Study Guide Med Surg NGN ATI 2024 Proctored Exam 2
Med Surg NGN ATI
2024 – Proctored
Exam 2, Both
Versions, 220 Correct
Answers
Page 1
,Study Guide Med Surg NGN ATI 2024 Proctored Exam 2
Introduction
This study guide is designed for nursing students preparing for the 2024 ATI Medical-Surgical
Next Generation NCLEX (NGN) Proctored Exam 2, covering both versions (A and B). It in-
cludes 100 sample questions, comprising traditional multiple-choice and NGN case studies with
select-all-that-apply, drag-and-drop, and prioritization formats. Topics span cardiovascular, res-
piratory, gastrointestinal, neurological, endocrine, renal, musculoskeletal, and patient safety.
Each question includes a verified answer with a concise rationale to enhance clinical judgment,
aligned with the NCSBN Clinical Judgment Measurement Model. The guide also provides
updated study tips, curated resources, a practice strategy, and pitfalls to avoid, offering a com-
prehensive preparation framework.
1 Key Topics Covered
• Cardiovascular: Acute coronary syndrome, heart failure, dysrhythmias, peripheral artery
disease.
• Respiratory: ARDS, pneumothorax, tuberculosis, mechanical ventilation.
• Gastrointestinal: Inflammatory bowel disease, liver failure, appendicitis, enteral feed-
ing.
• Neurological: Parkinson’s disease, spinal cord injury, Bell’s palsy, delirium.
• Endocrine: Addison’s disease, SIADH, hyperparathyroidism, insulin therapy.
• Renal/Urinary: Pyelonephritis, bladder cancer, hemodialysis, urinary diversion.
• Musculoskeletal: Amputation, gout, fibromyalgia, traction.
• Patient Safety: Sepsis protocols, restraint use, medication reconciliation, disaster triage.
• NGN Skills: Clinical decision-making, interprofessional collaboration, patient educa-
tion.
2 Sample Questions and Correct Answers
2.1 Version A: Traditional Multiple-Choice Questions
1. A nurse assesses a client with acute coronary syndrome. Which ECG finding is
expected?
A. Prolonged PR interval
B. ST elevation
C. Flattened T waves
D. Widened QRS
Answer: B. ST elevation
Rationale: ST elevation indicates myocardial ischemia. PR interval (A) relates to AV
block, T waves (C) to electrolytes, QRS (D) to bundle branch block.
2. A client with ARDS is on mechanical ventilation. Which setting should be monitored
closely?
A. Tidal volume
B. FiO2
Page 2
, Study Guide Med Surg NGN ATI 2024 Proctored Exam 2
C. PEEP
D. Respiratory rate
Answer: C. PEEP
Rationale: PEEP prevents alveolar collapse in ARDS. Tidal volume (A), FiO2 (B), and
rate (D) are secondary.
3. A nurse cares for a client with ulcerative colitis. Which symptom is priority?
A. Bloody diarrhea
B. Weight loss
C. Fatigue
D. Abdominal cramping
Answer: A. Bloody diarrhea
Rationale: Bloody diarrhea indicates active bleeding, requiring urgent intervention. Weight
loss (B), fatigue (C), and cramping (D) are chronic.
4. A client post-craniotomy has clear nasal drainage. Which action is priority?
A. Collect sample for glucose
B. Apply nasal packing
C. Encourage fluids
D. Administer antihistamines
Answer: A. Collect sample for glucose
Rationale: Clear drainage may be CSF, confirmed by glucose test. Packing (B), fluids
(C), and antihistamines (D) are inappropriate.
5. A nurse calculates IV flow rate for 500 mL D5W over 4 hours with 20 drops/mL
tubing. How many drops/min?
A. 42
B. 38
C. 31
D. 25
Answer: A. 42
Rationale: (500 × 20) ÷ (4 × 60) = 41.67, rounded to 42 drops/min.
6. A client with Addison’s disease is prescribed hydrocortisone. Which outcome is ex-
pected?
A. Decreased BP
B. Improved energy
C. Weight gain
D. Hypoglycemia
Answer: B. Improved energy
Rationale: Hydrocortisone corrects cortisol deficiency, improving energy. BP increases
(A), weight gain (C) is a side effect, hypoglycemia (D) is unrelated.
7. A client with pyelonephritis reports which symptom?
A. Dysuria
B. Flank pain
C. Hematuria
D. Urgency
Answer: B. Flank pain
Rationale: Flank pain is specific to pyelonephritis. Dysuria (A), hematuria (C), and ur-
gency (D) are general UTI symptoms.
Page 3
Med Surg NGN ATI
2024 – Proctored
Exam 2, Both
Versions, 220 Correct
Answers
Page 1
,Study Guide Med Surg NGN ATI 2024 Proctored Exam 2
Introduction
This study guide is designed for nursing students preparing for the 2024 ATI Medical-Surgical
Next Generation NCLEX (NGN) Proctored Exam 2, covering both versions (A and B). It in-
cludes 100 sample questions, comprising traditional multiple-choice and NGN case studies with
select-all-that-apply, drag-and-drop, and prioritization formats. Topics span cardiovascular, res-
piratory, gastrointestinal, neurological, endocrine, renal, musculoskeletal, and patient safety.
Each question includes a verified answer with a concise rationale to enhance clinical judgment,
aligned with the NCSBN Clinical Judgment Measurement Model. The guide also provides
updated study tips, curated resources, a practice strategy, and pitfalls to avoid, offering a com-
prehensive preparation framework.
1 Key Topics Covered
• Cardiovascular: Acute coronary syndrome, heart failure, dysrhythmias, peripheral artery
disease.
• Respiratory: ARDS, pneumothorax, tuberculosis, mechanical ventilation.
• Gastrointestinal: Inflammatory bowel disease, liver failure, appendicitis, enteral feed-
ing.
• Neurological: Parkinson’s disease, spinal cord injury, Bell’s palsy, delirium.
• Endocrine: Addison’s disease, SIADH, hyperparathyroidism, insulin therapy.
• Renal/Urinary: Pyelonephritis, bladder cancer, hemodialysis, urinary diversion.
• Musculoskeletal: Amputation, gout, fibromyalgia, traction.
• Patient Safety: Sepsis protocols, restraint use, medication reconciliation, disaster triage.
• NGN Skills: Clinical decision-making, interprofessional collaboration, patient educa-
tion.
2 Sample Questions and Correct Answers
2.1 Version A: Traditional Multiple-Choice Questions
1. A nurse assesses a client with acute coronary syndrome. Which ECG finding is
expected?
A. Prolonged PR interval
B. ST elevation
C. Flattened T waves
D. Widened QRS
Answer: B. ST elevation
Rationale: ST elevation indicates myocardial ischemia. PR interval (A) relates to AV
block, T waves (C) to electrolytes, QRS (D) to bundle branch block.
2. A client with ARDS is on mechanical ventilation. Which setting should be monitored
closely?
A. Tidal volume
B. FiO2
Page 2
, Study Guide Med Surg NGN ATI 2024 Proctored Exam 2
C. PEEP
D. Respiratory rate
Answer: C. PEEP
Rationale: PEEP prevents alveolar collapse in ARDS. Tidal volume (A), FiO2 (B), and
rate (D) are secondary.
3. A nurse cares for a client with ulcerative colitis. Which symptom is priority?
A. Bloody diarrhea
B. Weight loss
C. Fatigue
D. Abdominal cramping
Answer: A. Bloody diarrhea
Rationale: Bloody diarrhea indicates active bleeding, requiring urgent intervention. Weight
loss (B), fatigue (C), and cramping (D) are chronic.
4. A client post-craniotomy has clear nasal drainage. Which action is priority?
A. Collect sample for glucose
B. Apply nasal packing
C. Encourage fluids
D. Administer antihistamines
Answer: A. Collect sample for glucose
Rationale: Clear drainage may be CSF, confirmed by glucose test. Packing (B), fluids
(C), and antihistamines (D) are inappropriate.
5. A nurse calculates IV flow rate for 500 mL D5W over 4 hours with 20 drops/mL
tubing. How many drops/min?
A. 42
B. 38
C. 31
D. 25
Answer: A. 42
Rationale: (500 × 20) ÷ (4 × 60) = 41.67, rounded to 42 drops/min.
6. A client with Addison’s disease is prescribed hydrocortisone. Which outcome is ex-
pected?
A. Decreased BP
B. Improved energy
C. Weight gain
D. Hypoglycemia
Answer: B. Improved energy
Rationale: Hydrocortisone corrects cortisol deficiency, improving energy. BP increases
(A), weight gain (C) is a side effect, hypoglycemia (D) is unrelated.
7. A client with pyelonephritis reports which symptom?
A. Dysuria
B. Flank pain
C. Hematuria
D. Urgency
Answer: B. Flank pain
Rationale: Flank pain is specific to pyelonephritis. Dysuria (A), hematuria (C), and ur-
gency (D) are general UTI symptoms.
Page 3
