ATI PN Adult Medical-Surgical (Med-Surg) Proctored Exam with NGN
2023–2026 | Complete 130-Question Practice Test, Detailed Rationales,
Clinical Judgment Case Studies, Prioritization, Pharmacology, and
Comprehensive NCLEX-PN Review Guide
Overview
This comprehensive ATI PN Adult Medical-Surgical (Med-Surg) practice exam includes 130 original
NCLEX-PN–style questions with detailed rationales designed to strengthen clinical judgment and exam
readiness. The practice set covers high-yield adult health concepts commonly tested on ATI PN Med-Surg
assessments and integrates Next Generation NCLEX (NGN) item formats, including case studies, select-
all-that-apply questions, prioritization scenarios, and clinical decision-making exercises.
Coverage Includes
Cardiovascular Disorders and Heart Failure
Respiratory Disorders, COPD, and Pneumonia
Diabetes Mellitus and Diabetic Ketoacidosis (DKA)
Renal Disorders and Electrolyte Imbalances
Gastrointestinal and Hepatic Disorders
Neurological Disorders and Stroke Management
Musculoskeletal and Orthopedic Emergencies
Oncology and Chemotherapy Complications
Hematologic Disorders and Blood Transfusion Reactions
Burns, Sepsis, and Shock Management
Pharmacology and Medication Safety
Postoperative Care and Complications
Prioritization, Delegation, and Safety
NGN Clinical Judgment and Case Studies
Comprehensive Adult Medical-Surgical Nursing Review and Exam Preparation
1.
A nurse is caring for a client admitted with heart failure who reports increasing shortness of
breath and difficulty lying flat. Which assessment finding should the nurse identify as the
priority?
A. Bilateral ankle edema
B. Weight gain of 2 lb in one week
,C. Crackles in both lung bases and oxygen saturation of 88%
D. Fatigue with activity
Answer: C. Crackles in both lung bases and oxygen saturation of 88%
Rationale: Airway and breathing take priority. Crackles and low oxygen saturation indicate
pulmonary congestion and impaired oxygenation requiring immediate intervention.
2.
A client with chronic obstructive pulmonary disease suddenly becomes restless and
confused. Which action should the nurse take first?
A. Encourage oral fluids.
B. Assess oxygen saturation and respiratory status.
C. Assist the client with ambulation.
D. Obtain a dietary history.
Answer: B. Assess oxygen saturation and respiratory status.
Rationale: Restlessness and confusion are early signs of hypoxemia. Immediate
respiratory assessment is the priority.
3.
A client receiving intravenous morphine becomes difficult to arouse and has a respiratory
rate of 8/min. Which medication should the nurse anticipate administering?
A. Protamine sulfate
B. Vitamin K
,C. Naloxone
D. Acetylcysteine
Answer: C. Naloxone
Rationale: Naloxone reverses opioid-induced respiratory depression.
4.
A client with diabetes mellitus reports sweating, shakiness, and blurred vision. Which action
should the nurse take first?
A. Administer insulin.
B. Encourage exercise.
C. Check the blood glucose level and treat hypoglycemia if present.
D. Restrict oral intake.
Answer: C. Check the blood glucose level and treat hypoglycemia if present.
Rationale: The manifestations suggest hypoglycemia, which requires immediate
assessment and intervention.
5.
A client with chronic kidney disease has a serum potassium level of 6.5 mEq/L. Which
finding requires immediate intervention?
A. Dry mouth
B. Mild nausea
C. Peaked T waves on the electrocardiogram
D. Blood pressure of 138/84 mmHg
, Answer: C. Peaked T waves on the electrocardiogram
Rationale: Hyperkalemia can cause life-threatening dysrhythmias. Peaked T waves are a
serious manifestation requiring immediate treatment.
6.
A client who had abdominal surgery yesterday reports sudden shortness of breath and
chest pain. Which complication should the nurse suspect?
A. Pneumonia
B. Pulmonary embolism
C. Urinary retention
D. Constipation
Answer: B. Pulmonary embolism
Rationale: Sudden chest pain and dyspnea following surgery are classic signs of
pulmonary embolism.
7.
A client receiving a blood transfusion develops chills, fever, and low back pain. Which action
should the nurse take first?
A. Slow the infusion rate.
B. Stop the transfusion immediately.
C. Administer acetaminophen.
D. Continue monitoring.
Answer: B. Stop the transfusion immediately.
2023–2026 | Complete 130-Question Practice Test, Detailed Rationales,
Clinical Judgment Case Studies, Prioritization, Pharmacology, and
Comprehensive NCLEX-PN Review Guide
Overview
This comprehensive ATI PN Adult Medical-Surgical (Med-Surg) practice exam includes 130 original
NCLEX-PN–style questions with detailed rationales designed to strengthen clinical judgment and exam
readiness. The practice set covers high-yield adult health concepts commonly tested on ATI PN Med-Surg
assessments and integrates Next Generation NCLEX (NGN) item formats, including case studies, select-
all-that-apply questions, prioritization scenarios, and clinical decision-making exercises.
Coverage Includes
Cardiovascular Disorders and Heart Failure
Respiratory Disorders, COPD, and Pneumonia
Diabetes Mellitus and Diabetic Ketoacidosis (DKA)
Renal Disorders and Electrolyte Imbalances
Gastrointestinal and Hepatic Disorders
Neurological Disorders and Stroke Management
Musculoskeletal and Orthopedic Emergencies
Oncology and Chemotherapy Complications
Hematologic Disorders and Blood Transfusion Reactions
Burns, Sepsis, and Shock Management
Pharmacology and Medication Safety
Postoperative Care and Complications
Prioritization, Delegation, and Safety
NGN Clinical Judgment and Case Studies
Comprehensive Adult Medical-Surgical Nursing Review and Exam Preparation
1.
A nurse is caring for a client admitted with heart failure who reports increasing shortness of
breath and difficulty lying flat. Which assessment finding should the nurse identify as the
priority?
A. Bilateral ankle edema
B. Weight gain of 2 lb in one week
,C. Crackles in both lung bases and oxygen saturation of 88%
D. Fatigue with activity
Answer: C. Crackles in both lung bases and oxygen saturation of 88%
Rationale: Airway and breathing take priority. Crackles and low oxygen saturation indicate
pulmonary congestion and impaired oxygenation requiring immediate intervention.
2.
A client with chronic obstructive pulmonary disease suddenly becomes restless and
confused. Which action should the nurse take first?
A. Encourage oral fluids.
B. Assess oxygen saturation and respiratory status.
C. Assist the client with ambulation.
D. Obtain a dietary history.
Answer: B. Assess oxygen saturation and respiratory status.
Rationale: Restlessness and confusion are early signs of hypoxemia. Immediate
respiratory assessment is the priority.
3.
A client receiving intravenous morphine becomes difficult to arouse and has a respiratory
rate of 8/min. Which medication should the nurse anticipate administering?
A. Protamine sulfate
B. Vitamin K
,C. Naloxone
D. Acetylcysteine
Answer: C. Naloxone
Rationale: Naloxone reverses opioid-induced respiratory depression.
4.
A client with diabetes mellitus reports sweating, shakiness, and blurred vision. Which action
should the nurse take first?
A. Administer insulin.
B. Encourage exercise.
C. Check the blood glucose level and treat hypoglycemia if present.
D. Restrict oral intake.
Answer: C. Check the blood glucose level and treat hypoglycemia if present.
Rationale: The manifestations suggest hypoglycemia, which requires immediate
assessment and intervention.
5.
A client with chronic kidney disease has a serum potassium level of 6.5 mEq/L. Which
finding requires immediate intervention?
A. Dry mouth
B. Mild nausea
C. Peaked T waves on the electrocardiogram
D. Blood pressure of 138/84 mmHg
, Answer: C. Peaked T waves on the electrocardiogram
Rationale: Hyperkalemia can cause life-threatening dysrhythmias. Peaked T waves are a
serious manifestation requiring immediate treatment.
6.
A client who had abdominal surgery yesterday reports sudden shortness of breath and
chest pain. Which complication should the nurse suspect?
A. Pneumonia
B. Pulmonary embolism
C. Urinary retention
D. Constipation
Answer: B. Pulmonary embolism
Rationale: Sudden chest pain and dyspnea following surgery are classic signs of
pulmonary embolism.
7.
A client receiving a blood transfusion develops chills, fever, and low back pain. Which action
should the nurse take first?
A. Slow the infusion rate.
B. Stop the transfusion immediately.
C. Administer acetaminophen.
D. Continue monitoring.
Answer: B. Stop the transfusion immediately.
