ATI RN Med Surg Proctored / RN Med Surg 2026
Proctored RN Exam Actual New Latest Version With All
Questions And Correct Answers With Rationale |
Medical-Surgical Nursing Assessment
Q001: A 68-year-old male presents to the ED with crushing chest pain radiating to the
jaw, diaphoresis, and nausea. Vital signs: BP 88/52, HR 118, RR 28, SpO2 89% on
room air. The 12-lead ECG shows ST elevation in leads II, III, and aVF with reciprocal
changes. What is the priority nursing intervention?
Options:
A. Administer sublingual nitroglycerin 0.4 mg
B. Obtain a chest X-ray STAT
C. Initiate rapid sequence intubation
D. Activate the catheterization lab and prepare for immediate PCI
Answer: D
Q002: A 72-year-old female with a history of COPD is admitted with acute respiratory
distress. ABG results: pH 7.28, PaCO2 68 mmHg, PaO2 52 mmHg, HCO3- 32 mEq/L.
She is on 2L NC oxygen. What is the most appropriate action?
Options:
A. Increase oxygen to 4L NC
B. Initiate non-invasive positive pressure ventilation (BiPAP)
C. Administer nebulized bronchodilator treatment
D. Prepare for immediate intubation and mechanical ventilation
Answer: B
Q003: A 55-year-old male with end-stage renal disease on hemodialysis presents with
muscle weakness, paresthesia, and peaked T waves on ECG. Labs show K+ 6.8
mEq/L. What is the priority intervention?
Options:
A. Administer calcium gluconate IV
B. Give insulin 10 units IV with D50
,C. Initiate emergent hemodialysis
D. Administer sodium polystyrene sulfonate orally
Answer: A
Q004: A 32-year-old female with type 1 diabetes presents with Kussmaul respirations,
fruity breath, and glucose of 450 mg/dL. ABG shows pH 7.20, PaCO2 28, HCO3- 12.
What is the priority nursing action?
Options:
A. Start an insulin infusion at 0.1 units/kg/hr
B. Begin rapid infusion of 0.9% NS
C. Check serum potassium level immediately
D. Administer bicarbonate IV
Answer: B
Q005: A 78-year-old male with cirrhosis presents with massive hematemesis and
melena. BP is 70/40, HR 130. What is the priority intervention?
Options:
A. Insert a nasogastric tube for lavage
B. Initiate massive transfusion protocol
C. Administer vitamin K 10 mg IV
D. Start octreotide infusion
Answer: B
Q006: A 45-year-old female post-op day 2 after abdominal surgery reports sudden
chest pain and dyspnea. Vital signs: BP 90/60, HR 125, RR 32. She is receiving heparin
prophylaxis. What is the most likely diagnosis?
Options:
A. Myocardial infarction
B. Pulmonary embolism
C. Atelectasis
D. Pneumonia
Answer: B
, Q007: A 62-year-old male with a history of smoking presents with hemoptysis, weight
loss, and a new cough. Chest CT shows a 4cm spiculated mass in the right upper lobe.
What is the priority nursing intervention?
Options:
A. Prepare for immediate lobectomy
B. Obtain a sputum sample for cytology
C. Arrange for tissue biopsy via bronchoscopy
D. Start empiric antibiotics
Answer: C
Q008: A 38-year-old female with a history of IV drug use presents with fever, chills, and
a new holosystolic murmur. Blood cultures are positive for Staphylococcus aureus.
What complication should the nurse monitor for?
Options:
A. Acute kidney injury
B. Cerebral emboli
C. Acute respiratory distress syndrome
D. Disseminated intravascular coagulation
Answer: B
Q009: A 28-year-old male with a T6 spinal cord injury presents with severe headache,
flushing, and BP 220/120. He reports bladder distention. What is this condition?
Options:
A. Malignant hypertension
B. Autonomic dysreflexia
C. Spinal shock
D. Increased intracranial pressure
Answer: B
Q010: A 50-year-old female with rheumatoid arthritis on methotrexate presents with
fever, productive cough, and left lower lobe consolidation on chest X-ray. What is the
priority nursing consideration?
A. Hold methotrexate immediately
B. Obtain sputum culture before antibiotics
C. Place in protective isolation
D. Administer live attenuated influenza vaccine
Proctored RN Exam Actual New Latest Version With All
Questions And Correct Answers With Rationale |
Medical-Surgical Nursing Assessment
Q001: A 68-year-old male presents to the ED with crushing chest pain radiating to the
jaw, diaphoresis, and nausea. Vital signs: BP 88/52, HR 118, RR 28, SpO2 89% on
room air. The 12-lead ECG shows ST elevation in leads II, III, and aVF with reciprocal
changes. What is the priority nursing intervention?
Options:
A. Administer sublingual nitroglycerin 0.4 mg
B. Obtain a chest X-ray STAT
C. Initiate rapid sequence intubation
D. Activate the catheterization lab and prepare for immediate PCI
Answer: D
Q002: A 72-year-old female with a history of COPD is admitted with acute respiratory
distress. ABG results: pH 7.28, PaCO2 68 mmHg, PaO2 52 mmHg, HCO3- 32 mEq/L.
She is on 2L NC oxygen. What is the most appropriate action?
Options:
A. Increase oxygen to 4L NC
B. Initiate non-invasive positive pressure ventilation (BiPAP)
C. Administer nebulized bronchodilator treatment
D. Prepare for immediate intubation and mechanical ventilation
Answer: B
Q003: A 55-year-old male with end-stage renal disease on hemodialysis presents with
muscle weakness, paresthesia, and peaked T waves on ECG. Labs show K+ 6.8
mEq/L. What is the priority intervention?
Options:
A. Administer calcium gluconate IV
B. Give insulin 10 units IV with D50
,C. Initiate emergent hemodialysis
D. Administer sodium polystyrene sulfonate orally
Answer: A
Q004: A 32-year-old female with type 1 diabetes presents with Kussmaul respirations,
fruity breath, and glucose of 450 mg/dL. ABG shows pH 7.20, PaCO2 28, HCO3- 12.
What is the priority nursing action?
Options:
A. Start an insulin infusion at 0.1 units/kg/hr
B. Begin rapid infusion of 0.9% NS
C. Check serum potassium level immediately
D. Administer bicarbonate IV
Answer: B
Q005: A 78-year-old male with cirrhosis presents with massive hematemesis and
melena. BP is 70/40, HR 130. What is the priority intervention?
Options:
A. Insert a nasogastric tube for lavage
B. Initiate massive transfusion protocol
C. Administer vitamin K 10 mg IV
D. Start octreotide infusion
Answer: B
Q006: A 45-year-old female post-op day 2 after abdominal surgery reports sudden
chest pain and dyspnea. Vital signs: BP 90/60, HR 125, RR 32. She is receiving heparin
prophylaxis. What is the most likely diagnosis?
Options:
A. Myocardial infarction
B. Pulmonary embolism
C. Atelectasis
D. Pneumonia
Answer: B
, Q007: A 62-year-old male with a history of smoking presents with hemoptysis, weight
loss, and a new cough. Chest CT shows a 4cm spiculated mass in the right upper lobe.
What is the priority nursing intervention?
Options:
A. Prepare for immediate lobectomy
B. Obtain a sputum sample for cytology
C. Arrange for tissue biopsy via bronchoscopy
D. Start empiric antibiotics
Answer: C
Q008: A 38-year-old female with a history of IV drug use presents with fever, chills, and
a new holosystolic murmur. Blood cultures are positive for Staphylococcus aureus.
What complication should the nurse monitor for?
Options:
A. Acute kidney injury
B. Cerebral emboli
C. Acute respiratory distress syndrome
D. Disseminated intravascular coagulation
Answer: B
Q009: A 28-year-old male with a T6 spinal cord injury presents with severe headache,
flushing, and BP 220/120. He reports bladder distention. What is this condition?
Options:
A. Malignant hypertension
B. Autonomic dysreflexia
C. Spinal shock
D. Increased intracranial pressure
Answer: B
Q010: A 50-year-old female with rheumatoid arthritis on methotrexate presents with
fever, productive cough, and left lower lobe consolidation on chest X-ray. What is the
priority nursing consideration?
A. Hold methotrexate immediately
B. Obtain sputum culture before antibiotics
C. Place in protective isolation
D. Administer live attenuated influenza vaccine
