ATI RN Adult Medical-Surgical Test Bank
Complete Comprehensive Test Bank - 700 Questions with
Verified Answers
CARDIOVASCULAR DISORDERS
Question 1
A 68-year-old male client with known systolic heart failure reports sudden weight gain of 4 lb
in 24 hours, increased shortness of breath, and ankle swelling. Respiratory rate is 24/min,
SpO₂ is 90% on room air, and blood pressure is 150/90 mm Hg. Which action should the
nurse take first?
A. Administer PRN furosemide IV per order
B. Elevate the head of the bed and apply oxygen
C. Call the provider for a higher diuretic dose
D. Encourage a low-sodium diet and fluid restriction
Answer: B. Elevate the head of the bed and apply oxygen
Rationale: The immediate priority is airway and oxygenation—the client is hypoxemic (SpO₂
90%) and tachypneic. Elevating the head of the bed and applying oxygen stabilizes
respirations while preparing for other interventions. Administering furosemide (A) is
important but not the first action when oxygenation is compromised. Calling the provider for
a higher dose (C) should occur after the nurse intervenes to stabilize the client. Dietary
modifications (D) are longer-term interventions that do not address the acute respiratory
distress.
Question 2
A nurse is caring for a client following a coronary artery bypass graft (CABG). Which
assessment finding requires immediate intervention?
A. Chest tube drainage of 50 mL/hr
B. Heart rate of 90 bpm
C. Sudden hypotension with jugular venous distention
D. Temperature of 37.5°C (99.5°F)
Answer: C. Sudden hypotension with jugular venous distention
Rationale: This presentation suggests cardiac tamponade, a life-threatening complication
following cardiac surgery. Blood or fluid accumulates in the pericardial space, compressing
,the heart and reducing cardiac output. Immediate intervention is required to prevent cardiac
arrest. Chest tube drainage of 50 mL/hr (A) is within expected parameters postoperatively. A
heart rate of 90 bpm (B) is within normal range. A temperature of 37.5°C (D) is not
concerning.
Question 3
A client receiving IV heparin has a partial thromboplastin time (PTT) of 90 seconds. The
normal range is 25-35 seconds. What action should the nurse take?
A. Continue heparin at the current dose
B. Notify the provider immediately
C. Hold the heparin dose
D. Administer protamine sulfate
Answer: B. Notify the provider immediately
Rationale: A PTT of 90 seconds indicates significantly increased bleeding risk (therapeutic
goal is typically 1.5–2.5 times control). The provider must be notified immediately for dosage
adjustment. While holding the dose may be appropriate, notifying the provider is the
priority action for medication adjustment. Protamine sulfate (D) is the antidote for heparin
but should only be administered with a provider order in cases of severe bleeding.
Question 4
Which of the following are signs of digoxin toxicity? (Select all that apply)
A. Visual disturbances (yellow halos)
B. Bradycardia
C. Nausea and vomiting
D. Hypertension
E. Confusion
Answer: A, B, C, E
Rationale: Digoxin toxicity includes gastrointestinal symptoms (nausea, vomiting, anorexia),
bradycardia, visual changes (yellow-green halos, blurred vision), and central nervous system
effects (confusion, fatigue). Hypertension (D) is not a classic sign of digoxin toxicity;
hypotension may occur but is less specific.
Question 5
A client is receiving a blood transfusion. Fifteen minutes after initiation, the client develops
chills, fever, and lower back pain. What should the nurse do first?
A. Administer acetaminophen
B. Notify the provider
,C. Stop the transfusion
D. Slow the transfusion rate
Answer: C. Stop the transfusion
Rationale: These symptoms indicate a potential acute hemolytic transfusion reaction. The
priority action is to STOP the transfusion immediately, maintain IV access with normal saline,
and then notify the provider. The blood bag and tubing should be saved for investigation.
Administering acetaminophen (A) or slowing the rate (D) delays critical intervention.
Question 6
A client with atrial fibrillation is at highest risk for which complication?
A. Hemorrhagic stroke
B. Thromboembolic stroke
C. Myocardial infarction
D. Heart failure
Answer: B. Thromboembolic stroke
Rationale: Atrial fibrillation causes ineffective atrial contractions, leading to blood stasis in
the atria and potential clot formation. These clots can embolize to the brain, causing a
stroke. Anticoagulation therapy is typically prescribed to reduce this risk. While heart failure
(D) can result from untreated atrial fibrillation, thromboembolic stroke is the most direct and
serious complication.
Question 7
A nurse is assessing a client with left-sided heart failure. Which finding is most
characteristic?
A. Jugular venous distention
B. Peripheral edema
C. Crackles in the lungs
D. Hepatomegaly
Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure results in pulmonary congestion due to backup of blood
into the pulmonary circulation, causing crackles (rales) on lung auscultation. Jugular venous
distention (A), peripheral edema (B), and hepatomegaly (D) are signs of right-sided heart
failure.
Question 8
, A client with peripheral arterial disease has a non-healing ulcer on the left great toe. Which
finding is expected?
A. Bilateral leg edema
B. Brownish discoloration around the ankles
C. Diminished or absent pedal pulses
D. Warm, erythematous lower extremities
Answer: C. Diminished or absent pedal pulses
Rationale: Peripheral arterial disease causes reduced arterial blood flow leading to
diminished or absent pulses, cool extremities, and pallor with elevation. Edema (A) and
brownish discoloration (B) are characteristic of venous insufficiency, not arterial disease.
Question 9
A nurse is preparing to administer amiodarone IV to a client with ventricular tachycardia.
Which assessment finding would require the nurse to withhold the medication and notify
the provider?
A. Heart rate of 110 bpm
B. Blood pressure of 90/60 mm Hg
C. QTc interval of 520 msec
D. Respiratory rate of 22/min
Answer: C. QTc interval of 520 msec
Rationale: Amiodarone can prolong the QT interval, increasing the risk of torsades de
pointes. A QTc > 500 msec is a contraindication for administration. Heart rate of 110 bpm (A)
and blood pressure of 90/60 mm Hg (B) are expected findings in ventricular tachycardia. A
respiratory rate of 22/min (D) is within normal limits.
Question 10
A client with heart failure has a new prescription for carvedilol. Which statement by the
client indicates a need for further teaching?
A. "I should take this medication with food"
B. "I will monitor my weight daily"
C. "I can stop this medication if I feel dizzy"
D. "I should not stop this medication suddenly"
Answer: C. "I can stop this medication if I feel dizzy"
Rationale: Carvedilol is a beta-blocker that should never be stopped abruptly due to risk of
rebound hypertension, tachycardia, and worsening heart failure. Taking with food (A), daily
Complete Comprehensive Test Bank - 700 Questions with
Verified Answers
CARDIOVASCULAR DISORDERS
Question 1
A 68-year-old male client with known systolic heart failure reports sudden weight gain of 4 lb
in 24 hours, increased shortness of breath, and ankle swelling. Respiratory rate is 24/min,
SpO₂ is 90% on room air, and blood pressure is 150/90 mm Hg. Which action should the
nurse take first?
A. Administer PRN furosemide IV per order
B. Elevate the head of the bed and apply oxygen
C. Call the provider for a higher diuretic dose
D. Encourage a low-sodium diet and fluid restriction
Answer: B. Elevate the head of the bed and apply oxygen
Rationale: The immediate priority is airway and oxygenation—the client is hypoxemic (SpO₂
90%) and tachypneic. Elevating the head of the bed and applying oxygen stabilizes
respirations while preparing for other interventions. Administering furosemide (A) is
important but not the first action when oxygenation is compromised. Calling the provider for
a higher dose (C) should occur after the nurse intervenes to stabilize the client. Dietary
modifications (D) are longer-term interventions that do not address the acute respiratory
distress.
Question 2
A nurse is caring for a client following a coronary artery bypass graft (CABG). Which
assessment finding requires immediate intervention?
A. Chest tube drainage of 50 mL/hr
B. Heart rate of 90 bpm
C. Sudden hypotension with jugular venous distention
D. Temperature of 37.5°C (99.5°F)
Answer: C. Sudden hypotension with jugular venous distention
Rationale: This presentation suggests cardiac tamponade, a life-threatening complication
following cardiac surgery. Blood or fluid accumulates in the pericardial space, compressing
,the heart and reducing cardiac output. Immediate intervention is required to prevent cardiac
arrest. Chest tube drainage of 50 mL/hr (A) is within expected parameters postoperatively. A
heart rate of 90 bpm (B) is within normal range. A temperature of 37.5°C (D) is not
concerning.
Question 3
A client receiving IV heparin has a partial thromboplastin time (PTT) of 90 seconds. The
normal range is 25-35 seconds. What action should the nurse take?
A. Continue heparin at the current dose
B. Notify the provider immediately
C. Hold the heparin dose
D. Administer protamine sulfate
Answer: B. Notify the provider immediately
Rationale: A PTT of 90 seconds indicates significantly increased bleeding risk (therapeutic
goal is typically 1.5–2.5 times control). The provider must be notified immediately for dosage
adjustment. While holding the dose may be appropriate, notifying the provider is the
priority action for medication adjustment. Protamine sulfate (D) is the antidote for heparin
but should only be administered with a provider order in cases of severe bleeding.
Question 4
Which of the following are signs of digoxin toxicity? (Select all that apply)
A. Visual disturbances (yellow halos)
B. Bradycardia
C. Nausea and vomiting
D. Hypertension
E. Confusion
Answer: A, B, C, E
Rationale: Digoxin toxicity includes gastrointestinal symptoms (nausea, vomiting, anorexia),
bradycardia, visual changes (yellow-green halos, blurred vision), and central nervous system
effects (confusion, fatigue). Hypertension (D) is not a classic sign of digoxin toxicity;
hypotension may occur but is less specific.
Question 5
A client is receiving a blood transfusion. Fifteen minutes after initiation, the client develops
chills, fever, and lower back pain. What should the nurse do first?
A. Administer acetaminophen
B. Notify the provider
,C. Stop the transfusion
D. Slow the transfusion rate
Answer: C. Stop the transfusion
Rationale: These symptoms indicate a potential acute hemolytic transfusion reaction. The
priority action is to STOP the transfusion immediately, maintain IV access with normal saline,
and then notify the provider. The blood bag and tubing should be saved for investigation.
Administering acetaminophen (A) or slowing the rate (D) delays critical intervention.
Question 6
A client with atrial fibrillation is at highest risk for which complication?
A. Hemorrhagic stroke
B. Thromboembolic stroke
C. Myocardial infarction
D. Heart failure
Answer: B. Thromboembolic stroke
Rationale: Atrial fibrillation causes ineffective atrial contractions, leading to blood stasis in
the atria and potential clot formation. These clots can embolize to the brain, causing a
stroke. Anticoagulation therapy is typically prescribed to reduce this risk. While heart failure
(D) can result from untreated atrial fibrillation, thromboembolic stroke is the most direct and
serious complication.
Question 7
A nurse is assessing a client with left-sided heart failure. Which finding is most
characteristic?
A. Jugular venous distention
B. Peripheral edema
C. Crackles in the lungs
D. Hepatomegaly
Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure results in pulmonary congestion due to backup of blood
into the pulmonary circulation, causing crackles (rales) on lung auscultation. Jugular venous
distention (A), peripheral edema (B), and hepatomegaly (D) are signs of right-sided heart
failure.
Question 8
, A client with peripheral arterial disease has a non-healing ulcer on the left great toe. Which
finding is expected?
A. Bilateral leg edema
B. Brownish discoloration around the ankles
C. Diminished or absent pedal pulses
D. Warm, erythematous lower extremities
Answer: C. Diminished or absent pedal pulses
Rationale: Peripheral arterial disease causes reduced arterial blood flow leading to
diminished or absent pulses, cool extremities, and pallor with elevation. Edema (A) and
brownish discoloration (B) are characteristic of venous insufficiency, not arterial disease.
Question 9
A nurse is preparing to administer amiodarone IV to a client with ventricular tachycardia.
Which assessment finding would require the nurse to withhold the medication and notify
the provider?
A. Heart rate of 110 bpm
B. Blood pressure of 90/60 mm Hg
C. QTc interval of 520 msec
D. Respiratory rate of 22/min
Answer: C. QTc interval of 520 msec
Rationale: Amiodarone can prolong the QT interval, increasing the risk of torsades de
pointes. A QTc > 500 msec is a contraindication for administration. Heart rate of 110 bpm (A)
and blood pressure of 90/60 mm Hg (B) are expected findings in ventricular tachycardia. A
respiratory rate of 22/min (D) is within normal limits.
Question 10
A client with heart failure has a new prescription for carvedilol. Which statement by the
client indicates a need for further teaching?
A. "I should take this medication with food"
B. "I will monitor my weight daily"
C. "I can stop this medication if I feel dizzy"
D. "I should not stop this medication suddenly"
Answer: C. "I can stop this medication if I feel dizzy"
Rationale: Carvedilol is a beta-blocker that should never be stopped abruptly due to risk of
rebound hypertension, tachycardia, and worsening heart failure. Taking with food (A), daily
