RN ATI Adult Medical-Surgical Proctored Practice Exam with correct
answers and rationales 2026/2027 exam
1. A nurse is caring for a client admitted with acute myocardial infarction. Which
assessment finding requires immediate intervention?
A. Heart rate 88 beats/minute
B. Blood pressure 138/84 mmHg
C. Chest pain rated 8/10 despite nitroglycerin administration
D. Temperature 99.0°F (37.2°C)
Correct Answer: C. Chest pain rated 8/10 despite nitroglycerin administration
Rationale: Persistent chest pain after nitroglycerin may indicate ongoing myocardial ischemia.
The nurse should immediately reassess the client, obtain vital signs, perform a 12-lead ECG if
indicated, and notify the provider or activate the facility's acute coronary syndrome protocol.
2. A client with chronic obstructive pulmonary disease (COPD) suddenly becomes restless
and confused. What is the nurse's priority action?
A. Administer a sedative.
B. Assess oxygen saturation.
C. Encourage oral fluids.
D. Place the client in the supine position.
Correct Answer: B. Assess oxygen saturation.
Rationale: Restlessness and confusion are early signs of hypoxemia. The nurse should first assess
oxygenation and respiratory status before implementing additional interventions.
3. Which client should the nurse assess first?
A. A client reporting pain rated 6/10 after surgery.
B. A client with a blood glucose level of 48 mg/dL.
,C. A client requesting assistance to the bathroom.
D. A client awaiting discharge instructions.
Correct Answer: B. A client with a blood glucose level of 48 mg/dL.
Rationale: Severe hypoglycemia can rapidly progress to seizures, coma, or death. It is the highest
priority.
4. A client with heart failure has gained 5 lb (2.3 kg) in 48 hours. What should the nurse
suspect?
A. Improved cardiac output
B. Fluid volume overload
C. Dehydration
D. Medication compliance
Correct Answer: B. Fluid volume overload
Rationale: Rapid weight gain in a client with heart failure indicates fluid retention and worsening
heart failure.
5. A nurse is caring for a client receiving IV heparin. Which laboratory value should be
monitored to evaluate the effectiveness of therapy?
A. INR
B. PT
C. aPTT
D. Hemoglobin A1c
Correct Answer: C. aPTT
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor unfractionated
heparin therapy and guide dosage adjustments.
, 6. Which finding is expected in a client experiencing left-sided heart failure?
A. Peripheral edema
B. Jugular venous distention
C. Pulmonary crackles
D. Ascites
Correct Answer: C. Pulmonary crackles
Rationale: Left-sided heart failure causes pulmonary congestion, leading to crackles, dyspnea,
orthopnea, and reduced oxygenation.
7. A nurse is teaching a client prescribed warfarin. Which statement by the client indicates
understanding?
A. "I will take aspirin for headaches."
B. "I will keep my intake of vitamin K-containing foods consistent."
C. "I will stop taking warfarin when I feel better."
D. "I don't need blood tests while taking this medication."
Correct Answer: B. "I will keep my intake of vitamin K-containing foods consistent."
Rationale: Consistent vitamin K intake helps maintain stable anticoagulation. Clients should also
have regular INR monitoring.
8. A postoperative client suddenly reports shortness of breath and chest pain. Which
complication should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Pneumonia
D. Pleural effusion
answers and rationales 2026/2027 exam
1. A nurse is caring for a client admitted with acute myocardial infarction. Which
assessment finding requires immediate intervention?
A. Heart rate 88 beats/minute
B. Blood pressure 138/84 mmHg
C. Chest pain rated 8/10 despite nitroglycerin administration
D. Temperature 99.0°F (37.2°C)
Correct Answer: C. Chest pain rated 8/10 despite nitroglycerin administration
Rationale: Persistent chest pain after nitroglycerin may indicate ongoing myocardial ischemia.
The nurse should immediately reassess the client, obtain vital signs, perform a 12-lead ECG if
indicated, and notify the provider or activate the facility's acute coronary syndrome protocol.
2. A client with chronic obstructive pulmonary disease (COPD) suddenly becomes restless
and confused. What is the nurse's priority action?
A. Administer a sedative.
B. Assess oxygen saturation.
C. Encourage oral fluids.
D. Place the client in the supine position.
Correct Answer: B. Assess oxygen saturation.
Rationale: Restlessness and confusion are early signs of hypoxemia. The nurse should first assess
oxygenation and respiratory status before implementing additional interventions.
3. Which client should the nurse assess first?
A. A client reporting pain rated 6/10 after surgery.
B. A client with a blood glucose level of 48 mg/dL.
,C. A client requesting assistance to the bathroom.
D. A client awaiting discharge instructions.
Correct Answer: B. A client with a blood glucose level of 48 mg/dL.
Rationale: Severe hypoglycemia can rapidly progress to seizures, coma, or death. It is the highest
priority.
4. A client with heart failure has gained 5 lb (2.3 kg) in 48 hours. What should the nurse
suspect?
A. Improved cardiac output
B. Fluid volume overload
C. Dehydration
D. Medication compliance
Correct Answer: B. Fluid volume overload
Rationale: Rapid weight gain in a client with heart failure indicates fluid retention and worsening
heart failure.
5. A nurse is caring for a client receiving IV heparin. Which laboratory value should be
monitored to evaluate the effectiveness of therapy?
A. INR
B. PT
C. aPTT
D. Hemoglobin A1c
Correct Answer: C. aPTT
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor unfractionated
heparin therapy and guide dosage adjustments.
, 6. Which finding is expected in a client experiencing left-sided heart failure?
A. Peripheral edema
B. Jugular venous distention
C. Pulmonary crackles
D. Ascites
Correct Answer: C. Pulmonary crackles
Rationale: Left-sided heart failure causes pulmonary congestion, leading to crackles, dyspnea,
orthopnea, and reduced oxygenation.
7. A nurse is teaching a client prescribed warfarin. Which statement by the client indicates
understanding?
A. "I will take aspirin for headaches."
B. "I will keep my intake of vitamin K-containing foods consistent."
C. "I will stop taking warfarin when I feel better."
D. "I don't need blood tests while taking this medication."
Correct Answer: B. "I will keep my intake of vitamin K-containing foods consistent."
Rationale: Consistent vitamin K intake helps maintain stable anticoagulation. Clients should also
have regular INR monitoring.
8. A postoperative client suddenly reports shortness of breath and chest pain. Which
complication should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Pneumonia
D. Pleural effusion
