, 2026 ATI RN Medical Surgical (Med- Surg) 2023 Exam
with NGN 100 Questions and Answers| With Verified
Solutions EXAM with Questions and Answers/Plus a
Rationale Updated 2026 A+/Instant Download PDF
EXAM COVERAGE
1. Cardiovascular and Hemodynamic Alterations
2. Respiratory and Critical Care Management
3. Neurological and Neurosurgical Disorders
4. Renal, Urological, and Fluid-Electrolyte Balance
5. Endocrine and Metabolic Regulations
6. Gastrointestinal and Hepatic Pathologies
7. Oncology, Immunology, and Hematological Disorders
8. Musculoskeletal, Integumentary, and Multisystem Trauma
1. A nurse is caring for a client who is 4 hours postoperative following a coronary artery bypass
graft (CABG) surgery. Which of the following assessment findings should the nurse report to the
provider immediately?
A. Mediastinal chest tube drainage of 40 mL/hour for the past 2 hours
B. Mediastinal chest tube drainage of 160 mL/hour for the past 2 consecutive hours
C. Temperature of 37.4 °C (99.3 °F) and sinus tachycardia of 105/min
D. Potassium level of 4.2 mEq/L and ionized calcium of 1.2 mmol/L
CORRECT ANSWER : B
, Rationale: Mediastinal chest tube drainage exceeding 150 mL/hour for 2 consecutive hours
postoperatively indicates potential postoperative hemorrhage, requiring immediate surgical
notification and intervention. Drainage of 40 mL/hour is within normal limits. The temperature,
heart rate, and electrolyte values are stable and expected findings.
2. A nurse is assessing a client with acute heart failure who is receiving an intravenous infusion of
furosemide. Which of the following laboratory findings requires immediate intervention?
A. Serum sodium of 137 mEq/L
B. Serum potassium of 2.8 mEq/L
C. Blood urea nitrogen of 20 mg/dL
D. Serum creatinine of 1.1 mg/dL
CORRECT ANSWER : B
Rationale: Furosemide is a loop diuretic that causes substantial renal potassium wasting. A
potassium level of 2.8 mEq/L indicates severe hypokalemia, which places the client at high risk
for life-threatening cardiac dysrhythmias and requires immediate replacement. Sodium, BUN,
and creatinine values are within acceptable therapeutic parameters.
3. A nurse is caring for a client with increased intracranial pressure (ICP) following a traumatic
brain injury. Which of the following interventions should the nurse implement?
A. Position the client's head flat with the body aligned horizontally.
B. Maintain the head of the bed at 30 degrees with the client's head in a neutral, midline
position.
C. Encourage active turning, coughing, and deep breathing every hour.
D. Perform endotracheal suctioning routinely every 2 hours regardless of clinical need.
CORRECT ANSWER : B
Rationale: Elevating the head of the bed to 30 degrees and keeping the neck in a neutral, midline
position promotes venous drainage from the cranial vault and helps lower ICP. Flat positioning,
coughing, and routine suctioning all increase intrathoracic and intracranial pressure, risking
cerebral herniation.
4. A nurse is reviewing the arterial blood gas (ABG) results of a client with chronic obstructive
pulmonary disease (COPD) in acute respiratory failure. The results show: pH 7.31, PaCO2 60
mmHg, HCO3 28 mEq/L, and PaO2 58 mmHg. How should the nurse interpret these findings?
, A. Uncompensated metabolic acidosis
B. Partially compensated respiratory acidosis
C. Fully compensated metabolic alkalosis
D. Acute respiratory alkalosis without compensation
CORRECT ANSWER : B
Rationale: A low pH (7.31) indicates acidemia driven by an elevated PaCO2 (60 mmHg),
confirming a respiratory acidosis origin. The elevated HCO3 (28 mEq/L) demonstrates that the
kidneys have begun to retain bicarbonate, indicating partial compensation.
5. A nurse is monitoring a client receiving a transfusion of packed red blood cells (PRBCs) who
develops lower back pain, fever, chills, and hypotension 15 minutes into the infusion. Which of
the following actions should the nurse perform first?
A. Stop the blood transfusion immediately and disconnect the tubing.
B. Slow the infusion rate to half and administer an antipyretic.
C. Flush the intravenous line with 0.9% sodium chloride and continue observing.
D. Obtain a urine specimen and send it immediately to the laboratory.
CORRECT ANSWER : A
Rationale: Lower back pain, fever, chills, and hypotension are classic signs of an acute
hemolytic transfusion reaction. The nurse's immediate priority is to stop the transfusion,
disconnect the blood tubing, and infuse fresh 0.9% sodium chloride using a separate set of
tubing to preserve vascular access.
6. A nurse is caring for a client admitted with diabetic ketoacidosis (DKA). Following initial fluid
resuscitation with 0.9% sodium chloride, the client's blood glucose is now 240 mg/dL. Which of
the following intravenous solutions should the nurse anticipate adding to the client's regimen?
A. 0.9% sodium chloride with 40 mEq of potassium chloride
B. 5% dextrose in 0.45% sodium chloride
C. 3% hypertonic sodium chloride
D. Lactated Ringer's solution without additives
CORRECT ANSWER : B
with NGN 100 Questions and Answers| With Verified
Solutions EXAM with Questions and Answers/Plus a
Rationale Updated 2026 A+/Instant Download PDF
EXAM COVERAGE
1. Cardiovascular and Hemodynamic Alterations
2. Respiratory and Critical Care Management
3. Neurological and Neurosurgical Disorders
4. Renal, Urological, and Fluid-Electrolyte Balance
5. Endocrine and Metabolic Regulations
6. Gastrointestinal and Hepatic Pathologies
7. Oncology, Immunology, and Hematological Disorders
8. Musculoskeletal, Integumentary, and Multisystem Trauma
1. A nurse is caring for a client who is 4 hours postoperative following a coronary artery bypass
graft (CABG) surgery. Which of the following assessment findings should the nurse report to the
provider immediately?
A. Mediastinal chest tube drainage of 40 mL/hour for the past 2 hours
B. Mediastinal chest tube drainage of 160 mL/hour for the past 2 consecutive hours
C. Temperature of 37.4 °C (99.3 °F) and sinus tachycardia of 105/min
D. Potassium level of 4.2 mEq/L and ionized calcium of 1.2 mmol/L
CORRECT ANSWER : B
, Rationale: Mediastinal chest tube drainage exceeding 150 mL/hour for 2 consecutive hours
postoperatively indicates potential postoperative hemorrhage, requiring immediate surgical
notification and intervention. Drainage of 40 mL/hour is within normal limits. The temperature,
heart rate, and electrolyte values are stable and expected findings.
2. A nurse is assessing a client with acute heart failure who is receiving an intravenous infusion of
furosemide. Which of the following laboratory findings requires immediate intervention?
A. Serum sodium of 137 mEq/L
B. Serum potassium of 2.8 mEq/L
C. Blood urea nitrogen of 20 mg/dL
D. Serum creatinine of 1.1 mg/dL
CORRECT ANSWER : B
Rationale: Furosemide is a loop diuretic that causes substantial renal potassium wasting. A
potassium level of 2.8 mEq/L indicates severe hypokalemia, which places the client at high risk
for life-threatening cardiac dysrhythmias and requires immediate replacement. Sodium, BUN,
and creatinine values are within acceptable therapeutic parameters.
3. A nurse is caring for a client with increased intracranial pressure (ICP) following a traumatic
brain injury. Which of the following interventions should the nurse implement?
A. Position the client's head flat with the body aligned horizontally.
B. Maintain the head of the bed at 30 degrees with the client's head in a neutral, midline
position.
C. Encourage active turning, coughing, and deep breathing every hour.
D. Perform endotracheal suctioning routinely every 2 hours regardless of clinical need.
CORRECT ANSWER : B
Rationale: Elevating the head of the bed to 30 degrees and keeping the neck in a neutral, midline
position promotes venous drainage from the cranial vault and helps lower ICP. Flat positioning,
coughing, and routine suctioning all increase intrathoracic and intracranial pressure, risking
cerebral herniation.
4. A nurse is reviewing the arterial blood gas (ABG) results of a client with chronic obstructive
pulmonary disease (COPD) in acute respiratory failure. The results show: pH 7.31, PaCO2 60
mmHg, HCO3 28 mEq/L, and PaO2 58 mmHg. How should the nurse interpret these findings?
, A. Uncompensated metabolic acidosis
B. Partially compensated respiratory acidosis
C. Fully compensated metabolic alkalosis
D. Acute respiratory alkalosis without compensation
CORRECT ANSWER : B
Rationale: A low pH (7.31) indicates acidemia driven by an elevated PaCO2 (60 mmHg),
confirming a respiratory acidosis origin. The elevated HCO3 (28 mEq/L) demonstrates that the
kidneys have begun to retain bicarbonate, indicating partial compensation.
5. A nurse is monitoring a client receiving a transfusion of packed red blood cells (PRBCs) who
develops lower back pain, fever, chills, and hypotension 15 minutes into the infusion. Which of
the following actions should the nurse perform first?
A. Stop the blood transfusion immediately and disconnect the tubing.
B. Slow the infusion rate to half and administer an antipyretic.
C. Flush the intravenous line with 0.9% sodium chloride and continue observing.
D. Obtain a urine specimen and send it immediately to the laboratory.
CORRECT ANSWER : A
Rationale: Lower back pain, fever, chills, and hypotension are classic signs of an acute
hemolytic transfusion reaction. The nurse's immediate priority is to stop the transfusion,
disconnect the blood tubing, and infuse fresh 0.9% sodium chloride using a separate set of
tubing to preserve vascular access.
6. A nurse is caring for a client admitted with diabetic ketoacidosis (DKA). Following initial fluid
resuscitation with 0.9% sodium chloride, the client's blood glucose is now 240 mg/dL. Which of
the following intravenous solutions should the nurse anticipate adding to the client's regimen?
A. 0.9% sodium chloride with 40 mEq of potassium chloride
B. 5% dextrose in 0.45% sodium chloride
C. 3% hypertonic sodium chloride
D. Lactated Ringer's solution without additives
CORRECT ANSWER : B
