ATI RN ADULT MEDICAL-SURGICAL PROCTORED EXAM
PREP 2023–2026: 200 NGN-STYLE PRACTICE QUESTIONS
WITH ANSWERS AND RATIONALES
EXAM OVERVIEW
This comprehensive practice question bank contains 200 multiple-choice and Next Generation
NCLEX (NGN)-style questions designed to prepare nursing students for the ATI RN Adult
Medical-Surgical Proctored Exam. Questions cover all major content areas including
Cardiovascular, Respiratory, Gastrointestinal, Renal/Genitourinary, Endocrine, Neurological,
Musculoskeletal, Integumentary, Hematological/Immunological, Perioperative,
Fluid/Electrolytes, and Pharmacology. Each question includes the correct answer and a detailed
rationale to enhance understanding and reinforce key concepts aligned with the ATI Medical-
Surgical Nursing Content Mastery Series® (CMS) blueprint.
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-30)
1. A nurse is caring for a client who has heart failure and is receiving furosemide. Which
laboratory value should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B. Serum potassium
,Rationale: Furosemide is a loop diuretic that causes potassium wasting, leading to hypokalemia.
Hypokalemia can precipitate cardiac dysrhythmias, especially in clients taking digoxin. Serum
potassium should be monitored closely and replaced as needed.
2. A nurse is assessing a client who has unstable angina. Which finding should the nurse
expect?
A. Chest pain that is relieved by rest and nitroglycerin
B. Chest pain that occurs at rest and is not relieved by nitroglycerin
C. Chest pain that is worse with deep inspiration
D. Chest pain that radiates to the right shoulder
Correct Answer: B. Chest pain that occurs at rest and is not relieved by nitroglycerin
Rationale: Unstable angina is characterized by chest pain that occurs at rest or with minimal
exertion and is not readily relieved by nitroglycerin. This indicates an acute coronary syndrome
requiring immediate medical evaluation.
,3. A nurse is preparing to administer digoxin to a client who has heart failure. Which
assessment finding indicates the need to withhold the medication?
A. Heart rate 58 bpm
B. Blood pressure 110/70 mmHg
C. Respiratory rate 18 breaths/min
D. Serum potassium 4.0 mEq/L
Correct Answer: A. Heart rate 58 bpm
Rationale: Digoxin should be withheld if the heart rate is <60 bpm in adults. The healthcare
provider should be notified. Blood pressure, respiratory rate, and potassium level are within
normal limits.
4. A nurse is providing teaching to a client who has a new prescription for warfarin. Which
statement by the client indicates a need for further teaching?
A. "I will avoid eating large amounts of leafy green vegetables"
B. "I will report any bleeding or bruising to my provider"
, C. "I will take ibuprofen for headaches"
D. "I will have my blood tested regularly"
Correct Answer: C. "I will take ibuprofen for headaches"
Rationale: Ibuprofen and other NSAIDs increase the risk of bleeding when taken with warfarin.
The client should use acetaminophen for pain. Consistent vitamin K intake (leafy greens) is
important, not avoidance. Bleeding and regular INR monitoring are appropriate.
5. A nurse is assessing a client who has an acute myocardial infarction. Which finding is most
concerning?
A. Chest pain rated 6 on a scale of 0-10
B. Jugular venous distention
C. Crackles heard in the lung bases
D. New-onset heart block
Correct Answer: D. New-onset heart block
PREP 2023–2026: 200 NGN-STYLE PRACTICE QUESTIONS
WITH ANSWERS AND RATIONALES
EXAM OVERVIEW
This comprehensive practice question bank contains 200 multiple-choice and Next Generation
NCLEX (NGN)-style questions designed to prepare nursing students for the ATI RN Adult
Medical-Surgical Proctored Exam. Questions cover all major content areas including
Cardiovascular, Respiratory, Gastrointestinal, Renal/Genitourinary, Endocrine, Neurological,
Musculoskeletal, Integumentary, Hematological/Immunological, Perioperative,
Fluid/Electrolytes, and Pharmacology. Each question includes the correct answer and a detailed
rationale to enhance understanding and reinforce key concepts aligned with the ATI Medical-
Surgical Nursing Content Mastery Series® (CMS) blueprint.
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-30)
1. A nurse is caring for a client who has heart failure and is receiving furosemide. Which
laboratory value should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B. Serum potassium
,Rationale: Furosemide is a loop diuretic that causes potassium wasting, leading to hypokalemia.
Hypokalemia can precipitate cardiac dysrhythmias, especially in clients taking digoxin. Serum
potassium should be monitored closely and replaced as needed.
2. A nurse is assessing a client who has unstable angina. Which finding should the nurse
expect?
A. Chest pain that is relieved by rest and nitroglycerin
B. Chest pain that occurs at rest and is not relieved by nitroglycerin
C. Chest pain that is worse with deep inspiration
D. Chest pain that radiates to the right shoulder
Correct Answer: B. Chest pain that occurs at rest and is not relieved by nitroglycerin
Rationale: Unstable angina is characterized by chest pain that occurs at rest or with minimal
exertion and is not readily relieved by nitroglycerin. This indicates an acute coronary syndrome
requiring immediate medical evaluation.
,3. A nurse is preparing to administer digoxin to a client who has heart failure. Which
assessment finding indicates the need to withhold the medication?
A. Heart rate 58 bpm
B. Blood pressure 110/70 mmHg
C. Respiratory rate 18 breaths/min
D. Serum potassium 4.0 mEq/L
Correct Answer: A. Heart rate 58 bpm
Rationale: Digoxin should be withheld if the heart rate is <60 bpm in adults. The healthcare
provider should be notified. Blood pressure, respiratory rate, and potassium level are within
normal limits.
4. A nurse is providing teaching to a client who has a new prescription for warfarin. Which
statement by the client indicates a need for further teaching?
A. "I will avoid eating large amounts of leafy green vegetables"
B. "I will report any bleeding or bruising to my provider"
, C. "I will take ibuprofen for headaches"
D. "I will have my blood tested regularly"
Correct Answer: C. "I will take ibuprofen for headaches"
Rationale: Ibuprofen and other NSAIDs increase the risk of bleeding when taken with warfarin.
The client should use acetaminophen for pain. Consistent vitamin K intake (leafy greens) is
important, not avoidance. Bleeding and regular INR monitoring are appropriate.
5. A nurse is assessing a client who has an acute myocardial infarction. Which finding is most
concerning?
A. Chest pain rated 6 on a scale of 0-10
B. Jugular venous distention
C. Crackles heard in the lung bases
D. New-onset heart block
Correct Answer: D. New-onset heart block
