RN VATI Adult Medical Surgical Assessment Exam
Questions with Correct Verified Answers (Latest 2026)
Guaranteed Pass | Complete Med-Surg Nursing
Question 1:
A nurse is assessing a client who has left-sided heart failure. Which of the following
findings should the nurse identify as a manifestation of left-sided heart failure?
A. Dependent edema in the lower extremities
B. Frothy sputum
C. Jugular vein distention
D. Hepatomegaly
Correct Answer: B. Frothy sputum
Rationale: Pink-tinged frothy sputum indicates pulmonary edema, a key manifestation
of left-sided heart failure due to fluid backing up into the pulmonary circulation.
Options A, C, and D are manifestations of right-sided heart failure, which results in
systemic congestion.
Question 2:
A nurse is caring for a client receiving heparin therapy. Which laboratory value indicates
therapeutic effectiveness?
A. INR 2.5
B. PT 18 seconds
C. aPTT 65 seconds (normal control 30 seconds)
D. Platelet count 180,000/mm³
Correct Answer: C. aPTT 65 seconds (normal control 30 seconds)
,Rationale: Unfractionated heparin is monitored using activated partial thromboplastin
time (aPTT). The therapeutic range is generally 1.5–2.5 times the normal control value.
INR and PT are used to monitor warfarin therapy. Platelet count monitors for heparin-
induced thrombocytopenia, not therapeutic effectiveness.
Question 3:
A nurse receives stat orders for a client. Which order should the nurse question?
A. Oxygen per nasal cannula at 4 L per minute
B. Enoxaparin (Lovenox) 40 mg subcutaneously
C. Troponin level
D. Computed tomography (CT) angiogram
Correct Answer: B. Enoxaparin (Lovenox) 40 mg subcutaneously
Rationale: The nurse should question the order for Lovenox because the patient is
receiving a heparin drip. Concurrent use of unfractionated heparin and enoxaparin
increases bleeding risk and is generally contraindicated.
Question 4:
A nurse is assessing a client with a diagnosis of pericarditis. Which finding is most
concerning?
A. Friction rub heard at the left sternal border
B. Chest pain relieved by sitting forward
C. Muffled heart sounds
D. Fever of 100.4°F (38°C)
Correct Answer: C. Muffled heart sounds
Rationale: Muffled heart sounds suggest pericardial effusion, which can progress to
cardiac tamponade—a life-threatening emergency. A friction rub, pain relieved by
sitting forward, and low-grade fever are expected findings in pericarditis.
,Question 5:
A client with heart failure has crackles in the lung bases, peripheral edema, and neck
vein distention. Which dietary modification should the nurse prioritize?
A. Increase protein intake
B. Restrict sodium to 2 g/day
C. Increase potassium-rich foods
D. Restrict fluids to 1,500 mL/day
Correct Answer: B. Restrict sodium to 2 g/day
Rationale: Sodium restriction (2 g/day or less) is the priority dietary modification for
heart failure to reduce fluid retention. Fluid restriction may be indicated but is typically
implemented when sodium restriction alone is insufficient. Potassium-rich foods are
important for clients on diuretics but are not the priority.
Question 6:
A nurse is preparing to administer digoxin to a client with heart failure. Which finding
should cause the nurse to withhold the medication?
A. Serum potassium 3.2 mEq/L
B. Blood pressure 110/70 mmHg
C. Heart rate 72 beats/min
D. Serum digoxin level 1.0 ng/mL
Correct Answer: A. Serum potassium 3.2 mEq/L
Rationale: Hypokalemia (potassium < 3.5 mEq/L) increases the risk of digoxin toxicity.
The nurse should withhold digoxin and notify the provider. Normal digoxin level is 0.8-
2.0 ng/mL. Heart rate should be > 60 beats/min before administration.
, Question 7:
A client 2 days post-myocardial infarction reports sudden chest pain and shortness of
breath. The nurse notes a new pericardial friction rub. Which complication should the
nurse suspect?
A. Cardiac tamponade
B. Dressler's syndrome
C. Ventricular aneurysm
D. Pulmonary embolism
Correct Answer: B. Dressler's syndrome
Rationale: Dressler's syndrome (post-MI pericarditis) typically occurs 1-6 weeks after MI
and presents with fever, pleuritic chest pain, and pericardial friction rub. It is an
autoimmune inflammatory response to myocardial necrosis.
Question 8:
A nurse is teaching a client with hypertension about lifestyle modifications. Which
statement indicates understanding?
A. "I will limit my sodium intake to 3,000 mg daily"
B. "I should exercise vigorously for 20 minutes daily"
C. "I will aim to lose 5-10 pounds if I am overweight"
D. "I can stop my medication when I feel better"
Correct Answer: C. "I will aim to lose 5-10 pounds if I am overweight"
Rationale: Weight loss of 5-10 pounds can significantly reduce blood pressure in
overweight clients. Sodium should be limited to < 2,300 mg/day (ideally 1,500 mg).
Moderate exercise (not vigorous) for 30 minutes most days is recommended.
Medications should not be stopped without provider guidance.
Questions with Correct Verified Answers (Latest 2026)
Guaranteed Pass | Complete Med-Surg Nursing
Question 1:
A nurse is assessing a client who has left-sided heart failure. Which of the following
findings should the nurse identify as a manifestation of left-sided heart failure?
A. Dependent edema in the lower extremities
B. Frothy sputum
C. Jugular vein distention
D. Hepatomegaly
Correct Answer: B. Frothy sputum
Rationale: Pink-tinged frothy sputum indicates pulmonary edema, a key manifestation
of left-sided heart failure due to fluid backing up into the pulmonary circulation.
Options A, C, and D are manifestations of right-sided heart failure, which results in
systemic congestion.
Question 2:
A nurse is caring for a client receiving heparin therapy. Which laboratory value indicates
therapeutic effectiveness?
A. INR 2.5
B. PT 18 seconds
C. aPTT 65 seconds (normal control 30 seconds)
D. Platelet count 180,000/mm³
Correct Answer: C. aPTT 65 seconds (normal control 30 seconds)
,Rationale: Unfractionated heparin is monitored using activated partial thromboplastin
time (aPTT). The therapeutic range is generally 1.5–2.5 times the normal control value.
INR and PT are used to monitor warfarin therapy. Platelet count monitors for heparin-
induced thrombocytopenia, not therapeutic effectiveness.
Question 3:
A nurse receives stat orders for a client. Which order should the nurse question?
A. Oxygen per nasal cannula at 4 L per minute
B. Enoxaparin (Lovenox) 40 mg subcutaneously
C. Troponin level
D. Computed tomography (CT) angiogram
Correct Answer: B. Enoxaparin (Lovenox) 40 mg subcutaneously
Rationale: The nurse should question the order for Lovenox because the patient is
receiving a heparin drip. Concurrent use of unfractionated heparin and enoxaparin
increases bleeding risk and is generally contraindicated.
Question 4:
A nurse is assessing a client with a diagnosis of pericarditis. Which finding is most
concerning?
A. Friction rub heard at the left sternal border
B. Chest pain relieved by sitting forward
C. Muffled heart sounds
D. Fever of 100.4°F (38°C)
Correct Answer: C. Muffled heart sounds
Rationale: Muffled heart sounds suggest pericardial effusion, which can progress to
cardiac tamponade—a life-threatening emergency. A friction rub, pain relieved by
sitting forward, and low-grade fever are expected findings in pericarditis.
,Question 5:
A client with heart failure has crackles in the lung bases, peripheral edema, and neck
vein distention. Which dietary modification should the nurse prioritize?
A. Increase protein intake
B. Restrict sodium to 2 g/day
C. Increase potassium-rich foods
D. Restrict fluids to 1,500 mL/day
Correct Answer: B. Restrict sodium to 2 g/day
Rationale: Sodium restriction (2 g/day or less) is the priority dietary modification for
heart failure to reduce fluid retention. Fluid restriction may be indicated but is typically
implemented when sodium restriction alone is insufficient. Potassium-rich foods are
important for clients on diuretics but are not the priority.
Question 6:
A nurse is preparing to administer digoxin to a client with heart failure. Which finding
should cause the nurse to withhold the medication?
A. Serum potassium 3.2 mEq/L
B. Blood pressure 110/70 mmHg
C. Heart rate 72 beats/min
D. Serum digoxin level 1.0 ng/mL
Correct Answer: A. Serum potassium 3.2 mEq/L
Rationale: Hypokalemia (potassium < 3.5 mEq/L) increases the risk of digoxin toxicity.
The nurse should withhold digoxin and notify the provider. Normal digoxin level is 0.8-
2.0 ng/mL. Heart rate should be > 60 beats/min before administration.
, Question 7:
A client 2 days post-myocardial infarction reports sudden chest pain and shortness of
breath. The nurse notes a new pericardial friction rub. Which complication should the
nurse suspect?
A. Cardiac tamponade
B. Dressler's syndrome
C. Ventricular aneurysm
D. Pulmonary embolism
Correct Answer: B. Dressler's syndrome
Rationale: Dressler's syndrome (post-MI pericarditis) typically occurs 1-6 weeks after MI
and presents with fever, pleuritic chest pain, and pericardial friction rub. It is an
autoimmune inflammatory response to myocardial necrosis.
Question 8:
A nurse is teaching a client with hypertension about lifestyle modifications. Which
statement indicates understanding?
A. "I will limit my sodium intake to 3,000 mg daily"
B. "I should exercise vigorously for 20 minutes daily"
C. "I will aim to lose 5-10 pounds if I am overweight"
D. "I can stop my medication when I feel better"
Correct Answer: C. "I will aim to lose 5-10 pounds if I am overweight"
Rationale: Weight loss of 5-10 pounds can significantly reduce blood pressure in
overweight clients. Sodium should be limited to < 2,300 mg/day (ideally 1,500 mg).
Moderate exercise (not vigorous) for 30 minutes most days is recommended.
Medications should not be stopped without provider guidance.
