ATI RN Med Surg Proctored / RN Med Surg 2026
Proctored RN Exam New Latest Version With All
Questions And Correct Answers With Rationale |
Medical-Surgical Nursing Assessment
Q001: A 68-year-old with STEMI receives tenecteplase; 45 minutes later he reports
sudden severe flank pain and BP drops from 140/80 to 80/50 mmHg. What is the
priority nursing action?
Options:
A. Administer morphine 4 mg IV
B. Increase normal saline to 200 mL/h
C. Stop the thrombolytic infusion and call the provider
D. Obtain 12-lead ECG
(Correct Answer: C)
Q002: A 72-year-old with decompensated HF on dobutamine 5 mcg/kg/min develops
new-onset frequent multifocal PVCs. Which intervention is most appropriate?
Options:
A. Increase dobutamine to 8 mcg/kg/min
B. Administer amiodarone 150 mg IV over 10 min
C. Stop dobutamine and notify provider
D. Give metoprolol 5 mg IV push
(Correct Answer: C)
Q003: A 55-year-old with COPD on 4 L O₂ nasal cannula has ABG: pH 7.28, PaCO₂ 78
mmHg, PaO₂ 58 mmHg, HCO₃ 38 mEq/L. What is the priority action?
Options:
A. Increase O₂ to 6 L/min
B. Initiate non-invasive ventilation (BiPAP)
C. Administer naloxone
D. Draw stat magnesium level
(Correct Answer: B)
,Q004: A 60-year-old with CKD stage 4 receives epoetin alfa 4000 units subcut three
times weekly. Which lab trend best indicates therapeutic response?
Options:
A. Hemoglobin rise 1–2 g/dL over 4 weeks
B. Creatinine decrease 0.5 mg/dL
C. Ferritin increase to 800 ng/mL
D. Potassium decrease 0.5 mEq/L
(Correct Answer: A)
Q005: A 30-year-old with DKA has K⁺ 2.8 mEq/L on admission. Before starting insulin
infusion, what should the nurse do?
Options:
A. Begin 0.9% saline at 500 mL/h
B. Give KCl 40 mEq IV over 2 h
C. Start insulin at 0.1 units/kg/h now
D. Administer sodium bicarbonate 1 amp
(Correct Answer: B)
Q006: A 45-year-old with hepatic encephalopathy on lactulose 30 mL q8h has three soft
stools daily. Which finding indicates adequate dosing?
Options:
A. AST 55 U/L
B. Ammonia level 45 µmol/L
C. INR 1.6
D. Bilirubin 2.0 mg/dL
(Correct Answer: B)
Q007: A 25-year-old with asthma receives magnesium sulfate 2 g IV over 20 min. Which
adverse effect requires immediate intervention?
Options:
A. Heart rate 105 bpm
B. Respiratory rate 8/min and loss of DTRs
C. Temperature 37.8 °C
D. Oxygen saturation 94%
(Correct Answer: B)
Q008: A 70-year-old with pulmonary embolus on heparin has aPTT 92 sec (control 30
sec) and no bleeding. What is the priority action?
, Options:
A. Continue current rate
B. Decrease rate by 50% and repeat aPTT in 6 h
C. Switch to enoxaparin
D. Give protamine sulfate 10 mg IV
(Correct Answer: B)
Q009: A 38-week pregnant client reports painless bright red vaginal bleeding. Which
action should the nurse take first?
Options:
A. Perform sterile vaginal exam
B. Apply external fetal monitor
C. Start 18-gauge IV line
D. Check BP, HR, and fetal heart tones
(Correct Answer: D)
Q010: A 50-year-old with acute pancreatitis has pain 9/10 and BP 88/50 mmHg. Which
IV fluid order is most appropriate initially?
Options:
A. 0.45% saline at 100 mL/h
B. Lactated Ringer's 30 mL/kg bolus
C. D5W at 125 mL/h
D. 0.9% saline 500 mL over 30 min
(Correct Answer: B)
Q011: A 65-year-old post-TURP has continuous bladder irrigation. The output becomes
bright red and clots are visible. What is the priority action?
Options:
A. Increase irrigation rate to 500 mL/h
B. Stop irrigation and call provider
C. Milk the catheter and check vital signs
D. Give desmopressin 2 µg IV
(Correct Answer: C)
Q012: A 20-year-old with type 1 DM presents with glucose 38 mg/dL and is conscious.
Which instruction should the nurse give?
Options:
A. Drink 4 oz apple juice and recheck in 15 min
Proctored RN Exam New Latest Version With All
Questions And Correct Answers With Rationale |
Medical-Surgical Nursing Assessment
Q001: A 68-year-old with STEMI receives tenecteplase; 45 minutes later he reports
sudden severe flank pain and BP drops from 140/80 to 80/50 mmHg. What is the
priority nursing action?
Options:
A. Administer morphine 4 mg IV
B. Increase normal saline to 200 mL/h
C. Stop the thrombolytic infusion and call the provider
D. Obtain 12-lead ECG
(Correct Answer: C)
Q002: A 72-year-old with decompensated HF on dobutamine 5 mcg/kg/min develops
new-onset frequent multifocal PVCs. Which intervention is most appropriate?
Options:
A. Increase dobutamine to 8 mcg/kg/min
B. Administer amiodarone 150 mg IV over 10 min
C. Stop dobutamine and notify provider
D. Give metoprolol 5 mg IV push
(Correct Answer: C)
Q003: A 55-year-old with COPD on 4 L O₂ nasal cannula has ABG: pH 7.28, PaCO₂ 78
mmHg, PaO₂ 58 mmHg, HCO₃ 38 mEq/L. What is the priority action?
Options:
A. Increase O₂ to 6 L/min
B. Initiate non-invasive ventilation (BiPAP)
C. Administer naloxone
D. Draw stat magnesium level
(Correct Answer: B)
,Q004: A 60-year-old with CKD stage 4 receives epoetin alfa 4000 units subcut three
times weekly. Which lab trend best indicates therapeutic response?
Options:
A. Hemoglobin rise 1–2 g/dL over 4 weeks
B. Creatinine decrease 0.5 mg/dL
C. Ferritin increase to 800 ng/mL
D. Potassium decrease 0.5 mEq/L
(Correct Answer: A)
Q005: A 30-year-old with DKA has K⁺ 2.8 mEq/L on admission. Before starting insulin
infusion, what should the nurse do?
Options:
A. Begin 0.9% saline at 500 mL/h
B. Give KCl 40 mEq IV over 2 h
C. Start insulin at 0.1 units/kg/h now
D. Administer sodium bicarbonate 1 amp
(Correct Answer: B)
Q006: A 45-year-old with hepatic encephalopathy on lactulose 30 mL q8h has three soft
stools daily. Which finding indicates adequate dosing?
Options:
A. AST 55 U/L
B. Ammonia level 45 µmol/L
C. INR 1.6
D. Bilirubin 2.0 mg/dL
(Correct Answer: B)
Q007: A 25-year-old with asthma receives magnesium sulfate 2 g IV over 20 min. Which
adverse effect requires immediate intervention?
Options:
A. Heart rate 105 bpm
B. Respiratory rate 8/min and loss of DTRs
C. Temperature 37.8 °C
D. Oxygen saturation 94%
(Correct Answer: B)
Q008: A 70-year-old with pulmonary embolus on heparin has aPTT 92 sec (control 30
sec) and no bleeding. What is the priority action?
, Options:
A. Continue current rate
B. Decrease rate by 50% and repeat aPTT in 6 h
C. Switch to enoxaparin
D. Give protamine sulfate 10 mg IV
(Correct Answer: B)
Q009: A 38-week pregnant client reports painless bright red vaginal bleeding. Which
action should the nurse take first?
Options:
A. Perform sterile vaginal exam
B. Apply external fetal monitor
C. Start 18-gauge IV line
D. Check BP, HR, and fetal heart tones
(Correct Answer: D)
Q010: A 50-year-old with acute pancreatitis has pain 9/10 and BP 88/50 mmHg. Which
IV fluid order is most appropriate initially?
Options:
A. 0.45% saline at 100 mL/h
B. Lactated Ringer's 30 mL/kg bolus
C. D5W at 125 mL/h
D. 0.9% saline 500 mL over 30 min
(Correct Answer: B)
Q011: A 65-year-old post-TURP has continuous bladder irrigation. The output becomes
bright red and clots are visible. What is the priority action?
Options:
A. Increase irrigation rate to 500 mL/h
B. Stop irrigation and call provider
C. Milk the catheter and check vital signs
D. Give desmopressin 2 µg IV
(Correct Answer: C)
Q012: A 20-year-old with type 1 DM presents with glucose 38 mg/dL and is conscious.
Which instruction should the nurse give?
Options:
A. Drink 4 oz apple juice and recheck in 15 min
