1
ATI RN Adult Medical-Surgical Proctored
Exam 2023–2026: Comprehensive High-
Yield Practice Examination
Title: ATI RN Adult Medical-Surgical Proctored Exam 2023–2026 Mastery Preparation:
Comprehensive 220-Question Practice Bank with NGN-Style Clinical Judgment Scenarios
Covering Cardiovascular, Respiratory, Gastrointestinal, Renal, Endocrine, Neurological,
Musculoskeletal, Immunological, and Integumentary Disorders with Detailed Rationales
SECTION A: CARDIOVASCULAR DISORDERS (Questions 1-35)
Subsection A1: Coronary Artery Disease and Acute Coronary Syndrome (1-15)
1. A nurse is caring for a client who is 2 hours post-myocardial infarction. The client's cardiac
monitor shows frequent premature ventricular contractions (PVCs). Which of the following
actions should the nurse take FIRST?
A. Administer amiodarone IV as prescribed
B. Assess the client's oxygen saturation and administer oxygen
C. Notify the healthcare provider
D. Check the client's potassium and magnesium levels
Correct Answer: B. Assess the client's oxygen saturation and administer oxygen
,2
Rationale: PVCs after an MI may indicate myocardial irritability due to hypoxia, electrolyte
imbalances, or ischemia. The nurse should first assess oxygenation and administer oxygen if
needed to address potential hypoxia as the underlying cause. While amiodarone may be
ordered, oxygen and assessment are priority actions.
2. A nurse is preparing to administer sublingual nitroglycerin to a client with chest pain.
Which of the following findings is a contraindication to administration?
A. Blood pressure 88/52 mmHg
B. Heart rate 102 bpm
C. Oxygen saturation 94%
D. Chest pain rated 8 on a 0-10 scale
Correct Answer: A. Blood pressure 88/52 mmHg
Rationale: Nitroglycerin causes vasodilation and can significantly lower blood pressure. It is
contraindicated in clients with systolic blood pressure below 90 mmHg or those with significant
hypotension, as it may cause further dangerous drops in pressure.
,3
3. A nurse is caring for a client who is receiving IV heparin for a deep vein thrombosis. Which
of the following laboratory values should the nurse monitor to evaluate the effectiveness of
therapy?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
Correct Answer: B. aPTT
Rationale: Heparin therapy is monitored using the activated partial thromboplastin time (aPTT).
The therapeutic range is typically 1.5 to 2.5 times the control value. INR is used to monitor
warfarin therapy. Platelet count is monitored to detect heparin-induced thrombocytopenia.
4. A nurse is assessing a client with left-sided heart failure. Which of the following findings
should the nurse expect?
A. Peripheral edema
B. Jugular venous distention
, 4
C. Crackles in the lung bases
D. Hepatomegaly
Correct Answer: C. Crackles in the lung bases
Rationale: Left-sided heart failure causes fluid accumulation in the pulmonary circulation,
leading to crackles, dyspnea, and orthopnea. Peripheral edema, JVD, and hepatomegaly are
signs of right-sided heart failure.
5. A nurse is caring for a client who has unstable angina. Which of the following medications
should the nurse anticipate administering?
A. Nitroglycerin sublingual
B. Digoxin
C. Furosemide
D. Warfarin
Correct Answer: A. Nitroglycerin sublingual
Rationale: Unstable angina is treated with nitroglycerin to relieve chest pain by causing
vasodilation and reducing cardiac workload. Digoxin is used for heart failure and atrial
ATI RN Adult Medical-Surgical Proctored
Exam 2023–2026: Comprehensive High-
Yield Practice Examination
Title: ATI RN Adult Medical-Surgical Proctored Exam 2023–2026 Mastery Preparation:
Comprehensive 220-Question Practice Bank with NGN-Style Clinical Judgment Scenarios
Covering Cardiovascular, Respiratory, Gastrointestinal, Renal, Endocrine, Neurological,
Musculoskeletal, Immunological, and Integumentary Disorders with Detailed Rationales
SECTION A: CARDIOVASCULAR DISORDERS (Questions 1-35)
Subsection A1: Coronary Artery Disease and Acute Coronary Syndrome (1-15)
1. A nurse is caring for a client who is 2 hours post-myocardial infarction. The client's cardiac
monitor shows frequent premature ventricular contractions (PVCs). Which of the following
actions should the nurse take FIRST?
A. Administer amiodarone IV as prescribed
B. Assess the client's oxygen saturation and administer oxygen
C. Notify the healthcare provider
D. Check the client's potassium and magnesium levels
Correct Answer: B. Assess the client's oxygen saturation and administer oxygen
,2
Rationale: PVCs after an MI may indicate myocardial irritability due to hypoxia, electrolyte
imbalances, or ischemia. The nurse should first assess oxygenation and administer oxygen if
needed to address potential hypoxia as the underlying cause. While amiodarone may be
ordered, oxygen and assessment are priority actions.
2. A nurse is preparing to administer sublingual nitroglycerin to a client with chest pain.
Which of the following findings is a contraindication to administration?
A. Blood pressure 88/52 mmHg
B. Heart rate 102 bpm
C. Oxygen saturation 94%
D. Chest pain rated 8 on a 0-10 scale
Correct Answer: A. Blood pressure 88/52 mmHg
Rationale: Nitroglycerin causes vasodilation and can significantly lower blood pressure. It is
contraindicated in clients with systolic blood pressure below 90 mmHg or those with significant
hypotension, as it may cause further dangerous drops in pressure.
,3
3. A nurse is caring for a client who is receiving IV heparin for a deep vein thrombosis. Which
of the following laboratory values should the nurse monitor to evaluate the effectiveness of
therapy?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
Correct Answer: B. aPTT
Rationale: Heparin therapy is monitored using the activated partial thromboplastin time (aPTT).
The therapeutic range is typically 1.5 to 2.5 times the control value. INR is used to monitor
warfarin therapy. Platelet count is monitored to detect heparin-induced thrombocytopenia.
4. A nurse is assessing a client with left-sided heart failure. Which of the following findings
should the nurse expect?
A. Peripheral edema
B. Jugular venous distention
, 4
C. Crackles in the lung bases
D. Hepatomegaly
Correct Answer: C. Crackles in the lung bases
Rationale: Left-sided heart failure causes fluid accumulation in the pulmonary circulation,
leading to crackles, dyspnea, and orthopnea. Peripheral edema, JVD, and hepatomegaly are
signs of right-sided heart failure.
5. A nurse is caring for a client who has unstable angina. Which of the following medications
should the nurse anticipate administering?
A. Nitroglycerin sublingual
B. Digoxin
C. Furosemide
D. Warfarin
Correct Answer: A. Nitroglycerin sublingual
Rationale: Unstable angina is treated with nitroglycerin to relieve chest pain by causing
vasodilation and reducing cardiac workload. Digoxin is used for heart failure and atrial
