ATI RN Adult Medical-Surgical 2026/2027 Study Guide
| ACTUAL ATI RN Adult Medical-Surgical Practice
Questions & Answers, Latest Updated Exam Prep,
Verified Answers, Detailed Rationales, Clinical
Scenarios, Med-Surg Nursing, Prioritization, Safety &
Comprehensive Review
Question 1: A nurse is caring for a client who has a new
prescription for furosemide. Which of the following laboratory
values should the nurse monitor most closely?
A. Serum potassium
B. Serum calcium
C. Serum sodium
D. Serum magnesium
CORRECT ANSWER: A. Serum potassium
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride
reabsorption in the ascending loop of Henle, leading to increased excretion
of potassium. Hypokalemia is a common and potentially dangerous adverse
effect that can precipitate cardiac dysrhythmias.
Question 2: A nurse is assessing a client who had a thyroidectomy
8 hours ago. The client reports tingling around the mouth and in
the fingertips. Which of the following actions should the nurse take
first?
A. Administer prescribed calcium gluconate
B. Assess for Chvostek's sign
C. Notify the provider immediately
D. Prepare for emergency tracheostomy
CORRECT ANSWER: B. Assess for Chvostek's sign
Rationale: Tingling around the mouth and fingertips suggests
hypocalcemia, a complication of thyroidectomy from inadvertent
parathyroid removal. The nurse should first assess for Chvostek's sign,
which is a clinical indicator of hypocalcemia, before implementing
interventions.
,Question 3: A nurse is caring for a client who has heart failure and
is receiving digoxin. Which of the following findings indicates
possible digoxin toxicity?
A. Heart rate of 58/min
B. Blood pressure of 138/82 mm Hg
C. Visual disturbances with yellow halos
D. Increased urine output
CORRECT ANSWER: C. Visual disturbances with yellow halos
Rationale: Visual disturbances such as yellow or green halos around lights
are classic signs of digoxin toxicity. Other manifestations include nausea,
vomiting, bradycardia, and dysrhythmias.
Question 4: A nurse is teaching a client who has COPD about
pursed-lip breathing. Which of the following statements by the
client indicates understanding of the teaching?
A. "I should inhale quickly through my mouth."
B. "I will exhale slowly through pursed lips."
C. "I should hold my breath for 10 seconds after inhaling."
D. "I will breathe in through pursed lips."
CORRECT ANSWER: B. "I will exhale slowly through pursed lips."
Rationale: Pursed-lip breathing prolongs exhalation, preventing airway
collapse and allowing for more complete air exchange. The client should
inhale through the nose and exhale slowly through pursed lips.
Question 5: A nurse is assessing a client who has acute
pancreatitis. Which of the following laboratory findings should the
nurse expect?
A. Decreased serum amylase
B. Elevated serum lipase
C. Decreased serum glucose
D. Elevated serum calcium
CORRECT ANSWER: B. Elevated serum lipase
Rationale: Acute pancreatitis causes autodigestion of pancreatic cells,
releasing pancreatic enzymes into the bloodstream. Serum lipase is highly
specific for pancreatic injury and remains elevated longer than amylase.
,Question 6: A nurse is caring for a client who has a chest tube
connected to a water seal drainage system. The nurse observes
continuous bubbling in the water seal chamber. Which of the
following actions should the nurse take?
A. Document the finding as normal
B. Clamp the chest tube immediately
C. Assess for an air leak in the system
D. Increase the suction pressure
CORRECT ANSWER: C. Assess for an air leak in the system
Rationale: Continuous bubbling in the water seal chamber indicates an air
leak. The nurse should assess the system, including the insertion site,
connections, and tubing, to identify the source of the leak.
Question 7: A nurse is assessing a client who has syndrome of
inappropriate antidiuretic hormone (SIADH). Which of the
following findings should the nurse expect?
A. Hypernatremia
B. Polyuria
C. Weight gain
D. Increased serum osmolality
CORRECT ANSWER: C. Weight gain
Rationale: SIADH results in excessive ADH secretion, causing water
retention, dilutional hyponatremia, and weight gain. Clients typically have
concentrated urine and decreased serum osmolality.
Question 8: A nurse is caring for a client who is receiving a blood
transfusion. Which of the following findings indicates a febrile
nonhemolytic reaction?
A. Flushed skin and headache
B. Urticaria and itching
C. Wheezing and dyspnea
D. Dark urine and back pain
CORRECT ANSWER: A. Flushed skin and headache
, Rationale: Febrile nonhemolytic reactions are the most common type of
transfusion reaction, caused by leukocyte incompatibility. Manifestations
include fever, chills, flushing, and headache.
Question 9: A nurse is teaching a client who has diabetes mellitus
about foot care. Which of the following instructions should the
nurse include?
A. Soak feet in warm water daily
B. Cut toenails in a rounded shape
C. Inspect feet daily for cuts or blisters
D. Apply heating pads to cold feet
CORRECT ANSWER: C. Inspect feet daily for cuts or blisters
Rationale: Clients with diabetes have decreased sensation and poor
circulation, increasing the risk for foot injuries and infections. Daily foot
inspection allows early detection of problems.
Question 10: A nurse is assessing a client who has chronic kidney
disease. Which of the following findings indicates fluid volume
overload?
A. Decreased blood pressure
B. Distended neck veins
C. Increased urine output
D. Dry mucous membranes
CORRECT ANSWER: B. Distended neck veins
Rationale: Fluid volume overload in chronic kidney disease manifests as
jugular venous distention, edema, weight gain, and hypertension due to the
kidneys' inability to excrete excess fluid.
Question 11: A nurse is caring for a client who is postoperative
following a total hip arthroplasty. Which of the following actions
should the nurse take to prevent dislocation of the hip prosthesis?
A. Place a pillow between the client's legs
B. Encourage hip flexion beyond 90 degrees
C. Position the client on the operative side
D. Keep the affected leg adducted
CORRECT ANSWER: A. Place a pillow between the client's legs
| ACTUAL ATI RN Adult Medical-Surgical Practice
Questions & Answers, Latest Updated Exam Prep,
Verified Answers, Detailed Rationales, Clinical
Scenarios, Med-Surg Nursing, Prioritization, Safety &
Comprehensive Review
Question 1: A nurse is caring for a client who has a new
prescription for furosemide. Which of the following laboratory
values should the nurse monitor most closely?
A. Serum potassium
B. Serum calcium
C. Serum sodium
D. Serum magnesium
CORRECT ANSWER: A. Serum potassium
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride
reabsorption in the ascending loop of Henle, leading to increased excretion
of potassium. Hypokalemia is a common and potentially dangerous adverse
effect that can precipitate cardiac dysrhythmias.
Question 2: A nurse is assessing a client who had a thyroidectomy
8 hours ago. The client reports tingling around the mouth and in
the fingertips. Which of the following actions should the nurse take
first?
A. Administer prescribed calcium gluconate
B. Assess for Chvostek's sign
C. Notify the provider immediately
D. Prepare for emergency tracheostomy
CORRECT ANSWER: B. Assess for Chvostek's sign
Rationale: Tingling around the mouth and fingertips suggests
hypocalcemia, a complication of thyroidectomy from inadvertent
parathyroid removal. The nurse should first assess for Chvostek's sign,
which is a clinical indicator of hypocalcemia, before implementing
interventions.
,Question 3: A nurse is caring for a client who has heart failure and
is receiving digoxin. Which of the following findings indicates
possible digoxin toxicity?
A. Heart rate of 58/min
B. Blood pressure of 138/82 mm Hg
C. Visual disturbances with yellow halos
D. Increased urine output
CORRECT ANSWER: C. Visual disturbances with yellow halos
Rationale: Visual disturbances such as yellow or green halos around lights
are classic signs of digoxin toxicity. Other manifestations include nausea,
vomiting, bradycardia, and dysrhythmias.
Question 4: A nurse is teaching a client who has COPD about
pursed-lip breathing. Which of the following statements by the
client indicates understanding of the teaching?
A. "I should inhale quickly through my mouth."
B. "I will exhale slowly through pursed lips."
C. "I should hold my breath for 10 seconds after inhaling."
D. "I will breathe in through pursed lips."
CORRECT ANSWER: B. "I will exhale slowly through pursed lips."
Rationale: Pursed-lip breathing prolongs exhalation, preventing airway
collapse and allowing for more complete air exchange. The client should
inhale through the nose and exhale slowly through pursed lips.
Question 5: A nurse is assessing a client who has acute
pancreatitis. Which of the following laboratory findings should the
nurse expect?
A. Decreased serum amylase
B. Elevated serum lipase
C. Decreased serum glucose
D. Elevated serum calcium
CORRECT ANSWER: B. Elevated serum lipase
Rationale: Acute pancreatitis causes autodigestion of pancreatic cells,
releasing pancreatic enzymes into the bloodstream. Serum lipase is highly
specific for pancreatic injury and remains elevated longer than amylase.
,Question 6: A nurse is caring for a client who has a chest tube
connected to a water seal drainage system. The nurse observes
continuous bubbling in the water seal chamber. Which of the
following actions should the nurse take?
A. Document the finding as normal
B. Clamp the chest tube immediately
C. Assess for an air leak in the system
D. Increase the suction pressure
CORRECT ANSWER: C. Assess for an air leak in the system
Rationale: Continuous bubbling in the water seal chamber indicates an air
leak. The nurse should assess the system, including the insertion site,
connections, and tubing, to identify the source of the leak.
Question 7: A nurse is assessing a client who has syndrome of
inappropriate antidiuretic hormone (SIADH). Which of the
following findings should the nurse expect?
A. Hypernatremia
B. Polyuria
C. Weight gain
D. Increased serum osmolality
CORRECT ANSWER: C. Weight gain
Rationale: SIADH results in excessive ADH secretion, causing water
retention, dilutional hyponatremia, and weight gain. Clients typically have
concentrated urine and decreased serum osmolality.
Question 8: A nurse is caring for a client who is receiving a blood
transfusion. Which of the following findings indicates a febrile
nonhemolytic reaction?
A. Flushed skin and headache
B. Urticaria and itching
C. Wheezing and dyspnea
D. Dark urine and back pain
CORRECT ANSWER: A. Flushed skin and headache
, Rationale: Febrile nonhemolytic reactions are the most common type of
transfusion reaction, caused by leukocyte incompatibility. Manifestations
include fever, chills, flushing, and headache.
Question 9: A nurse is teaching a client who has diabetes mellitus
about foot care. Which of the following instructions should the
nurse include?
A. Soak feet in warm water daily
B. Cut toenails in a rounded shape
C. Inspect feet daily for cuts or blisters
D. Apply heating pads to cold feet
CORRECT ANSWER: C. Inspect feet daily for cuts or blisters
Rationale: Clients with diabetes have decreased sensation and poor
circulation, increasing the risk for foot injuries and infections. Daily foot
inspection allows early detection of problems.
Question 10: A nurse is assessing a client who has chronic kidney
disease. Which of the following findings indicates fluid volume
overload?
A. Decreased blood pressure
B. Distended neck veins
C. Increased urine output
D. Dry mucous membranes
CORRECT ANSWER: B. Distended neck veins
Rationale: Fluid volume overload in chronic kidney disease manifests as
jugular venous distention, edema, weight gain, and hypertension due to the
kidneys' inability to excrete excess fluid.
Question 11: A nurse is caring for a client who is postoperative
following a total hip arthroplasty. Which of the following actions
should the nurse take to prevent dislocation of the hip prosthesis?
A. Place a pillow between the client's legs
B. Encourage hip flexion beyond 90 degrees
C. Position the client on the operative side
D. Keep the affected leg adducted
CORRECT ANSWER: A. Place a pillow between the client's legs
