ATI RN Adult Medical-Surgical (Med-Surg) Advanced Practice
Examination v2.0
Comprehensive 100-Question Test Bank with Detailed Rationales
Cardiovascular System (Questions 1–20)
Question 1
A nurse is caring for a client with acute pericarditis who reports sharp chest pain that worsens with
deep inspiration and improves when sitting upright and leaning forward. Which medication should the
nurse anticipate administering first?
A. Morphine sulfate
B. Ibuprofen
C. Nitroglycerin
D. Heparin
Correct Answer: B
Rationale: Pericarditis is typically inflammatory in origin, and NSAIDs (ibuprofen) are the first-line
treatment to reduce inflammation and relieve pain. Morphine may be used for severe pain but is not
first-line. Nitroglycerin is used for angina, not pericarditis. Heparin is used for thromboembolic
conditions.
Question 2
A client with heart failure has jugular venous distension, peripheral edema, and crackles in the lung
bases. The nurse notes a weight gain of 2.5 kg (5.5 lb) over the past 3 days. Which intervention should
the nurse implement first?
A. Restrict oral fluid intake to 1,500 mL/day
B. Administer furosemide as prescribed
C. Elevate the client's legs above heart level
D. Place the client in high Fowler's position
,Correct Answer: D
Rationale: High Fowler's position promotes venous return and reduces preload, helping to alleviate
pulmonary congestion and dyspnea. This is the priority to improve oxygenation. While furosemide and
fluid restriction are appropriate, positioning is the immediate intervention.
Question 3
A nurse is assessing a client who is 2 hours post-cardiac catheterization via the femoral artery. The
client's blood pressure is 88/54 mm Hg, heart rate is 112/min, and the groin site has a large expanding
hematoma. Which action should the nurse take first?
A. Notify the healthcare provider
B. Apply firm manual pressure to the groin site
C. Administer IV fluids as prescribed
D. Check the client's hemoglobin and hematocrit
Correct Answer: B
Rationale: An expanding hematoma with hypotension and tachycardia indicates active bleeding at the
femoral access site. The immediate priority is to apply firm manual pressure to achieve hemostasis.
After stabilizing the site, the provider should be notified.
Question 4
A client with chronic atrial fibrillation is prescribed rivaroxaban. Which statement by the client indicates
understanding of this medication?
A. "I will stop taking this medication if I develop any bruising."
B. "I should take this medication with food to prevent stomach upset."
C. "I will need to have my blood drawn regularly to check my levels."
D. "I can take this medication with or without food at the same time each day."
Correct Answer: D
Rationale: Rivaroxaban is a direct oral anticoagulant that should be taken at the same time each day
with food to maximize absorption. Routine blood monitoring is not required as it is for warfarin.
,Bruising is an expected side effect; the client should not stop the medication without consulting the
provider.
Question 5
A client with an acute myocardial infarction is receiving alteplase (tPA). Which assessment finding
indicates a potential complication of this therapy?
A. Chest pain rated 3/10
B. ST-segment elevation on ECG
C. Bleeding from the IV site
D. Heart rate 88/min
Correct Answer: C
Rationale: Alteplase is a thrombolytic agent that can cause bleeding complications. Bleeding from the
IV site is an expected but potentially serious complication requiring monitoring. Chest pain and ST-
segment elevation are expected findings in acute MI.
Question 6
A client with a permanent pacemaker is being discharged. Which instruction should the nurse include
in the discharge teaching?
A. "You may use a cell phone on the same side as your pacemaker."
B. "Avoid sources of strong electromagnetic fields."
C. "You cannot travel by airplane with a pacemaker."
D. "You should limit your arm movement on the pacemaker side permanently."
Correct Answer: B
Rationale: Clients with pacemakers should avoid strong electromagnetic fields (e.g., MRI, large
magnets) to prevent interference with pacemaker function. Cell phones should be used on the
opposite side. Air travel is permitted. Arm movement should be limited only temporarily (4-6 weeks).
, Question 7
A nurse is caring for a client with a deep vein thrombosis who is receiving enoxaparin. Which
laboratory value should the nurse monitor?
A. aPTT
B. INR
C. Platelet count
D. PT
Correct Answer: C
Rationale: Enoxaparin (low-molecular-weight heparin) can cause heparin-induced thrombocytopenia.
Platelet counts should be monitored regularly. aPTT and PT are not routinely monitored for
enoxaparin.
Question 8
A client with aortic regurgitation is being evaluated. Which finding is most characteristic of this
condition?
A. Systolic ejection murmur
B. Diastolic murmur heard at the left sternal border
C. Systolic murmur at the apex
D. Continuous murmur
Correct Answer: B
Rationale: Aortic regurgitation is characterized by a diastolic decrescendo murmur heard best at the
left sternal border. A systolic ejection murmur is characteristic of aortic stenosis. A systolic murmur at
the apex is characteristic of mitral regurgitation.
Question 9
A client with cardiogenic shock is receiving dobutamine. Which finding indicates the medication is
having the desired effect?
Examination v2.0
Comprehensive 100-Question Test Bank with Detailed Rationales
Cardiovascular System (Questions 1–20)
Question 1
A nurse is caring for a client with acute pericarditis who reports sharp chest pain that worsens with
deep inspiration and improves when sitting upright and leaning forward. Which medication should the
nurse anticipate administering first?
A. Morphine sulfate
B. Ibuprofen
C. Nitroglycerin
D. Heparin
Correct Answer: B
Rationale: Pericarditis is typically inflammatory in origin, and NSAIDs (ibuprofen) are the first-line
treatment to reduce inflammation and relieve pain. Morphine may be used for severe pain but is not
first-line. Nitroglycerin is used for angina, not pericarditis. Heparin is used for thromboembolic
conditions.
Question 2
A client with heart failure has jugular venous distension, peripheral edema, and crackles in the lung
bases. The nurse notes a weight gain of 2.5 kg (5.5 lb) over the past 3 days. Which intervention should
the nurse implement first?
A. Restrict oral fluid intake to 1,500 mL/day
B. Administer furosemide as prescribed
C. Elevate the client's legs above heart level
D. Place the client in high Fowler's position
,Correct Answer: D
Rationale: High Fowler's position promotes venous return and reduces preload, helping to alleviate
pulmonary congestion and dyspnea. This is the priority to improve oxygenation. While furosemide and
fluid restriction are appropriate, positioning is the immediate intervention.
Question 3
A nurse is assessing a client who is 2 hours post-cardiac catheterization via the femoral artery. The
client's blood pressure is 88/54 mm Hg, heart rate is 112/min, and the groin site has a large expanding
hematoma. Which action should the nurse take first?
A. Notify the healthcare provider
B. Apply firm manual pressure to the groin site
C. Administer IV fluids as prescribed
D. Check the client's hemoglobin and hematocrit
Correct Answer: B
Rationale: An expanding hematoma with hypotension and tachycardia indicates active bleeding at the
femoral access site. The immediate priority is to apply firm manual pressure to achieve hemostasis.
After stabilizing the site, the provider should be notified.
Question 4
A client with chronic atrial fibrillation is prescribed rivaroxaban. Which statement by the client indicates
understanding of this medication?
A. "I will stop taking this medication if I develop any bruising."
B. "I should take this medication with food to prevent stomach upset."
C. "I will need to have my blood drawn regularly to check my levels."
D. "I can take this medication with or without food at the same time each day."
Correct Answer: D
Rationale: Rivaroxaban is a direct oral anticoagulant that should be taken at the same time each day
with food to maximize absorption. Routine blood monitoring is not required as it is for warfarin.
,Bruising is an expected side effect; the client should not stop the medication without consulting the
provider.
Question 5
A client with an acute myocardial infarction is receiving alteplase (tPA). Which assessment finding
indicates a potential complication of this therapy?
A. Chest pain rated 3/10
B. ST-segment elevation on ECG
C. Bleeding from the IV site
D. Heart rate 88/min
Correct Answer: C
Rationale: Alteplase is a thrombolytic agent that can cause bleeding complications. Bleeding from the
IV site is an expected but potentially serious complication requiring monitoring. Chest pain and ST-
segment elevation are expected findings in acute MI.
Question 6
A client with a permanent pacemaker is being discharged. Which instruction should the nurse include
in the discharge teaching?
A. "You may use a cell phone on the same side as your pacemaker."
B. "Avoid sources of strong electromagnetic fields."
C. "You cannot travel by airplane with a pacemaker."
D. "You should limit your arm movement on the pacemaker side permanently."
Correct Answer: B
Rationale: Clients with pacemakers should avoid strong electromagnetic fields (e.g., MRI, large
magnets) to prevent interference with pacemaker function. Cell phones should be used on the
opposite side. Air travel is permitted. Arm movement should be limited only temporarily (4-6 weeks).
, Question 7
A nurse is caring for a client with a deep vein thrombosis who is receiving enoxaparin. Which
laboratory value should the nurse monitor?
A. aPTT
B. INR
C. Platelet count
D. PT
Correct Answer: C
Rationale: Enoxaparin (low-molecular-weight heparin) can cause heparin-induced thrombocytopenia.
Platelet counts should be monitored regularly. aPTT and PT are not routinely monitored for
enoxaparin.
Question 8
A client with aortic regurgitation is being evaluated. Which finding is most characteristic of this
condition?
A. Systolic ejection murmur
B. Diastolic murmur heard at the left sternal border
C. Systolic murmur at the apex
D. Continuous murmur
Correct Answer: B
Rationale: Aortic regurgitation is characterized by a diastolic decrescendo murmur heard best at the
left sternal border. A systolic ejection murmur is characteristic of aortic stenosis. A systolic murmur at
the apex is characteristic of mitral regurgitation.
Question 9
A client with cardiogenic shock is receiving dobutamine. Which finding indicates the medication is
having the desired effect?
