ATI RN MED SURG PROCTORED RETAKE 2 PRACTICE TEST
2026 Q@A
1. A nurse is caring for a patient with chronic obstructive
pulmonary disease (COPD) who is receiving 2 L/min of
oxygen via nasal cannula. The patient's oxygen saturation is
88%, and they report increased shortness of breath. Which
action should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min
B. Assess the patient's respiratory rate and effort
C. Administer a bronchodilator via nebulizer
D. Place the patient in a high-Fowler's position
Correct Answer: B
Explanation: The nurse must first assess the patient's
respiratory status before implementing interventions.
Increasing oxygen without assessment could suppress the
hypoxic drive in COPD patients. Assessment guides
appropriate treatment.
2. A postoperative patient 24 hours after abdominal surgery
has a temperature of 38.9°C (102°F), pulse of 110 bpm, and
foul-smelling drainage from the wound. Which complication
should the nurse suspect?
A. Normal postoperative response
B. Wound infection
C. Deep vein thrombosis
D. Pulmonary embolism
Correct Answer: B
Explanation: Fever, tachycardia, and foul-smelling wound
drainage are classic signs of wound infection. DVT presents
, with leg swelling/pain, and PE with sudden dyspnea and
chest pain.
3. A patient with diabetic ketoacidosis (DKA) has a blood
glucose of 450 mg/dL, pH of 6.92, and potassium of 3.2
mEq/L. Which intervention is most critical before starting
insulin therapy?
A. Administer IV bicarbonate
B. Give IV potassium replacement
C. Start a fluid bolus with dextrose
D. Administer subcutaneous insulin glargine
Correct Answer: B
Explanation: Insulin therapy lowers potassium further, so
hypokalemia (K+ 3.2) must be corrected first to prevent life-
threatening cardiac arrhythmias. Fluids are started but
potassium is priority.
4. A nurse is caring for a patient with a new tracheostomy.
Which action demonstrates proper tracheostomy care?
A. Use sterile gloves and saline for cleaning
B. Clean around the stoma with hydrogen peroxide
C. Change tracheostomy ties daily
D. Suction only when the patient requests it
Correct Answer: A
Explanation: Tracheostomy care requires sterile technique
to prevent infection. Hydrogen peroxide is too harsh for
stoma skin, ties are changed every 2-3 days, and suctioning
is based on assessment needs, not patient request.
,5. A patient with heart failure reports waking up multiple times
at night feeling like they cannot breathe. Which term should
the nurse use to document this symptom?
A. Orthopnea
B. Paroxysmal nocturnal dyspnea
C. Pleurisy
D. Apnea
Correct Answer: B
Explanation: Paroxysmal nocturnal dyspnea (PND)
describes sudden nighttime breathing difficulty in heart
failure. Orthopnea is shortness of breath when lying flat
(improved by sitting up), pleurisy is chest pain with
breathing, and apnea is absence of breathing.
6. Which laboratory result is most concerning for a patient
receiving warfarin for deep vein thrombosis?
A. INR of 2.5
B. Platelet count of 180,000/mm³
C. Prothrombin time (PT) of 45 seconds
D. Hemoglobin of 10.5 g/dL
Correct Answer: C
Explanation: PT of 45 seconds is significantly prolonged
(normal 11-13.5 seconds), indicating over-anticoagulation
and high bleeding risk. INR of 2.5 is therapeutic for DVT
(target 2-3). Platelets and hemoglobin are within
acceptable ranges.
, 7. A patient with acute kidney injury (AKI) has a potassium
level of 6.8 mEq/L. Which medication should the nurse
administer first?
A. Furosemide
B. Sodium polystyrene sulfonate (Kayexalate)
C. Insulin 10 units with dextrose
D. Spironolactone
Correct Answer: C
Explanation: Insulin with dextrose rapidly shifts potassium
into cells (within 15-30 minutes), making it the first-line
treatment for severe hyperkalemia. Kayexalate removes
potassium but takes hours. Furosemide helps but is slower.
Spironolactone is contraindicated (increases potassium).
8. A nurse is preparing to transfuse packed red blood cells.
Which action is essential before starting the transfusion?
A. Mix the blood with normal saline in the bag
B. Verify the blood product with another nurse
C. Administer aspirin for pain prevention
D. Warm the blood to 38°C in a microwave
Correct Answer: B
Explanation: Two-nurse verification of blood product is
mandatory to prevent transfusion errors. Blood is never
mixed, aspirin is not given prophylactically, and
microwaving destroys blood cells (use approved warming
devices if needed).
9. A patient with a abdominal aortic aneurysm (AAA) reports
sudden, severe back pain and feels dizzy. Which intervention
2026 Q@A
1. A nurse is caring for a patient with chronic obstructive
pulmonary disease (COPD) who is receiving 2 L/min of
oxygen via nasal cannula. The patient's oxygen saturation is
88%, and they report increased shortness of breath. Which
action should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min
B. Assess the patient's respiratory rate and effort
C. Administer a bronchodilator via nebulizer
D. Place the patient in a high-Fowler's position
Correct Answer: B
Explanation: The nurse must first assess the patient's
respiratory status before implementing interventions.
Increasing oxygen without assessment could suppress the
hypoxic drive in COPD patients. Assessment guides
appropriate treatment.
2. A postoperative patient 24 hours after abdominal surgery
has a temperature of 38.9°C (102°F), pulse of 110 bpm, and
foul-smelling drainage from the wound. Which complication
should the nurse suspect?
A. Normal postoperative response
B. Wound infection
C. Deep vein thrombosis
D. Pulmonary embolism
Correct Answer: B
Explanation: Fever, tachycardia, and foul-smelling wound
drainage are classic signs of wound infection. DVT presents
, with leg swelling/pain, and PE with sudden dyspnea and
chest pain.
3. A patient with diabetic ketoacidosis (DKA) has a blood
glucose of 450 mg/dL, pH of 6.92, and potassium of 3.2
mEq/L. Which intervention is most critical before starting
insulin therapy?
A. Administer IV bicarbonate
B. Give IV potassium replacement
C. Start a fluid bolus with dextrose
D. Administer subcutaneous insulin glargine
Correct Answer: B
Explanation: Insulin therapy lowers potassium further, so
hypokalemia (K+ 3.2) must be corrected first to prevent life-
threatening cardiac arrhythmias. Fluids are started but
potassium is priority.
4. A nurse is caring for a patient with a new tracheostomy.
Which action demonstrates proper tracheostomy care?
A. Use sterile gloves and saline for cleaning
B. Clean around the stoma with hydrogen peroxide
C. Change tracheostomy ties daily
D. Suction only when the patient requests it
Correct Answer: A
Explanation: Tracheostomy care requires sterile technique
to prevent infection. Hydrogen peroxide is too harsh for
stoma skin, ties are changed every 2-3 days, and suctioning
is based on assessment needs, not patient request.
,5. A patient with heart failure reports waking up multiple times
at night feeling like they cannot breathe. Which term should
the nurse use to document this symptom?
A. Orthopnea
B. Paroxysmal nocturnal dyspnea
C. Pleurisy
D. Apnea
Correct Answer: B
Explanation: Paroxysmal nocturnal dyspnea (PND)
describes sudden nighttime breathing difficulty in heart
failure. Orthopnea is shortness of breath when lying flat
(improved by sitting up), pleurisy is chest pain with
breathing, and apnea is absence of breathing.
6. Which laboratory result is most concerning for a patient
receiving warfarin for deep vein thrombosis?
A. INR of 2.5
B. Platelet count of 180,000/mm³
C. Prothrombin time (PT) of 45 seconds
D. Hemoglobin of 10.5 g/dL
Correct Answer: C
Explanation: PT of 45 seconds is significantly prolonged
(normal 11-13.5 seconds), indicating over-anticoagulation
and high bleeding risk. INR of 2.5 is therapeutic for DVT
(target 2-3). Platelets and hemoglobin are within
acceptable ranges.
, 7. A patient with acute kidney injury (AKI) has a potassium
level of 6.8 mEq/L. Which medication should the nurse
administer first?
A. Furosemide
B. Sodium polystyrene sulfonate (Kayexalate)
C. Insulin 10 units with dextrose
D. Spironolactone
Correct Answer: C
Explanation: Insulin with dextrose rapidly shifts potassium
into cells (within 15-30 minutes), making it the first-line
treatment for severe hyperkalemia. Kayexalate removes
potassium but takes hours. Furosemide helps but is slower.
Spironolactone is contraindicated (increases potassium).
8. A nurse is preparing to transfuse packed red blood cells.
Which action is essential before starting the transfusion?
A. Mix the blood with normal saline in the bag
B. Verify the blood product with another nurse
C. Administer aspirin for pain prevention
D. Warm the blood to 38°C in a microwave
Correct Answer: B
Explanation: Two-nurse verification of blood product is
mandatory to prevent transfusion errors. Blood is never
mixed, aspirin is not given prophylactically, and
microwaving destroys blood cells (use approved warming
devices if needed).
9. A patient with a abdominal aortic aneurysm (AAA) reports
sudden, severe back pain and feels dizzy. Which intervention
