ATI RN ADULT MEDICAL–SURGICAL
NGN-ALIGNED PROCTORED EXAM
(2023–2026) QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS!!
<LATEST VERSION>
Question 1
A nurse is caring for a client admitted with acute decompensated heart failure.
Which finding is the priority to report to the provider?
A. Crackles in bilateral lung bases
B. Weight gain of 1.5 kg in 24 hours
C. Potassium level of 3.2 mEq/L
D. Oxygen saturation of 90% on room air
Correct Answer: C
Rationale: Hypokalemia (potassium 3.2 mEq/L) places the client at risk for life-
threatening dysrhythmias, especially in heart failure where diuretics are commonly
used. This requires immediate intervention.
,Question 2
A client with type 1 diabetes mellitus presents with polyuria, polydipsia, and
fruity-smelling breath. Which laboratory finding supports diabetic ketoacidosis?
A. pH 7.36
B. Serum glucose 520 mg/dL
C. Potassium 3.1 mEq/L
D. Bicarbonate 24 mEq/L
Correct Answer: B
Rationale: Severe hyperglycemia is a hallmark of diabetic ketoacidosis. The
condition is also associated with metabolic acidosis and ketone production.
Question 3
The nurse is administering packed red blood cells to a client. Which assessment
finding requires immediate action?
A. Temperature increase from 36.8°C to 37.4°C
B. Blood pressure decrease from 128/76 to 110/70 mm Hg
C. Complaint of chills and back pain
D. Mild flushing of the face
Correct Answer: C
Rationale: Chills and back pain are classic signs of an acute hemolytic transfusion
reaction. The transfusion must be stopped immediately.
Question 4
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen
at 6 L/min via nasal cannula. Which finding indicates the nurse should intervene?
A. Respiratory rate of 18/min
B. Oxygen saturation of 98%
C. Barrel-shaped chest
D. Productive cough
,Correct Answer: B
Rationale: High oxygen saturation in a COPD client may indicate over-
oxygenation, which can suppress respiratory drive in clients who rely on hypoxic
drive.
Question 5
A nurse is reviewing laboratory values for a client with chronic kidney disease.
Which value is most concerning?
A. Creatinine 4.8 mg/dL
B. Calcium 8.2 mg/dL
C. Phosphorus 5.9 mg/dL
D. Potassium 6.1 mEq/L
Correct Answer: D
Rationale: Hyperkalemia poses an immediate risk for cardiac dysrhythmias and
requires urgent intervention.
Question 6
A client is admitted with suspected pulmonary embolism. Which assessment
finding supports this diagnosis?
A. Bradycardia and hypotension
B. Sudden dyspnea and pleuritic chest pain
C. Productive cough with purulent sputum
D. Crackles throughout both lungs
Correct Answer: B
Rationale: Sudden onset dyspnea and sharp chest pain are classic manifestations
of pulmonary embolism.
, Question 7
The nurse is teaching a client newly diagnosed with hypertension about lifestyle
modifications. Which statement by the client indicates understanding?
A. “I will limit my sodium intake to less than 1,500 mg per day.”
B. “I should avoid all forms of exercise.”
C. “I can stop my medication once my blood pressure improves.”
D. “I should increase my intake of processed foods.”
Correct Answer: A
Rationale: Sodium restriction is a cornerstone of hypertension management and
helps reduce blood pressure.
Question 8
A client with cirrhosis develops ascites. Which intervention is most appropriate?
A. Increase oral fluid intake
B. Administer lactulose daily
C. Restrict sodium intake
D. Encourage high-protein meals
Correct Answer: C
Rationale: Sodium restriction helps reduce fluid retention and is essential in
managing ascites.
Question 9
A client is receiving heparin therapy. Which laboratory value should the nurse
monitor to evaluate therapeutic effectiveness?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
NGN-ALIGNED PROCTORED EXAM
(2023–2026) QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS!!
<LATEST VERSION>
Question 1
A nurse is caring for a client admitted with acute decompensated heart failure.
Which finding is the priority to report to the provider?
A. Crackles in bilateral lung bases
B. Weight gain of 1.5 kg in 24 hours
C. Potassium level of 3.2 mEq/L
D. Oxygen saturation of 90% on room air
Correct Answer: C
Rationale: Hypokalemia (potassium 3.2 mEq/L) places the client at risk for life-
threatening dysrhythmias, especially in heart failure where diuretics are commonly
used. This requires immediate intervention.
,Question 2
A client with type 1 diabetes mellitus presents with polyuria, polydipsia, and
fruity-smelling breath. Which laboratory finding supports diabetic ketoacidosis?
A. pH 7.36
B. Serum glucose 520 mg/dL
C. Potassium 3.1 mEq/L
D. Bicarbonate 24 mEq/L
Correct Answer: B
Rationale: Severe hyperglycemia is a hallmark of diabetic ketoacidosis. The
condition is also associated with metabolic acidosis and ketone production.
Question 3
The nurse is administering packed red blood cells to a client. Which assessment
finding requires immediate action?
A. Temperature increase from 36.8°C to 37.4°C
B. Blood pressure decrease from 128/76 to 110/70 mm Hg
C. Complaint of chills and back pain
D. Mild flushing of the face
Correct Answer: C
Rationale: Chills and back pain are classic signs of an acute hemolytic transfusion
reaction. The transfusion must be stopped immediately.
Question 4
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen
at 6 L/min via nasal cannula. Which finding indicates the nurse should intervene?
A. Respiratory rate of 18/min
B. Oxygen saturation of 98%
C. Barrel-shaped chest
D. Productive cough
,Correct Answer: B
Rationale: High oxygen saturation in a COPD client may indicate over-
oxygenation, which can suppress respiratory drive in clients who rely on hypoxic
drive.
Question 5
A nurse is reviewing laboratory values for a client with chronic kidney disease.
Which value is most concerning?
A. Creatinine 4.8 mg/dL
B. Calcium 8.2 mg/dL
C. Phosphorus 5.9 mg/dL
D. Potassium 6.1 mEq/L
Correct Answer: D
Rationale: Hyperkalemia poses an immediate risk for cardiac dysrhythmias and
requires urgent intervention.
Question 6
A client is admitted with suspected pulmonary embolism. Which assessment
finding supports this diagnosis?
A. Bradycardia and hypotension
B. Sudden dyspnea and pleuritic chest pain
C. Productive cough with purulent sputum
D. Crackles throughout both lungs
Correct Answer: B
Rationale: Sudden onset dyspnea and sharp chest pain are classic manifestations
of pulmonary embolism.
, Question 7
The nurse is teaching a client newly diagnosed with hypertension about lifestyle
modifications. Which statement by the client indicates understanding?
A. “I will limit my sodium intake to less than 1,500 mg per day.”
B. “I should avoid all forms of exercise.”
C. “I can stop my medication once my blood pressure improves.”
D. “I should increase my intake of processed foods.”
Correct Answer: A
Rationale: Sodium restriction is a cornerstone of hypertension management and
helps reduce blood pressure.
Question 8
A client with cirrhosis develops ascites. Which intervention is most appropriate?
A. Increase oral fluid intake
B. Administer lactulose daily
C. Restrict sodium intake
D. Encourage high-protein meals
Correct Answer: C
Rationale: Sodium restriction helps reduce fluid retention and is essential in
managing ascites.
Question 9
A client is receiving heparin therapy. Which laboratory value should the nurse
monitor to evaluate therapeutic effectiveness?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
