ATI RN Adult MedicalSurgical Proctored Exam NGN
2026/2027 | 200 Practice Questions & Detailed Answers |
Forms A, B & C Test Bank | A+ Graded
1. A nurse is caring for a client who has a new diagnosis of heart failure. Which of the following findings
is an early manifestation of fluid overload?
A) Dyspnea on exertion
B) Peripheral edema
C) Jugular venous distention
D) Crackles in the lung bases
Answer: A) Dyspnea on exertion
Rationale: Dyspnea on exertion is often one of the earliest signs of heart failure, resulting from
pulmonary congestion that worsens with activity. Peripheral edema, JVD, and crackles are later
manifestations.
2. A nurse is preparing to administer digoxin to a client who has heart failure. Which of the following
findings should indicate to the nurse that the client is at risk for digoxin toxicity?
A) Serum potassium 3.2 mEq/L
B) Serum potassium 4.8 mEq/L
C) Serum sodium 140 mEq/L
D) Serum calcium 9.5 mg/dL
Answer: A) Serum potassium 3.2 mEq/L
Rationale: Hypokalemia (potassium < 3.5 mEq/L) increases the risk for digoxin toxicity by enhancing the
drug's effect on the heart. Normal potassium is 3.5–5.0 mEq/L.
,3. A client with COPD is prescribed a corticosteroid inhaler. Which of the following instructions should
the nurse include in the teaching?
A) Use the inhaler as needed for acute symptoms
B) Rinse the mouth after each use
C) Use the inhaler before a bronchodilator
D) Expect immediate relief after administration
Answer: B) Rinse the mouth after each use
Rationale: Corticosteroid inhalers can cause oral candidiasis (thrush). Rinsing the mouth after use
reduces the risk. These are maintenance medications, not for acute symptoms.
4. A nurse is caring for a client who has acute pancreatitis. Which of the following laboratory findings
would the nurse expect?
A) Elevated serum amylase
B) Decreased serum lipase
C) Elevated serum calcium
D) Decreased serum glucose
Answer: A) Elevated serum amylase
Rationale: Serum amylase and lipase are elevated in acute pancreatitis due to leakage of these enzymes
from damaged pancreatic cells. Calcium may decrease, and glucose may increase.
,5. A nurse is providing postoperative care for a client who had a total hip arthroplasty. Which of the
following actions should the nurse take to prevent dislocation?
A) Keep the client's legs crossed at the ankles
B) Maintain the client in a low Fowler's position
C) Place a pillow between the client's legs when turning
D) Encourage the client to lean forward when sitting
Answer: C) Place a pillow between the client's legs when turning
Rationale: After hip arthroplasty, the hip should not be adducted past midline. Placing an abduction
pillow between the legs prevents adduction and reduces dislocation risk.
6. A nurse is assessing a client who has a suspected pulmonary embolism. Which of the following
findings is consistent with this diagnosis?
A) Bradypnea
B) Pleuritic chest pain
C) Hypotension
D) Hemoptysis
Answer: B) Pleuritic chest pain
Rationale: Pleuritic chest pain (sharp pain worsened by inspiration) is a classic finding in pulmonary
embolism. Other signs include tachypnea, tachycardia, and hypoxemia.
, 7. A client with diabetes mellitus type 2 is prescribed metformin. Which of the following statements by
the client indicates understanding of the medication?
A) "I should take this medication with my evening meal."
B) "I need to monitor for signs of hypoglycemia."
C) "I should report any muscle pain to my provider."
D) "This medication may cause weight gain."
Answer: B) I need to monitor for signs of hypoglycemia.
Rationale: Metformin can cause hypoglycemia, especially when combined with other antidiabetic agents
or when meals are skipped. Patients should be taught to recognize hypoglycemia symptoms.
8. A nurse is caring for a client who has acute kidney injury. Which of the following findings should the
nurse report to the provider?
A) Urine output 30 mL/hr
B) Serum potassium 6.0 mEq/L
C) Blood pressure 140/88 mm Hg
D) Serum creatinine 2.0 mg/dL
Answer: B) Serum potassium 6.0 mEq/L
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) is a lifethreatening complication of acute kidney injury
that can cause cardiac arrhythmias and requires immediate intervention.
9. A nurse is providing discharge teaching to a client who has a new col ostomy. Which of the following
statements indicates the client understands the teaching?
2026/2027 | 200 Practice Questions & Detailed Answers |
Forms A, B & C Test Bank | A+ Graded
1. A nurse is caring for a client who has a new diagnosis of heart failure. Which of the following findings
is an early manifestation of fluid overload?
A) Dyspnea on exertion
B) Peripheral edema
C) Jugular venous distention
D) Crackles in the lung bases
Answer: A) Dyspnea on exertion
Rationale: Dyspnea on exertion is often one of the earliest signs of heart failure, resulting from
pulmonary congestion that worsens with activity. Peripheral edema, JVD, and crackles are later
manifestations.
2. A nurse is preparing to administer digoxin to a client who has heart failure. Which of the following
findings should indicate to the nurse that the client is at risk for digoxin toxicity?
A) Serum potassium 3.2 mEq/L
B) Serum potassium 4.8 mEq/L
C) Serum sodium 140 mEq/L
D) Serum calcium 9.5 mg/dL
Answer: A) Serum potassium 3.2 mEq/L
Rationale: Hypokalemia (potassium < 3.5 mEq/L) increases the risk for digoxin toxicity by enhancing the
drug's effect on the heart. Normal potassium is 3.5–5.0 mEq/L.
,3. A client with COPD is prescribed a corticosteroid inhaler. Which of the following instructions should
the nurse include in the teaching?
A) Use the inhaler as needed for acute symptoms
B) Rinse the mouth after each use
C) Use the inhaler before a bronchodilator
D) Expect immediate relief after administration
Answer: B) Rinse the mouth after each use
Rationale: Corticosteroid inhalers can cause oral candidiasis (thrush). Rinsing the mouth after use
reduces the risk. These are maintenance medications, not for acute symptoms.
4. A nurse is caring for a client who has acute pancreatitis. Which of the following laboratory findings
would the nurse expect?
A) Elevated serum amylase
B) Decreased serum lipase
C) Elevated serum calcium
D) Decreased serum glucose
Answer: A) Elevated serum amylase
Rationale: Serum amylase and lipase are elevated in acute pancreatitis due to leakage of these enzymes
from damaged pancreatic cells. Calcium may decrease, and glucose may increase.
,5. A nurse is providing postoperative care for a client who had a total hip arthroplasty. Which of the
following actions should the nurse take to prevent dislocation?
A) Keep the client's legs crossed at the ankles
B) Maintain the client in a low Fowler's position
C) Place a pillow between the client's legs when turning
D) Encourage the client to lean forward when sitting
Answer: C) Place a pillow between the client's legs when turning
Rationale: After hip arthroplasty, the hip should not be adducted past midline. Placing an abduction
pillow between the legs prevents adduction and reduces dislocation risk.
6. A nurse is assessing a client who has a suspected pulmonary embolism. Which of the following
findings is consistent with this diagnosis?
A) Bradypnea
B) Pleuritic chest pain
C) Hypotension
D) Hemoptysis
Answer: B) Pleuritic chest pain
Rationale: Pleuritic chest pain (sharp pain worsened by inspiration) is a classic finding in pulmonary
embolism. Other signs include tachypnea, tachycardia, and hypoxemia.
, 7. A client with diabetes mellitus type 2 is prescribed metformin. Which of the following statements by
the client indicates understanding of the medication?
A) "I should take this medication with my evening meal."
B) "I need to monitor for signs of hypoglycemia."
C) "I should report any muscle pain to my provider."
D) "This medication may cause weight gain."
Answer: B) I need to monitor for signs of hypoglycemia.
Rationale: Metformin can cause hypoglycemia, especially when combined with other antidiabetic agents
or when meals are skipped. Patients should be taught to recognize hypoglycemia symptoms.
8. A nurse is caring for a client who has acute kidney injury. Which of the following findings should the
nurse report to the provider?
A) Urine output 30 mL/hr
B) Serum potassium 6.0 mEq/L
C) Blood pressure 140/88 mm Hg
D) Serum creatinine 2.0 mg/dL
Answer: B) Serum potassium 6.0 mEq/L
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) is a lifethreatening complication of acute kidney injury
that can cause cardiac arrhythmias and requires immediate intervention.
9. A nurse is providing discharge teaching to a client who has a new col ostomy. Which of the following
statements indicates the client understands the teaching?
