1
ATI Capstone Adult Medical Surgical
Assessment 2 | Questions and Answers |
2026 Update | 100% Correct
SECTION 1: CARDIOVASCULAR & PERIPHERAL VASCULAR DISORDERS (18 Questions)
Q1: A client with newly diagnosed Stage 2 hypertension (BP 158/96 mmHg) is prescribed
lisinopril. Which instruction should the nurse include in the discharge teaching?
A. "Take your blood pressure medication only when your systolic reading is above 160."
B. "Report any persistent dry cough to your healthcare provider immediately." [CORRECT]
C. "You may stop the medication once your blood pressure returns to normal."
D. "Increase your dietary potassium intake while taking this medication."
Correct Answer: B
Rationale: Correct because ACE inhibitors such as lisinopril commonly cause a dry,
nonproductive cough due to bradykinin accumulation; per ATI/NCLEX standards, clients must
report this adverse effect promptly as it may necessitate switching to an ARB.
Q2: A client with heart failure has a left ventricular ejection fraction of 30%. Which
medication class is essential for guideline-directed medical therapy (GDMT) in this client?
A. Calcium channel blocker
B. Angiotensin receptor-neprilysin inhibitor [CORRECT]
C. Alpha-blocker
D. Loop diuretic alone
Correct Answer: B
Rationale: Correct because ARNI (sacubitril/valsartan) is a cornerstone of GDMT for HFrEF
with EF ≤40%, as it reduces mortality and hospitalization by inhibiting neprilysin and blocking
angiotensin receptors per evidence-based practice.
Q3: A client with acute coronary syndrome is receiving MONA therapy. Which component
requires the nurse to verify an SpO2 reading before administration?
A. Morphine sulfate
,2
B. Oxygen therapy [CORRECT]
C. Nitroglycerin
D. Aspirin
Correct Answer: B
Rationale: Correct because oxygen therapy in ACS is indicated only if SpO2 is <90%; routine
oxygen administration is no longer recommended for normoxic clients per current guidelines,
making SpO2 verification the priority nursing action.
Q4: A client presents with sudden onset dyspnea, tachycardia, and chest pain. An ECG reveals
S1Q3T3 pattern. What is the nurse's priority intervention?
A. Administer aspirin 325 mg orally
B. Initiate anticoagulation therapy per protocol [CORRECT]
C. Prepare the client for immediate thrombolysis
D. Obtain a chest X-ray before any treatment
Correct Answer: B
Rationale: Correct because the S1Q3T3 pattern is pathognomonic for pulmonary embolism;
priority nursing action is immediate anticoagulation to prevent further clot propagation while
awaiting definitive CT pulmonary angiography.
Q5: A client with atrial fibrillation has a CHA2DS2-VASc score of 4. Which medication is most
appropriate for stroke prevention?
A. Aspirin 81 mg daily
B. Warfarin with target INR 2-3
C. Apixaban 5 mg twice daily [CORRECT]
D. Clopidogrel 75 mg daily
Correct Answer: C
Rationale: Correct because DOACs such as apixaban are preferred over warfarin for non-
valvular atrial fibrillation with moderate-to-high stroke risk; they offer fixed dosing without
INR monitoring and superior safety profiles per evidence-based practice.
Q6: A client receiving heparin therapy has an aPTT of 90 seconds (control 30 seconds). Which
intervention is appropriate?
,3
A. Administer the next scheduled dose of heparin
B. Hold the heparin infusion and notify the provider [CORRECT]
C. Increase the heparin infusion rate
D. Administer protamine sulfate immediately
Correct Answer: B
Rationale: Correct because an aPTT of 3x control (90 seconds) indicates supratherapeutic
anticoagulation; priority nursing action is holding the infusion and notifying the provider to
prevent bleeding complications per ATI/NCLEX standards.
Q7: A client with peripheral artery disease reports intermittent claudication after walking two
blocks. Which intervention should the nurse prioritize?
A. Recommend complete bed rest to preserve circulation
B. Encourage a supervised exercise walking program [CORRECT]
C. Apply warm compresses to the lower extremities
D. Elevate the legs above heart level when resting
Correct Answer: B
Rationale: Correct because supervised exercise therapy is first-line management for PAD with
claudication; it improves collateral circulation and walking distance per evidence-based
practice, while leg elevation may further compromise arterial perfusion.
Q8: A client with a DVT is prescribed warfarin. The nurse should instruct the client to avoid
which food?
A. Bananas
B. Leafy green vegetables [CORRECT]
C. Dairy products
D. Citrus fruits
Correct Answer: B
Rationale: Correct because leafy green vegetables are high in vitamin K, which antagonizes
warfarin's anticoagulant effect; clients must maintain consistent vitamin K intake rather than
avoid it completely per ATI/NCLEX standards.
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Q9: A client in cardiogenic shock has a blood pressure of 78/50 mmHg and cool, clammy skin.
Which medication should the nurse anticipate?
A. Nitroprusside
B. Dobutamine [CORRECT]
C. Propranolol
D. Furosemide
Correct Answer: B
Rationale: Correct because dobutamine is a positive inotrope that increases cardiac
contractility and output in cardiogenic shock; it improves tissue perfusion without excessive
vasoconstriction per evidence-based practice for hemodynamic support.
Q10: A client with a STEMI arrives in the emergency department 45 minutes after symptom
onset. Which intervention is the priority?
A. Administer thrombolytics immediately
B. Prepare for immediate percutaneous coronary intervention [CORRECT]
C. Obtain serial troponin levels before intervention
D. Start beta-blocker therapy orally
Correct Answer: B
Rationale: Correct because PCI is the preferred reperfusion strategy for STEMI with door-to-
balloon time ≤90 minutes; it offers superior outcomes compared to fibrinolysis when
available within the recommended timeframe per current guidelines.
Q11: A client with heart failure reports weight gain of 4 pounds in 2 days. Which action should
the nurse take first?
A. Restrict fluid intake to 1 liter per day
B. Assess for peripheral edema and lung sounds [CORRECT]
C. Increase the dose of loop diuretic independently
D. Schedule an echocardiogram
Correct Answer: B
ATI Capstone Adult Medical Surgical
Assessment 2 | Questions and Answers |
2026 Update | 100% Correct
SECTION 1: CARDIOVASCULAR & PERIPHERAL VASCULAR DISORDERS (18 Questions)
Q1: A client with newly diagnosed Stage 2 hypertension (BP 158/96 mmHg) is prescribed
lisinopril. Which instruction should the nurse include in the discharge teaching?
A. "Take your blood pressure medication only when your systolic reading is above 160."
B. "Report any persistent dry cough to your healthcare provider immediately." [CORRECT]
C. "You may stop the medication once your blood pressure returns to normal."
D. "Increase your dietary potassium intake while taking this medication."
Correct Answer: B
Rationale: Correct because ACE inhibitors such as lisinopril commonly cause a dry,
nonproductive cough due to bradykinin accumulation; per ATI/NCLEX standards, clients must
report this adverse effect promptly as it may necessitate switching to an ARB.
Q2: A client with heart failure has a left ventricular ejection fraction of 30%. Which
medication class is essential for guideline-directed medical therapy (GDMT) in this client?
A. Calcium channel blocker
B. Angiotensin receptor-neprilysin inhibitor [CORRECT]
C. Alpha-blocker
D. Loop diuretic alone
Correct Answer: B
Rationale: Correct because ARNI (sacubitril/valsartan) is a cornerstone of GDMT for HFrEF
with EF ≤40%, as it reduces mortality and hospitalization by inhibiting neprilysin and blocking
angiotensin receptors per evidence-based practice.
Q3: A client with acute coronary syndrome is receiving MONA therapy. Which component
requires the nurse to verify an SpO2 reading before administration?
A. Morphine sulfate
,2
B. Oxygen therapy [CORRECT]
C. Nitroglycerin
D. Aspirin
Correct Answer: B
Rationale: Correct because oxygen therapy in ACS is indicated only if SpO2 is <90%; routine
oxygen administration is no longer recommended for normoxic clients per current guidelines,
making SpO2 verification the priority nursing action.
Q4: A client presents with sudden onset dyspnea, tachycardia, and chest pain. An ECG reveals
S1Q3T3 pattern. What is the nurse's priority intervention?
A. Administer aspirin 325 mg orally
B. Initiate anticoagulation therapy per protocol [CORRECT]
C. Prepare the client for immediate thrombolysis
D. Obtain a chest X-ray before any treatment
Correct Answer: B
Rationale: Correct because the S1Q3T3 pattern is pathognomonic for pulmonary embolism;
priority nursing action is immediate anticoagulation to prevent further clot propagation while
awaiting definitive CT pulmonary angiography.
Q5: A client with atrial fibrillation has a CHA2DS2-VASc score of 4. Which medication is most
appropriate for stroke prevention?
A. Aspirin 81 mg daily
B. Warfarin with target INR 2-3
C. Apixaban 5 mg twice daily [CORRECT]
D. Clopidogrel 75 mg daily
Correct Answer: C
Rationale: Correct because DOACs such as apixaban are preferred over warfarin for non-
valvular atrial fibrillation with moderate-to-high stroke risk; they offer fixed dosing without
INR monitoring and superior safety profiles per evidence-based practice.
Q6: A client receiving heparin therapy has an aPTT of 90 seconds (control 30 seconds). Which
intervention is appropriate?
,3
A. Administer the next scheduled dose of heparin
B. Hold the heparin infusion and notify the provider [CORRECT]
C. Increase the heparin infusion rate
D. Administer protamine sulfate immediately
Correct Answer: B
Rationale: Correct because an aPTT of 3x control (90 seconds) indicates supratherapeutic
anticoagulation; priority nursing action is holding the infusion and notifying the provider to
prevent bleeding complications per ATI/NCLEX standards.
Q7: A client with peripheral artery disease reports intermittent claudication after walking two
blocks. Which intervention should the nurse prioritize?
A. Recommend complete bed rest to preserve circulation
B. Encourage a supervised exercise walking program [CORRECT]
C. Apply warm compresses to the lower extremities
D. Elevate the legs above heart level when resting
Correct Answer: B
Rationale: Correct because supervised exercise therapy is first-line management for PAD with
claudication; it improves collateral circulation and walking distance per evidence-based
practice, while leg elevation may further compromise arterial perfusion.
Q8: A client with a DVT is prescribed warfarin. The nurse should instruct the client to avoid
which food?
A. Bananas
B. Leafy green vegetables [CORRECT]
C. Dairy products
D. Citrus fruits
Correct Answer: B
Rationale: Correct because leafy green vegetables are high in vitamin K, which antagonizes
warfarin's anticoagulant effect; clients must maintain consistent vitamin K intake rather than
avoid it completely per ATI/NCLEX standards.
, 4
Q9: A client in cardiogenic shock has a blood pressure of 78/50 mmHg and cool, clammy skin.
Which medication should the nurse anticipate?
A. Nitroprusside
B. Dobutamine [CORRECT]
C. Propranolol
D. Furosemide
Correct Answer: B
Rationale: Correct because dobutamine is a positive inotrope that increases cardiac
contractility and output in cardiogenic shock; it improves tissue perfusion without excessive
vasoconstriction per evidence-based practice for hemodynamic support.
Q10: A client with a STEMI arrives in the emergency department 45 minutes after symptom
onset. Which intervention is the priority?
A. Administer thrombolytics immediately
B. Prepare for immediate percutaneous coronary intervention [CORRECT]
C. Obtain serial troponin levels before intervention
D. Start beta-blocker therapy orally
Correct Answer: B
Rationale: Correct because PCI is the preferred reperfusion strategy for STEMI with door-to-
balloon time ≤90 minutes; it offers superior outcomes compared to fibrinolysis when
available within the recommended timeframe per current guidelines.
Q11: A client with heart failure reports weight gain of 4 pounds in 2 days. Which action should
the nurse take first?
A. Restrict fluid intake to 1 liter per day
B. Assess for peripheral edema and lung sounds [CORRECT]
C. Increase the dose of loop diuretic independently
D. Schedule an echocardiogram
Correct Answer: B
