ATI RN Adult Medical-Surgical Proctored Exam 2026/2027 – ACTUAL-
Style Practice Questions & Answers, ATI RN Adult Medical-Surgical
Nursing Content Mastery Review, Cardiovascular Disorders, Respiratory
Diseases, Neurological Conditions, Fluid and Electrolyte Imbalances, Acid-
Base Balance, Renal and Urinary Disorders, Endocrine Conditions,
Gastrointestinal Disorders, Hematology, Infection Control, Immune
Disorders, Musculoskeletal Conditions, Perioperative Nursing,
Pharmacology, Clinical Judgment & Detailed Rationales
Question 1: 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 prosthesis?
A. Keep the client's hips flexed at 110 degrees when sitting.
B. Encourage the client to cross their legs at the knees.
C. Place an abduction pillow between the client's legs.
D. Instruct the client to rotate the affected leg internally.
CORRECT ANSWER: C. Place an abduction pillow between the client's
legs.
Rationale: An abduction pillow helps maintain the hip in a neutral position
and prevents the legs from crossing, which reduces the risk of dislocation
after a total hip arthroplasty. Flexion beyond 90 degrees and internal
rotation are contraindicated.
Question 2: A client with diabetes insipidus is being treated with
desmopressin. Which finding indicates the medication is effective?
A. Increased thirst
B. Decreased urine output
C. Weight loss
D. Decreased urine specific gravity
CORRECT ANSWER: B. Decreased urine output
Rationale: Diabetes insipidus is characterized by excessive dilute urine.
Desmopressin is an antidiuretic hormone that increases water
reabsorption, leading to decreased urine output and increased urine
concentration.
,Question 3: Which of the following interventions should a nurse
implement for a client experiencing a sickle cell crisis?
A. Apply cold compresses to painful joints.
B. Restrict fluid intake to 1 liter per day.
C. Administer high-flow oxygen and IV fluids.
D. Encourage active range-of-motion exercises.
CORRECT ANSWER: C. Administer high-flow oxygen and IV fluids.
Rationale: Hydration and oxygenation are priorities during a sickle cell
crisis to reduce sickling of red blood cells and improve tissue perfusion.
Cold compresses can worsen vaso-occlusion.
Question 4: A nurse is reviewing the lab results of a client with chronic
kidney disease. Which of the following findings should the nurse
expect?
A. Hypokalemia
B. Hypercalcemia
C. Elevated serum creatinine
D. Hypophosphatemia
CORRECT ANSWER: C. Elevated serum creatinine
Rationale: In CKD, the kidneys are unable to filter waste products
effectively, leading to elevated creatinine and BUN levels, as well as
hyperkalemia and hyperphosphatemia.
Question 5: A client is admitted with suspected appendicitis. Where
should the nurse expect the client to report the most intense pain?
A. Right lower quadrant
B. Right upper quadrant
C. Left lower quadrant
D. Left upper quadrant
CORRECT ANSWER: A. Right lower quadrant
Rationale: Pain from appendicitis typically localizes in the right lower
quadrant at McBurney's point.
Question 6: A nurse is monitoring a client receiving a blood transfusion.
Which of the following symptoms indicates a hemolytic reaction?
,A. Bradycardia
B. Urticaria and itching
C. Distended neck veins
D. Low back pain and hypotension
CORRECT ANSWER: D. Low back pain and hypotension
Rationale: Low back pain, hypotension, and fever are classic signs of an
acute hemolytic transfusion reaction due to ABO incompatibility.
Question 7: A client has a chest tube connected to a water-seal
drainage system. Which finding requires immediate intervention?
A. Tidaling in the water-seal chamber
B. Continuous bubbling in the water-seal chamber
C. Intermittent bubbling in the suction control chamber
D. 50 mL of serosanguineous drainage in 1 hour
CORRECT ANSWER: B. Continuous bubbling in the water-seal chamber
Rationale: Continuous bubbling in the water-seal chamber indicates an air
leak in the system, which requires immediate troubleshooting. Tidaling is
an expected finding.
Question 8: Which diet should a nurse recommend for a client with
diverticulitis during an acute flare-up?
A. High-fiber diet
B. Low-protein diet
C. Clear liquid diet
D. High-fat diet
CORRECT ANSWER: C. Clear liquid diet
Rationale: During an acute flare-up of diverticulitis, the bowel needs rest. A
clear liquid diet is initially prescribed, followed by low fiber until
inflammation subsides.
Question 9: A client with an acute myocardial infarction is receiving
alteplase. Which of the following findings indicates a potential
complication of this therapy?
A. Blood pressure 110/70 mm Hg
B. Heart rate 88/min
, C. Oozing from IV site
D. Urine output 40 mL/hr
CORRECT ANSWER: C. Oozing from IV site
Rationale: Alteplase is a thrombolytic agent that dissolves clots and can
cause bleeding. Oozing from puncture sites is an early sign of hemorrhage,
a major complication of thrombolytic therapy.
Question 10: A nurse is assessing a client with a diagnosis of
rheumatoid arthritis. Which of the following nonpharmacological
interventions should the nurse suggest to the client to reduce pain?
A. Increase intake of foods containing calcium
B. Alternate application of heat and cold to the affected joints
C. Keep the affected extremities elevated
D. Limit movement of the affected joints
CORRECT ANSWER: B. Alternate application of heat and cold to the
affected joints
Rationale: The nurse should instruct the client to alternate heat and cold
applications to decrease joint inflammation and pain. The application of
cold can relieve joint swelling and the application of heat can decrease
joint stiffness and pain.
Question 11: A nurse is caring for a client who is receiving a blood
transfusion. The client becomes restless, dyspneic, and has crackles
noted to the lung bases. Which of the following actions should the
nurse anticipate taking?
A. Administer an antihistamine
B. Slow the infusion rate
C. Give the client a corticosteroid
D. Elevate the client's lower extremities
CORRECT ANSWER: B. Slow the infusion rate
Rationale: Dyspnea, restlessness, and the onset of crackles during a blood
transfusion are manifestations of circulatory overload. The nurse should
slow or stop the infusion to improve the client's ability to breathe, place the
client in an upright position, and notify the provider.
Style Practice Questions & Answers, ATI RN Adult Medical-Surgical
Nursing Content Mastery Review, Cardiovascular Disorders, Respiratory
Diseases, Neurological Conditions, Fluid and Electrolyte Imbalances, Acid-
Base Balance, Renal and Urinary Disorders, Endocrine Conditions,
Gastrointestinal Disorders, Hematology, Infection Control, Immune
Disorders, Musculoskeletal Conditions, Perioperative Nursing,
Pharmacology, Clinical Judgment & Detailed Rationales
Question 1: 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 prosthesis?
A. Keep the client's hips flexed at 110 degrees when sitting.
B. Encourage the client to cross their legs at the knees.
C. Place an abduction pillow between the client's legs.
D. Instruct the client to rotate the affected leg internally.
CORRECT ANSWER: C. Place an abduction pillow between the client's
legs.
Rationale: An abduction pillow helps maintain the hip in a neutral position
and prevents the legs from crossing, which reduces the risk of dislocation
after a total hip arthroplasty. Flexion beyond 90 degrees and internal
rotation are contraindicated.
Question 2: A client with diabetes insipidus is being treated with
desmopressin. Which finding indicates the medication is effective?
A. Increased thirst
B. Decreased urine output
C. Weight loss
D. Decreased urine specific gravity
CORRECT ANSWER: B. Decreased urine output
Rationale: Diabetes insipidus is characterized by excessive dilute urine.
Desmopressin is an antidiuretic hormone that increases water
reabsorption, leading to decreased urine output and increased urine
concentration.
,Question 3: Which of the following interventions should a nurse
implement for a client experiencing a sickle cell crisis?
A. Apply cold compresses to painful joints.
B. Restrict fluid intake to 1 liter per day.
C. Administer high-flow oxygen and IV fluids.
D. Encourage active range-of-motion exercises.
CORRECT ANSWER: C. Administer high-flow oxygen and IV fluids.
Rationale: Hydration and oxygenation are priorities during a sickle cell
crisis to reduce sickling of red blood cells and improve tissue perfusion.
Cold compresses can worsen vaso-occlusion.
Question 4: A nurse is reviewing the lab results of a client with chronic
kidney disease. Which of the following findings should the nurse
expect?
A. Hypokalemia
B. Hypercalcemia
C. Elevated serum creatinine
D. Hypophosphatemia
CORRECT ANSWER: C. Elevated serum creatinine
Rationale: In CKD, the kidneys are unable to filter waste products
effectively, leading to elevated creatinine and BUN levels, as well as
hyperkalemia and hyperphosphatemia.
Question 5: A client is admitted with suspected appendicitis. Where
should the nurse expect the client to report the most intense pain?
A. Right lower quadrant
B. Right upper quadrant
C. Left lower quadrant
D. Left upper quadrant
CORRECT ANSWER: A. Right lower quadrant
Rationale: Pain from appendicitis typically localizes in the right lower
quadrant at McBurney's point.
Question 6: A nurse is monitoring a client receiving a blood transfusion.
Which of the following symptoms indicates a hemolytic reaction?
,A. Bradycardia
B. Urticaria and itching
C. Distended neck veins
D. Low back pain and hypotension
CORRECT ANSWER: D. Low back pain and hypotension
Rationale: Low back pain, hypotension, and fever are classic signs of an
acute hemolytic transfusion reaction due to ABO incompatibility.
Question 7: A client has a chest tube connected to a water-seal
drainage system. Which finding requires immediate intervention?
A. Tidaling in the water-seal chamber
B. Continuous bubbling in the water-seal chamber
C. Intermittent bubbling in the suction control chamber
D. 50 mL of serosanguineous drainage in 1 hour
CORRECT ANSWER: B. Continuous bubbling in the water-seal chamber
Rationale: Continuous bubbling in the water-seal chamber indicates an air
leak in the system, which requires immediate troubleshooting. Tidaling is
an expected finding.
Question 8: Which diet should a nurse recommend for a client with
diverticulitis during an acute flare-up?
A. High-fiber diet
B. Low-protein diet
C. Clear liquid diet
D. High-fat diet
CORRECT ANSWER: C. Clear liquid diet
Rationale: During an acute flare-up of diverticulitis, the bowel needs rest. A
clear liquid diet is initially prescribed, followed by low fiber until
inflammation subsides.
Question 9: A client with an acute myocardial infarction is receiving
alteplase. Which of the following findings indicates a potential
complication of this therapy?
A. Blood pressure 110/70 mm Hg
B. Heart rate 88/min
, C. Oozing from IV site
D. Urine output 40 mL/hr
CORRECT ANSWER: C. Oozing from IV site
Rationale: Alteplase is a thrombolytic agent that dissolves clots and can
cause bleeding. Oozing from puncture sites is an early sign of hemorrhage,
a major complication of thrombolytic therapy.
Question 10: A nurse is assessing a client with a diagnosis of
rheumatoid arthritis. Which of the following nonpharmacological
interventions should the nurse suggest to the client to reduce pain?
A. Increase intake of foods containing calcium
B. Alternate application of heat and cold to the affected joints
C. Keep the affected extremities elevated
D. Limit movement of the affected joints
CORRECT ANSWER: B. Alternate application of heat and cold to the
affected joints
Rationale: The nurse should instruct the client to alternate heat and cold
applications to decrease joint inflammation and pain. The application of
cold can relieve joint swelling and the application of heat can decrease
joint stiffness and pain.
Question 11: A nurse is caring for a client who is receiving a blood
transfusion. The client becomes restless, dyspneic, and has crackles
noted to the lung bases. Which of the following actions should the
nurse anticipate taking?
A. Administer an antihistamine
B. Slow the infusion rate
C. Give the client a corticosteroid
D. Elevate the client's lower extremities
CORRECT ANSWER: B. Slow the infusion rate
Rationale: Dyspnea, restlessness, and the onset of crackles during a blood
transfusion are manifestations of circulatory overload. The nurse should
slow or stop the infusion to improve the client's ability to breathe, place the
client in an upright position, and notify the provider.
