptions. Focus remediation on content
areas where you score below 75–80%. This practice set is designed to reinforce the clinical
judgment and prioritization skills required for safe practical nursing practice.
---
Table of Contents
1. Cardiovascular Disorders (Questions 1–70)
2. Gastrointestinal Disorders (Questions 71–137)
3. Endocrine Disorders (Questions 138–197)
4. Neurological Disorders (Questions 198–254)
5. Respiratory Disorders (Questions 255–304)
6. Renal and Urinary Disorders (Questions 305–351)
,7. Musculoskeletal Disorders (Questions 352–391)
8. Fluid, Electrolyte, and Acid–Base Balance (Questions 392–431)
9. Hematologic and Oncologic Disorders (Questions 432–468)
10. Immune Disorders (Questions 469–491)
11. Perioperative Nursing (Questions 492–514)
12. Integumentary Disorders and Burns (Questions 515–534)
13. Infection Control and Safety (Questions 535–554)
14. Sensory Disorders (Eye and Ear) (Questions 555–571)
15. Reproductive and Breast Disorders (Questions 572–584)
16. Coordinated Care and Prioritization (Questions 585–597)
17. Health Promotion and Screening (Questions 598–600)
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1. Cardiovascular Disorders (Questions 1–70)
1. A nurse is caring for a client who has heart failure and is prescribed furosemide. Which of
the following findings should the nurse report to the provider immediately?
A. Serum potassium 3.1 mEq/L
B. Urine output of 50 mL/hr
C. Weight loss of 1 kg (2.2 lb) in 24 hr
D. Blood pressure 112/68 mm Hg
Correct Answer: A
Rationale: Furosemide is a loop diuretic that causes potassium loss. A serum potassium of
3.1 mEq/L is below the expected reference range (3.5–5.0 mEq/L) and indicates
hypokalemia, which can precipitate dysrhythmias. The nurse should report this finding
, immediately. Urine output of 50 mL/hr is adequate, a 1 kg weight loss in 24 hr is expected
with diuresis, and a BP of 112/68 mm Hg is within acceptable limits for many clients.
2. A client who has atrial fibrillation is prescribed warfarin. Which of the following
laboratory values should the nurse monitor to evaluate the effectiveness of therapy?
A. Platelet count
B. International normalized ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Fibrinogen level
Correct Answer: B
Rationale: Warfarin therapy is monitored using the INR, with a typical target range of 2.0–
3.0 for most clients with atrial fibrillation. Platelet count assesses for thrombocytopenia,
aPTT monitors heparin therapy, and fibrinogen reflects clotting factor levels but is not the
standard monitoring test for warfarin.
3. A nurse is assessing a client who has peripheral arterial disease (PAD). Which of the
following findings should the nurse expect?
A. Dependent rubor and absent or diminished pedal pulses
B. Warm, moist skin with edema
C. Thick, brownish discoloration of the lower legs
D. Pain that is relieved by elevation
Correct Answer: A
Rationale: PAD results from arterial insufficiency, leading to decreased blood flow. Classic
findings include dependent rubor (redness when the leg is dependent), pallor with
elevation, cool skin, diminished or absent pulses, and pain that worsens with elevation and
improves with dependency. Warm, moist skin with edema and brownish discoloration are
more characteristic of venous insufficiency.
Proctored Exam – Complete Practice Test Bank
Total Questions: 600
Question Format: Multiple Choice (single best answer) with correct answer and detailed
rationale.
Content Alignment:
This practice exam is mapped to the ATI PN Adult Medical-Surgical 2026 blueprint and the
NCLEX-PN 2026 Client Needs categories. The distribution reflects the core domains tested
on the proctored assessment, with emphasis on Physiological Integrity (Basic Care and
Comfort, Pharmacological Therapies, Reduction of Risk Potential, Physiological
Adaptation) and Safe and Effective Care Environment (Coordinated Care, Safety and
Infection Prevention and Control). Questions are organized by body system and specialty
area to facilitate targeted remediation and mastery of medical-surgical nursing concepts
for practical nursing practice.
Core Domains and Approximate Question Distribution:
- Cardiovascular Disorders: 70 questions
- Gastrointestinal Disorders: 67 questions
- Endocrine Disorders: 60 questions
- Neurological Disorders: 57 questions
- Respiratory Disorders: 50 questions
- Renal and Urinary Disorders: 47 questions
- Musculoskeletal Disorders: 40 questions
- Fluid, Electrolyte, and Acid–Base Balance: 40 questions
,- Hematologic and Oncologic Disorders: 37 questions
- Immune Disorders: 23 questions
- Perioperative Nursing: 23 questions
- Integumentary Disorders and Burns: 20 questions
- Infection Control and Safety: 20 questions
- Sensory Disorders (Eye and Ear): 17 questions
- Reproductive and Breast Disorders: 13 questions
- Coordinated Care and Prioritization: 13 questions
- Health Promotion and Screening: 3 questions
How to Use This Resource:
Take the exam in timed blocks (e.g., 50–75 questions per session) to simulate proctored
conditions. Review the rationale for every question, including the distractors, as incorrect
options often represent common clinical misconceptions. Focus remediation on content
areas where you score below 75–80%. This practice set is designed to reinforce the clinical
judgment and prioritization skills required for safe practical nursing practice.
---
Table of Contents
1. Cardiovascular Disorders (Questions 1–70)
2. Gastrointestinal Disorders (Questions 71–137)
3. Endocrine Disorders (Questions 138–197)
4. Neurological Disorders (Questions 198–254)
5. Respiratory Disorders (Questions 255–304)
6. Renal and Urinary Disorders (Questions 305–351)
,7. Musculoskeletal Disorders (Questions 352–391)
8. Fluid, Electrolyte, and Acid–Base Balance (Questions 392–431)
9. Hematologic and Oncologic Disorders (Questions 432–468)
10. Immune Disorders (Questions 469–491)
11. Perioperative Nursing (Questions 492–514)
12. Integumentary Disorders and Burns (Questions 515–534)
13. Infection Control and Safety (Questions 535–554)
14. Sensory Disorders (Eye and Ear) (Questions 555–571)
15. Reproductive and Breast Disorders (Questions 572–584)
16. Coordinated Care and Prioritization (Questions 585–597)
17. Health Promotion and Screening (Questions 598–600)
---
1. Cardiovascular Disorders (Questions 1–70)
1. A nurse is caring for a client who has heart failure and is prescribed furosemide. Which of
the following findings should the nurse report to the provider immediately?
A. Serum potassium 3.1 mEq/L
B. Urine output of 50 mL/hr
C. Weight loss of 1 kg (2.2 lb) in 24 hr
D. Blood pressure 112/68 mm Hg
Correct Answer: A
Rationale: Furosemide is a loop diuretic that causes potassium loss. A serum potassium of
3.1 mEq/L is below the expected reference range (3.5–5.0 mEq/L) and indicates
hypokalemia, which can precipitate dysrhythmias. The nurse should report this finding
, immediately. Urine output of 50 mL/hr is adequate, a 1 kg weight loss in 24 hr is expected
with diuresis, and a BP of 112/68 mm Hg is within acceptable limits for many clients.
2. A client who has atrial fibrillation is prescribed warfarin. Which of the following
laboratory values should the nurse monitor to evaluate the effectiveness of therapy?
A. Platelet count
B. International normalized ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Fibrinogen level
Correct Answer: B
Rationale: Warfarin therapy is monitored using the INR, with a typical target range of 2.0–
3.0 for most clients with atrial fibrillation. Platelet count assesses for thrombocytopenia,
aPTT monitors heparin therapy, and fibrinogen reflects clotting factor levels but is not the
standard monitoring test for warfarin.
3. A nurse is assessing a client who has peripheral arterial disease (PAD). Which of the
following findings should the nurse expect?
A. Dependent rubor and absent or diminished pedal pulses
B. Warm, moist skin with edema
C. Thick, brownish discoloration of the lower legs
D. Pain that is relieved by elevation
Correct Answer: A
Rationale: PAD results from arterial insufficiency, leading to decreased blood flow. Classic
findings include dependent rubor (redness when the leg is dependent), pallor with
elevation, cool skin, diminished or absent pulses, and pain that worsens with elevation and
improves with dependency. Warm, moist skin with edema and brownish discoloration are
more characteristic of venous insufficiency.
