ATI PN Adult Medical-Surgical Proctored Exam – 2025/2026
ATI PN Adult Medical-Surgical Proctored Exam – 2025/2026
Verified-Style Test Bank: 120 Questions & A+ Graded Answers with Rationales
Test Bank
Question 1: A client with chronic obstructive pulmonary disease (COPD) is experiencing dys-
pnea and has an oxygen saturation of 88%. Which action should the nurse take first?
A. Position the client in a high Fowler’s position.
B. Administer oxygen via nasal cannula at 2 L/min.
C. Administer a bronchodilator nebulizer treatment.
D. Obtain a sputum culture.
Rationale: Administering oxygen is the priority to address hypoxemia (oxygen saturation <
90%) in a client with COPD. According to 2025 American Thoracic Society guidelines, sup-
plemental oxygen improves oxygenation and reduces dyspnea. Positioning aids comfort but is
secondary to oxygen therapy. Bronchodilators are important but not the first action, and sputum
cultures are diagnostic, not therapeutic.
Question 2: A client with type 2 diabetes mellitus is admitted with a blood glucose level of 350
mg/dL. Which assessment finding requires immediate intervention?
A. Polyuria.
B. Kussmaul respirations.
C. Dry skin.
D. Fatigue.
Rationale: Kussmaul respirations indicate diabetic ketoacidosis (DKA), a life-threatening com-
plication requiring immediate intervention. Per 2025 American Diabetes Association standards,
DKA is characterized by hyperglycemia, acidosis, and compensatory rapid breathing. Polyuria,
dry skin, and fatigue are expected but less urgent findings.
Question 3: A postoperative client develops a temperature of 101.2°F and has redness at the
surgical site. Which action should the nurse prioritize?
A. Administer acetaminophen.
B. Apply a cool compress to the site.
C. Notify the healthcare provider.
D. Increase the client’s fluid intake.
Rationale: Redness and fever suggest a potential surgical site infection, which requires prompt
notification of the healthcare provider for further evaluation and possible antibiotic therapy.
1
, ATI PN Adult Medical-Surgical Proctored Exam – 2025/2026
According to 2025 CDC guidelines, early recognition of infection prevents complications. Ac-
etaminophen, compresses, and fluids are secondary actions.
Question 4: A client with heart failure is prescribed furosemide 40 mg IV. Which laboratory
value should the nurse monitor closely?
A. Serum sodium.
B. Serum potassium.
C. Blood glucose.
D. Serum creatinine.
Rationale: Furosemide, a loop diuretic, can cause hypokalemia due to potassium loss in urine.
Per 2025 American Heart Association guidelines, monitoring serum potassium is critical to
prevent arrhythmias in heart failure clients. Sodium and creatinine are relevant but less urgent,
and glucose is not directly affected.
Question 5: A client with a history of peptic ulcer disease reports severe epigastric pain. Which
finding should the nurse report immediately?
A. Heartburn after meals.
B. Board-like abdomen.
C. Occasional nausea.
D. Dark stools.
Rationale: A board-like abdomen suggests perforation, a surgical emergency requiring imme-
diate reporting. Per 2025 gastroenterology standards, perforation can lead to peritonitis. Heart-
burn, nausea, and dark stools are concerning but less acute unless accompanied by other critical
signs.
Question 6: A client with pneumonia is receiving ceftriaxone IV. Which assessment indicates
a potential adverse reaction to the medication?
A. Increased sputum production.
B. Rash and itching.
C. Mild diarrhea.
D. Fatigue.
Rationale: Rash and itching may indicate an allergic reaction to ceftriaxone, a cephalosporin,
which requires immediate attention to prevent anaphylaxis. Per 2025 infectious disease guide-
lines, allergic reactions are a priority. Sputum production, diarrhea, and fatigue are less specific
to adverse reactions.
2
, ATI PN Adult Medical-Surgical Proctored Exam – 2025/2026
Question 7: A client with chronic kidney disease is on a low-potassium diet. Which food should
the nurse instruct the client to avoid?
A. Apples.
B. Bananas.
C. Carrots.
D. White rice.
Rationale: Bananas are high in potassium and should be avoided in chronic kidney disease
to prevent hyperkalemia. Per 2025 National Kidney Foundation guidelines, dietary potassium
restriction is essential. Apples, carrots, and white rice are low-potassium options.
Question 8: A client with a new colostomy reports leakage around the stoma. Which action
should the nurse take first?
A. Assess the stoma and skin barrier.
B. Change the ostomy pouch.
C. Apply a skin protectant.
D. Notify the surgeon.
Rationale: Assessing the stoma and skin barrier is the first step to identify the cause of leakage,
such as improper fit or skin irritation. Per 2025 WOCN Society guidelines, assessment guides
interventions. Changing the pouch or applying protectant follows assessment, and notification
is premature without data.
Question 9: A client with a myocardial infarction is receiving heparin. Which laboratory value
should the nurse monitor?
A. International normalized ratio (INR).
B. Activated partial thromboplastin time (aPTT).
C. Platelet count.
D. Prothrombin time (PT).
Rationale: Heparin’s anticoagulant effect is monitored via aPTT to ensure therapeutic levels
and prevent bleeding. Per 2025 ACC guidelines, aPTT is the standard for heparin monitoring.
INR and PT are used for warfarin, while platelet count is less specific unless thrombocytopenia
is suspected.
Question 10: A client with rheumatoid arthritis reports increased joint stiffness. Which inter-
vention should the nurse recommend?
A. Apply cold packs to joints.
B. Perform gentle range-of-motion exercises.
3
, ATI PN Adult Medical-Surgical Proctored Exam – 2025/2026
C. Increase rest periods.
D. Avoid all physical activity.
Rationale: Gentle range-of-motion exercises reduce stiffness and maintain joint function in
rheumatoid arthritis. Per 2025 ACR guidelines, exercise is essential for mobility. Cold packs
are better for acute inflammation, rest is secondary, and avoiding activity worsens stiffness.
Question 11: A client with a urinary tract infection is prescribed ciprofloxacin. Which instruc-
tion should the nurse include?
A. Take with dairy products.
B. Avoid prolonged sun exposure.
C. Reduce fluid intake.
D. Take on an empty stomach.
Rationale: Ciprofloxacin increases photosensitivity, and clients should avoid prolonged sun
exposure to prevent burns. Per 2025 IDSA guidelines, this is a key teaching point. Dairy reduces
absorption, fluids should be increased, and ciprofloxacin can be taken with or without food.
Question 12: A client with a spinal cord injury at T4 reports a severe headache and flushing.
Which action should the nurse take first?
A. Administer acetaminophen.
B. Check for bladder distension.
C. Elevate the head of the bed.
D. Apply a cool cloth.
Rationale: Headache and flushing in a T4 spinal cord injury suggest autonomic dysreflexia, of-
ten triggered by bladder distension. Per 2025 spinal cord injury guidelines, checking for triggers
like bladder issues is the priority. Other actions are supportive but not first-line.
Question 13: A client with cirrhosis has ascites. Which dietary recommendation should the
nurse provide?
A. Increase protein intake.
B. Restrict sodium intake.
C. Avoid fluids.
D. Increase carbohydrate intake.
Rationale: Sodium restriction reduces fluid retention in ascites, per 2025 AASLD guidelines.
Protein is needed but moderated, fluids are not broadly restricted unless specified, and carbo-
hydrates are not the focus.
4
ATI PN Adult Medical-Surgical Proctored Exam – 2025/2026
Verified-Style Test Bank: 120 Questions & A+ Graded Answers with Rationales
Test Bank
Question 1: A client with chronic obstructive pulmonary disease (COPD) is experiencing dys-
pnea and has an oxygen saturation of 88%. Which action should the nurse take first?
A. Position the client in a high Fowler’s position.
B. Administer oxygen via nasal cannula at 2 L/min.
C. Administer a bronchodilator nebulizer treatment.
D. Obtain a sputum culture.
Rationale: Administering oxygen is the priority to address hypoxemia (oxygen saturation <
90%) in a client with COPD. According to 2025 American Thoracic Society guidelines, sup-
plemental oxygen improves oxygenation and reduces dyspnea. Positioning aids comfort but is
secondary to oxygen therapy. Bronchodilators are important but not the first action, and sputum
cultures are diagnostic, not therapeutic.
Question 2: A client with type 2 diabetes mellitus is admitted with a blood glucose level of 350
mg/dL. Which assessment finding requires immediate intervention?
A. Polyuria.
B. Kussmaul respirations.
C. Dry skin.
D. Fatigue.
Rationale: Kussmaul respirations indicate diabetic ketoacidosis (DKA), a life-threatening com-
plication requiring immediate intervention. Per 2025 American Diabetes Association standards,
DKA is characterized by hyperglycemia, acidosis, and compensatory rapid breathing. Polyuria,
dry skin, and fatigue are expected but less urgent findings.
Question 3: A postoperative client develops a temperature of 101.2°F and has redness at the
surgical site. Which action should the nurse prioritize?
A. Administer acetaminophen.
B. Apply a cool compress to the site.
C. Notify the healthcare provider.
D. Increase the client’s fluid intake.
Rationale: Redness and fever suggest a potential surgical site infection, which requires prompt
notification of the healthcare provider for further evaluation and possible antibiotic therapy.
1
, ATI PN Adult Medical-Surgical Proctored Exam – 2025/2026
According to 2025 CDC guidelines, early recognition of infection prevents complications. Ac-
etaminophen, compresses, and fluids are secondary actions.
Question 4: A client with heart failure is prescribed furosemide 40 mg IV. Which laboratory
value should the nurse monitor closely?
A. Serum sodium.
B. Serum potassium.
C. Blood glucose.
D. Serum creatinine.
Rationale: Furosemide, a loop diuretic, can cause hypokalemia due to potassium loss in urine.
Per 2025 American Heart Association guidelines, monitoring serum potassium is critical to
prevent arrhythmias in heart failure clients. Sodium and creatinine are relevant but less urgent,
and glucose is not directly affected.
Question 5: A client with a history of peptic ulcer disease reports severe epigastric pain. Which
finding should the nurse report immediately?
A. Heartburn after meals.
B. Board-like abdomen.
C. Occasional nausea.
D. Dark stools.
Rationale: A board-like abdomen suggests perforation, a surgical emergency requiring imme-
diate reporting. Per 2025 gastroenterology standards, perforation can lead to peritonitis. Heart-
burn, nausea, and dark stools are concerning but less acute unless accompanied by other critical
signs.
Question 6: A client with pneumonia is receiving ceftriaxone IV. Which assessment indicates
a potential adverse reaction to the medication?
A. Increased sputum production.
B. Rash and itching.
C. Mild diarrhea.
D. Fatigue.
Rationale: Rash and itching may indicate an allergic reaction to ceftriaxone, a cephalosporin,
which requires immediate attention to prevent anaphylaxis. Per 2025 infectious disease guide-
lines, allergic reactions are a priority. Sputum production, diarrhea, and fatigue are less specific
to adverse reactions.
2
, ATI PN Adult Medical-Surgical Proctored Exam – 2025/2026
Question 7: A client with chronic kidney disease is on a low-potassium diet. Which food should
the nurse instruct the client to avoid?
A. Apples.
B. Bananas.
C. Carrots.
D. White rice.
Rationale: Bananas are high in potassium and should be avoided in chronic kidney disease
to prevent hyperkalemia. Per 2025 National Kidney Foundation guidelines, dietary potassium
restriction is essential. Apples, carrots, and white rice are low-potassium options.
Question 8: A client with a new colostomy reports leakage around the stoma. Which action
should the nurse take first?
A. Assess the stoma and skin barrier.
B. Change the ostomy pouch.
C. Apply a skin protectant.
D. Notify the surgeon.
Rationale: Assessing the stoma and skin barrier is the first step to identify the cause of leakage,
such as improper fit or skin irritation. Per 2025 WOCN Society guidelines, assessment guides
interventions. Changing the pouch or applying protectant follows assessment, and notification
is premature without data.
Question 9: A client with a myocardial infarction is receiving heparin. Which laboratory value
should the nurse monitor?
A. International normalized ratio (INR).
B. Activated partial thromboplastin time (aPTT).
C. Platelet count.
D. Prothrombin time (PT).
Rationale: Heparin’s anticoagulant effect is monitored via aPTT to ensure therapeutic levels
and prevent bleeding. Per 2025 ACC guidelines, aPTT is the standard for heparin monitoring.
INR and PT are used for warfarin, while platelet count is less specific unless thrombocytopenia
is suspected.
Question 10: A client with rheumatoid arthritis reports increased joint stiffness. Which inter-
vention should the nurse recommend?
A. Apply cold packs to joints.
B. Perform gentle range-of-motion exercises.
3
, ATI PN Adult Medical-Surgical Proctored Exam – 2025/2026
C. Increase rest periods.
D. Avoid all physical activity.
Rationale: Gentle range-of-motion exercises reduce stiffness and maintain joint function in
rheumatoid arthritis. Per 2025 ACR guidelines, exercise is essential for mobility. Cold packs
are better for acute inflammation, rest is secondary, and avoiding activity worsens stiffness.
Question 11: A client with a urinary tract infection is prescribed ciprofloxacin. Which instruc-
tion should the nurse include?
A. Take with dairy products.
B. Avoid prolonged sun exposure.
C. Reduce fluid intake.
D. Take on an empty stomach.
Rationale: Ciprofloxacin increases photosensitivity, and clients should avoid prolonged sun
exposure to prevent burns. Per 2025 IDSA guidelines, this is a key teaching point. Dairy reduces
absorption, fluids should be increased, and ciprofloxacin can be taken with or without food.
Question 12: A client with a spinal cord injury at T4 reports a severe headache and flushing.
Which action should the nurse take first?
A. Administer acetaminophen.
B. Check for bladder distension.
C. Elevate the head of the bed.
D. Apply a cool cloth.
Rationale: Headache and flushing in a T4 spinal cord injury suggest autonomic dysreflexia, of-
ten triggered by bladder distension. Per 2025 spinal cord injury guidelines, checking for triggers
like bladder issues is the priority. Other actions are supportive but not first-line.
Question 13: A client with cirrhosis has ascites. Which dietary recommendation should the
nurse provide?
A. Increase protein intake.
B. Restrict sodium intake.
C. Avoid fluids.
D. Increase carbohydrate intake.
Rationale: Sodium restriction reduces fluid retention in ascites, per 2025 AASLD guidelines.
Protein is needed but moderated, fluids are not broadly restricted unless specified, and carbo-
hydrates are not the focus.
4
