ATI PN Adult Medical Surgical (Med-Surg) 2026
Proctored Exam with NGN: 100 Practice Questions &
Answers /ATI PN Adult Medical Surgical Proctored
Exam with NGN
Below are original practice questions modeled on the ATI PN Adult Medical Surgical
Proctored Exam with NGN format, based on verified exam documents . Each answer
includes a detailed rationale to reinforce clinical judgment and exam readiness .
Exam Overview
Feature Detail
Exam Name ATI PN Adult Medical Surgical Proctored Exam with NGN
Target Practical Nursing (PN) students
Audience
Format Multiple-choice, NGN case studies (unfolding, bow-tie, matrix)
Content Cardiovascular, respiratory, endocrine, GI, renal, neuro,
Areas musculoskeletal, pharmacology, perioperative care, infection control
Key Focus Clinical judgment, prioritization, safety, delegation
Section 1: Cardiovascular Disorders (Questions 1–20)
1. A nurse is assessing a client with heart failure who reports sudden onset of
dyspnea and is coughing up pink, frothy sputum. Which action should the nurse take
first?
A) Place the client in high-Fowler's position
B) Administer furosemide IV push
C) Apply oxygen via non-rebreather mask
D) Notify the healthcare provider immediately
,Answer: A
Rationale: The client is experiencing acute pulmonary edema. The priority intervention
is to position the client upright (high-Fowler's) to reduce venous return (preload) and
facilitate breathing. Oxygen and furosemide are then given, but positioning is the immediate
first step .
2. A nurse is assessing a client with heart failure. Which finding is an early indication
of fluid volume overload?
A) Jugular vein distention
B) Weight gain of 2 lbs (1 kg) in 24 hours
C) Crackles in the lung bases
D) Peripheral edema (2+)
Answer: B
Rationale: Weight gain is an early indicator of fluid retention because 1 kg (2.2 lbs) of
weight gain equals approximately 1 liter of fluid. Jugular vein distention, crackles, and
peripheral edema are later signs of fluid overload .
3. A client with angina pectoris is prescribed nitroglycerin sublingual. Which
instruction should the nurse include?
A) Swallow the tablet with water
B) Take one tablet every 5 minutes for up to three doses for chest pain
C) Store the tablets in the refrigerator
D) Take the medication with food to prevent nausea
Answer: B
Rationale: Standard instruction for nitroglycerin sublingual: take one tablet at the onset
of chest pain, then every 5 minutes for up to three doses. If pain is not relieved after the first
tablet, call 911 immediately .
4. A client with hypertension is prescribed hydrochlorothiazide. Which electrolyte
imbalance should the nurse monitor for?
,A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Answer: B
Rationale: Hydrochlorothiazide is a thiazide diuretic that causes potassium wasting,
leading to hypokalemia. Signs include muscle weakness, fatigue, and cardiac arrhythmias .
5. A nurse is caring for a client following a cardiac catheterization via the right
femoral artery. Which finding requires immediate intervention?
A) Heart rate 90 bpm
B) Blood pressure 110/70 mmHg
C) Right foot is cool and pulseless
D) Pain at the insertion site
Answer: C
Rationale: A cool, pulseless foot indicates possible arterial occlusion from thrombus or
hematoma. This is a medical emergency requiring immediate provider notification. Pain at
the insertion site is expected .
6. A client taking digoxin presents with nausea, vomiting, visual halos (yellow-green
halos around lights), and a serum digoxin level of 2.5 ng/mL. What is the priority
nursing intervention?
A) Administer activated charcoal
B) Hold the digoxin and obtain an ECG
C) Increase the digoxin dose
D) Encourage a high-potassium diet
Answer: B
Rationale: Nausea, vomiting, and visual disturbances are classic signs of digoxin
toxicity. The therapeutic range is 0.5–2 ng/mL; 2.5 ng/mL is toxic. The priority is to hold the
medication and obtain an ECG to assess for life-threatening dysrhythmias .
, 7. A client with heart failure has a prescription for furosemide. Which laboratory value
should the nurse monitor most closely?
A) Sodium
B) Potassium
C) Chloride
D) Calcium
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia
can precipitate cardiac dysrhythmias, especially in clients taking digoxin. Potassium levels
should be monitored closely .
8. A nurse is caring for a client with peripheral arterial disease (PAD). Which finding
should the nurse expect?
A) Bilateral lower extremity edema
B) Cool, pale feet with diminished pulses
C) Warm, erythematous lower legs
D) Distended neck veins
Answer: B
Rationale: PAD results from atherosclerosis causing reduced blood flow to extremities.
Manifestations include cool, pale skin, diminished or absent pulses, and pain with activity
(intermittent claudication). Edema and warmth are more consistent with venous
insufficiency .
9. A client with deep vein thrombosis (DVT) is receiving heparin IV. Which laboratory
test is used to monitor heparin therapy?
A) PT/INR
B) aPTT
C) Platelet count
D) Hemoglobin A1c
Proctored Exam with NGN: 100 Practice Questions &
Answers /ATI PN Adult Medical Surgical Proctored
Exam with NGN
Below are original practice questions modeled on the ATI PN Adult Medical Surgical
Proctored Exam with NGN format, based on verified exam documents . Each answer
includes a detailed rationale to reinforce clinical judgment and exam readiness .
Exam Overview
Feature Detail
Exam Name ATI PN Adult Medical Surgical Proctored Exam with NGN
Target Practical Nursing (PN) students
Audience
Format Multiple-choice, NGN case studies (unfolding, bow-tie, matrix)
Content Cardiovascular, respiratory, endocrine, GI, renal, neuro,
Areas musculoskeletal, pharmacology, perioperative care, infection control
Key Focus Clinical judgment, prioritization, safety, delegation
Section 1: Cardiovascular Disorders (Questions 1–20)
1. A nurse is assessing a client with heart failure who reports sudden onset of
dyspnea and is coughing up pink, frothy sputum. Which action should the nurse take
first?
A) Place the client in high-Fowler's position
B) Administer furosemide IV push
C) Apply oxygen via non-rebreather mask
D) Notify the healthcare provider immediately
,Answer: A
Rationale: The client is experiencing acute pulmonary edema. The priority intervention
is to position the client upright (high-Fowler's) to reduce venous return (preload) and
facilitate breathing. Oxygen and furosemide are then given, but positioning is the immediate
first step .
2. A nurse is assessing a client with heart failure. Which finding is an early indication
of fluid volume overload?
A) Jugular vein distention
B) Weight gain of 2 lbs (1 kg) in 24 hours
C) Crackles in the lung bases
D) Peripheral edema (2+)
Answer: B
Rationale: Weight gain is an early indicator of fluid retention because 1 kg (2.2 lbs) of
weight gain equals approximately 1 liter of fluid. Jugular vein distention, crackles, and
peripheral edema are later signs of fluid overload .
3. A client with angina pectoris is prescribed nitroglycerin sublingual. Which
instruction should the nurse include?
A) Swallow the tablet with water
B) Take one tablet every 5 minutes for up to three doses for chest pain
C) Store the tablets in the refrigerator
D) Take the medication with food to prevent nausea
Answer: B
Rationale: Standard instruction for nitroglycerin sublingual: take one tablet at the onset
of chest pain, then every 5 minutes for up to three doses. If pain is not relieved after the first
tablet, call 911 immediately .
4. A client with hypertension is prescribed hydrochlorothiazide. Which electrolyte
imbalance should the nurse monitor for?
,A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Answer: B
Rationale: Hydrochlorothiazide is a thiazide diuretic that causes potassium wasting,
leading to hypokalemia. Signs include muscle weakness, fatigue, and cardiac arrhythmias .
5. A nurse is caring for a client following a cardiac catheterization via the right
femoral artery. Which finding requires immediate intervention?
A) Heart rate 90 bpm
B) Blood pressure 110/70 mmHg
C) Right foot is cool and pulseless
D) Pain at the insertion site
Answer: C
Rationale: A cool, pulseless foot indicates possible arterial occlusion from thrombus or
hematoma. This is a medical emergency requiring immediate provider notification. Pain at
the insertion site is expected .
6. A client taking digoxin presents with nausea, vomiting, visual halos (yellow-green
halos around lights), and a serum digoxin level of 2.5 ng/mL. What is the priority
nursing intervention?
A) Administer activated charcoal
B) Hold the digoxin and obtain an ECG
C) Increase the digoxin dose
D) Encourage a high-potassium diet
Answer: B
Rationale: Nausea, vomiting, and visual disturbances are classic signs of digoxin
toxicity. The therapeutic range is 0.5–2 ng/mL; 2.5 ng/mL is toxic. The priority is to hold the
medication and obtain an ECG to assess for life-threatening dysrhythmias .
, 7. A client with heart failure has a prescription for furosemide. Which laboratory value
should the nurse monitor most closely?
A) Sodium
B) Potassium
C) Chloride
D) Calcium
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia
can precipitate cardiac dysrhythmias, especially in clients taking digoxin. Potassium levels
should be monitored closely .
8. A nurse is caring for a client with peripheral arterial disease (PAD). Which finding
should the nurse expect?
A) Bilateral lower extremity edema
B) Cool, pale feet with diminished pulses
C) Warm, erythematous lower legs
D) Distended neck veins
Answer: B
Rationale: PAD results from atherosclerosis causing reduced blood flow to extremities.
Manifestations include cool, pale skin, diminished or absent pulses, and pain with activity
(intermittent claudication). Edema and warmth are more consistent with venous
insufficiency .
9. A client with deep vein thrombosis (DVT) is receiving heparin IV. Which laboratory
test is used to monitor heparin therapy?
A) PT/INR
B) aPTT
C) Platelet count
D) Hemoglobin A1c
