Comprehensive Test Bank: ATI PN Adult
Medical-Surgical Mastery (30 Questions) EXAM
QUESTIONS AND ANSWERS 100% CORRECT!
Table of Contents
1. Cardiovascular Disorders and Hemodynamics
2. Respiratory Management and Acid-Base Balance
3. Renal, Urinary, and Fluid/Electrolyte Balance
4. Endocrine, Gastrointestinal, and Metabolic Emergencies
5. Neurological, Musculoskeletal, and Perioperative Care
1. Cardiovascular Disorders and Hemodynamics
Question 1 (Multiple Choice)
A nurse is assessing a client with left-sided heart failure. Which of the following
findings should the nurse expect?
● A. Jugular vein distension
● B. Dependent pedal edema
● C. Dyspnea on exertion and crackles
● D. Hepatomegaly and ascites
Correct Answer: C. Dyspnea on exertion and crackles Rationale: Left-sided
heart failure causes blood to back up into the pulmonary circulation, leading to
pulmonary congestion, dyspnea, orthopnea, and crackles in the lung fields.
Jugular vein distension, pedal edema, and hepatomegaly are clinical
manifestations of right-sided heart failure.
Question 2 (Scenario-Based)
A nurse is caring for a client who is 1 day postoperative following a coronary
artery bypass graft (CABG) surgery. The client's chest tube output drops from 70
mL/hr to 10 mL/hr over a 2-hour window, and the client suddenly develops
, muffled heart sounds and hypotension. Which complication should the nurse
suspect?
● A. Pulmonary embolism
● B. Cardiac tamponade
● C. Hypovolemic shock
● D. Atelectasis
Correct Answer: B. Cardiac tamponade Rationale: A sudden drop in chest tube
drainage combined with hypotension and muffled heart sounds indicates an
obstruction of the chest tube, leading to blood accumulation around the heart
(cardiac tamponade). This compresses the myocardium and restricts cardiac
output, constituting a medical emergency.
Question 3 (Short Answer)
What is the primary pharmacological action of digoxin when administered to a
client with heart failure?
Correct Answer: It increases myocardial contractility (positive inotrope) while
decreasing heart rate (negative chronotrope). Rationale: Digoxin enhances the
force of ventricular contractions to improve cardiac output while slowing
conduction through the atrioventricular (AV) node, allowing more time for
ventricular filling.
Question 4 (Multiple Choice)
A nurse is preparing to administer digoxin to a client with heart failure. Which of
the following pre-assessment findings requires the nurse to withhold the
medication and notify the provider?
● A. Blood pressure of 128/82 mmHg
● B. Serum potassium level of 4.2 mEq/L
● C. Apical pulse rate of 54 beats/min
● D. Respiratory rate of 16 breaths/min
Correct Answer: C. Apical pulse rate of 54 beats/min Rationale: Digoxin slows
the heart rate. Standard safety guidelines require the nurse to withhold the dose
and notify the provider if an adult client's apical pulse is less than 60 beats/min to
prevent severe bradycardia and toxicity.
Medical-Surgical Mastery (30 Questions) EXAM
QUESTIONS AND ANSWERS 100% CORRECT!
Table of Contents
1. Cardiovascular Disorders and Hemodynamics
2. Respiratory Management and Acid-Base Balance
3. Renal, Urinary, and Fluid/Electrolyte Balance
4. Endocrine, Gastrointestinal, and Metabolic Emergencies
5. Neurological, Musculoskeletal, and Perioperative Care
1. Cardiovascular Disorders and Hemodynamics
Question 1 (Multiple Choice)
A nurse is assessing a client with left-sided heart failure. Which of the following
findings should the nurse expect?
● A. Jugular vein distension
● B. Dependent pedal edema
● C. Dyspnea on exertion and crackles
● D. Hepatomegaly and ascites
Correct Answer: C. Dyspnea on exertion and crackles Rationale: Left-sided
heart failure causes blood to back up into the pulmonary circulation, leading to
pulmonary congestion, dyspnea, orthopnea, and crackles in the lung fields.
Jugular vein distension, pedal edema, and hepatomegaly are clinical
manifestations of right-sided heart failure.
Question 2 (Scenario-Based)
A nurse is caring for a client who is 1 day postoperative following a coronary
artery bypass graft (CABG) surgery. The client's chest tube output drops from 70
mL/hr to 10 mL/hr over a 2-hour window, and the client suddenly develops
, muffled heart sounds and hypotension. Which complication should the nurse
suspect?
● A. Pulmonary embolism
● B. Cardiac tamponade
● C. Hypovolemic shock
● D. Atelectasis
Correct Answer: B. Cardiac tamponade Rationale: A sudden drop in chest tube
drainage combined with hypotension and muffled heart sounds indicates an
obstruction of the chest tube, leading to blood accumulation around the heart
(cardiac tamponade). This compresses the myocardium and restricts cardiac
output, constituting a medical emergency.
Question 3 (Short Answer)
What is the primary pharmacological action of digoxin when administered to a
client with heart failure?
Correct Answer: It increases myocardial contractility (positive inotrope) while
decreasing heart rate (negative chronotrope). Rationale: Digoxin enhances the
force of ventricular contractions to improve cardiac output while slowing
conduction through the atrioventricular (AV) node, allowing more time for
ventricular filling.
Question 4 (Multiple Choice)
A nurse is preparing to administer digoxin to a client with heart failure. Which of
the following pre-assessment findings requires the nurse to withhold the
medication and notify the provider?
● A. Blood pressure of 128/82 mmHg
● B. Serum potassium level of 4.2 mEq/L
● C. Apical pulse rate of 54 beats/min
● D. Respiratory rate of 16 breaths/min
Correct Answer: C. Apical pulse rate of 54 beats/min Rationale: Digoxin slows
the heart rate. Standard safety guidelines require the nurse to withhold the dose
and notify the provider if an adult client's apical pulse is less than 60 beats/min to
prevent severe bradycardia and toxicity.
