ATI RN ADULT MEDICAL-SURGICAL PROCTORED
RETAKE EXAM PRACTICE QUESTIONS
COMPREHENSIVE 350-QUESTION BANK WITH
DETAILED RATIONALES.
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SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-45)
Question 1
A nurse is caring for a client who has heart failure and a prescription for
digoxin 125 mcg PO daily. Which of the following findings should indicate to
the nurse that the client is experiencing digoxin toxicity?
A) Heart rate 62/min
B) Serum potassium 4.0 mEq/L
C) Anorexia and nausea
D) Blood pressure 138/88 mmHg
Answer: C
Rationale: Early signs of digoxin toxicity include gastrointestinal symptoms
such as anorexia, nausea, vomiting, and abdominal pain. Other signs include
visual disturbances (blurred vision, yellow-green halos), bradycardia, and
cardiac dysrhythmias. A heart rate of 62/min is within normal range,
potassium 4.0 mEq/L is normal, and blood pressure 138/88 mmHg is slightly
elevated but not indicative of digoxin toxicity.
Question 2
,A nurse is assessing a client who has a serum potassium level of 6.8 mEq/L.
Which of the following assessments is the priority?
A) Skin turgor
B) Lung sounds
C) Cardiac rhythm
D) Deep tendon reflexes
Answer: C
Rationale: Hyperkalemia (potassium >5.0 mEq/L) can cause fatal cardiac
dysrhythmias, including peaked T waves, widened QRS complexes, and
ventricular fibrillation. ECG monitoring is essential. Skin turgor, lung sounds,
and reflexes are not the priority in hyperkalemia.
Question 3
A nurse is reviewing the laboratory results of a client who is receiving a
continuous intravenous heparin infusion for a deep vein thrombosis (DVT).
The client's current activated partial thromboplastin time (aPTT) is 98
seconds. Which of the following actions should the nurse take?
A) Increase the heparin infusion rate
B) Decrease the heparin infusion rate
C) Administer protamine sulfate
D) Continue the infusion at the current rate
Answer: B
Rationale: The therapeutic aPTT range for heparin therapy is typically 1.5 to
2.5 times the normal control value (approximately 60-80 seconds). An aPTT of
98 seconds indicates the client is over-anticoagulated and at risk for bleeding.
,The nurse should decrease the infusion rate. Protamine sulfate is the antidote
for heparin but is used for severe bleeding or markedly elevated aPTT.
Question 4
A nurse is caring for a client who has atrial fibrillation. Which of the following
medications should the nurse anticipate administering?
A) Atropine
B) Amiodarone
C) Epinephrine
D) Norepinephrine
Answer: B
Rationale: Amiodarone is a class III antiarrhythmic used to treat atrial
fibrillation. Atropine is used for symptomatic bradycardia. Epinephrine and
norepinephrine are used for cardiac arrest and severe hypotension.
Synchronized cardioversion is the electrical management for atrial fibrillation.
Question 5
A nurse is assessing a client who has heart failure. Which of the following
findings should the nurse expect?
A) Decreased jugular venous pressure
B) Bounding peripheral pulses
C) Crackles in the lung bases
D) Decreased central venous pressure
Answer: C
, Rationale: Heart failure leads to fluid accumulation in the lungs, causing
crackles (rales) upon auscultation, particularly in the lung bases. Jugular
venous pressure is typically elevated, peripheral pulses may be weak, and
central venous pressure is increased due to fluid overload.
Question 6
A nurse is providing teaching to a client who has a new prescription for
warfarin. Which of the following statements by the client indicates an
understanding of the teaching?
A) "I will eat more green leafy vegetables"
B) "I will take ibuprofen for headaches"
C) "I will have my blood tested regularly"
D) "I will stop taking the medication if I notice bruising"
Answer: C
Rationale: Clients taking warfarin require regular monitoring of their
International Normalized Ratio (INR) to ensure therapeutic levels and prevent
complications. Green leafy vegetables contain vitamin K, which antagonizes
warfarin. Ibuprofen increases bleeding risk. Clients should not stop
medications without provider guidance.
Question 7
A nurse is assessing a client who has pericarditis. Which of the following
findings should the nurse expect?
A) Pleuritic chest pain that worsens when lying flat
B) Substernal chest pain that radiates to the left arm
C) Pain that is relieved by lying flat
D) Pain that is unrelieved by sitting forward
RETAKE EXAM PRACTICE QUESTIONS
COMPREHENSIVE 350-QUESTION BANK WITH
DETAILED RATIONALES.
---
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-45)
Question 1
A nurse is caring for a client who has heart failure and a prescription for
digoxin 125 mcg PO daily. Which of the following findings should indicate to
the nurse that the client is experiencing digoxin toxicity?
A) Heart rate 62/min
B) Serum potassium 4.0 mEq/L
C) Anorexia and nausea
D) Blood pressure 138/88 mmHg
Answer: C
Rationale: Early signs of digoxin toxicity include gastrointestinal symptoms
such as anorexia, nausea, vomiting, and abdominal pain. Other signs include
visual disturbances (blurred vision, yellow-green halos), bradycardia, and
cardiac dysrhythmias. A heart rate of 62/min is within normal range,
potassium 4.0 mEq/L is normal, and blood pressure 138/88 mmHg is slightly
elevated but not indicative of digoxin toxicity.
Question 2
,A nurse is assessing a client who has a serum potassium level of 6.8 mEq/L.
Which of the following assessments is the priority?
A) Skin turgor
B) Lung sounds
C) Cardiac rhythm
D) Deep tendon reflexes
Answer: C
Rationale: Hyperkalemia (potassium >5.0 mEq/L) can cause fatal cardiac
dysrhythmias, including peaked T waves, widened QRS complexes, and
ventricular fibrillation. ECG monitoring is essential. Skin turgor, lung sounds,
and reflexes are not the priority in hyperkalemia.
Question 3
A nurse is reviewing the laboratory results of a client who is receiving a
continuous intravenous heparin infusion for a deep vein thrombosis (DVT).
The client's current activated partial thromboplastin time (aPTT) is 98
seconds. Which of the following actions should the nurse take?
A) Increase the heparin infusion rate
B) Decrease the heparin infusion rate
C) Administer protamine sulfate
D) Continue the infusion at the current rate
Answer: B
Rationale: The therapeutic aPTT range for heparin therapy is typically 1.5 to
2.5 times the normal control value (approximately 60-80 seconds). An aPTT of
98 seconds indicates the client is over-anticoagulated and at risk for bleeding.
,The nurse should decrease the infusion rate. Protamine sulfate is the antidote
for heparin but is used for severe bleeding or markedly elevated aPTT.
Question 4
A nurse is caring for a client who has atrial fibrillation. Which of the following
medications should the nurse anticipate administering?
A) Atropine
B) Amiodarone
C) Epinephrine
D) Norepinephrine
Answer: B
Rationale: Amiodarone is a class III antiarrhythmic used to treat atrial
fibrillation. Atropine is used for symptomatic bradycardia. Epinephrine and
norepinephrine are used for cardiac arrest and severe hypotension.
Synchronized cardioversion is the electrical management for atrial fibrillation.
Question 5
A nurse is assessing a client who has heart failure. Which of the following
findings should the nurse expect?
A) Decreased jugular venous pressure
B) Bounding peripheral pulses
C) Crackles in the lung bases
D) Decreased central venous pressure
Answer: C
, Rationale: Heart failure leads to fluid accumulation in the lungs, causing
crackles (rales) upon auscultation, particularly in the lung bases. Jugular
venous pressure is typically elevated, peripheral pulses may be weak, and
central venous pressure is increased due to fluid overload.
Question 6
A nurse is providing teaching to a client who has a new prescription for
warfarin. Which of the following statements by the client indicates an
understanding of the teaching?
A) "I will eat more green leafy vegetables"
B) "I will take ibuprofen for headaches"
C) "I will have my blood tested regularly"
D) "I will stop taking the medication if I notice bruising"
Answer: C
Rationale: Clients taking warfarin require regular monitoring of their
International Normalized Ratio (INR) to ensure therapeutic levels and prevent
complications. Green leafy vegetables contain vitamin K, which antagonizes
warfarin. Ibuprofen increases bleeding risk. Clients should not stop
medications without provider guidance.
Question 7
A nurse is assessing a client who has pericarditis. Which of the following
findings should the nurse expect?
A) Pleuritic chest pain that worsens when lying flat
B) Substernal chest pain that radiates to the left arm
C) Pain that is relieved by lying flat
D) Pain that is unrelieved by sitting forward
