Actual ATI RN Adult Medical Surgical 2026/2027 (Med-Surg) NGN Proctored
Exam 200 Questions and Answers with Rationales Pass Guaranteed
TABLE OF CONTENTS
1. Respiratory Disorders
2. Cardiovascular Disorders
3. Neurologic Disorders
4. Renal & Urinary Disorders
5. Endocrine Disorders
6. Gastrointestinal & Hepatic Disorders
7. Hematologic & Oncologic Disorders
8. Fluid, Electrolyte & Acid-Base Disorders
9. Musculoskeletal Disorders
10. Immune & Infectious Disorders
11. Integumentary & Burn Disorders
SECTION 1 — RESPIRATORY DISORDERS
Question 1
A nurse assesses a client with COPD who has increasing dyspnea. Which finding
requires the most immediate intervention?
A. Barrel-shaped chest
B. Respiratory rate of 26/min
C. Oxygen saturation of 86%
D. Productive cough with clear sputum
Answer: C. Oxygen saturation of 86%
Rationale: An oxygen saturation of 86% indicates significant hypoxemia and
requires prompt assessment and intervention. The nurse should assess airway
and breathing and administer oxygen as prescribed while evaluating the
underlying cause.
,Question 2
A client with asthma develops wheezing and difficulty breathing after exposure to
an allergen. Which medication should the nurse expect to administer for rapid
relief?
A. Montelukast
B. Albuterol
C. Fluticasone
D. Salmeterol
Answer: B. Albuterol
Rationale: Albuterol is a short-acting beta₂-adrenergic agonist that rapidly relaxes
bronchial smooth muscle and is used for acute bronchospasm.
Question 3 — SATA
A nurse is teaching a client with COPD about strategies to improve ventilation.
Which instructions should the nurse include?
A. Use pursed-lip breathing.
B. Avoid all physical activity.
C. Eat smaller, more frequent meals.
D. Practice diaphragmatic breathing.
E. Increase oxygen flow whenever dyspnea occurs without an order.
Answers: A, C, D
Rationale: Pursed-lip and diaphragmatic breathing can improve ventilation. Small
meals reduce abdominal pressure and fatigue associated with eating. Oxygen
should be administered according to the prescribed target and clinical condition
rather than independently increasing the flow rate.
Question 4
Which assessment finding is most characteristic of a pulmonary embolism?
,A. Bradycardia and hypertension
B. Sudden dyspnea and pleuritic chest pain
C. Gradual weight gain and peripheral edema
D. Productive cough lasting several months
Answer: B. Sudden dyspnea and pleuritic chest pain
Rationale: Pulmonary embolism commonly presents with sudden dyspnea,
pleuritic chest pain, tachycardia, and hypoxemia.
Question 5
A client with ARDS has severe hypoxemia despite oxygen therapy. Which
pathophysiologic mechanism primarily contributes to the hypoxemia?
A. Increased hemoglobin production
B. Alveolar-capillary membrane dysfunction
C. Increased airway diameter
D. Reduced pulmonary blood flow only
Answer: B. Alveolar-capillary membrane dysfunction
Rationale: ARDS causes increased pulmonary vascular permeability, alveolar
edema, impaired diffusion, and severe ventilation-perfusion abnormalities.
Question 6
Which arterial blood gas result indicates respiratory acidosis?
A. pH 7.30, PaCO₂ 52 mm Hg, HCO₃⁻ 24 mEq/L
B. pH 7.48, PaCO₂ 30 mm Hg, HCO₃⁻ 24 mEq/L
C. pH 7.30, PaCO₂ 35 mm Hg, HCO₃⁻ 18 mEq/L
D. pH 7.48, PaCO₂ 48 mm Hg, HCO₃⁻ 25 mEq/L
Answer: A. pH 7.30, PaCO₂ 52 mm Hg, HCO₃⁻ 24 mEq/L
Rationale: Respiratory acidosis is characterized by decreased pH and increased
PaCO₂. The elevated carbon dioxide indicates hypoventilation.
, Question 7
A client with pneumonia has crackles, fever, productive cough, and hypoxemia.
Which intervention has priority?
A. Encourage bed rest only
B. Maintain airway and oxygenation
C. Restrict all fluids
D. Administer an antidiarrheal medication
Answer: B. Maintain airway and oxygenation
Rationale: Airway and breathing are immediate priorities. Oxygen therapy,
positioning, pulmonary hygiene, and prescribed antimicrobial therapy may be
required.
Question 8
A nurse is caring for a client with a chest tube connected to a drainage system.
Which finding requires immediate attention?
A. Tidaling in the water-seal chamber
B. Small amount of drainage
C. Continuous bubbling in the water-seal chamber
D. Mild discomfort at the insertion site
Answer: C. Continuous bubbling in the water-seal chamber
Rationale: Continuous bubbling in the water-seal chamber may indicate an air
leak. The nurse should assess the system and client promptly.
Question 9
Which finding is expected in a client experiencing hypoventilation?
A. Decreased PaCO₂
B. Increased PaCO₂
Exam 200 Questions and Answers with Rationales Pass Guaranteed
TABLE OF CONTENTS
1. Respiratory Disorders
2. Cardiovascular Disorders
3. Neurologic Disorders
4. Renal & Urinary Disorders
5. Endocrine Disorders
6. Gastrointestinal & Hepatic Disorders
7. Hematologic & Oncologic Disorders
8. Fluid, Electrolyte & Acid-Base Disorders
9. Musculoskeletal Disorders
10. Immune & Infectious Disorders
11. Integumentary & Burn Disorders
SECTION 1 — RESPIRATORY DISORDERS
Question 1
A nurse assesses a client with COPD who has increasing dyspnea. Which finding
requires the most immediate intervention?
A. Barrel-shaped chest
B. Respiratory rate of 26/min
C. Oxygen saturation of 86%
D. Productive cough with clear sputum
Answer: C. Oxygen saturation of 86%
Rationale: An oxygen saturation of 86% indicates significant hypoxemia and
requires prompt assessment and intervention. The nurse should assess airway
and breathing and administer oxygen as prescribed while evaluating the
underlying cause.
,Question 2
A client with asthma develops wheezing and difficulty breathing after exposure to
an allergen. Which medication should the nurse expect to administer for rapid
relief?
A. Montelukast
B. Albuterol
C. Fluticasone
D. Salmeterol
Answer: B. Albuterol
Rationale: Albuterol is a short-acting beta₂-adrenergic agonist that rapidly relaxes
bronchial smooth muscle and is used for acute bronchospasm.
Question 3 — SATA
A nurse is teaching a client with COPD about strategies to improve ventilation.
Which instructions should the nurse include?
A. Use pursed-lip breathing.
B. Avoid all physical activity.
C. Eat smaller, more frequent meals.
D. Practice diaphragmatic breathing.
E. Increase oxygen flow whenever dyspnea occurs without an order.
Answers: A, C, D
Rationale: Pursed-lip and diaphragmatic breathing can improve ventilation. Small
meals reduce abdominal pressure and fatigue associated with eating. Oxygen
should be administered according to the prescribed target and clinical condition
rather than independently increasing the flow rate.
Question 4
Which assessment finding is most characteristic of a pulmonary embolism?
,A. Bradycardia and hypertension
B. Sudden dyspnea and pleuritic chest pain
C. Gradual weight gain and peripheral edema
D. Productive cough lasting several months
Answer: B. Sudden dyspnea and pleuritic chest pain
Rationale: Pulmonary embolism commonly presents with sudden dyspnea,
pleuritic chest pain, tachycardia, and hypoxemia.
Question 5
A client with ARDS has severe hypoxemia despite oxygen therapy. Which
pathophysiologic mechanism primarily contributes to the hypoxemia?
A. Increased hemoglobin production
B. Alveolar-capillary membrane dysfunction
C. Increased airway diameter
D. Reduced pulmonary blood flow only
Answer: B. Alveolar-capillary membrane dysfunction
Rationale: ARDS causes increased pulmonary vascular permeability, alveolar
edema, impaired diffusion, and severe ventilation-perfusion abnormalities.
Question 6
Which arterial blood gas result indicates respiratory acidosis?
A. pH 7.30, PaCO₂ 52 mm Hg, HCO₃⁻ 24 mEq/L
B. pH 7.48, PaCO₂ 30 mm Hg, HCO₃⁻ 24 mEq/L
C. pH 7.30, PaCO₂ 35 mm Hg, HCO₃⁻ 18 mEq/L
D. pH 7.48, PaCO₂ 48 mm Hg, HCO₃⁻ 25 mEq/L
Answer: A. pH 7.30, PaCO₂ 52 mm Hg, HCO₃⁻ 24 mEq/L
Rationale: Respiratory acidosis is characterized by decreased pH and increased
PaCO₂. The elevated carbon dioxide indicates hypoventilation.
, Question 7
A client with pneumonia has crackles, fever, productive cough, and hypoxemia.
Which intervention has priority?
A. Encourage bed rest only
B. Maintain airway and oxygenation
C. Restrict all fluids
D. Administer an antidiarrheal medication
Answer: B. Maintain airway and oxygenation
Rationale: Airway and breathing are immediate priorities. Oxygen therapy,
positioning, pulmonary hygiene, and prescribed antimicrobial therapy may be
required.
Question 8
A nurse is caring for a client with a chest tube connected to a drainage system.
Which finding requires immediate attention?
A. Tidaling in the water-seal chamber
B. Small amount of drainage
C. Continuous bubbling in the water-seal chamber
D. Mild discomfort at the insertion site
Answer: C. Continuous bubbling in the water-seal chamber
Rationale: Continuous bubbling in the water-seal chamber may indicate an air
leak. The nurse should assess the system and client promptly.
Question 9
Which finding is expected in a client experiencing hypoventilation?
A. Decreased PaCO₂
B. Increased PaCO₂
