ATI Med Surg Proctored Practice Exam Study
Guide | Complete Actual Exam Questions with
Answers and Rationales | Latest Updated Version
2026/2027 | Already Graded A+
Question 1
The nurse is completing an admission interview for a client with Parkinson disease.
Which question will provide additional information about manifestations that the client
is likely to experience?
A. "Have you ever experienced any paralysis of your arms or legs?"
B. "Do you have frequent blackout spells?"
C. "Have you ever been frozen in one spot, unable to move?"
D. "Do you have headaches, especially ones with throbbing pain?"
Answer: C
Rationale: Clients with Parkinson disease frequently experience difficulty in initiating,
maintaining, and performing motor activities. They may even experience being rooted to
the spot and unable to move.
Question 2
The nurse notes that the client's drainage has decreased from 50 to 5 mL/hr 12 hours
after chest tube insertion for hemothorax. What is the best initial action for the nurse to
take?
A. Document this expected decrease in drainage.
B. Clamp the chest tube while assessing for air leaks.
C. Milk the tube to remove any excessive blood clot buildup.
D. Assess for kinks or dependent loops in the tubing.
Answer: D
Rationale: The least invasive nursing action should be performed first to determine
why the drainage has diminished.
Question 3
A 77-year-old female client is admitted to the hospital with confusion and anorexia of
several days' duration. She has symptoms of nausea and vomiting and is currently
complaining of a headache. The client's pulse rate is 43 beats/min. The nurse is most
concerned about the client's history related to which medication?
A. Warfarin (Coumadin)
B. Ibuprofen (Motrin)
C. Nitroglycerin (Nitrostat)
pg. 1
,D. Digoxin (Lanoxin)
Answer: D
Rationale: Older persons are particularly susceptible to the buildup of cardiac
glycosides, such as digoxin, to a toxic level. Toxicity can cause anorexia, nausea,
vomiting, diarrhea, headache, and fatigue.
Question 4
The nurse is observing an unlicensed assistive personnel (UAP) performing morning
care for a bedridden client with Huntington disease. Which care measure is most
important for the nurse to supervise?
A. Oral care
B. Bathing
C. Foot care
D. Catheter care
Answer: A
Rationale: The client with Huntington disease experiences problems with motor skills
such as swallowing and is at high risk for aspiration, so the highest priority for the nurse
to observe is oral care.
Question 5
A client who is receiving an angiotensin-converting enzyme (ACE) inhibitor for
hypertension calls the clinic and reports the recent onset of a cough to the nurse. Which
action should the nurse implement?
A. Advise the client to come to the clinic immediately for further assessment.
B. Instruct the client to discontinue use of the drug and to make an appointment at the
clinic.
C. Suggest that the client learn to accept the cough as a side effect to a necessary
prescription.
D. Encourage the client to keep taking the drug until seen by the health care provider.
Answer: D
Rationale: Coughing is a common side effect of ACE inhibitors and is not an indication
to discontinue the medication. Antihypertensive medications should not be stopped
abruptly because rebound hypertension may occur.
Question 6
When assigning clients on a medical-surgical floor to an RN and a PN, it is best for the
charge nurse to assign which client to the PN?
A. A young adult with bacterial meningitis with recent seizures
B. An older adult client with pneumonia and viral meningitis
C. A female client in isolation with meningococcal meningitis
D. A male client 1 day postoperative after drainage of a brain abscess
pg. 2
,Answer: B
Rationale: The most stable client is option B. Options A, C, and D are all at high risk
for increased intracranial pressure and require the expertise of the RN.
Question 7
In assessing a client diagnosed with primary aldosteronism, the nurse expects the
laboratory test results to indicate a decreased serum level of which substance?
A. Sodium
B. Phosphate
C. Potassium
D. Glucose
Answer: C
Rationale: Clients with primary aldosteronism exhibit a profound decline in serum
levels of potassium (hypokalemia). Hypertension is the most prominent and universal
sign.
Question 8
A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid
ventricular response. Based on this finding, the nurse anticipates assisting the physician
with which treatment?
A. Administer lidocaine, 75 mg intravenous push.
B. Perform synchronized cardioversion.
C. Defibrillate the client as soon as possible.
D. Administer atropine, 0.4 mg intravenous push.
Answer: B
Rationale: With uncontrolled atrial fibrillation, the treatment of choice is
synchronized cardioversion to convert the cardiac rhythm back to normal sinus rhythm.
Question 9
A client with hypertension has been receiving ramipril (Altace), 5 mg PO, daily for 2
weeks and is scheduled to receive a dose at 0900. At 0830, the client's blood pressure is
120/70 mm Hg. Which action should the nurse take?
A. Administer the prescribed dose at the scheduled time.
B. Hold the dose and contact the health care provider.
C. Hold the dose and recheck the blood pressure in 1 hour.
D. Check the health care provider's prescription to clarify the dose.
Answer: A
Rationale: The client's blood pressure is within normal limits, indicating that the
ramipril is having the desired effect and should be administered.
Question 10
pg. 3
, Which consideration is most important when the nurse is assigning a room for a client
being admitted with progressive systemic sclerosis (scleroderma)?
A. Provide a room that can be kept warm.
B. Make sure that the room can be kept dark.
C. Keep the client close to the nursing unit.
D. Select a room that is visible from the nurses' desk.
Answer: A
Rationale: Abnormal blood flow in response to cold (Raynaud phenomenon) is
precipitated in clients with scleroderma.
Question 11
A male client has just undergone a laryngectomy and has a cuffed tracheostomy tube in
place. When initiating bolus tube feedings postoperatively, when should the nurse
inflate the cuff?
A. Immediately after feeding
B. Just prior to tube feeding
C. Continuous inflation is required
D. Inflation is not required
Answer: B
Rationale: The cuff should be inflated before the feeding to block the trachea and
prevent food from entering if oral feedings are started.
Question 12
A 55-year-old male client has been admitted to the hospital with a medical diagnosis of
chronic obstructive pulmonary disease (COPD). Which risk factor is the most significant
in the development of this client's COPD?
A. The client's father was diagnosed with COPD in his 50s.
B. A close family member contracted tuberculosis last year.
C. The client smokes one to two packs of cigarettes per day.
D. The client has been 40 pounds overweight for 15 years.
Answer: C
Rationale: Smoking, considered to be a modifiable risk factor, is the most significant
risk factor for the development of COPD.
Question 13
A family member was taught to suction a client's tracheostomy prior to the client's
discharge from the hospital. Which observation by the nurse indicates that the family
member is capable of correctly performing the suctioning technique?
A. Turns on the continuous wall suction to 190 mm Hg.
B. Inserts the catheter until resistance or coughing occurs.
C. Withdraws the catheter while maintaining suctioning.
pg. 4
Guide | Complete Actual Exam Questions with
Answers and Rationales | Latest Updated Version
2026/2027 | Already Graded A+
Question 1
The nurse is completing an admission interview for a client with Parkinson disease.
Which question will provide additional information about manifestations that the client
is likely to experience?
A. "Have you ever experienced any paralysis of your arms or legs?"
B. "Do you have frequent blackout spells?"
C. "Have you ever been frozen in one spot, unable to move?"
D. "Do you have headaches, especially ones with throbbing pain?"
Answer: C
Rationale: Clients with Parkinson disease frequently experience difficulty in initiating,
maintaining, and performing motor activities. They may even experience being rooted to
the spot and unable to move.
Question 2
The nurse notes that the client's drainage has decreased from 50 to 5 mL/hr 12 hours
after chest tube insertion for hemothorax. What is the best initial action for the nurse to
take?
A. Document this expected decrease in drainage.
B. Clamp the chest tube while assessing for air leaks.
C. Milk the tube to remove any excessive blood clot buildup.
D. Assess for kinks or dependent loops in the tubing.
Answer: D
Rationale: The least invasive nursing action should be performed first to determine
why the drainage has diminished.
Question 3
A 77-year-old female client is admitted to the hospital with confusion and anorexia of
several days' duration. She has symptoms of nausea and vomiting and is currently
complaining of a headache. The client's pulse rate is 43 beats/min. The nurse is most
concerned about the client's history related to which medication?
A. Warfarin (Coumadin)
B. Ibuprofen (Motrin)
C. Nitroglycerin (Nitrostat)
pg. 1
,D. Digoxin (Lanoxin)
Answer: D
Rationale: Older persons are particularly susceptible to the buildup of cardiac
glycosides, such as digoxin, to a toxic level. Toxicity can cause anorexia, nausea,
vomiting, diarrhea, headache, and fatigue.
Question 4
The nurse is observing an unlicensed assistive personnel (UAP) performing morning
care for a bedridden client with Huntington disease. Which care measure is most
important for the nurse to supervise?
A. Oral care
B. Bathing
C. Foot care
D. Catheter care
Answer: A
Rationale: The client with Huntington disease experiences problems with motor skills
such as swallowing and is at high risk for aspiration, so the highest priority for the nurse
to observe is oral care.
Question 5
A client who is receiving an angiotensin-converting enzyme (ACE) inhibitor for
hypertension calls the clinic and reports the recent onset of a cough to the nurse. Which
action should the nurse implement?
A. Advise the client to come to the clinic immediately for further assessment.
B. Instruct the client to discontinue use of the drug and to make an appointment at the
clinic.
C. Suggest that the client learn to accept the cough as a side effect to a necessary
prescription.
D. Encourage the client to keep taking the drug until seen by the health care provider.
Answer: D
Rationale: Coughing is a common side effect of ACE inhibitors and is not an indication
to discontinue the medication. Antihypertensive medications should not be stopped
abruptly because rebound hypertension may occur.
Question 6
When assigning clients on a medical-surgical floor to an RN and a PN, it is best for the
charge nurse to assign which client to the PN?
A. A young adult with bacterial meningitis with recent seizures
B. An older adult client with pneumonia and viral meningitis
C. A female client in isolation with meningococcal meningitis
D. A male client 1 day postoperative after drainage of a brain abscess
pg. 2
,Answer: B
Rationale: The most stable client is option B. Options A, C, and D are all at high risk
for increased intracranial pressure and require the expertise of the RN.
Question 7
In assessing a client diagnosed with primary aldosteronism, the nurse expects the
laboratory test results to indicate a decreased serum level of which substance?
A. Sodium
B. Phosphate
C. Potassium
D. Glucose
Answer: C
Rationale: Clients with primary aldosteronism exhibit a profound decline in serum
levels of potassium (hypokalemia). Hypertension is the most prominent and universal
sign.
Question 8
A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid
ventricular response. Based on this finding, the nurse anticipates assisting the physician
with which treatment?
A. Administer lidocaine, 75 mg intravenous push.
B. Perform synchronized cardioversion.
C. Defibrillate the client as soon as possible.
D. Administer atropine, 0.4 mg intravenous push.
Answer: B
Rationale: With uncontrolled atrial fibrillation, the treatment of choice is
synchronized cardioversion to convert the cardiac rhythm back to normal sinus rhythm.
Question 9
A client with hypertension has been receiving ramipril (Altace), 5 mg PO, daily for 2
weeks and is scheduled to receive a dose at 0900. At 0830, the client's blood pressure is
120/70 mm Hg. Which action should the nurse take?
A. Administer the prescribed dose at the scheduled time.
B. Hold the dose and contact the health care provider.
C. Hold the dose and recheck the blood pressure in 1 hour.
D. Check the health care provider's prescription to clarify the dose.
Answer: A
Rationale: The client's blood pressure is within normal limits, indicating that the
ramipril is having the desired effect and should be administered.
Question 10
pg. 3
, Which consideration is most important when the nurse is assigning a room for a client
being admitted with progressive systemic sclerosis (scleroderma)?
A. Provide a room that can be kept warm.
B. Make sure that the room can be kept dark.
C. Keep the client close to the nursing unit.
D. Select a room that is visible from the nurses' desk.
Answer: A
Rationale: Abnormal blood flow in response to cold (Raynaud phenomenon) is
precipitated in clients with scleroderma.
Question 11
A male client has just undergone a laryngectomy and has a cuffed tracheostomy tube in
place. When initiating bolus tube feedings postoperatively, when should the nurse
inflate the cuff?
A. Immediately after feeding
B. Just prior to tube feeding
C. Continuous inflation is required
D. Inflation is not required
Answer: B
Rationale: The cuff should be inflated before the feeding to block the trachea and
prevent food from entering if oral feedings are started.
Question 12
A 55-year-old male client has been admitted to the hospital with a medical diagnosis of
chronic obstructive pulmonary disease (COPD). Which risk factor is the most significant
in the development of this client's COPD?
A. The client's father was diagnosed with COPD in his 50s.
B. A close family member contracted tuberculosis last year.
C. The client smokes one to two packs of cigarettes per day.
D. The client has been 40 pounds overweight for 15 years.
Answer: C
Rationale: Smoking, considered to be a modifiable risk factor, is the most significant
risk factor for the development of COPD.
Question 13
A family member was taught to suction a client's tracheostomy prior to the client's
discharge from the hospital. Which observation by the nurse indicates that the family
member is capable of correctly performing the suctioning technique?
A. Turns on the continuous wall suction to 190 mm Hg.
B. Inserts the catheter until resistance or coughing occurs.
C. Withdraws the catheter while maintaining suctioning.
pg. 4
