ATI RN Medical-Surgical Proctored Exam 2026
180+ Real Exam Questions & Correct Verified Answers
INTRODUCTION
The ATI RN Adult Medical-Surgical Proctored Exam assesses
clinical judgment across cardiovascular, respiratory,
neurological, gastrointestinal, endocrine, renal,
musculoskeletal, and perioperative nursing .
SECTION 1: CARDIOVASCULAR DISORDERS
1. A nurse is caring for a client with acute decompensated
heart failure (ADHF) receiving IV furosemide. Which
assessment finding indicates the medication is having the
desired therapeutic effect?
A) Increased heart rate from 88 to 102 bpm
B) Decreased blood pressure from 142/90 to 128/78 mm Hg
C) Urine output of 250 mL over the past 2 hours
D) Respiratory rate decreasing from 28 to 20 breaths/min
Correct Answer: D
Rationale: In ADHF, the therapeutic goal of furosemide is to
reduce fluid volume, decrease preload, and improve pulmonary
congestion. A decreasing respiratory rate indicates
,improvement in pulmonary edema and respiratory status.
While increased urine output is desired, the clinical
improvement in respiratory status is the best indicator of
therapeutic effect .
2. A client with a history of MI is prescribed clopidogrel. The
nurse should monitor for which adverse effect?
A) Hepatotoxicity
B) Bleeding
C) Nephrotoxicity
D) Hyperglycemia
Correct Answer: B
Rationale: Clopidogrel is a P2Y12 platelet inhibitor that
prevents platelet aggregation. The primary adverse effect is
bleeding, including gastrointestinal bleeding and intracranial
hemorrhage .
3. A nurse is assessing a client with pericarditis who reports
sharp chest pain worsening with inspiration and improving
when leaning forward. Which additional finding would the
nurse expect?
A) Pericardial friction rub on auscultation
B) Distended jugular veins
,C) Muffled heart sounds
D) Hypotension with narrowed pulse pressure
Correct Answer: A
Rationale: A pericardial friction rub is a hallmark finding in
pericarditis, caused by inflamed pericardial layers rubbing
together. Distended jugular veins, muffled heart sounds, and
hypotension with narrowed pulse pressure indicate cardiac
tamponade .
4. A nurse is assessing a client with heart failure. Which
finding is the earliest sign of left-sided heart failure?
A) Peripheral edema
B) Jugular venous distention
C) Dyspnea on exertion
D) Hepatomegaly
Correct Answer: C
Rationale: Dyspnea on exertion is the earliest sign of left-sided
heart failure due to pulmonary congestion. As left ventricular
function declines, blood backs up into the pulmonary
circulation. Peripheral edema, JVD, and hepatomegaly are signs
of right-sided heart failure .
, 5. A client with heart failure reports sudden weight gain,
dyspnea, and jugular vein distention. Which action should the
nurse take FIRST?
A) Administer furosemide IV push
B) Place the client in high-Fowler's position
C) Increase oxygen to 4 L/min via nasal cannula
D) Notify the healthcare provider
Correct Answer: B
Rationale: Placing the client in high-Fowler's position is the
priority intervention to facilitate breathing and reduce venous
return, which decreases preload and pulmonary congestion.
Oxygen therapy and medication administration should follow
positioning .
6. A client with heart failure has a prescription for digoxin.
Which finding indicates digoxin toxicity?
A) Heart rate of 72 bpm
B) Nausea and yellow vision
C) Blood pressure of 140/90 mm Hg
D) Dry cough
Correct Answer: B
Rationale: Classic signs of digoxin toxicity include GI symptoms
(nausea, vomiting, anorexia) and visual disturbances (yellow or
180+ Real Exam Questions & Correct Verified Answers
INTRODUCTION
The ATI RN Adult Medical-Surgical Proctored Exam assesses
clinical judgment across cardiovascular, respiratory,
neurological, gastrointestinal, endocrine, renal,
musculoskeletal, and perioperative nursing .
SECTION 1: CARDIOVASCULAR DISORDERS
1. A nurse is caring for a client with acute decompensated
heart failure (ADHF) receiving IV furosemide. Which
assessment finding indicates the medication is having the
desired therapeutic effect?
A) Increased heart rate from 88 to 102 bpm
B) Decreased blood pressure from 142/90 to 128/78 mm Hg
C) Urine output of 250 mL over the past 2 hours
D) Respiratory rate decreasing from 28 to 20 breaths/min
Correct Answer: D
Rationale: In ADHF, the therapeutic goal of furosemide is to
reduce fluid volume, decrease preload, and improve pulmonary
congestion. A decreasing respiratory rate indicates
,improvement in pulmonary edema and respiratory status.
While increased urine output is desired, the clinical
improvement in respiratory status is the best indicator of
therapeutic effect .
2. A client with a history of MI is prescribed clopidogrel. The
nurse should monitor for which adverse effect?
A) Hepatotoxicity
B) Bleeding
C) Nephrotoxicity
D) Hyperglycemia
Correct Answer: B
Rationale: Clopidogrel is a P2Y12 platelet inhibitor that
prevents platelet aggregation. The primary adverse effect is
bleeding, including gastrointestinal bleeding and intracranial
hemorrhage .
3. A nurse is assessing a client with pericarditis who reports
sharp chest pain worsening with inspiration and improving
when leaning forward. Which additional finding would the
nurse expect?
A) Pericardial friction rub on auscultation
B) Distended jugular veins
,C) Muffled heart sounds
D) Hypotension with narrowed pulse pressure
Correct Answer: A
Rationale: A pericardial friction rub is a hallmark finding in
pericarditis, caused by inflamed pericardial layers rubbing
together. Distended jugular veins, muffled heart sounds, and
hypotension with narrowed pulse pressure indicate cardiac
tamponade .
4. A nurse is assessing a client with heart failure. Which
finding is the earliest sign of left-sided heart failure?
A) Peripheral edema
B) Jugular venous distention
C) Dyspnea on exertion
D) Hepatomegaly
Correct Answer: C
Rationale: Dyspnea on exertion is the earliest sign of left-sided
heart failure due to pulmonary congestion. As left ventricular
function declines, blood backs up into the pulmonary
circulation. Peripheral edema, JVD, and hepatomegaly are signs
of right-sided heart failure .
, 5. A client with heart failure reports sudden weight gain,
dyspnea, and jugular vein distention. Which action should the
nurse take FIRST?
A) Administer furosemide IV push
B) Place the client in high-Fowler's position
C) Increase oxygen to 4 L/min via nasal cannula
D) Notify the healthcare provider
Correct Answer: B
Rationale: Placing the client in high-Fowler's position is the
priority intervention to facilitate breathing and reduce venous
return, which decreases preload and pulmonary congestion.
Oxygen therapy and medication administration should follow
positioning .
6. A client with heart failure has a prescription for digoxin.
Which finding indicates digoxin toxicity?
A) Heart rate of 72 bpm
B) Nausea and yellow vision
C) Blood pressure of 140/90 mm Hg
D) Dry cough
Correct Answer: B
Rationale: Classic signs of digoxin toxicity include GI symptoms
(nausea, vomiting, anorexia) and visual disturbances (yellow or
