ATI PN Adult Medical Exam: The Ultimate 200-
Question With Correct Answers And Rationals Latest
Update 2026.
Introduction:
Welcome to this rigorous 200-question practice examination designed specifically for
Practical Nursing (PN) students preparing for the ATI Adult Medical Proctored Exam and
the NCLEX-PN. This question bank is meticulously organized to mirror the content,
difficulty, and style of the official ATI exam.
Content Coverage: This exam spans all major adult medical-surgical nursing domains,
including:
• Cardiovascular (hypertension, heart failure, MI, dysrhythmias, vascular disease)
• Respiratory (COPD, asthma, pneumonia, TB, PE, mechanical ventilation)
• Gastrointestinal (IBD, ostomies, hepatitis, pancreatitis, GERD)
• Endocrine (diabetes mellitus, DKA, thyroid disorders, adrenal insufficiency)
• Renal/Urinary (CKD, dialysis, AKI, UTI, kidney stones)
• Neurological (stroke, seizures, head injury, Parkinson’s, MS, meningitis)
• Musculoskeletal (fractures, arthritis, gout, amputations, osteoporosis)
• Integumentary (wounds, shingles, pressure injuries)
• Hematologic/Immune (anemia, sickle cell, ITP, HIV)
• Perioperative care, pain management, fluid/electrolyte balance, and infection contro
1. A nurse assesses a client with heart failure who has crackles in the lung bases, dyspnea
on exertion, and 2+ pitting edema in the ankles. Which intervention should the nurse
implement first?
o A) Restrict oral fluids to 1500 mL/day
, o B) Administer furosemide as prescribed
o C) Place the client in high-Fowler’s position
o D) Check serum potassium level
o Rationale: Furosemide is a loop diuretic that rapidly reduces preload, relieving
pulmonary congestion. Positioning and monitoring are important, but
medication administration addresses the acute fluid overload first.
2. A client with hypertension is prescribed hydrochlorothiazide. Which statement by the
client indicates a need for further teaching?
o A) “I will take this medication in the morning.”
o B) “I should eat bananas to maintain my potassium.”
o C) “I can stop the medication when my blood pressure is normal.”
o D) “I need to change positions slowly to avoid dizziness.”
o . Rationale: Antihypertensive drugs control, not cure, hypertension; stopping
them can cause rebound hypertension and complications. Thiazides can cause
hypokalemia, so potassium-rich foods are beneficial
3. A client with angina reports chest pain rated 6/10 that radiates to the jaw. Nitroglycerin
0.4 mg sublingual is prescribed. After the first dose, the pain is 4/10. What should the
nurse do next?
o A) Apply a nitroglycerin patch
o B) Administer a second nitroglycerin tablet
o C) Call a rapid response team
o D) Obtain a 12-lead ECG
o Rationale: Nitroglycerin is given every 5 minutes up to 3 doses for angina. After
one dose with partial relief, a second dose is indicated before escalating care.
4. A client post-myocardial infarction has a heart rate of 118 bpm and blood pressure 90/60
mm Hg. Which finding is most concerning?
o A) Crackles in bilateral lung bases
o B) Complaint of nausea
o C) Jugular venous distention
, o D) Pain at the IV site
o Rationale: JVD with tachycardia and hypotension suggests right ventricular
failure or cardiogenic shock; this requires immediate intervention such as
inotropes or fluids guided by hemodynamic monitoring.
5. A nurse teaches a client with peripheral arterial disease (PAD). Which client statement
shows understanding?
o A) “I’ll wear compression stockings daily.”
o B) “I’ll inspect my feet for cuts or blisters every day.”
o C) “Elevating my legs will improve circulation.”
o D) “Heat packs help relieve my leg pain.”
o Rationale: PAD reduces blood flow, increasing infection risk. Daily foot
inspection prevents ulcers. Compression and elevation worsen ischemia; heat
can burn insensate skin.
6. A client with atrial fibrillation is started on warfarin. Which instruction is most
important?
o A) “Avoid eating green leafy vegetables consistently.”
o B) “Take aspirin for headache relief.”
o C) “Report any bleeding gums or easy bruising.”
o D) “Use a soft-bristled toothbrush.”
o Rationale: Bleeding is the major adverse effect of warfarin; early reporting
prevents severe hemorrhage. Soft toothbrushes are correct but not the priority
teaching point.
7. A client with deep vein thrombosis (DVT) is on heparin infusion. Which lab value
requires immediate action?
o A) Platelets 240,000/mm³
o B) aPTT 65 seconds (control 30 seconds)
o C) Platelets 80,000/mm³
o D) INR 1.2
, o Rationale: A sudden drop in platelets may indicate heparin-induced
thrombocytopenia (HIT), a life-threatening condition requiring immediate
discontinuation of heparin.
8. A client after cardiac catheterization via the femoral artery reports severe groin pain and
dizziness. The nurse notes a large expanding hematoma. What is the priority action?
o A) Apply a warm compress to the groin
o B) Apply firm manual pressure above the puncture site
o C) Increase the IV fluid rate
o D) Document the finding and reassess in 5 minutes
o Rationale: Expanding hematoma indicates retroperitoneal bleeding; direct
pressure is needed to stop bleeding while notifying the provider.
9. A client with infective endocarditis develops sudden left-sided weakness and slurred
speech. What should the nurse suspect?
o A) Hypertensive crisis
o B) Embolic stroke
o C) Hypoglycemia
o D) Transient ischemic attack
o Rationale: Endocarditis vegetations can embolize to cerebral arteries, causing
stroke. This is a medical emergency.
10. A client with chronic venous insufficiency has a venous stasis ulcer. Which intervention is
most appropriate?
o A) Apply dry sterile dressing only
o B) Apply compression stockings before ambulation
o C) Keep the leg elevated continuously
o D) Use a heating pad to the wound
o Rationale: Compression improves venous return, reducing edema and
promoting healing. Elevation helps but must be combined with compression.
11. A client with heart failure is prescribed digoxin. Which finding indicates toxicity?
Question With Correct Answers And Rationals Latest
Update 2026.
Introduction:
Welcome to this rigorous 200-question practice examination designed specifically for
Practical Nursing (PN) students preparing for the ATI Adult Medical Proctored Exam and
the NCLEX-PN. This question bank is meticulously organized to mirror the content,
difficulty, and style of the official ATI exam.
Content Coverage: This exam spans all major adult medical-surgical nursing domains,
including:
• Cardiovascular (hypertension, heart failure, MI, dysrhythmias, vascular disease)
• Respiratory (COPD, asthma, pneumonia, TB, PE, mechanical ventilation)
• Gastrointestinal (IBD, ostomies, hepatitis, pancreatitis, GERD)
• Endocrine (diabetes mellitus, DKA, thyroid disorders, adrenal insufficiency)
• Renal/Urinary (CKD, dialysis, AKI, UTI, kidney stones)
• Neurological (stroke, seizures, head injury, Parkinson’s, MS, meningitis)
• Musculoskeletal (fractures, arthritis, gout, amputations, osteoporosis)
• Integumentary (wounds, shingles, pressure injuries)
• Hematologic/Immune (anemia, sickle cell, ITP, HIV)
• Perioperative care, pain management, fluid/electrolyte balance, and infection contro
1. A nurse assesses a client with heart failure who has crackles in the lung bases, dyspnea
on exertion, and 2+ pitting edema in the ankles. Which intervention should the nurse
implement first?
o A) Restrict oral fluids to 1500 mL/day
, o B) Administer furosemide as prescribed
o C) Place the client in high-Fowler’s position
o D) Check serum potassium level
o Rationale: Furosemide is a loop diuretic that rapidly reduces preload, relieving
pulmonary congestion. Positioning and monitoring are important, but
medication administration addresses the acute fluid overload first.
2. A client with hypertension is prescribed hydrochlorothiazide. Which statement by the
client indicates a need for further teaching?
o A) “I will take this medication in the morning.”
o B) “I should eat bananas to maintain my potassium.”
o C) “I can stop the medication when my blood pressure is normal.”
o D) “I need to change positions slowly to avoid dizziness.”
o . Rationale: Antihypertensive drugs control, not cure, hypertension; stopping
them can cause rebound hypertension and complications. Thiazides can cause
hypokalemia, so potassium-rich foods are beneficial
3. A client with angina reports chest pain rated 6/10 that radiates to the jaw. Nitroglycerin
0.4 mg sublingual is prescribed. After the first dose, the pain is 4/10. What should the
nurse do next?
o A) Apply a nitroglycerin patch
o B) Administer a second nitroglycerin tablet
o C) Call a rapid response team
o D) Obtain a 12-lead ECG
o Rationale: Nitroglycerin is given every 5 minutes up to 3 doses for angina. After
one dose with partial relief, a second dose is indicated before escalating care.
4. A client post-myocardial infarction has a heart rate of 118 bpm and blood pressure 90/60
mm Hg. Which finding is most concerning?
o A) Crackles in bilateral lung bases
o B) Complaint of nausea
o C) Jugular venous distention
, o D) Pain at the IV site
o Rationale: JVD with tachycardia and hypotension suggests right ventricular
failure or cardiogenic shock; this requires immediate intervention such as
inotropes or fluids guided by hemodynamic monitoring.
5. A nurse teaches a client with peripheral arterial disease (PAD). Which client statement
shows understanding?
o A) “I’ll wear compression stockings daily.”
o B) “I’ll inspect my feet for cuts or blisters every day.”
o C) “Elevating my legs will improve circulation.”
o D) “Heat packs help relieve my leg pain.”
o Rationale: PAD reduces blood flow, increasing infection risk. Daily foot
inspection prevents ulcers. Compression and elevation worsen ischemia; heat
can burn insensate skin.
6. A client with atrial fibrillation is started on warfarin. Which instruction is most
important?
o A) “Avoid eating green leafy vegetables consistently.”
o B) “Take aspirin for headache relief.”
o C) “Report any bleeding gums or easy bruising.”
o D) “Use a soft-bristled toothbrush.”
o Rationale: Bleeding is the major adverse effect of warfarin; early reporting
prevents severe hemorrhage. Soft toothbrushes are correct but not the priority
teaching point.
7. A client with deep vein thrombosis (DVT) is on heparin infusion. Which lab value
requires immediate action?
o A) Platelets 240,000/mm³
o B) aPTT 65 seconds (control 30 seconds)
o C) Platelets 80,000/mm³
o D) INR 1.2
, o Rationale: A sudden drop in platelets may indicate heparin-induced
thrombocytopenia (HIT), a life-threatening condition requiring immediate
discontinuation of heparin.
8. A client after cardiac catheterization via the femoral artery reports severe groin pain and
dizziness. The nurse notes a large expanding hematoma. What is the priority action?
o A) Apply a warm compress to the groin
o B) Apply firm manual pressure above the puncture site
o C) Increase the IV fluid rate
o D) Document the finding and reassess in 5 minutes
o Rationale: Expanding hematoma indicates retroperitoneal bleeding; direct
pressure is needed to stop bleeding while notifying the provider.
9. A client with infective endocarditis develops sudden left-sided weakness and slurred
speech. What should the nurse suspect?
o A) Hypertensive crisis
o B) Embolic stroke
o C) Hypoglycemia
o D) Transient ischemic attack
o Rationale: Endocarditis vegetations can embolize to cerebral arteries, causing
stroke. This is a medical emergency.
10. A client with chronic venous insufficiency has a venous stasis ulcer. Which intervention is
most appropriate?
o A) Apply dry sterile dressing only
o B) Apply compression stockings before ambulation
o C) Keep the leg elevated continuously
o D) Use a heating pad to the wound
o Rationale: Compression improves venous return, reducing edema and
promoting healing. Elevation helps but must be combined with compression.
11. A client with heart failure is prescribed digoxin. Which finding indicates toxicity?
