ATI Adult Medical-Surgical NEWEST
EVALUATED ACTUAL EXAM
PRACTICE 170 QUESTIONS 2026
2027|ORIGINAL QUESTIONS &
ANSWERS |DETAILED
RATIONALES |HINTED
COMPLETE EXAM PREP GRADED
A+*INSTANT DOWNLOAD PDF*
1. A nurse is caring for a client who has acute pulmonary edema and is experiencing severe
dyspnea. Which action should the nurse take first?
A. Administer prescribed IV furosemide
B. Place the client in high-Fowler's position
C. Obtain a daily body weight
D. Restrict the client's oral fluid intake
Answer: B. Place the client in high-Fowler's position
High-Fowler's positioning promotes maximum lung expansion and decreases venous return,
helping improve oxygenation and reduce the workload of the heart.
2. A client with heart failure is receiving digoxin. Which finding should the nurse identify
as a possible indication of digoxin toxicity?
A. Blood pressure of 138/84 mm Hg
B. Heart rate of 88/min
C. Yellow-green visual disturbances
D. Respiratory rate of 20/min
Answer: C. Yellow-green visual disturbances
Visual disturbances, nausea, vomiting, anorexia, and dysrhythmias are manifestations of digoxin
toxicity. The nurse should withhold the medication and notify the provider when toxicity is
suspected.
, 3. A nurse is assessing a client who has COPD. Which finding requires immediate
intervention?
A. Barrel-shaped chest
B. Productive cough
C. Oxygen saturation of 86%
D. Increased anterior-posterior chest diameter
Answer: C. Oxygen saturation of 86%
An oxygen saturation of 86% indicates significant hypoxemia and requires prompt intervention.
The nurse should assess the client's respiratory status and provide oxygen as prescribed.
4. A client with diabetic ketoacidosis has a serum potassium level of 3.0 mEq/L. Which
prescription should the nurse question?
A. Begin IV fluid replacement
B. Administer IV regular insulin
C. Monitor cardiac rhythm continuously
D. Administer potassium replacement
Answer: B. Administer IV regular insulin
Insulin shifts potassium into cells and can cause a dangerous further decrease in serum
potassium. Severe hypokalemia should be corrected before insulin therapy is initiated.
5. A client develops sudden facial drooping, right-sided weakness, and difficulty speaking.
Which action should the nurse take first?
A. Give the client oral fluids
B. Determine the time the symptoms began
C. Place the client in a supine position
D. Administer prescribed antihypertensive medication
Answer: B. Determine the time the symptoms began
The time of symptom onset is critical when evaluating a possible ischemic stroke because
eligibility for time-sensitive reperfusion therapy depends on when symptoms began.
6. A nurse is caring for a client who has increased intracranial pressure. Which intervention
should the nurse implement?
A. Keep the neck flexed
B. Position the client flat
C. Maintain the head in a midline position
D. Encourage frequent coughing
,Answer: C. Maintain the head in a midline position
Maintaining the head and neck in a neutral midline position promotes venous drainage from the
brain and can help reduce intracranial pressure.
7. A client with chronic kidney disease has a potassium level of 6.2 mEq/L. Which finding
should the nurse anticipate?
A. Flattened T waves
B. Peaked T waves
C. Increased QT interval
D. Prominent U waves
Answer: B. Peaked T waves
Hyperkalemia commonly causes tall, peaked T waves and can progress to conduction
abnormalities and life-threatening dysrhythmias.
8. A nurse is caring for a client who has SIADH. Which finding should the nurse expect?
A. Serum sodium of 124 mEq/L
B. Increased urine output
C. Severe hypernatremia
D. Excessive thirst with dilute urine
Answer: A. Serum sodium of 124 mEq/L
SIADH causes excessive water retention, producing dilutional hyponatremia and concentrated
urine.
9. A client receiving a blood transfusion reports chills, fever, and low back pain. What is the
nurse's priority action?
A. Slow the transfusion
B. Stop the transfusion
C. Administer acetaminophen
D. Obtain another unit of blood
Answer: B. Stop the transfusion
Fever, chills, and back pain can indicate an acute hemolytic transfusion reaction. The transfusion
must be stopped immediately.
10. A client with a chest tube suddenly has continuous bubbling in the water-seal chamber.
Which action should the nurse take?
, A. Clamp the chest tube
B. Increase wall suction
C. Assess the system for an air leak
D. Remove the chest tube
Answer: C. Assess the system for an air leak
Continuous bubbling in the water-seal chamber can indicate an air leak. The nurse should inspect
the tubing, connections, and insertion site.
11. A client with Addison's disease is experiencing weakness, hypotension, and vomiting.
Which laboratory finding should the nurse expect?
A. Hypernatremia
B. Hypokalemia
C. Hyperkalemia
D. Hyperglycemia
Answer: C. Hyperkalemia
Decreased aldosterone secretion in Addison's disease causes sodium loss and potassium
retention, resulting in hyponatremia and hyperkalemia.
12. A client is admitted with a suspected myocardial infarction. Which laboratory test is most
specific for myocardial injury?
A. Serum potassium
B. Troponin
C. D-dimer
D. C-reactive protein
Answer: B. Troponin
Cardiac troponins are highly specific biomarkers of myocardial injury and are commonly used
when acute coronary syndrome is suspected.
13. A client with atrial fibrillation is prescribed warfarin. Which laboratory test should the
nurse monitor?
A. aPTT
B. INR
C. Serum sodium
D. Platelet aggregation time
Answer: B. INR
EVALUATED ACTUAL EXAM
PRACTICE 170 QUESTIONS 2026
2027|ORIGINAL QUESTIONS &
ANSWERS |DETAILED
RATIONALES |HINTED
COMPLETE EXAM PREP GRADED
A+*INSTANT DOWNLOAD PDF*
1. A nurse is caring for a client who has acute pulmonary edema and is experiencing severe
dyspnea. Which action should the nurse take first?
A. Administer prescribed IV furosemide
B. Place the client in high-Fowler's position
C. Obtain a daily body weight
D. Restrict the client's oral fluid intake
Answer: B. Place the client in high-Fowler's position
High-Fowler's positioning promotes maximum lung expansion and decreases venous return,
helping improve oxygenation and reduce the workload of the heart.
2. A client with heart failure is receiving digoxin. Which finding should the nurse identify
as a possible indication of digoxin toxicity?
A. Blood pressure of 138/84 mm Hg
B. Heart rate of 88/min
C. Yellow-green visual disturbances
D. Respiratory rate of 20/min
Answer: C. Yellow-green visual disturbances
Visual disturbances, nausea, vomiting, anorexia, and dysrhythmias are manifestations of digoxin
toxicity. The nurse should withhold the medication and notify the provider when toxicity is
suspected.
, 3. A nurse is assessing a client who has COPD. Which finding requires immediate
intervention?
A. Barrel-shaped chest
B. Productive cough
C. Oxygen saturation of 86%
D. Increased anterior-posterior chest diameter
Answer: C. Oxygen saturation of 86%
An oxygen saturation of 86% indicates significant hypoxemia and requires prompt intervention.
The nurse should assess the client's respiratory status and provide oxygen as prescribed.
4. A client with diabetic ketoacidosis has a serum potassium level of 3.0 mEq/L. Which
prescription should the nurse question?
A. Begin IV fluid replacement
B. Administer IV regular insulin
C. Monitor cardiac rhythm continuously
D. Administer potassium replacement
Answer: B. Administer IV regular insulin
Insulin shifts potassium into cells and can cause a dangerous further decrease in serum
potassium. Severe hypokalemia should be corrected before insulin therapy is initiated.
5. A client develops sudden facial drooping, right-sided weakness, and difficulty speaking.
Which action should the nurse take first?
A. Give the client oral fluids
B. Determine the time the symptoms began
C. Place the client in a supine position
D. Administer prescribed antihypertensive medication
Answer: B. Determine the time the symptoms began
The time of symptom onset is critical when evaluating a possible ischemic stroke because
eligibility for time-sensitive reperfusion therapy depends on when symptoms began.
6. A nurse is caring for a client who has increased intracranial pressure. Which intervention
should the nurse implement?
A. Keep the neck flexed
B. Position the client flat
C. Maintain the head in a midline position
D. Encourage frequent coughing
,Answer: C. Maintain the head in a midline position
Maintaining the head and neck in a neutral midline position promotes venous drainage from the
brain and can help reduce intracranial pressure.
7. A client with chronic kidney disease has a potassium level of 6.2 mEq/L. Which finding
should the nurse anticipate?
A. Flattened T waves
B. Peaked T waves
C. Increased QT interval
D. Prominent U waves
Answer: B. Peaked T waves
Hyperkalemia commonly causes tall, peaked T waves and can progress to conduction
abnormalities and life-threatening dysrhythmias.
8. A nurse is caring for a client who has SIADH. Which finding should the nurse expect?
A. Serum sodium of 124 mEq/L
B. Increased urine output
C. Severe hypernatremia
D. Excessive thirst with dilute urine
Answer: A. Serum sodium of 124 mEq/L
SIADH causes excessive water retention, producing dilutional hyponatremia and concentrated
urine.
9. A client receiving a blood transfusion reports chills, fever, and low back pain. What is the
nurse's priority action?
A. Slow the transfusion
B. Stop the transfusion
C. Administer acetaminophen
D. Obtain another unit of blood
Answer: B. Stop the transfusion
Fever, chills, and back pain can indicate an acute hemolytic transfusion reaction. The transfusion
must be stopped immediately.
10. A client with a chest tube suddenly has continuous bubbling in the water-seal chamber.
Which action should the nurse take?
, A. Clamp the chest tube
B. Increase wall suction
C. Assess the system for an air leak
D. Remove the chest tube
Answer: C. Assess the system for an air leak
Continuous bubbling in the water-seal chamber can indicate an air leak. The nurse should inspect
the tubing, connections, and insertion site.
11. A client with Addison's disease is experiencing weakness, hypotension, and vomiting.
Which laboratory finding should the nurse expect?
A. Hypernatremia
B. Hypokalemia
C. Hyperkalemia
D. Hyperglycemia
Answer: C. Hyperkalemia
Decreased aldosterone secretion in Addison's disease causes sodium loss and potassium
retention, resulting in hyponatremia and hyperkalemia.
12. A client is admitted with a suspected myocardial infarction. Which laboratory test is most
specific for myocardial injury?
A. Serum potassium
B. Troponin
C. D-dimer
D. C-reactive protein
Answer: B. Troponin
Cardiac troponins are highly specific biomarkers of myocardial injury and are commonly used
when acute coronary syndrome is suspected.
13. A client with atrial fibrillation is prescribed warfarin. Which laboratory test should the
nurse monitor?
A. aPTT
B. INR
C. Serum sodium
D. Platelet aggregation time
Answer: B. INR
