RN VATI ADULT MEDICAL SURGICAL ASSESSMENT
EXAM 300 ACTUAL QUESTIONS AND CORRECT
ANSWERS WITH RATIONALE LATEST UPDATE
ALREADY GRADED A+
The RN VATI Adult Medical Surgical Assessment Exam is a comprehensive,
computer-adaptive standardized test designed for nursing students and recent
graduates to evaluate their clinical knowledge in adult medical-surgical
nursing. It covers a wide range of topics, including cardiovascular,
respiratory, gastrointestinal, renal, neurological, endocrine, and
integumentary disorders, as well as perioperative care, pharmacology, and
fluid/electrolyte balance. The exam assesses critical thinking, clinical
judgment, and the ability to prioritize patient care. Results provide a detailed
score report with individualized remediation plans, identifying specific
content areas needing further study. It is a valuable tool for NCLEX-RN
preparation, helping students strengthen their weaknesses and build
confidence before the licensure examination.
1. A nurse is caring for a client who has acute pancreatitis. Which of the following
laboratory values should the nurse expect to be elevated?
A) Serum amylase
B) Serum potassium
C) Serum calcium
D) Serum sodium
Correct Answer: A
Rationale: Serum amylase and lipase are elevated in acute pancreatitis due to
leakage of these enzymes from damaged pancreatic cells into the bloodstream.
Potassium, calcium, and sodium are not specific markers for this condition.
2. A nurse is assessing a client who has just returned from a cardiac catheterization
via the femoral artery. Which of the following findings requires immediate
intervention?
A) Small amount of dried blood at the insertion site
B) Pedal pulse of 2+ bilaterally
C) Pallor and coolness of the affected foot
,D) Blood pressure of 118/76 mm Hg
Correct Answer: C
Rationale: Pallor and coolness of the affected foot indicate arterial insufficiency or
occlusion, which is a medical emergency. A small amount of dried blood is
expected, and bilateral pedal pulses are normal.
3. A nurse is providing teaching to a client who has a new prescription for
nitroglycerin sublingual tablets. Which of the following instructions should the
nurse include?
A) "Take one tablet every 15 minutes for up to three doses."
B) "Chew the tablet thoroughly for faster absorption."
C) "Swallow the tablet with a full glass of water."
D) "Store the tablets in a clear plastic bottle."
Correct Answer: A
Rationale: The correct protocol is to take one tablet sublingually every 5 minutes
for up to three doses. If pain persists after the third dose, emergency services
should be called. Tablets should not be chewed or swallowed and must be kept in
the original dark glass container.
4. A nurse is caring for a client who has a bowel obstruction and has a nasogastric
(NG) tube set to low intermittent suction. Which of the following findings
indicates that the NG tube is functioning correctly?
A) The client reports nausea
B) The abdomen is firm and distended
C) The output is 1,200 mL in 8 hours
D) The client has active bowel sounds
Correct Answer: C
Rationale: A high output (over 1,000 mL) in 8 hours indicates that the suction is
effectively removing gastric contents and relieving the obstruction. Nausea, firm
distention, and active bowel sounds suggest the obstruction is not resolved.
5. A nurse is assessing a client who has chronic obstructive pulmonary disease
(COPD). Which of the following findings should the nurse expect?
A) Barrel-shaped chest
B) Clubbing of the fingers
C) Pursed-lip breathing
D) All of the above
Correct Answer: D
,Rationale: All three findings are classic manifestations of COPD. Barrel chest
results from hyperinflation, clubbing occurs from chronic hypoxemia, and pursed-
lip breathing helps maintain positive airway pressure and improve oxygenation.
6. A nurse is monitoring a client who is receiving a continuous heparin infusion.
Which of the following laboratory values should the nurse monitor to evaluate the
effectiveness of the therapy?
A) International normalized ratio (INR)
B) Activated partial thromboplastin time (aPTT)
C) Prothrombin time (PT)
D) Platelet count
Correct Answer: B
Rationale: aPTT is the primary lab value used to monitor unfractionated heparin
therapy. The therapeutic goal is typically 1.5 to 2.5 times the normal control value.
INR and PT are used for warfarin monitoring.
7. A nurse is preparing to administer a subcutaneous injection of enoxaparin.
Which of the following actions should the nurse take?
A) Expel the air bubble from the prefilled syringe
B) Massage the injection site after administration
C) Administer the injection in the abdomen
D) Use a 22-gauge needle
Correct Answer: C
Rationale: Enoxaparin should be administered subcutaneously in the abdomen, at
least 2 inches away from the umbilicus. The air bubble should not be expelled to
prevent medication loss, and the site should not be massaged to avoid bruising.
8. A nurse is caring for a client who has a new tracheostomy. Which of the
following actions should the nurse take when suctioning the tracheostomy?
A) Apply suction during insertion of the catheter
B) Suction for 30 seconds each pass
C) Hyperoxygenate the client before suctioning
D) Use a sterile catheter for each suctioning attempt
Correct Answer: C
Rationale: Hyperoxygenating the client before suctioning prevents hypoxemia.
Suction should only be applied during withdrawal, not insertion, for no more than
10 to 15 seconds. A sterile catheter is used, but it can be reused if kept sterile.
9. A nurse is assessing a client who has a potassium level of 3.0 mEq/L. Which of
the following findings should the nurse expect?
, A) Hyperactive bowel sounds
B) Muscle weakness
C) Tachycardia
D) Hypertension
Correct Answer: B
Rationale: Hypokalemia (potassium <3.5 mEq/L) causes muscle weakness, fatigue,
and hyporeflexia. Hyperactive bowel sounds, tachycardia, and hypertension are
more commonly associated with hyperkalemia.
10. A nurse is caring for a client who has a new prescription for a continuous
positive airway pressure (CPAP) device for obstructive sleep apnea. The client
asks, "Why do I need this machine?" Which response should the nurse give?
A) "It delivers oxygen at a high concentration while you sleep."
B) "It keeps your airway open by providing constant positive pressure."
C) "It monitors your heart rate and oxygen level during sleep."
D) "It forces you to breathe at a set rate while you are sleeping."
Correct Answer: B
Rationale: CPAP provides a continuous positive pressure that prevents the upper
airway from collapsing during sleep, which is the primary cause of obstructive
sleep apnea. It is not a high-flow oxygen device or a ventilator.
11. A nurse is assessing a client who has acute pyelonephritis. Which of the
following findings should the nurse expect?
A) Costovertebral angle tenderness
B) Suprapubic pain
C) Painful urination
D) Urinary frequency
Correct Answer: A
Rationale: Costovertebral angle tenderness is a classic sign of pyelonephritis,
indicating kidney inflammation. Suprapubic pain, painful urination, and frequency
are more typical of lower urinary tract infections like cystitis.
12. A nurse is providing teaching to a client who is scheduled for a colonoscopy.
Which of the following instructions should the nurse include?
A) "You may eat a light breakfast the morning of the procedure."
B) "You will need to drink a bowel-cleansing solution the day before."
C) "You should stop all medications 1 week before the test."
D) "You will be awake during the entire procedure."
Correct Answer: B
EXAM 300 ACTUAL QUESTIONS AND CORRECT
ANSWERS WITH RATIONALE LATEST UPDATE
ALREADY GRADED A+
The RN VATI Adult Medical Surgical Assessment Exam is a comprehensive,
computer-adaptive standardized test designed for nursing students and recent
graduates to evaluate their clinical knowledge in adult medical-surgical
nursing. It covers a wide range of topics, including cardiovascular,
respiratory, gastrointestinal, renal, neurological, endocrine, and
integumentary disorders, as well as perioperative care, pharmacology, and
fluid/electrolyte balance. The exam assesses critical thinking, clinical
judgment, and the ability to prioritize patient care. Results provide a detailed
score report with individualized remediation plans, identifying specific
content areas needing further study. It is a valuable tool for NCLEX-RN
preparation, helping students strengthen their weaknesses and build
confidence before the licensure examination.
1. A nurse is caring for a client who has acute pancreatitis. Which of the following
laboratory values should the nurse expect to be elevated?
A) Serum amylase
B) Serum potassium
C) Serum calcium
D) Serum sodium
Correct Answer: A
Rationale: Serum amylase and lipase are elevated in acute pancreatitis due to
leakage of these enzymes from damaged pancreatic cells into the bloodstream.
Potassium, calcium, and sodium are not specific markers for this condition.
2. A nurse is assessing a client who has just returned from a cardiac catheterization
via the femoral artery. Which of the following findings requires immediate
intervention?
A) Small amount of dried blood at the insertion site
B) Pedal pulse of 2+ bilaterally
C) Pallor and coolness of the affected foot
,D) Blood pressure of 118/76 mm Hg
Correct Answer: C
Rationale: Pallor and coolness of the affected foot indicate arterial insufficiency or
occlusion, which is a medical emergency. A small amount of dried blood is
expected, and bilateral pedal pulses are normal.
3. A nurse is providing teaching to a client who has a new prescription for
nitroglycerin sublingual tablets. Which of the following instructions should the
nurse include?
A) "Take one tablet every 15 minutes for up to three doses."
B) "Chew the tablet thoroughly for faster absorption."
C) "Swallow the tablet with a full glass of water."
D) "Store the tablets in a clear plastic bottle."
Correct Answer: A
Rationale: The correct protocol is to take one tablet sublingually every 5 minutes
for up to three doses. If pain persists after the third dose, emergency services
should be called. Tablets should not be chewed or swallowed and must be kept in
the original dark glass container.
4. A nurse is caring for a client who has a bowel obstruction and has a nasogastric
(NG) tube set to low intermittent suction. Which of the following findings
indicates that the NG tube is functioning correctly?
A) The client reports nausea
B) The abdomen is firm and distended
C) The output is 1,200 mL in 8 hours
D) The client has active bowel sounds
Correct Answer: C
Rationale: A high output (over 1,000 mL) in 8 hours indicates that the suction is
effectively removing gastric contents and relieving the obstruction. Nausea, firm
distention, and active bowel sounds suggest the obstruction is not resolved.
5. A nurse is assessing a client who has chronic obstructive pulmonary disease
(COPD). Which of the following findings should the nurse expect?
A) Barrel-shaped chest
B) Clubbing of the fingers
C) Pursed-lip breathing
D) All of the above
Correct Answer: D
,Rationale: All three findings are classic manifestations of COPD. Barrel chest
results from hyperinflation, clubbing occurs from chronic hypoxemia, and pursed-
lip breathing helps maintain positive airway pressure and improve oxygenation.
6. A nurse is monitoring a client who is receiving a continuous heparin infusion.
Which of the following laboratory values should the nurse monitor to evaluate the
effectiveness of the therapy?
A) International normalized ratio (INR)
B) Activated partial thromboplastin time (aPTT)
C) Prothrombin time (PT)
D) Platelet count
Correct Answer: B
Rationale: aPTT is the primary lab value used to monitor unfractionated heparin
therapy. The therapeutic goal is typically 1.5 to 2.5 times the normal control value.
INR and PT are used for warfarin monitoring.
7. A nurse is preparing to administer a subcutaneous injection of enoxaparin.
Which of the following actions should the nurse take?
A) Expel the air bubble from the prefilled syringe
B) Massage the injection site after administration
C) Administer the injection in the abdomen
D) Use a 22-gauge needle
Correct Answer: C
Rationale: Enoxaparin should be administered subcutaneously in the abdomen, at
least 2 inches away from the umbilicus. The air bubble should not be expelled to
prevent medication loss, and the site should not be massaged to avoid bruising.
8. A nurse is caring for a client who has a new tracheostomy. Which of the
following actions should the nurse take when suctioning the tracheostomy?
A) Apply suction during insertion of the catheter
B) Suction for 30 seconds each pass
C) Hyperoxygenate the client before suctioning
D) Use a sterile catheter for each suctioning attempt
Correct Answer: C
Rationale: Hyperoxygenating the client before suctioning prevents hypoxemia.
Suction should only be applied during withdrawal, not insertion, for no more than
10 to 15 seconds. A sterile catheter is used, but it can be reused if kept sterile.
9. A nurse is assessing a client who has a potassium level of 3.0 mEq/L. Which of
the following findings should the nurse expect?
, A) Hyperactive bowel sounds
B) Muscle weakness
C) Tachycardia
D) Hypertension
Correct Answer: B
Rationale: Hypokalemia (potassium <3.5 mEq/L) causes muscle weakness, fatigue,
and hyporeflexia. Hyperactive bowel sounds, tachycardia, and hypertension are
more commonly associated with hyperkalemia.
10. A nurse is caring for a client who has a new prescription for a continuous
positive airway pressure (CPAP) device for obstructive sleep apnea. The client
asks, "Why do I need this machine?" Which response should the nurse give?
A) "It delivers oxygen at a high concentration while you sleep."
B) "It keeps your airway open by providing constant positive pressure."
C) "It monitors your heart rate and oxygen level during sleep."
D) "It forces you to breathe at a set rate while you are sleeping."
Correct Answer: B
Rationale: CPAP provides a continuous positive pressure that prevents the upper
airway from collapsing during sleep, which is the primary cause of obstructive
sleep apnea. It is not a high-flow oxygen device or a ventilator.
11. A nurse is assessing a client who has acute pyelonephritis. Which of the
following findings should the nurse expect?
A) Costovertebral angle tenderness
B) Suprapubic pain
C) Painful urination
D) Urinary frequency
Correct Answer: A
Rationale: Costovertebral angle tenderness is a classic sign of pyelonephritis,
indicating kidney inflammation. Suprapubic pain, painful urination, and frequency
are more typical of lower urinary tract infections like cystitis.
12. A nurse is providing teaching to a client who is scheduled for a colonoscopy.
Which of the following instructions should the nurse include?
A) "You may eat a light breakfast the morning of the procedure."
B) "You will need to drink a bowel-cleansing solution the day before."
C) "You should stop all medications 1 week before the test."
D) "You will be awake during the entire procedure."
Correct Answer: B
