ATI Adult Medical-Surgical
Practice Assessment B:
Version 2.0 well written one
year 2025 /2026 updated
graded A+Comprehensive 150-Question
Exam Bank with Detailed Rationales
Target Audience: RN Nursing Students & Professionals
Difficulty Level: Mixed (Entry to Advanced)
Content Focus: Cardiovascular, Respiratory, Neurological, Gastrointestinal, Renal, Endocrine, Immune,
Musculoskeletal, Oncology, Perioperative Care, Fluid/Electrolyte Balance, Pharmacology, Prioritization,
Clinical Judgment, and Next Generation NCLEX-Style Questions
,Questions 1–150
Cardiovascular System
1. A nurse is assessing a client with aortic stenosis. Which of the following findings should
the nurseexpect?
A) Bounding peripheral pulses
B) Systolic ejection murmur
C) Widened pulse pressure
D) Hypotension
- detailed answer 100% correct:_B
Rationale: Aortic stenosis causes a systolic ejection murmur heard best at the right upper sternal
border. It is characterized by narrowed pulse pressure, weak pulses, and left ventricular hypertrophy.
Bounding pulses and widened pulse pressure are associated with aortic regurgitation.
2. A nurse is caring for a client who has pericarditis. Which of the following findings is the
mostcharacteristic of this condition?
A) Pain that worsens when lying flat
B) Pain that improves with deep inspiration
C) Pain that is relieved by leaning forward
D) Pain that is constant and dull
- detailed answer 100% correct:_C
Rationale: Pericarditis pain is typically relieved by leaning forward and worsens when lying flat or with
deep inspiration. The pain is often sharp and pleuritic. Leaning forward reduces pressure on the
pericardium.
3. A nurse is monitoring a client who is receiving IV heparin for a pulmonary embolism.
Which ofthe following laboratory values is the best indicator that heparin therapy is
therapeutic?
, A) INR 2.5
B) aPTT 65 seconds (normal 25-35 seconds)
C) Platelet count 100,000/mm³
D) PT 15 seconds (normal 11-13 seconds)
- detailed answer 100% correct:_B
Rationale: The therapeutic aPTT for heparin therapy is 1.5-2.5 times the normal control value. With a
normal control of 25-35 seconds, a therapeutic value would be 60-80 seconds. An aPTT of 65 seconds
indicates therapeutic anticoagulation.
4. A nurse is assessing a client who is 24 hours post-cardiac catheterization via the femoral
artery.Which of the following findings requires immediate intervention?
A) Pulse at the insertion site 2+
B) A hematoma at the insertion site
C) Slight bruising around the insertion site
D) Client reports mild discomfort at the site
- detailed answer 100% correct:_B
Rationale: A hematoma at the insertion site indicates bleeding or pseudoaneurysm formation and
requires immediate intervention. Slight bruising and mild discomfort are expected; a 2+ pulse is
normal.
5. A nurse is providing discharge teaching to a client who has a new permanent pacemaker.
Whichof the following instructions should the nurse include?
A) "You should avoid using a microwave oven."
B) "You should avoid lifting objects heavier than 5 pounds for 2 weeks."
C) "You should not fly in an airplane with a pacemaker."
D) "You should wear a medical alert bracelet."
- detailed answer 100% correct:_D
, Rationale: Clients with pacemakers should wear a medical alert bracelet to alert healthcare providers
of the device. Microwaves are safe; lifting restrictions vary; flying is permitted.
6. A nurse is caring for a client who has heart failure and is taking spironolactone. Which of
thefollowing findings indicates a potential adverse effect of this medication?
A) Hyponatremia
B) Hyperkalemia
C) Hypokalemia
D) Hypercalcemia
- detailed answer 100% correct:_B
Rationale: Spironolactone is a potassium-sparing diuretic and can cause hyperkalemia. Serum
potassium levels should be monitored closely. Hyponatremia, hypokalemia, and hypercalcemia are not
typical adverse effects.
7. A nurse is assessing a client with varicose veins. Which of the following findings is
consistent withthis condition?
A) Cool, pale lower extremities
B) Dilated, tortuous superficial veins
C) Diminished pedal pulses
D) Brownish discoloration around the ankles
- detailed answer 100% correct:_B
Rationale: Varicose veins are dilated, tortuous superficial veins. Cool, pale extremities and diminished
pulses indicate arterial insufficiency; brownish discoloration indicates chronic venous insufficiency.
8. A nurse is caring for a client who has an abdominal aortic aneurysm (AAA). Which of
thefollowing findings should the nurse report immediately?
A) Midline abdominal bruit
B) Pulsatile abdominal mass
C) Sudden back pain with hypotension
Practice Assessment B:
Version 2.0 well written one
year 2025 /2026 updated
graded A+Comprehensive 150-Question
Exam Bank with Detailed Rationales
Target Audience: RN Nursing Students & Professionals
Difficulty Level: Mixed (Entry to Advanced)
Content Focus: Cardiovascular, Respiratory, Neurological, Gastrointestinal, Renal, Endocrine, Immune,
Musculoskeletal, Oncology, Perioperative Care, Fluid/Electrolyte Balance, Pharmacology, Prioritization,
Clinical Judgment, and Next Generation NCLEX-Style Questions
,Questions 1–150
Cardiovascular System
1. A nurse is assessing a client with aortic stenosis. Which of the following findings should
the nurseexpect?
A) Bounding peripheral pulses
B) Systolic ejection murmur
C) Widened pulse pressure
D) Hypotension
- detailed answer 100% correct:_B
Rationale: Aortic stenosis causes a systolic ejection murmur heard best at the right upper sternal
border. It is characterized by narrowed pulse pressure, weak pulses, and left ventricular hypertrophy.
Bounding pulses and widened pulse pressure are associated with aortic regurgitation.
2. A nurse is caring for a client who has pericarditis. Which of the following findings is the
mostcharacteristic of this condition?
A) Pain that worsens when lying flat
B) Pain that improves with deep inspiration
C) Pain that is relieved by leaning forward
D) Pain that is constant and dull
- detailed answer 100% correct:_C
Rationale: Pericarditis pain is typically relieved by leaning forward and worsens when lying flat or with
deep inspiration. The pain is often sharp and pleuritic. Leaning forward reduces pressure on the
pericardium.
3. A nurse is monitoring a client who is receiving IV heparin for a pulmonary embolism.
Which ofthe following laboratory values is the best indicator that heparin therapy is
therapeutic?
, A) INR 2.5
B) aPTT 65 seconds (normal 25-35 seconds)
C) Platelet count 100,000/mm³
D) PT 15 seconds (normal 11-13 seconds)
- detailed answer 100% correct:_B
Rationale: The therapeutic aPTT for heparin therapy is 1.5-2.5 times the normal control value. With a
normal control of 25-35 seconds, a therapeutic value would be 60-80 seconds. An aPTT of 65 seconds
indicates therapeutic anticoagulation.
4. A nurse is assessing a client who is 24 hours post-cardiac catheterization via the femoral
artery.Which of the following findings requires immediate intervention?
A) Pulse at the insertion site 2+
B) A hematoma at the insertion site
C) Slight bruising around the insertion site
D) Client reports mild discomfort at the site
- detailed answer 100% correct:_B
Rationale: A hematoma at the insertion site indicates bleeding or pseudoaneurysm formation and
requires immediate intervention. Slight bruising and mild discomfort are expected; a 2+ pulse is
normal.
5. A nurse is providing discharge teaching to a client who has a new permanent pacemaker.
Whichof the following instructions should the nurse include?
A) "You should avoid using a microwave oven."
B) "You should avoid lifting objects heavier than 5 pounds for 2 weeks."
C) "You should not fly in an airplane with a pacemaker."
D) "You should wear a medical alert bracelet."
- detailed answer 100% correct:_D
, Rationale: Clients with pacemakers should wear a medical alert bracelet to alert healthcare providers
of the device. Microwaves are safe; lifting restrictions vary; flying is permitted.
6. A nurse is caring for a client who has heart failure and is taking spironolactone. Which of
thefollowing findings indicates a potential adverse effect of this medication?
A) Hyponatremia
B) Hyperkalemia
C) Hypokalemia
D) Hypercalcemia
- detailed answer 100% correct:_B
Rationale: Spironolactone is a potassium-sparing diuretic and can cause hyperkalemia. Serum
potassium levels should be monitored closely. Hyponatremia, hypokalemia, and hypercalcemia are not
typical adverse effects.
7. A nurse is assessing a client with varicose veins. Which of the following findings is
consistent withthis condition?
A) Cool, pale lower extremities
B) Dilated, tortuous superficial veins
C) Diminished pedal pulses
D) Brownish discoloration around the ankles
- detailed answer 100% correct:_B
Rationale: Varicose veins are dilated, tortuous superficial veins. Cool, pale extremities and diminished
pulses indicate arterial insufficiency; brownish discoloration indicates chronic venous insufficiency.
8. A nurse is caring for a client who has an abdominal aortic aneurysm (AAA). Which of
thefollowing findings should the nurse report immediately?
A) Midline abdominal bruit
B) Pulsatile abdominal mass
C) Sudden back pain with hypotension
