ATI RN ConceptBased Assessment Level 3 Proctored Exam
2026/2027 | 200 Practice Questions & Detailed Answers |
NGNStyle Test Bank | A+ Graded
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 120)
1. A client with heart failure has 2+ pitting edema in the lower extremities. Which intervention should
the nurse implement first?
A) Administer a diuretic as prescribed
B) Elevate the head of the bed
C) Encourage ambulation
D) Restrict fluid intake
Correct Answer: A
Rationale: Administering a prescribed diuretic addresses fluid overload, which is the priority in managing
heart failure with edema. While elevating the head of the bed may help with breathing and fluid
restriction may be part of the plan, pharmacological intervention to remove excess fluid is the most
direct and immediate action to address the edema.
2. Which laboratory value indicates effective anticoagulant therapy with warfarin?
A) INR 1.0
B) INR 2.5
C) PT 10 seconds
D) Platelets 250,000/mm³
,Correct Answer: B
Rationale: The therapeutic INR range for most indications (such as atrial fibrillation, DVT, or pulmonary
embolism) is 23. An INR of 2.5 falls within this therapeutic window, indicating effective anticoagulation.
INR 1.0 is subtherapeutic. PT without INR standardization is not reliable for monitoring warfarin.
3. A client receiving morphine via PCA becomes difficult to arouse, with a respiratory rate of 8
breaths/min. Which action should the nurse perform first?
A) Administer naloxone
B) Notify the provider
C) Stop the PCA infusion
D) Apply supplemental oxygen
Correct Answer: C
Rationale: The priority action is to stop the PCA infusion to prevent further opioid admini stration. After
stopping the infusion, the nurse should administer naloxone if indicated, notify the provider, and apply
supplemental oxygen. Airway and breathing are the priority, but stopping the infusion is the first step.
4. A client is prescribed furosemide. Which electrolyte imbalance is most concerning for a patient on
furosemide?
A) Hypernatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypophosphatemia
,Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia is the most
concerning electrolyte imbalance because it can lead to cardiac arrhythmias. Clients on furosemide
should have their potassium levels monitored and may require potassium supplementation.
5. A nurse is assessing a client with leftsided heart failure. Which finding is most consistent with this
condition?
A) Jugular venous distention
B) Peripheral edema
C) Crackles in the lungs
D) Ascites
Correct Answer: C
Rationale: Leftsided heart failure results in pulmonary congestion due to the backup of blood into the
pulmonary circulation. Crackles in the lungs are a hallmark sign of pulmonary edema. Jugular venous
distention, peripheral edema, and ascites are more consistent with rightsided heart failure.
6. A client with a history of deep vein thrombosis is prescribed enoxaparin. Which teaching point is most
important for the nurse to include?
A) "This medication will dissolve existing clots."
B) "You should take this medication with food."
C) "You should report any unusual bleeding or bruising."
, D) "You can stop taking this medication once your symptoms improve."
Correct Answer: C
Rationale: Enoxaparin is an anticoagulant that increases the risk of bleeding. The client should be taught
to report any unusual bleeding, bruising, or signs of hemorrhage. Enoxaparin prevents new clot
formation but does not dissolve existing clots. It is administered subcutaneously, not orally.
7. A client with angina pectoris is prescribed nitroglycerin sublingually. Which instruction should the
nurse provide?
A) "Take one tablet daily at the same time each day."
B) "Take one tablet every 5 minutes up to three doses for chest pain."
C) "Swallow the tablet with a full glass of water."
D) "Chew the tablet for faster absorption."
Correct Answer: B
Rationale: Nitroglycerin sublingual tablets should be taken at the onset of chest pain. The client should
take one tablet, and if pain persists after 5 minutes, take a second tablet, and a third after another 5
minutes if pain continues. If pain persists after three tablets, the client should seek emergency care. The
tablets should be dissolved under the tongue, not swallowed or chewed.
8. A nurse is caring for a client postcardiac catheterization. Which assessment finding requires
immediate intervention?
A) Pulse rate of 72 beats/min
2026/2027 | 200 Practice Questions & Detailed Answers |
NGNStyle Test Bank | A+ Graded
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 120)
1. A client with heart failure has 2+ pitting edema in the lower extremities. Which intervention should
the nurse implement first?
A) Administer a diuretic as prescribed
B) Elevate the head of the bed
C) Encourage ambulation
D) Restrict fluid intake
Correct Answer: A
Rationale: Administering a prescribed diuretic addresses fluid overload, which is the priority in managing
heart failure with edema. While elevating the head of the bed may help with breathing and fluid
restriction may be part of the plan, pharmacological intervention to remove excess fluid is the most
direct and immediate action to address the edema.
2. Which laboratory value indicates effective anticoagulant therapy with warfarin?
A) INR 1.0
B) INR 2.5
C) PT 10 seconds
D) Platelets 250,000/mm³
,Correct Answer: B
Rationale: The therapeutic INR range for most indications (such as atrial fibrillation, DVT, or pulmonary
embolism) is 23. An INR of 2.5 falls within this therapeutic window, indicating effective anticoagulation.
INR 1.0 is subtherapeutic. PT without INR standardization is not reliable for monitoring warfarin.
3. A client receiving morphine via PCA becomes difficult to arouse, with a respiratory rate of 8
breaths/min. Which action should the nurse perform first?
A) Administer naloxone
B) Notify the provider
C) Stop the PCA infusion
D) Apply supplemental oxygen
Correct Answer: C
Rationale: The priority action is to stop the PCA infusion to prevent further opioid admini stration. After
stopping the infusion, the nurse should administer naloxone if indicated, notify the provider, and apply
supplemental oxygen. Airway and breathing are the priority, but stopping the infusion is the first step.
4. A client is prescribed furosemide. Which electrolyte imbalance is most concerning for a patient on
furosemide?
A) Hypernatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypophosphatemia
,Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia is the most
concerning electrolyte imbalance because it can lead to cardiac arrhythmias. Clients on furosemide
should have their potassium levels monitored and may require potassium supplementation.
5. A nurse is assessing a client with leftsided heart failure. Which finding is most consistent with this
condition?
A) Jugular venous distention
B) Peripheral edema
C) Crackles in the lungs
D) Ascites
Correct Answer: C
Rationale: Leftsided heart failure results in pulmonary congestion due to the backup of blood into the
pulmonary circulation. Crackles in the lungs are a hallmark sign of pulmonary edema. Jugular venous
distention, peripheral edema, and ascites are more consistent with rightsided heart failure.
6. A client with a history of deep vein thrombosis is prescribed enoxaparin. Which teaching point is most
important for the nurse to include?
A) "This medication will dissolve existing clots."
B) "You should take this medication with food."
C) "You should report any unusual bleeding or bruising."
, D) "You can stop taking this medication once your symptoms improve."
Correct Answer: C
Rationale: Enoxaparin is an anticoagulant that increases the risk of bleeding. The client should be taught
to report any unusual bleeding, bruising, or signs of hemorrhage. Enoxaparin prevents new clot
formation but does not dissolve existing clots. It is administered subcutaneously, not orally.
7. A client with angina pectoris is prescribed nitroglycerin sublingually. Which instruction should the
nurse provide?
A) "Take one tablet daily at the same time each day."
B) "Take one tablet every 5 minutes up to three doses for chest pain."
C) "Swallow the tablet with a full glass of water."
D) "Chew the tablet for faster absorption."
Correct Answer: B
Rationale: Nitroglycerin sublingual tablets should be taken at the onset of chest pain. The client should
take one tablet, and if pain persists after 5 minutes, take a second tablet, and a third after another 5
minutes if pain continues. If pain persists after three tablets, the client should seek emergency care. The
tablets should be dissolved under the tongue, not swallowed or chewed.
8. A nurse is caring for a client postcardiac catheterization. Which assessment finding requires
immediate intervention?
A) Pulse rate of 72 beats/min
