ATI Medical-Surgical Proctored Exam Study
Guide 2024
Versions A and B: 220 Questions with Answers and Rationales
For Nursing Students Preparing for Medical-Surgical Nursing Excellence
Aligned with ATI Guidelines and Evidence-Based Practice
June 19, 2025
,Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2 Version A: Questions 1110 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.1 Cardiovascular Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.2 Respiratory Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.3 Gastrointestinal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2.4 Endocrine Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
2.5 Neurological Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.6 Musculoskeletal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2.7 Case Study 1: Heart Failure (Questions 6165) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
2.8 Case Study 2: Gastrointestinal Bleeding (Questions 6670) . . . . . . . . . . . . . . . . . . . . . . 10
2.9 Case Study 3: Diabetic Ketoacidosis (Questions 7175) . . . . . . . . . . . . . . . . . . . . . . . . 11
2.10 Additional Questions (76110) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
3 Version B: Questions 111220 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
3.1 Cardiovascular Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
3.2 Respiratory Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.3 Gastrointestinal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4 Study Tips and Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
1
, ATI Med Surg Proctored Exam Study Guide 2024 2
1 Introduction
This study guide prepares nursing students for the ATI Medical-Surgical Proctored Exam 2024, covering Versions
A and B. It assesses proficiency in medical-surgical nursing across systems (cardiovascular, respiratory, gastroin-
testinal, endocrine, neurological, musculoskeletal) using NGN formats, including multiple-choice, case studies,
bow-tie, and matrix questions. Below are 220 questions (110 per version) with answers and rationales, organized
by topic to reflect the exams scope. Content aligns with ATI guidelines and general nursing principles.
2 Version A: Questions 1110
2.1 Cardiovascular Disorders
1. A client with angina uses sublingual nitroglycerin. Which statement indicates understanding?
A) "Ill take up to five tablets for pain."
B) "I should lie down when taking it."
C) "Ill store it in a warm place."
D) "Ill replace it every 12 months."
Answer: B) "I should lie down when taking it."
Rationale: Lying down prevents falls due to hypotension. Maximum is three tablets, storage is at room
temperature, and replacement is every 6 months.
2. A client with chest pain arrives at the ED. What is the first action?
A) Administer aspirin 325 mg
B) Assess vital signs
C) Obtain a 12-lead ECG
D) Administer nitroglycerin
Answer: B) Assess vital signs
Rationale: Vital signs guide interventions by assessing stability.
3. A client with heart failure reports dyspnea and 4 kg weight gain in 48 hours. What should the nurse
prioritize?
A) Notify the provider
B) Increase diuretic dose
C) Encourage fluid intake
D) Administer oxygen
Answer: A) Notify the provider
Rationale: Rapid weight gain and dyspnea indicate worsening heart failure.
4. A client post-myocardial infarction has atrial fibrillation. What is the priority?
A) Assess for thromboembolism risk
B) Monitor blood pressure
C) Administer beta-blockers
D) Prepare for cardioversion
Answer: A) Assess for thromboembolism risk
Rationale: Atrial fibrillation increases thromboembolism risk.
5. A client on an ACE inhibitor reports a dry cough. What should the nurse advise?
A) "Your cough may require changing medication."
B) "Increase fluids to reduce it."
C) "Use lozenges to relieve it."
D) "The cough will resolve over time."
Answer: A) "Your cough may require changing medication."
Rationale: A dry cough often necessitates switching to an ARB.
6. A client with hypertension is prescribed metoprolol. Which finding requires intervention?
A) Heart rate 46 bpm
B) BP 130/80 mmHg
C) No edema
D) Clear lungs
Answer: A) Heart rate 46 bpm
Rationale: Bradycardia requires provider notification.
7. A client post-cardiac catheterization reports groin pain. Which finding requires action?
A) Hardness at the site
Guide 2024
Versions A and B: 220 Questions with Answers and Rationales
For Nursing Students Preparing for Medical-Surgical Nursing Excellence
Aligned with ATI Guidelines and Evidence-Based Practice
June 19, 2025
,Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2 Version A: Questions 1110 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.1 Cardiovascular Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.2 Respiratory Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.3 Gastrointestinal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2.4 Endocrine Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
2.5 Neurological Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.6 Musculoskeletal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2.7 Case Study 1: Heart Failure (Questions 6165) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
2.8 Case Study 2: Gastrointestinal Bleeding (Questions 6670) . . . . . . . . . . . . . . . . . . . . . . 10
2.9 Case Study 3: Diabetic Ketoacidosis (Questions 7175) . . . . . . . . . . . . . . . . . . . . . . . . 11
2.10 Additional Questions (76110) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
3 Version B: Questions 111220 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
3.1 Cardiovascular Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
3.2 Respiratory Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.3 Gastrointestinal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4 Study Tips and Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
1
, ATI Med Surg Proctored Exam Study Guide 2024 2
1 Introduction
This study guide prepares nursing students for the ATI Medical-Surgical Proctored Exam 2024, covering Versions
A and B. It assesses proficiency in medical-surgical nursing across systems (cardiovascular, respiratory, gastroin-
testinal, endocrine, neurological, musculoskeletal) using NGN formats, including multiple-choice, case studies,
bow-tie, and matrix questions. Below are 220 questions (110 per version) with answers and rationales, organized
by topic to reflect the exams scope. Content aligns with ATI guidelines and general nursing principles.
2 Version A: Questions 1110
2.1 Cardiovascular Disorders
1. A client with angina uses sublingual nitroglycerin. Which statement indicates understanding?
A) "Ill take up to five tablets for pain."
B) "I should lie down when taking it."
C) "Ill store it in a warm place."
D) "Ill replace it every 12 months."
Answer: B) "I should lie down when taking it."
Rationale: Lying down prevents falls due to hypotension. Maximum is three tablets, storage is at room
temperature, and replacement is every 6 months.
2. A client with chest pain arrives at the ED. What is the first action?
A) Administer aspirin 325 mg
B) Assess vital signs
C) Obtain a 12-lead ECG
D) Administer nitroglycerin
Answer: B) Assess vital signs
Rationale: Vital signs guide interventions by assessing stability.
3. A client with heart failure reports dyspnea and 4 kg weight gain in 48 hours. What should the nurse
prioritize?
A) Notify the provider
B) Increase diuretic dose
C) Encourage fluid intake
D) Administer oxygen
Answer: A) Notify the provider
Rationale: Rapid weight gain and dyspnea indicate worsening heart failure.
4. A client post-myocardial infarction has atrial fibrillation. What is the priority?
A) Assess for thromboembolism risk
B) Monitor blood pressure
C) Administer beta-blockers
D) Prepare for cardioversion
Answer: A) Assess for thromboembolism risk
Rationale: Atrial fibrillation increases thromboembolism risk.
5. A client on an ACE inhibitor reports a dry cough. What should the nurse advise?
A) "Your cough may require changing medication."
B) "Increase fluids to reduce it."
C) "Use lozenges to relieve it."
D) "The cough will resolve over time."
Answer: A) "Your cough may require changing medication."
Rationale: A dry cough often necessitates switching to an ARB.
6. A client with hypertension is prescribed metoprolol. Which finding requires intervention?
A) Heart rate 46 bpm
B) BP 130/80 mmHg
C) No edema
D) Clear lungs
Answer: A) Heart rate 46 bpm
Rationale: Bradycardia requires provider notification.
7. A client post-cardiac catheterization reports groin pain. Which finding requires action?
A) Hardness at the site
