Questions with Answers & Rationales
,
,
, Below is a comprehensive set of practice questions modeled on the ATI RN Adult Medical-Surgical
Proctored Exam with Next Generation NCLEX (NGN) formats, including case studies and multiple-select
questions, with detailed rationales. These questions are based on unofficial student-shared resources
designed for exam preparation .
SECTION 1: CARDIOVASCULAR SYSTEM (Questions 1–15)
Question 1 (NGN Case Study: Heparin Drip Calculation)
Mr. James, a 68-year-old male with atrial fibrillation, is started on a heparin drip. The prescription reads:
Heparin IV at 1,500 units/hr. The pharmacy sends heparin 25,000 units in 500 mL D5W.
a) Calculate the initial mL/hr rate for the infusion.
A) 20 mL/hr
B) 30 mL/hr
C) 40 mL/hr
D) 50 mL/hr
100%Correct VERIFid Answer:: B) 30 mL/hr
Rationale: Calculation: (1,500 units × 500 mL) ÷ 25,000 units = 30 mL/hr .
b) After 3 hours, the nurse notes the client's aPTT is above therapeutic range. What is the nurse's
priority action?
A) Continue the infusion and recheck aPTT in 6 hours
B) Hold the infusion and notify the provider immediately
C) Decrease the infusion rate by half
D) Administer vitamin K
100%Correct VERIFid Answer:: B) Hold the infusion and notify the provider immediately
Rationale: An elevated aPTT above therapeutic range indicates increased bleeding risk. The infusion
should be held and the provider notified immediately. Vitamin K is the antidote for warfarin, not heparin
.
c) The provider orders vitamin K for an overdose. What client teaching should the nurse provide
regarding vitamin K?