Latest ATI RN Adult Medical Surgical (Med-Surg) 2026
Proctored Exam with NGN and 100 Questions with Answers |
Real ATI RN Med-Surg Exam Content
Exam
ATI RN Adult Medical-Surgical Proctored Exam 2026
SECTION 1: Cardiovascular Disorders (Questions 1-25)
Question 1
A nurse is assessing a client who is 12 hours post-cardiac catheterization via the
right femoral artery. The nurse notes the client's right foot is pale, cool to the
touch, and the client reports numbness. Which action should the nurse take
FIRST?
A) Apply warm blankets to the right foot
B) Elevate the head of the bed to 45 degrees
C) Assess the right femoral pulse
D) Document the findings as normal
Answer: C) Assess the right femoral pulse
Rationale: Pale, cool, and numb extremity post-catheterization suggests arterial
occlusion or thrombus formation. Assessing the femoral pulse checks for
perfusion. Warm blankets treat symptoms but delay emergent intervention.
Elevating HOB does not restore arterial flow .
Question 2
A nurse is monitoring a client receiving a blood transfusion. Which finding
indicates a hemolytic transfusion reaction?
,A) Hypertension and bradycardia
B) Low back pain and tachycardia
C) Flushed skin and fever
D) Hypothermia and urticaria
Answer: B) Low back pain and tachycardia
Rationale: Low back pain (from kidney stress), tachycardia, hypotension, and
hemoglobinuria are hallmark signs of an acute hemolytic reaction due to RBC
destruction. Hemolytic reactions usually cause hypotension, not hypertension .
Question 3
A client with heart failure is prescribed furosemide (Lasix) 40 mg IV push. Which
laboratory value should the nurse monitor most closely?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Answer: B) Potassium
Rationale: Furosemide is a loop diuretic that causes excretion of potassium
(hypokalemia). Hypokalemia can lead to cardiac arrhythmias, especially in clients
taking digoxin. Monitor potassium levels before and after administration .
Question 4
A client is prescribed warfarin (Coumadin) for chronic atrial fibrillation. Which lab
value indicates therapeutic effectiveness?
A) aPTT of 60 seconds
B) INR of 2.5
C) Platelet count of 150,000
D) Bleeding time of 8 minutes
Answer: B) INR of 2.5
,Rationale: Warfarin affects the extrinsic pathway. A therapeutic INR for most
conditions (like a-fib or DVT) is 2.0-3.0. aPTT monitors heparin, not warfarin.
Platelet count monitors bone marrow function but not warfarin efficacy .
Question 5
A nurse is caring for a client with a deep vein thrombosis (DVT) on a heparin drip.
Which finding requires immediate intervention?
A) aPTT of 80 seconds (control 30 seconds)
B) Platelet count drop from 250,000 to 100,000
C) Client reports headache and visual changes
D) Presence of pedal edema
Answer: C) Client reports headache and visual changes
Rationale: Headache + visual changes on heparin could indicate adrenal
hemorrhage (rare but fatal) or heparin-induced thrombocytopenia (HIT) with
thrombosis. An aPTT of 80 seconds is therapeutic .
Question 6
A nurse is assessing a client with right-sided heart failure. Which finding should
the nurse expect?
A) Dyspnea
B) Crackles in the lungs
C) Jugular vein distention (JVD)
D) Paroxysmal nocturnal dyspnea (PND)
Answer: C) Jugular vein distention (JVD)
Rationale: Right-sided heart failure causes backup of blood into the venous
system, leading to JVD, peripheral edema, hepatomegaly, ascites, and weight
gain. Dyspnea, crackles, and PND are manifestations of left-sided heart failure
(pulmonary congestion) .
, Question 7
A client with hypertension is started on lisinopril. After 2 days, the client reports a
persistent dry cough. Which action should the nurse take?
A) Reassure the client that the cough is harmless
B) Document the finding and continue the medication
C) Notify the provider to consider switching to an ARB
D) Instruct the client to take cough syrup before the dose
Answer: C) Notify the provider to consider switching to an ARB
Rationale: ACE inhibitors like lisinopril cause a dry, persistent cough due to
bradykinin accumulation. This is a common reason for discontinuation. ARBs
(angiotensin receptor blockers like losartan) are often substituted because they
have a lower incidence of cough .
Question 8
A client with peripheral arterial disease (PAD) of the lower extremities reports leg
pain at rest. Which intervention should the nurse include?
A) Place moist heat pads on the extremities
B) Perform manual massage of the affected extremities
C) Dangle the extremities off the side of the bed
D) Apply support stockings before getting out of bed
Answer: C) Dangle the extremities off the side of the bed
Rationale: Rest pain in PAD indicates severe arterial insufficiency. Dangling the
legs uses gravity to increase arterial blood flow, relieving pain. Heat and massage
increase oxygen demand and can cause tissue damage. Support stockings are for
venous disorders .
Question 9
A nurse is providing discharge teaching to a client with a new prescription for
sublingual nitroglycerin. Which client statement indicates understanding?
Proctored Exam with NGN and 100 Questions with Answers |
Real ATI RN Med-Surg Exam Content
Exam
ATI RN Adult Medical-Surgical Proctored Exam 2026
SECTION 1: Cardiovascular Disorders (Questions 1-25)
Question 1
A nurse is assessing a client who is 12 hours post-cardiac catheterization via the
right femoral artery. The nurse notes the client's right foot is pale, cool to the
touch, and the client reports numbness. Which action should the nurse take
FIRST?
A) Apply warm blankets to the right foot
B) Elevate the head of the bed to 45 degrees
C) Assess the right femoral pulse
D) Document the findings as normal
Answer: C) Assess the right femoral pulse
Rationale: Pale, cool, and numb extremity post-catheterization suggests arterial
occlusion or thrombus formation. Assessing the femoral pulse checks for
perfusion. Warm blankets treat symptoms but delay emergent intervention.
Elevating HOB does not restore arterial flow .
Question 2
A nurse is monitoring a client receiving a blood transfusion. Which finding
indicates a hemolytic transfusion reaction?
,A) Hypertension and bradycardia
B) Low back pain and tachycardia
C) Flushed skin and fever
D) Hypothermia and urticaria
Answer: B) Low back pain and tachycardia
Rationale: Low back pain (from kidney stress), tachycardia, hypotension, and
hemoglobinuria are hallmark signs of an acute hemolytic reaction due to RBC
destruction. Hemolytic reactions usually cause hypotension, not hypertension .
Question 3
A client with heart failure is prescribed furosemide (Lasix) 40 mg IV push. Which
laboratory value should the nurse monitor most closely?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Answer: B) Potassium
Rationale: Furosemide is a loop diuretic that causes excretion of potassium
(hypokalemia). Hypokalemia can lead to cardiac arrhythmias, especially in clients
taking digoxin. Monitor potassium levels before and after administration .
Question 4
A client is prescribed warfarin (Coumadin) for chronic atrial fibrillation. Which lab
value indicates therapeutic effectiveness?
A) aPTT of 60 seconds
B) INR of 2.5
C) Platelet count of 150,000
D) Bleeding time of 8 minutes
Answer: B) INR of 2.5
,Rationale: Warfarin affects the extrinsic pathway. A therapeutic INR for most
conditions (like a-fib or DVT) is 2.0-3.0. aPTT monitors heparin, not warfarin.
Platelet count monitors bone marrow function but not warfarin efficacy .
Question 5
A nurse is caring for a client with a deep vein thrombosis (DVT) on a heparin drip.
Which finding requires immediate intervention?
A) aPTT of 80 seconds (control 30 seconds)
B) Platelet count drop from 250,000 to 100,000
C) Client reports headache and visual changes
D) Presence of pedal edema
Answer: C) Client reports headache and visual changes
Rationale: Headache + visual changes on heparin could indicate adrenal
hemorrhage (rare but fatal) or heparin-induced thrombocytopenia (HIT) with
thrombosis. An aPTT of 80 seconds is therapeutic .
Question 6
A nurse is assessing a client with right-sided heart failure. Which finding should
the nurse expect?
A) Dyspnea
B) Crackles in the lungs
C) Jugular vein distention (JVD)
D) Paroxysmal nocturnal dyspnea (PND)
Answer: C) Jugular vein distention (JVD)
Rationale: Right-sided heart failure causes backup of blood into the venous
system, leading to JVD, peripheral edema, hepatomegaly, ascites, and weight
gain. Dyspnea, crackles, and PND are manifestations of left-sided heart failure
(pulmonary congestion) .
, Question 7
A client with hypertension is started on lisinopril. After 2 days, the client reports a
persistent dry cough. Which action should the nurse take?
A) Reassure the client that the cough is harmless
B) Document the finding and continue the medication
C) Notify the provider to consider switching to an ARB
D) Instruct the client to take cough syrup before the dose
Answer: C) Notify the provider to consider switching to an ARB
Rationale: ACE inhibitors like lisinopril cause a dry, persistent cough due to
bradykinin accumulation. This is a common reason for discontinuation. ARBs
(angiotensin receptor blockers like losartan) are often substituted because they
have a lower incidence of cough .
Question 8
A client with peripheral arterial disease (PAD) of the lower extremities reports leg
pain at rest. Which intervention should the nurse include?
A) Place moist heat pads on the extremities
B) Perform manual massage of the affected extremities
C) Dangle the extremities off the side of the bed
D) Apply support stockings before getting out of bed
Answer: C) Dangle the extremities off the side of the bed
Rationale: Rest pain in PAD indicates severe arterial insufficiency. Dangling the
legs uses gravity to increase arterial blood flow, relieving pain. Heat and massage
increase oxygen demand and can cause tissue damage. Support stockings are for
venous disorders .
Question 9
A nurse is providing discharge teaching to a client with a new prescription for
sublingual nitroglycerin. Which client statement indicates understanding?
