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ATI Med-Surg Final Exam Study Guide | Updated Practice Questions & Rationales A+ 2025–2026

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This ATI Med-Surg Final Exam Study Guide is fully updated for 2025–2026 and designed to strengthen nursing students’ understanding of key medical-surgical concepts. Includes high-yield practice questions with detailed rationales to reinforce critical thinking and clinical reasoning. Perfect for students seeking a structured, ethical approach to exam preparation and confident test performance.

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ATI Med Surge Final Exam Questions Correct
Answers with Rationales Rated A+ TESTBANK
1. A client with COPD has O₂ saturation of 88% on room air. Nurse should:

A. Administer high-flow O₂ at 10 L/min
B. Assess respiratory status
C. Encourage deep breathing only
D. Notify provider in 1 hour

Rationale:
COPD patients are sensitive to high O₂; assessment comes first to guide intervention.



2. Post-op client HR 128, BP 88/54. First action:

A. Encourage ambulation
B. Administer PRN pain med
C. Assess for bleeding
D. Notify provider later

Rationale:
Tachycardia + hypotension = possible hemorrhage; rapid assessment is priority.



3. Task delegable to UAP:

A. Administer insulin
B. Measure and record vitals
C. Assess lung sounds
D. Evaluate IV site

Rationale:
UAPs collect routine data, not perform assessments or med administration.



4. Client with DKA, lethargic, K+ 3.1:

A. Start insulin immediately
B. Hold fluids, call provider



2026 2027 GRADED A+

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C. Administer potassium replacement
D. Give oral glucose

Rationale:
Hypokalemia must be corrected before insulin to prevent cardiac arrest.



5. Lab indicating infection:

A. WBC 12,500
B. Hgb 13
C. Platelets 250k
D. Sodium 138

Rationale:
Elevated WBC indicates possible infection.



6. Priority for chest pain, diaphoresis, ST elevation:

A. Give pain med
B. Obtain ECG
C. Encourage rest
D. Apply heating pad

Rationale:
Immediate ECG is required to diagnose MI and initiate treatment.



7. Client on heparin, platelets 50k:

A. Continue infusion
B. Hold med and notify provider
C. Administer aspirin
D. Encourage ambulation

Rationale:
Thrombocytopenia is a serious heparin adverse effect.




2026 2027 GRADED A+

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8. High fall risk client:

A. 25 yo post-appendectomy
B. 78 yo on diuretics, confused
C. 35 yo on antibiotics
D. 50 yo with hypertension

Rationale:
Elderly + diuretics + confusion = high fall risk.



9. Hyperkalemia 6.5, palpitations:

A. Administer IV glucose
B. Place on cardiac monitor
C. Call provider tomorrow
D. Encourage oral fluids

Rationale:
Hyperkalemia = life-threatening dysrhythmias; monitor immediately.



10. Patient-centered care example:

A. Teach self-administer insulin
B. Schedule labs without explanation
C. Decide treatment for patient
D. Ignore concerns

Rationale:
Patient-centered care teaches and empowers patients.



11. ABG pH 7.32, CO₂ 52, HCO₃ 24:

A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis

Rationale:
Low pH + high CO₂ = respiratory acidosis.



2026 2027 GRADED A+

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12. Client with heart failure, SOB, edema, 4 lb gain in 2 days:

A. Fluid deficit
B. Fluid overload
C. Normal weight
D. Improved cardiac function

Rationale:
Rapid weight gain signals fluid retention.



13. Client with hypoglycemia (glucose 48), confused, diaphoretic:

A. Administer insulin
B. Give 15 g fast-acting carb
C. Start IV antibiotics
D. Notify provider

Rationale:
Immediate glucose replacement is first priority.



14. Post-op client with calf pain, swelling:

A. Massage leg
B. Encourage ambulation
C. Notify provider immediately
D. Apply heat

Rationale:
Signs of DVT → risk for pulmonary embolism.



15. Client with AKI has K+ 6.2. Nurse should:

A. Administer potassium-sparing diuretic
B. Prepare for dialysis
C. Restrict fluids only
D. Encourage high K+ foods

Rationale:
Severe hyperkalemia in AKI may require dialysis.


2026 2027 GRADED A+

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