ATI PN Medical-Surgical Proctored
Final Exam Study Guide Actual
Questions and Answers | 2026/2027
Academic Year | A+ Grade Verified |
NCLEX-PN Style Exam Prep
DOMAIN 1: CARDIOVASCULAR DISORDERS (15-20%)
Anticoagulant Therapy
TableCopy
Medication Monitoring Key Teaching Points
Warfarin INR (therapeutic 2.0-3.0 for Avoid vitamin K-rich foods (spinach, kale,
(Coumadin) most conditions) broccoli); consistent intake if consumed
Enoxaparin Anti-factor Xa levels (rarely); Subcutaneous injection; do not massage;
(Lovenox) platelet count for HIT same time daily
Antidote: Protamine sulfate; monitor for
Heparin aPTT (1.5-2.5× baseline)
bleeding
Critical Lab Values:
● INR therapeutic range: 2.0-3.0 (2.5-3.5 for mechanical valves)
● aPTT therapeutic: 1.5-2.5 times control
, ● Platelet count: Monitor for heparin-induced thrombocytopenia (HIT)
Heart Failure Management
TableCopy
Assessment Intervention Rationale
Most accurate indicator of fluid status; gain of
Same scale, time,
Daily weight 2-3 lbs in 24 hrs or 3-5 lbs in week = fluid
clothing
retention
Dietary sodium Restrict to 2-3g/day Reduces fluid retention
Loop diuretics Monitor for
K⁺ wasting; may need supplementation
(furosemide) hypokalemia
Elevate HOB, oxygen
Orthopnea/DOE Left-sided failure symptoms
as needed
Peripheral Arterial Disease (PAD)
TableCopy
Symptom Cause Management
Intermittent Ischemia during Walk to point of pain daily to develop collateral
claudication activity circulation
, Gravity reduces
Pain with elevation Keep legs dependent when resting
blood flow
Rubor with
Reactive hyperemia Elevation pallor, dependency rubor
dependency
Cardiac Assessment
TableCopy
Finding Technique Significance
Murmur enhancement Left lateral decubitus position Better auscultation of mitral valve
Spike followed by QRS Ventricular depolarization
Pacemaker capture
complex confirmed
S3 gallop Heard at apex with bell Indicator of heart failure
DOMAIN 2: RESPIRATORY DISORDERS (15-20%)
Asthma Management
TableCopy
Phase Priority Intervention Medication
Acute attack Bronchodilation first Albuterol (short-acting β2-agonist)
, Long-term control Anti-inflammatory Inhaled corticosteroids (fluticasone)
Severe exacerbation Systemic steroids Prednisone (oral) or methylprednisolone (IV)
Emergency Management - Anaphylaxis:
● First action: Assess airway patency
● Medication: Epinephrine (EpiPen) - drug of choice
● Position: Supine with legs elevated (unless respiratory distress)
COPD Management
TableCopy
Priority Intervention Rationale
Avoid high-flow O₂ to maintain hypoxic
Oxygen therapy Maintain SpO2 88-92%
drive
Breathing Prolongs exhalation, prevents airway
Pursed-lip breathing
technique collapse
Improves lung expansion, secretion
Exercise Deep breathing exercises
clearance
Tripod position (leaning
Positioning Decreases work of breathing
forward)
Pulmonary Embolism (PE)
TableCopy
Final Exam Study Guide Actual
Questions and Answers | 2026/2027
Academic Year | A+ Grade Verified |
NCLEX-PN Style Exam Prep
DOMAIN 1: CARDIOVASCULAR DISORDERS (15-20%)
Anticoagulant Therapy
TableCopy
Medication Monitoring Key Teaching Points
Warfarin INR (therapeutic 2.0-3.0 for Avoid vitamin K-rich foods (spinach, kale,
(Coumadin) most conditions) broccoli); consistent intake if consumed
Enoxaparin Anti-factor Xa levels (rarely); Subcutaneous injection; do not massage;
(Lovenox) platelet count for HIT same time daily
Antidote: Protamine sulfate; monitor for
Heparin aPTT (1.5-2.5× baseline)
bleeding
Critical Lab Values:
● INR therapeutic range: 2.0-3.0 (2.5-3.5 for mechanical valves)
● aPTT therapeutic: 1.5-2.5 times control
, ● Platelet count: Monitor for heparin-induced thrombocytopenia (HIT)
Heart Failure Management
TableCopy
Assessment Intervention Rationale
Most accurate indicator of fluid status; gain of
Same scale, time,
Daily weight 2-3 lbs in 24 hrs or 3-5 lbs in week = fluid
clothing
retention
Dietary sodium Restrict to 2-3g/day Reduces fluid retention
Loop diuretics Monitor for
K⁺ wasting; may need supplementation
(furosemide) hypokalemia
Elevate HOB, oxygen
Orthopnea/DOE Left-sided failure symptoms
as needed
Peripheral Arterial Disease (PAD)
TableCopy
Symptom Cause Management
Intermittent Ischemia during Walk to point of pain daily to develop collateral
claudication activity circulation
, Gravity reduces
Pain with elevation Keep legs dependent when resting
blood flow
Rubor with
Reactive hyperemia Elevation pallor, dependency rubor
dependency
Cardiac Assessment
TableCopy
Finding Technique Significance
Murmur enhancement Left lateral decubitus position Better auscultation of mitral valve
Spike followed by QRS Ventricular depolarization
Pacemaker capture
complex confirmed
S3 gallop Heard at apex with bell Indicator of heart failure
DOMAIN 2: RESPIRATORY DISORDERS (15-20%)
Asthma Management
TableCopy
Phase Priority Intervention Medication
Acute attack Bronchodilation first Albuterol (short-acting β2-agonist)
, Long-term control Anti-inflammatory Inhaled corticosteroids (fluticasone)
Severe exacerbation Systemic steroids Prednisone (oral) or methylprednisolone (IV)
Emergency Management - Anaphylaxis:
● First action: Assess airway patency
● Medication: Epinephrine (EpiPen) - drug of choice
● Position: Supine with legs elevated (unless respiratory distress)
COPD Management
TableCopy
Priority Intervention Rationale
Avoid high-flow O₂ to maintain hypoxic
Oxygen therapy Maintain SpO2 88-92%
drive
Breathing Prolongs exhalation, prevents airway
Pursed-lip breathing
technique collapse
Improves lung expansion, secretion
Exercise Deep breathing exercises
clearance
Tripod position (leaning
Positioning Decreases work of breathing
forward)
Pulmonary Embolism (PE)
TableCopy
