Updated ATI RN Adult Medical Surgical (Med-Surg) 2026 NGN
Proctored Exam with 100 Questions and Answers | Actual ATI
RN Med-Surg Latest Version Proctored Exam
Exam
Cardiovascular & Vascular
Q101. A nurse is assessing a client with acute decompensated heart failure
(ADHF). Which of the following findings is most concerning?
• A. BNP 400 pg/mL
• B. Jugular venous distention
• C. Oxygen saturation 88% on room air
• D. 2+ pitting edema in lower extremities
Correct Answer: C. Oxygen saturation 88% on room air
Rationale: Hypoxemia (SpO2 <90%) indicates impaired gas exchange and is a life-
threatening priority. The nurse should administer oxygen immediately. BNP >100
pg/mL indicates HF but is not an acute priority. JVD and edema are important but
not as urgent as hypoxemia.
Q102. A client with heart failure has a new prescription for carvedilol. Which of
the following statements by the client indicates a need for further teaching?
• A. "I will weigh myself every morning."
• B. "I can stop this medication if I feel dizzy."
• C. "This medication may make me feel tired at first."
• D. "I will report any swelling in my feet or ankles."
Correct Answer: B. I can stop this medication if I feel dizzy.
,Rationale: Carvedilol is a beta-blocker used in heart failure. It should never be
stopped abruptly, as this can cause rebound tachycardia, worsening HF, or
myocardial ischemia. Dizziness is common initially and often resolves. The client
should contact the provider before making any changes.
Q103. A nurse is caring for a client following a cardiac catheterization via the
right femoral artery. The client reports feeling "dizzy" and the nurse notes a
heart rate of 48 bpm and blood pressure of 82/50 mm Hg. Which of the
following actions should the nurse take first?
• A. Administer atropine IV.
• B. Elevate the foot of the bed.
• C. Assess the femoral insertion site.
• D. Notify the provider.
Correct Answer: C. Assess the femoral insertion site.
Rationale: Bradycardia and hypotension after femoral artery catheterization
suggest possible vagal response or bleeding. The nurse should first assess the
insertion site for hematoma or active bleeding. If bleeding is present, the nurse
should apply firm pressure and then notify the provider.
Q104. A client with peripheral artery disease (PAD) reports leg pain when
walking that resolves with rest. The nurse should document this finding as:
• A. Neuropathic pain
• B. Rest pain
• C. Intermittent claudication
• D. Venous insufficiency
Correct Answer: C. Intermittent claudication
,Rationale: Intermittent claudication is defined as muscle pain (cramping, aching)
in the lower extremities that occurs with exercise and is relieved by rest. It is
caused by insufficient blood flow due to atherosclerosis.
Q105. A nurse is providing discharge teaching to a client with peripheral artery
disease (PAD). Which of the following instructions should the nurse include?
• A. "Elevate your legs above heart level when resting."
• B. "Apply heat to your legs to improve circulation."
• C. "Walk until you feel pain, then rest and resume walking."
• D. "Wear tight compression stockings all day."
Correct Answer: C. Walk until you feel pain, then rest and resume walking.
Rationale: A structured walking program (walk to pain, rest, resume) is the most
effective non-pharmacologic treatment for PAD. It stimulates collateral
circulation. Elevation worsens ischemia (legs should be in a dependent position).
Heat can cause burns due to decreased sensation.
Q106. A client with atrial fibrillation is prescribed warfarin. The nurse should
instruct the client to avoid which of the following foods?
• A. Bananas
• B. Leafy green vegetables
• C. Red meat
• D. Dairy products
Correct Answer: B. Leafy green vegetables
Rationale: Leafy green vegetables (spinach, kale, broccoli) are high in vitamin K,
which antagonizes the effects of warfarin and decreases INR. Clients should
maintain a consistent intake of vitamin K, not avoid it entirely, but large
fluctuations can affect anticoagulation.
, Q107. A nurse is monitoring a client receiving a blood transfusion. Fifteen
minutes after initiation, the client reports low back pain and chills. Which of the
following actions should the nurse take first?
• A. Stop the transfusion.
• B. Slow the infusion rate.
• C. Administer acetaminophen.
• D. Notify the provider.
Correct Answer: A. Stop the transfusion.
Rationale: Low back pain and chills are signs of an acute hemolytic transfusion
reaction (ABO incompatibility). The priority is to stop the transfusion immediately
to prevent further reaction, then disconnect the tubing and keep the IV line open
with normal saline.
Q108. A client with a history of deep vein thrombosis (DVT) is prescribed
enoxaparin (Lovenox). The nurse should administer this medication by which
route?
• A. Intravenous push
• B. Subcutaneous injection in the abdomen
• C. Intramuscular injection in the deltoid
• D. Oral administration
Correct Answer: B. Subcutaneous injection in the abdomen
Rationale: Enoxaparin is a low-molecular-weight heparin (LMWH) administered
subcutaneously, typically in the abdomen. It should not be given IM (risk of
hematoma) or IV push. The abdomen provides consistent absorption.
Proctored Exam with 100 Questions and Answers | Actual ATI
RN Med-Surg Latest Version Proctored Exam
Exam
Cardiovascular & Vascular
Q101. A nurse is assessing a client with acute decompensated heart failure
(ADHF). Which of the following findings is most concerning?
• A. BNP 400 pg/mL
• B. Jugular venous distention
• C. Oxygen saturation 88% on room air
• D. 2+ pitting edema in lower extremities
Correct Answer: C. Oxygen saturation 88% on room air
Rationale: Hypoxemia (SpO2 <90%) indicates impaired gas exchange and is a life-
threatening priority. The nurse should administer oxygen immediately. BNP >100
pg/mL indicates HF but is not an acute priority. JVD and edema are important but
not as urgent as hypoxemia.
Q102. A client with heart failure has a new prescription for carvedilol. Which of
the following statements by the client indicates a need for further teaching?
• A. "I will weigh myself every morning."
• B. "I can stop this medication if I feel dizzy."
• C. "This medication may make me feel tired at first."
• D. "I will report any swelling in my feet or ankles."
Correct Answer: B. I can stop this medication if I feel dizzy.
,Rationale: Carvedilol is a beta-blocker used in heart failure. It should never be
stopped abruptly, as this can cause rebound tachycardia, worsening HF, or
myocardial ischemia. Dizziness is common initially and often resolves. The client
should contact the provider before making any changes.
Q103. A nurse is caring for a client following a cardiac catheterization via the
right femoral artery. The client reports feeling "dizzy" and the nurse notes a
heart rate of 48 bpm and blood pressure of 82/50 mm Hg. Which of the
following actions should the nurse take first?
• A. Administer atropine IV.
• B. Elevate the foot of the bed.
• C. Assess the femoral insertion site.
• D. Notify the provider.
Correct Answer: C. Assess the femoral insertion site.
Rationale: Bradycardia and hypotension after femoral artery catheterization
suggest possible vagal response or bleeding. The nurse should first assess the
insertion site for hematoma or active bleeding. If bleeding is present, the nurse
should apply firm pressure and then notify the provider.
Q104. A client with peripheral artery disease (PAD) reports leg pain when
walking that resolves with rest. The nurse should document this finding as:
• A. Neuropathic pain
• B. Rest pain
• C. Intermittent claudication
• D. Venous insufficiency
Correct Answer: C. Intermittent claudication
,Rationale: Intermittent claudication is defined as muscle pain (cramping, aching)
in the lower extremities that occurs with exercise and is relieved by rest. It is
caused by insufficient blood flow due to atherosclerosis.
Q105. A nurse is providing discharge teaching to a client with peripheral artery
disease (PAD). Which of the following instructions should the nurse include?
• A. "Elevate your legs above heart level when resting."
• B. "Apply heat to your legs to improve circulation."
• C. "Walk until you feel pain, then rest and resume walking."
• D. "Wear tight compression stockings all day."
Correct Answer: C. Walk until you feel pain, then rest and resume walking.
Rationale: A structured walking program (walk to pain, rest, resume) is the most
effective non-pharmacologic treatment for PAD. It stimulates collateral
circulation. Elevation worsens ischemia (legs should be in a dependent position).
Heat can cause burns due to decreased sensation.
Q106. A client with atrial fibrillation is prescribed warfarin. The nurse should
instruct the client to avoid which of the following foods?
• A. Bananas
• B. Leafy green vegetables
• C. Red meat
• D. Dairy products
Correct Answer: B. Leafy green vegetables
Rationale: Leafy green vegetables (spinach, kale, broccoli) are high in vitamin K,
which antagonizes the effects of warfarin and decreases INR. Clients should
maintain a consistent intake of vitamin K, not avoid it entirely, but large
fluctuations can affect anticoagulation.
, Q107. A nurse is monitoring a client receiving a blood transfusion. Fifteen
minutes after initiation, the client reports low back pain and chills. Which of the
following actions should the nurse take first?
• A. Stop the transfusion.
• B. Slow the infusion rate.
• C. Administer acetaminophen.
• D. Notify the provider.
Correct Answer: A. Stop the transfusion.
Rationale: Low back pain and chills are signs of an acute hemolytic transfusion
reaction (ABO incompatibility). The priority is to stop the transfusion immediately
to prevent further reaction, then disconnect the tubing and keep the IV line open
with normal saline.
Q108. A client with a history of deep vein thrombosis (DVT) is prescribed
enoxaparin (Lovenox). The nurse should administer this medication by which
route?
• A. Intravenous push
• B. Subcutaneous injection in the abdomen
• C. Intramuscular injection in the deltoid
• D. Oral administration
Correct Answer: B. Subcutaneous injection in the abdomen
Rationale: Enoxaparin is a low-molecular-weight heparin (LMWH) administered
subcutaneously, typically in the abdomen. It should not be given IM (risk of
hematoma) or IV push. The abdomen provides consistent absorption.
