ATI Medical-Surgical Proctored Exam
2024 Study Guide
Versions A and B: 220 Real-Style Questions with
Detailed Answers and Rationales
Designed for Nursing Students to Achieve A+ Excellence in
Medical-Surgical Nursing
Aligned with ATI Guidelines, NGN Formats, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
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) . . . . . . . . . . . . . . . . . . . . . . . . 10
2.10 Bow-Tie Question: Sepsis Management (Questions 7681) . . . . . . . . . . . . . . . . . . . . . . . 11
2.11 Matrix Question: Postoperative Care (Questions 8286) . . . . . . . . . . . . . . . . . . . . . . . . 12
2.12 Additional Questions (87110) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
3 Version B: Questions 111220 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.1 Cardiovascular Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.2 Respiratory Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
3.3 Gastrointestinal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4 Study Tips and Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
1
, ATI Med Surg Proctored Exam 2024 Study Guide 2
1 Introduction
This study guide prepares nursing students for the ATI Medical-Surgical Proctored Exam 2024, Versions A and
B, with 220 NGN-style questions (110 per version) in multiple-choice, case study, bow-tie, and matrix formats.
Covering cardiovascular, respiratory, gastrointestinal, endocrine, neurological, and musculoskeletal systems, it
aligns with ATI guidelines and the NCSBN Clinical Judgment Measurement Model to enhance clinical reasoning.
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 three tablets, 5 minutes apart."
B) "I should stand upright when taking it."
C) "Ill store it in a warm bathroom."
D) "Ill replace it every 12 months."
Answer: A) "Ill take up to three tablets, 5 minutes apart."
Rationale: The correct dose is up to three tablets, 5 minutes apart, for chest pain. Nitroglycerin causes
hypotension, so lying down is advised. Store at room temperature and replace every 6 months.
2. A client with chest pain arrives at the ED. What is the first action?
A) Obtain vital signs
B) Administer aspirin 325 mg
C) Perform a 12-lead ECG
D) Give sublingual nitroglycerin
Answer: A) Obtain vital signs
Rationale: Vital signs assess stability and guide interventions in acute chest pain.
3. A client with heart failure reports dyspnea and 3 kg weight gain in 48 hours. What is the priority?
A) Notify the provider
B) Administer furosemide IV
C) Increase fluid intake
D) Apply oxygen at 4 L/min
Answer: A) Notify the provider
Rationale: Rapid weight gain and dyspnea indicate worsening heart failure, requiring provider interven-
tion.
4. A client post-myocardial infarction has atrial fibrillation. What is the priority assessment?
A) Thromboembolism risk
B) Blood pressure
C) Pain level
D) Respiratory rate
Answer: A) Thromboembolism risk
Rationale: Atrial fibrillation increases thromboembolism risk due to atrial stasis.
5. A client on lisinopril reports a dry cough. What should the nurse advise?
A) "You may need a medication change."
B) "Drink more water to soothe it."
C) "Use cough syrup daily."
D) "It will resolve with time."
Answer: A) "You may need a medication change."
Rationale: A dry cough often requires switching from an ACE inhibitor to an ARB.
6. A client with hypertension on metoprolol has a heart rate of 44 bpm. What should the nurse do?
A) Withhold the dose and notify the provider
B) Administer the dose
C) Monitor for 1 hour
D) Encourage activity
Answer: A) Withhold the dose and notify the provider
Rationale: Bradycardia (<50 bpm) is a serious side effect of beta-blockers.
7. A client post-cardiac catheterization reports groin pain. Which finding requires action?
A) Hard swelling at the site
B) Mild bruising
C) Warm distal extremity
D) Strong distal pulse
Answer: A) Hard swelling at the site
2024 Study Guide
Versions A and B: 220 Real-Style Questions with
Detailed Answers and Rationales
Designed for Nursing Students to Achieve A+ Excellence in
Medical-Surgical Nursing
Aligned with ATI Guidelines, NGN Formats, 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
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) . . . . . . . . . . . . . . . . . . . . . . . . 10
2.10 Bow-Tie Question: Sepsis Management (Questions 7681) . . . . . . . . . . . . . . . . . . . . . . . 11
2.11 Matrix Question: Postoperative Care (Questions 8286) . . . . . . . . . . . . . . . . . . . . . . . . 12
2.12 Additional Questions (87110) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
3 Version B: Questions 111220 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.1 Cardiovascular Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.2 Respiratory Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
3.3 Gastrointestinal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4 Study Tips and Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
1
, ATI Med Surg Proctored Exam 2024 Study Guide 2
1 Introduction
This study guide prepares nursing students for the ATI Medical-Surgical Proctored Exam 2024, Versions A and
B, with 220 NGN-style questions (110 per version) in multiple-choice, case study, bow-tie, and matrix formats.
Covering cardiovascular, respiratory, gastrointestinal, endocrine, neurological, and musculoskeletal systems, it
aligns with ATI guidelines and the NCSBN Clinical Judgment Measurement Model to enhance clinical reasoning.
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 three tablets, 5 minutes apart."
B) "I should stand upright when taking it."
C) "Ill store it in a warm bathroom."
D) "Ill replace it every 12 months."
Answer: A) "Ill take up to three tablets, 5 minutes apart."
Rationale: The correct dose is up to three tablets, 5 minutes apart, for chest pain. Nitroglycerin causes
hypotension, so lying down is advised. Store at room temperature and replace every 6 months.
2. A client with chest pain arrives at the ED. What is the first action?
A) Obtain vital signs
B) Administer aspirin 325 mg
C) Perform a 12-lead ECG
D) Give sublingual nitroglycerin
Answer: A) Obtain vital signs
Rationale: Vital signs assess stability and guide interventions in acute chest pain.
3. A client with heart failure reports dyspnea and 3 kg weight gain in 48 hours. What is the priority?
A) Notify the provider
B) Administer furosemide IV
C) Increase fluid intake
D) Apply oxygen at 4 L/min
Answer: A) Notify the provider
Rationale: Rapid weight gain and dyspnea indicate worsening heart failure, requiring provider interven-
tion.
4. A client post-myocardial infarction has atrial fibrillation. What is the priority assessment?
A) Thromboembolism risk
B) Blood pressure
C) Pain level
D) Respiratory rate
Answer: A) Thromboembolism risk
Rationale: Atrial fibrillation increases thromboembolism risk due to atrial stasis.
5. A client on lisinopril reports a dry cough. What should the nurse advise?
A) "You may need a medication change."
B) "Drink more water to soothe it."
C) "Use cough syrup daily."
D) "It will resolve with time."
Answer: A) "You may need a medication change."
Rationale: A dry cough often requires switching from an ACE inhibitor to an ARB.
6. A client with hypertension on metoprolol has a heart rate of 44 bpm. What should the nurse do?
A) Withhold the dose and notify the provider
B) Administer the dose
C) Monitor for 1 hour
D) Encourage activity
Answer: A) Withhold the dose and notify the provider
Rationale: Bradycardia (<50 bpm) is a serious side effect of beta-blockers.
7. A client post-cardiac catheterization reports groin pain. Which finding requires action?
A) Hard swelling at the site
B) Mild bruising
C) Warm distal extremity
D) Strong distal pulse
Answer: A) Hard swelling at the site
