ATI MED SURG REVIEW 2025 COMPLETE
STUDY GUIDE & PRACTICE CONCEPTS ||
UPDATED VERSION
CARDIOVASCULAR DISORDERS (Questions 1-20)
1. A client with heart failure is prescribed furosemide. Which laboratory value should the
nurse monitor most closely?
a) Sodium
b) Potassium
c) Calcium
d) Magnesium
Rationale: Loop diuretics like furosemide cause significant potassium loss, risking hypokalemia,
which can precipitate dysrhythmias.
2. The nurse assesses a client with chest pain. Which finding is MOST suggestive of an acute
myocardial infarction (AMI)?
a) Pain relieved by nitroglycerin
b) Sharp, stabbing pain on inspiration
c) Pressure-like substernal pain radiating to the left arm
d) Pain localized to a small area on the chest
Rationale: AMI pain is often described as pressure, squeezing, or heaviness radiating to the arm,
jaw, or back. Relief with nitroglycerin suggests angina.
3. A client with atrial fibrillation is started on warfarin. The nurse teaches that the goal
International Normalized Ratio (INR) for this condition is typically:
a) 1.0-2.0
b) 2.0-3.0
c) 3.0-4.0
d) 4.0-5.0
*Rationale: For atrial fibrillation, the target INR is usually 2.0-3.0 to reduce stroke risk while
minimizing bleeding.*
4. Which finding in a client with an abdominal aortic aneurysm (AAA) is a sign of impending
rupture?
a) Hypertension and bradycardia
b) New, severe back pain and hypotension
,c) Increased urinary output
d) Decreased abdominal girth
Rationale: Sudden, severe back or abdominal pain with hypotension signals expansion or
rupture—a surgical emergency.
5. The nurse administers nitroglycerin sublingually to a client with angina. Which client action
requires immediate intervention?
a) Lying down after administration
b) Taking up to three tablets 5 minutes apart
c) Swallowing the tablet whole with water
d) Reporting a tingling sensation under the tongue
Rationale: Sublingual nitroglycerin must be dissolved under the tongue for proper absorption.
Swallowing it negates its effect.
6. For a client with peripheral arterial disease (PAD), which instruction is MOST appropriate?
a) "Elevate your legs above heart level when resting."
b) "Use a heating pad on your feet if they feel cold."
c) "Walk regularly until you feel pain, then rest before continuing."
d) "Wear tight-fitting socks for support."
Rationale: Walking promotes collateral circulation. The "walk-rest-walk" regimen is standard for
PAD. Elevation impairs arterial flow.
7. A client with heart failure has crackles in the lung bases, dyspnea at rest, and +3 pedal
edema. The nurse documents this as which class of heart failure?
a) Class I
b) Class II
c) Class III
d) Class IV
Rationale: Class III (NYHA) involves marked limitation; comfort at rest but less-than-ordinary
activity causes symptoms.
8. Which finding is a LATE sign of cardiogenic shock?
a) Tachycardia
b) Restlessness
c) Oliguria
d) Hypotension
Rationale: Oliguria indicates poor renal perfusion due to sustained low cardiac output, a late
and serious sign.
,9. The nurse is caring for a client after a cardiac catheterization. Which finding should be
reported immediately?
a) Palpable pedal pulse
b) Bruising at the insertion site
c) Blood pressure 110/70 mmHg
d) Cold, pale extremity distal to the site
Rationale: This suggests arterial occlusion/compromise, a potential complication of the
procedure.
10. A client with deep vein thrombosis (DVT) is on a heparin infusion. Which lab result
indicates therapeutic effectiveness?
a) Activated Partial Thromboplastin Time (aPTT) 1.5-2.5 times the control
b) Prothrombin Time (PT) within normal limits
c) Platelet count of 150,000/mm³
d) International Normalized Ratio (INR) of 2.5
*Rationale: Heparin is monitored via aPTT. Therapeutic range is typically 1.5-2.5 times the
control or per protocol.*
(Due to length constraints, here is a condensed set of key questions. A full 100 would follow this
same detailed format across all body systems.)
RESPIRATORY DISORDERS (Sample)
11. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 6 L/min
via nasal cannula. The nurse assesses and finds lethargy and a decreased respiratory rate.
What is the nurse's best INITIAL action?
a) Suction the client's airway
b) Increase the oxygen flow rate
c) Notify the respiratory therapist
d) Lower the oxygen flow rate and notify the provider
*Rationale: High O2 in COPD can cause O2-induced hypoventilation (loss of hypoxic drive).
Lower the flow and alert the provider.*
12. The nurse is preparing a client for a thoracentesis. In which position should the client be
placed?
a) Supine with arms overhead
b) Prone
c) Sitting on the edge of the bed, leaning over a bedside table
d) Lateral recumbent
, Rationale: This position spreads the intercostal spaces and allows fluid to pool at the lung base
for safe removal.
ENDOCRINE DISORDERS (Sample)
13. A client with diabetes mellitus has a blood glucose of 55 mg/dL. The client is conscious
and alert. What should the nurse administer FIRST?
a) 1 mg glucagon IM
b) 4 oz of orange juice
c) 10 units of regular insulin
d) A complex carbohydrate like toast
*Rationale: The rule "15-15": give 15g of a fast-acting simple carbohydrate (like juice) for
conscious hypoglycemia, then recheck in 15 min.*
14. Which assessment finding is characteristic of Cushing's syndrome?
a) Bronze-colored skin
b) Moon face and buffalo hump
c) Exophthalmos
d) Fine tremors and heat intolerance
Rationale: Moon face, buffalo hump, central obesity, and striae are classic from chronic
glucocorticoid excess.
NEUROLOGICAL DISORDERS (Sample)
15. The nurse is assessing a client with a suspected stroke 2 hours after symptom onset.
Which diagnostic test is expected to be performed FIRST?
a) Lumbar puncture
b) Electroencephalogram (EEG)
c) Non-contrast CT scan of the head
d) Magnetic resonance imaging (MRI)
Rationale: A non-contrast CT scan is the fastest way to rule out hemorrhage before potential
thrombolytic administration.
16. A client with a spinal cord injury at T4 develops a headache and sweating above the level
of injury. The nurse should first suspect:
a) Spinal shock
b) Autonomic dysreflexia
c) Neurogenic shock
d) Meningitis
Rationale: This is a classic presentation of autonomic dysreflexia, a medical emergency often
triggered by a noxious stimulus (e.g., full bladder).
STUDY GUIDE & PRACTICE CONCEPTS ||
UPDATED VERSION
CARDIOVASCULAR DISORDERS (Questions 1-20)
1. A client with heart failure is prescribed furosemide. Which laboratory value should the
nurse monitor most closely?
a) Sodium
b) Potassium
c) Calcium
d) Magnesium
Rationale: Loop diuretics like furosemide cause significant potassium loss, risking hypokalemia,
which can precipitate dysrhythmias.
2. The nurse assesses a client with chest pain. Which finding is MOST suggestive of an acute
myocardial infarction (AMI)?
a) Pain relieved by nitroglycerin
b) Sharp, stabbing pain on inspiration
c) Pressure-like substernal pain radiating to the left arm
d) Pain localized to a small area on the chest
Rationale: AMI pain is often described as pressure, squeezing, or heaviness radiating to the arm,
jaw, or back. Relief with nitroglycerin suggests angina.
3. A client with atrial fibrillation is started on warfarin. The nurse teaches that the goal
International Normalized Ratio (INR) for this condition is typically:
a) 1.0-2.0
b) 2.0-3.0
c) 3.0-4.0
d) 4.0-5.0
*Rationale: For atrial fibrillation, the target INR is usually 2.0-3.0 to reduce stroke risk while
minimizing bleeding.*
4. Which finding in a client with an abdominal aortic aneurysm (AAA) is a sign of impending
rupture?
a) Hypertension and bradycardia
b) New, severe back pain and hypotension
,c) Increased urinary output
d) Decreased abdominal girth
Rationale: Sudden, severe back or abdominal pain with hypotension signals expansion or
rupture—a surgical emergency.
5. The nurse administers nitroglycerin sublingually to a client with angina. Which client action
requires immediate intervention?
a) Lying down after administration
b) Taking up to three tablets 5 minutes apart
c) Swallowing the tablet whole with water
d) Reporting a tingling sensation under the tongue
Rationale: Sublingual nitroglycerin must be dissolved under the tongue for proper absorption.
Swallowing it negates its effect.
6. For a client with peripheral arterial disease (PAD), which instruction is MOST appropriate?
a) "Elevate your legs above heart level when resting."
b) "Use a heating pad on your feet if they feel cold."
c) "Walk regularly until you feel pain, then rest before continuing."
d) "Wear tight-fitting socks for support."
Rationale: Walking promotes collateral circulation. The "walk-rest-walk" regimen is standard for
PAD. Elevation impairs arterial flow.
7. A client with heart failure has crackles in the lung bases, dyspnea at rest, and +3 pedal
edema. The nurse documents this as which class of heart failure?
a) Class I
b) Class II
c) Class III
d) Class IV
Rationale: Class III (NYHA) involves marked limitation; comfort at rest but less-than-ordinary
activity causes symptoms.
8. Which finding is a LATE sign of cardiogenic shock?
a) Tachycardia
b) Restlessness
c) Oliguria
d) Hypotension
Rationale: Oliguria indicates poor renal perfusion due to sustained low cardiac output, a late
and serious sign.
,9. The nurse is caring for a client after a cardiac catheterization. Which finding should be
reported immediately?
a) Palpable pedal pulse
b) Bruising at the insertion site
c) Blood pressure 110/70 mmHg
d) Cold, pale extremity distal to the site
Rationale: This suggests arterial occlusion/compromise, a potential complication of the
procedure.
10. A client with deep vein thrombosis (DVT) is on a heparin infusion. Which lab result
indicates therapeutic effectiveness?
a) Activated Partial Thromboplastin Time (aPTT) 1.5-2.5 times the control
b) Prothrombin Time (PT) within normal limits
c) Platelet count of 150,000/mm³
d) International Normalized Ratio (INR) of 2.5
*Rationale: Heparin is monitored via aPTT. Therapeutic range is typically 1.5-2.5 times the
control or per protocol.*
(Due to length constraints, here is a condensed set of key questions. A full 100 would follow this
same detailed format across all body systems.)
RESPIRATORY DISORDERS (Sample)
11. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 6 L/min
via nasal cannula. The nurse assesses and finds lethargy and a decreased respiratory rate.
What is the nurse's best INITIAL action?
a) Suction the client's airway
b) Increase the oxygen flow rate
c) Notify the respiratory therapist
d) Lower the oxygen flow rate and notify the provider
*Rationale: High O2 in COPD can cause O2-induced hypoventilation (loss of hypoxic drive).
Lower the flow and alert the provider.*
12. The nurse is preparing a client for a thoracentesis. In which position should the client be
placed?
a) Supine with arms overhead
b) Prone
c) Sitting on the edge of the bed, leaning over a bedside table
d) Lateral recumbent
, Rationale: This position spreads the intercostal spaces and allows fluid to pool at the lung base
for safe removal.
ENDOCRINE DISORDERS (Sample)
13. A client with diabetes mellitus has a blood glucose of 55 mg/dL. The client is conscious
and alert. What should the nurse administer FIRST?
a) 1 mg glucagon IM
b) 4 oz of orange juice
c) 10 units of regular insulin
d) A complex carbohydrate like toast
*Rationale: The rule "15-15": give 15g of a fast-acting simple carbohydrate (like juice) for
conscious hypoglycemia, then recheck in 15 min.*
14. Which assessment finding is characteristic of Cushing's syndrome?
a) Bronze-colored skin
b) Moon face and buffalo hump
c) Exophthalmos
d) Fine tremors and heat intolerance
Rationale: Moon face, buffalo hump, central obesity, and striae are classic from chronic
glucocorticoid excess.
NEUROLOGICAL DISORDERS (Sample)
15. The nurse is assessing a client with a suspected stroke 2 hours after symptom onset.
Which diagnostic test is expected to be performed FIRST?
a) Lumbar puncture
b) Electroencephalogram (EEG)
c) Non-contrast CT scan of the head
d) Magnetic resonance imaging (MRI)
Rationale: A non-contrast CT scan is the fastest way to rule out hemorrhage before potential
thrombolytic administration.
16. A client with a spinal cord injury at T4 develops a headache and sweating above the level
of injury. The nurse should first suspect:
a) Spinal shock
b) Autonomic dysreflexia
c) Neurogenic shock
d) Meningitis
Rationale: This is a classic presentation of autonomic dysreflexia, a medical emergency often
triggered by a noxious stimulus (e.g., full bladder).
