, ATI PN Adult Medical-Surgical
2026/2027 Proctored Exam with NGN –
Questions and Answers with Detailed
Rationales
Question 1
A nurse is caring for a client who is 4 hours postoperative
following a total knee arthroplasty. Which of the following
findings should the nurse report immediately to the provider?
A. Temperature of 37.8°C (100.0°F)
B. Pain score of 6 on a scale of 0 to 10
C. Absent distal pulse in the operative extremity
D. Serosanguineous drainage on the surgical dressing
measuring 4 cm in diameter
Correct Answer: C
Rationale: An absent distal pulse indicates severe arterial
compromise or a vascular occlusion, which is a surgical
emergency that can lead to tissue ischemia or loss of the limb.
This requires immediate notification of the provider. Low-grade
fever, moderate incisional pain, and small amounts of
serosanguineous drainage are expected early postoperative
findings.
Question 2
,A nurse is reinforcing discharge teaching with a client who has a
new prescription for digoxin. Which of the following statements
by the client indicates an understanding of the teaching?
A. "I will take my pulse every morning before I take the
medication."
B. "I will increase my intake of foods high in sodium."
C. "I should stop taking the medication if I feel dizzy."
D. "I will take the medication with an antacid if I
experience nausea."
Correct Answer: A
Rationale: The client should check their pulse daily prior to
administration and withhold the dose if the pulse is below
60/min (for adults) to prevent severe bradycardia and digitalis
toxicity. Digoxin toxicity causes nausea and visual changes,
which should be reported rather than treated with antacids.
Sodium intake does not directly alter digoxin safety, though
potassium levels do.
Question 3
A nurse is caring for a client who has type 1 diabetes mellitus
and reports feeling shaky, dizzy, and diaphoretic. A point-of-
care blood glucose test reveals a level of 52 mg/dL. Which of
the following actions should the nurse take first?
A. Administer 1 mg of glucagon intramuscularly.
B. Provide 15 g of a fast-acting simple carbohydrate.
C. Recheck the blood glucose level in 1 hour.
D. Administer regular insulin subcutaneously according to
the sliding scale.
, Correct Answer: B
Rationale: According to the "Rule of 15," a conscious client
with hypoglycemia (blood glucose less than 70 mg/dL) should
immediately receive 15 g of a fast-acting carbohydrate (such as
4 oz of juice or regular soda). Glucagon is used if the client is
unconscious or unable to swallow. Blood glucose should be
rechecked in 15 minutes, not 1 hour.
Question 4
A nurse is caring for a client who has a closed-chest drainage
system in place following a thoracotomy. Which of the
following findings requires immediate intervention by the
nurse?
A. Continuous bubbling in the water-seal chamber
B. Constant gentle bubbling in the suction control chamber
C. Fluctuations of the water level in the water-seal chamber
with inspiration and expiration
D. 50 mL of dark red drainage in the collection chamber 1
hour post-op
Correct Answer: A
Rationale: Continuous bubbling in the water-seal chamber
indicates an air leak in the system (either at a connection site or
from the client's chest), which requires immediate identification
and correction. Gentle bubbling in the suction control chamber
is normal, as is tidaling (fluctuations) in the water-seal chamber
and expected early post-op drainage volumes.
Question 5
2026/2027 Proctored Exam with NGN –
Questions and Answers with Detailed
Rationales
Question 1
A nurse is caring for a client who is 4 hours postoperative
following a total knee arthroplasty. Which of the following
findings should the nurse report immediately to the provider?
A. Temperature of 37.8°C (100.0°F)
B. Pain score of 6 on a scale of 0 to 10
C. Absent distal pulse in the operative extremity
D. Serosanguineous drainage on the surgical dressing
measuring 4 cm in diameter
Correct Answer: C
Rationale: An absent distal pulse indicates severe arterial
compromise or a vascular occlusion, which is a surgical
emergency that can lead to tissue ischemia or loss of the limb.
This requires immediate notification of the provider. Low-grade
fever, moderate incisional pain, and small amounts of
serosanguineous drainage are expected early postoperative
findings.
Question 2
,A nurse is reinforcing discharge teaching with a client who has a
new prescription for digoxin. Which of the following statements
by the client indicates an understanding of the teaching?
A. "I will take my pulse every morning before I take the
medication."
B. "I will increase my intake of foods high in sodium."
C. "I should stop taking the medication if I feel dizzy."
D. "I will take the medication with an antacid if I
experience nausea."
Correct Answer: A
Rationale: The client should check their pulse daily prior to
administration and withhold the dose if the pulse is below
60/min (for adults) to prevent severe bradycardia and digitalis
toxicity. Digoxin toxicity causes nausea and visual changes,
which should be reported rather than treated with antacids.
Sodium intake does not directly alter digoxin safety, though
potassium levels do.
Question 3
A nurse is caring for a client who has type 1 diabetes mellitus
and reports feeling shaky, dizzy, and diaphoretic. A point-of-
care blood glucose test reveals a level of 52 mg/dL. Which of
the following actions should the nurse take first?
A. Administer 1 mg of glucagon intramuscularly.
B. Provide 15 g of a fast-acting simple carbohydrate.
C. Recheck the blood glucose level in 1 hour.
D. Administer regular insulin subcutaneously according to
the sliding scale.
, Correct Answer: B
Rationale: According to the "Rule of 15," a conscious client
with hypoglycemia (blood glucose less than 70 mg/dL) should
immediately receive 15 g of a fast-acting carbohydrate (such as
4 oz of juice or regular soda). Glucagon is used if the client is
unconscious or unable to swallow. Blood glucose should be
rechecked in 15 minutes, not 1 hour.
Question 4
A nurse is caring for a client who has a closed-chest drainage
system in place following a thoracotomy. Which of the
following findings requires immediate intervention by the
nurse?
A. Continuous bubbling in the water-seal chamber
B. Constant gentle bubbling in the suction control chamber
C. Fluctuations of the water level in the water-seal chamber
with inspiration and expiration
D. 50 mL of dark red drainage in the collection chamber 1
hour post-op
Correct Answer: A
Rationale: Continuous bubbling in the water-seal chamber
indicates an air leak in the system (either at a connection site or
from the client's chest), which requires immediate identification
and correction. Gentle bubbling in the suction control chamber
is normal, as is tidaling (fluctuations) in the water-seal chamber
and expected early post-op drainage volumes.
Question 5
