ATI Adult Medical-
Surgical Practice
Assessment A well
written one year
2025 /2026
updated graded A+
Comprehensive 150-Question Practice Exam
,Instructions
This comprehensive practice examination contains 150 multiple-choice questions designed to assess
knowledge and clinical judgment in adult medical-surgical nursing. Each question includes one correct
answer with a detailed rationale. Select the best answer for each question.
Cardiovascular Disorders (Questions 1-20)
1. A nurse is caring for a client with heart failure who is prescribed furosemide. Which
findingindicates the medication is effective?
A. Increased blood pressure
B. Weight gain
C. Decreased edema
D. Increased dyspnea
- detailed answer 100% correct:_C. Decreased edema
Rationale: Furosemide is a loop diuretic that reduces fluid overload by promoting excretion of sodium
and water. Decreased edema indicates therapeutic effectiveness of the medication. Weight gain and
increased dyspnea would suggest worsening fluid overload.
2. A client with heart failure is prescribed furosemide. Which electrolyte imbalance should the
nursemonitor most closely?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
- detailed answer 100% correct:_B. Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss through urine. Hypokalemia can
lead to cardiac dysrhythmias and is the most significant electrolyte imbalance to monitor.
,3. A nurse is assessing the heart sounds of a client who has developed chest pain that
becomesworse with inspiration. The nurse auscultates a high-pitched scratching sound
during both systole and diastole with the diaphragm of the stethoscope positioned at the
left sternal border. Which heart sound should the nurse document?
A. S3 gallop
B. S4 gallop
C. Pericardial friction rub
D. Murmur
- detailed answer 100% correct:_C. Pericardial friction rub
Rationale: A pericardial friction rub is a high-pitched scratching sound heard during both systole and
diastole, best heard at the left sternal border. It is characteristic of pericarditis, and chest pain that
worsens with inspiration (pleuritic pain) is a classic finding.
4. A client is admitted with chest pain suspected of having a myocardial infarction. What is
thenurse's priority action?
A. Obtain ECG
B. Administer morphine
C. Check blood pressure
D. Start IV fluids
- detailed answer 100% correct:_A. Obtain ECG
Rationale: ECG confirms cardiac ischemia and guides urgent treatment. Time is muscle in MI
management, and rapid ECG acquisition is essential for diagnosis and treatment decisions.
5. A postoperative client suddenly develops chest pain and dyspnea. What is the priority
concern?
A. Atelectasis
B. Pulmonary embolism
C. Pneumonia
D. Anxiety
- detailed answer 100% correct:_B. Pulmonary embolism
, Rationale: Sudden-onset chest pain and dyspnea in a postoperative client are classic signs of
pulmonary embolism (PE). PE is a medical emergency requiring immediate intervention.
6. Which sign is most indicative of right-sided heart failure?
A. Pulmonary edema
B. Peripheral edema
C. Pink frothy sputum
D. Crackles in lungs
- detailed answer 100% correct:_B. Peripheral edema
Rationale: Right-sided heart failure causes systemic venous congestion, leading to peripheral edema,
jugular vein distention, and hepatomegaly. Left-sided failure causes pulmonary congestion with
crackles and pink frothy sputum.
7. A client on warfarin should avoid which food?
A. Apples
B. Spinach
C. Rice
D. Chicken
- detailed answer 100% correct:_B. Spinach
Rationale: Spinach is high in vitamin K, which counteracts the anticoagulant effect of warfarin. Clients
on warfarin should maintain consistent vitamin K intake and avoid sudden increases in vitamin K-rich
foods.
8. A nurse is reviewing the medication record of a client taking digoxin. Which laboratory
valueshould the nurse monitor to prevent digoxin toxicity?
A. Sodium level
B. Potassium level
C. Calcium level
D. Magnesium level
- detailed answer 100% correct:_B. Potassium level
Surgical Practice
Assessment A well
written one year
2025 /2026
updated graded A+
Comprehensive 150-Question Practice Exam
,Instructions
This comprehensive practice examination contains 150 multiple-choice questions designed to assess
knowledge and clinical judgment in adult medical-surgical nursing. Each question includes one correct
answer with a detailed rationale. Select the best answer for each question.
Cardiovascular Disorders (Questions 1-20)
1. A nurse is caring for a client with heart failure who is prescribed furosemide. Which
findingindicates the medication is effective?
A. Increased blood pressure
B. Weight gain
C. Decreased edema
D. Increased dyspnea
- detailed answer 100% correct:_C. Decreased edema
Rationale: Furosemide is a loop diuretic that reduces fluid overload by promoting excretion of sodium
and water. Decreased edema indicates therapeutic effectiveness of the medication. Weight gain and
increased dyspnea would suggest worsening fluid overload.
2. A client with heart failure is prescribed furosemide. Which electrolyte imbalance should the
nursemonitor most closely?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
- detailed answer 100% correct:_B. Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss through urine. Hypokalemia can
lead to cardiac dysrhythmias and is the most significant electrolyte imbalance to monitor.
,3. A nurse is assessing the heart sounds of a client who has developed chest pain that
becomesworse with inspiration. The nurse auscultates a high-pitched scratching sound
during both systole and diastole with the diaphragm of the stethoscope positioned at the
left sternal border. Which heart sound should the nurse document?
A. S3 gallop
B. S4 gallop
C. Pericardial friction rub
D. Murmur
- detailed answer 100% correct:_C. Pericardial friction rub
Rationale: A pericardial friction rub is a high-pitched scratching sound heard during both systole and
diastole, best heard at the left sternal border. It is characteristic of pericarditis, and chest pain that
worsens with inspiration (pleuritic pain) is a classic finding.
4. A client is admitted with chest pain suspected of having a myocardial infarction. What is
thenurse's priority action?
A. Obtain ECG
B. Administer morphine
C. Check blood pressure
D. Start IV fluids
- detailed answer 100% correct:_A. Obtain ECG
Rationale: ECG confirms cardiac ischemia and guides urgent treatment. Time is muscle in MI
management, and rapid ECG acquisition is essential for diagnosis and treatment decisions.
5. A postoperative client suddenly develops chest pain and dyspnea. What is the priority
concern?
A. Atelectasis
B. Pulmonary embolism
C. Pneumonia
D. Anxiety
- detailed answer 100% correct:_B. Pulmonary embolism
, Rationale: Sudden-onset chest pain and dyspnea in a postoperative client are classic signs of
pulmonary embolism (PE). PE is a medical emergency requiring immediate intervention.
6. Which sign is most indicative of right-sided heart failure?
A. Pulmonary edema
B. Peripheral edema
C. Pink frothy sputum
D. Crackles in lungs
- detailed answer 100% correct:_B. Peripheral edema
Rationale: Right-sided heart failure causes systemic venous congestion, leading to peripheral edema,
jugular vein distention, and hepatomegaly. Left-sided failure causes pulmonary congestion with
crackles and pink frothy sputum.
7. A client on warfarin should avoid which food?
A. Apples
B. Spinach
C. Rice
D. Chicken
- detailed answer 100% correct:_B. Spinach
Rationale: Spinach is high in vitamin K, which counteracts the anticoagulant effect of warfarin. Clients
on warfarin should maintain consistent vitamin K intake and avoid sudden increases in vitamin K-rich
foods.
8. A nurse is reviewing the medication record of a client taking digoxin. Which laboratory
valueshould the nurse monitor to prevent digoxin toxicity?
A. Sodium level
B. Potassium level
C. Calcium level
D. Magnesium level
- detailed answer 100% correct:_B. Potassium level
