ATI RN Adult Medical Surgical Nursing Comprehensive
Practice Examination | Complete Actual Exam Questions
with Verified Correct Answers and Detailed Rationales |
Latest Updated Exam- 2026/2027 | Already Graded A+
Question 1
A client with a history of angina is scheduled for exercise electrocardiography at 1100.
Which of the following statements by the client requires the nurse to contact the
provider for possible rescheduling?
A) "I'm still hungry after the bowl of cereal I ate at 0700"
B) "I didn't take my heart pills this morning because the doctor told me not to"
C) "I have had chest pain a couple of times since I saw my doctor in the office last
week"
D) "I smoked a cigarette this morning to calm my nerves about having this procedure"
Answer: D
Rationale: Smoking a cigarette before exercise electrocardiography is
contraindicated because nicotine causes vasoconstriction and tachycardia, which can
alter test results. The client should refrain from smoking before the procedure. The
nurse should contact the provider for possible rescheduling.
Question 2
A client with heart failure is being discharged. The nurse should instruct the client to
report which of the following findings immediately to the provider?
A) Weight gain of 2 pounds in 24 hours indicating fluid retention
B) Increase of 10 mmHg in systolic blood pressure indicating hypertension
C) Dyspnea with exertion indicating expected heart failure symptoms
D) Dizziness when rising quickly indicating orthostatic hypotension
Answer: A
Rationale: Weight gain of 2 pounds (0.9 kg) in 24 hours indicates fluid retention
and worsening heart failure. This requires immediate provider notification. Dyspnea
with exertion and dizziness with position changes are important but not the priority.
Question 3
A client with a history of deep-vein thrombosis is receiving Warfarin. Which of the
following findings should indicate to the nurse that the medication is effective?
1
,A) Hemoglobin 14 g/dL indicating adequate oxygen carrying capacity
B) Minimal bruising of extremities indicating normal platelet function
C) Decreased blood pressure indicating reduced cardiac workload
D) INR of 2.0 to 3.0 indicating therapeutic anticoagulation
Answer: D
Rationale: Warfarin is an anticoagulant that works by inhibiting vitamin K-
dependent clotting factors. The therapeutic effect is measured by the International
Normalized Ratio (INR). A therapeutic INR range for most indications is 2.0 to 3.0.
Hemoglobin, bruising, and blood pressure are not indicators of Warfarin effectiveness.
Question 4
A client is receiving heparin therapy and develops hematuria. The nurse notes the
aPTT is 96 seconds. Which of the following actions should the nurse take?
A) Increase the heparin infusion flow rate by 2 mL/hr to achieve therapeutic range
B) Continue to monitor the heparin infusion as prescribed without intervention
C) Request a prothrombin time (PT) to evaluate clotting factors
D) Stop the heparin infusion and notify the provider immediately
Answer: D
Rationale: The normal aPTT is approximately 30-40 seconds. A value of 96 seconds
indicates excessive anticoagulation and increased bleeding risk. Hematuria (blood in
urine) is a sign of bleeding. The nurse should stop the heparin infusion and notify the
provider immediately.
Question 5
A client with heart failure and atrial fibrillation reports slurred speech. Which of the
following actions should the nurse take?
A) Document the finding as an expected symptom of atrial fibrillation
B) Continue to monitor the client's irregular pulse without intervention
C) Assess for dependent edema as a sign of worsening heart failure
D) Report this finding to the provider immediately as it may indicate a stroke
Answer: D
Rationale: Slurred speech in a client with atrial fibrillation and heart failure is a
critical finding that may indicate a cerebrovascular accident (stroke) due to emboli
from atrial fibrillation. This finding requires immediate provider notification.
2
,Question 6
A client's laboratory results show Cholesterol 190 mg/dL, HDL 25 mg/dL, and LDL
160 mg/dL. The nurse should recognize that dietary teaching is needed because:
A) Cholesterol 190 mg/dL is within normal range requiring no intervention
B) HDL 25 mg/dL is low and LDL 160 mg/dL is high, increasing cardiac risk
C) Cholesterol 190 mg/dL is high but HDL and LDL are acceptable
D) HDL 25 mg/dL is high indicating good cardiovascular health
Answer: B
Rationale: A normal HDL is 40-60 mg/dL, and an LDL below 130 mg/dL is
desirable. HDL 25 mg/dL is low (increased risk), and LDL 160 mg/dL is high
(increased risk). Total cholesterol 190 mg/dL is borderline high. The nurse should
plan to provide dietary teaching.
Question 7
A client with bradycardia is being assessed by the nurse. Which of the following
findings should the nurse monitor for?
A) Confusion and altered mental status indicating decreased cerebral perfusion
B) Friction rub indicating pericardial inflammation
C) Hypertension indicating increased cardiac output
D) Dry skin indicating decreased peripheral perfusion
Answer: A
Rationale: Bradycardia can lead to decreased cardiac output and reduced cerebral
perfusion, resulting in confusion, dizziness, and syncope. Friction rub is associated
with pericarditis, hypertension is not typically associated with bradycardia, and dry
skin is not a primary finding in bradycardia.
Question 8
A client following permanent pacemaker insertion states, "I can't get rid of these
hiccups." Which of the following should the nurse recognize as a potential
complication?
A) Normal postoperative recovery requiring no intervention
B) Dizziness when standing indicating orthostatic hypotension
C) Incision site stinging indicating normal healing
D) Potential pacemaker lead displacement or phrenic nerve stimulation
Answer: D
3
, Rationale: Persistent hiccups following pacemaker insertion may indicate lead
displacement or phrenic nerve stimulation. The nurse should report this finding to
the provider.
Question 9
A nurse is planning a presentation for a group of clients who have hypertension.
Which of the following lifestyle modifications should the nurse include? (Select all
that apply)
A) Limited alcohol intake
B) Regular exercise program
C) Decreased magnesium intake
D) Reduced potassium intake
E) Tobacco cessation
Answer: A, B, E
Rationale: Lifestyle modifications for hypertension include limited alcohol intake,
regular exercise, reduced sodium intake, increased potassium intake, and tobacco
cessation. Magnesium intake should be adequate, not decreased, and potassium
intake should be increased, not reduced.
Question 10
A nurse is providing health teaching to a group of clients. Which of the following
clients is at risk for developing peripheral arterial disease?
A) A client who has hypothyroidism
B) A client who has diabetes mellitus
C) A client whose daily caloric intake consists of 25% fat
D) A client who consumes two 12-oz bottles of beer a day
Answer: B
Rationale: Diabetes mellitus is a major risk factor for peripheral arterial disease due
to accelerated atherosclerosis. Hypothyroidism is a separate endocrine condition, and
while diet and alcohol affect cardiovascular risk, diabetes specifically increases PAD
risk.
Question 11
A client's ECG monitor shows a change from normal sinus rhythm to supraventricular
tachycardia (SVT). The nurse should prepare to assist with which of the following
interventions?
4
Practice Examination | Complete Actual Exam Questions
with Verified Correct Answers and Detailed Rationales |
Latest Updated Exam- 2026/2027 | Already Graded A+
Question 1
A client with a history of angina is scheduled for exercise electrocardiography at 1100.
Which of the following statements by the client requires the nurse to contact the
provider for possible rescheduling?
A) "I'm still hungry after the bowl of cereal I ate at 0700"
B) "I didn't take my heart pills this morning because the doctor told me not to"
C) "I have had chest pain a couple of times since I saw my doctor in the office last
week"
D) "I smoked a cigarette this morning to calm my nerves about having this procedure"
Answer: D
Rationale: Smoking a cigarette before exercise electrocardiography is
contraindicated because nicotine causes vasoconstriction and tachycardia, which can
alter test results. The client should refrain from smoking before the procedure. The
nurse should contact the provider for possible rescheduling.
Question 2
A client with heart failure is being discharged. The nurse should instruct the client to
report which of the following findings immediately to the provider?
A) Weight gain of 2 pounds in 24 hours indicating fluid retention
B) Increase of 10 mmHg in systolic blood pressure indicating hypertension
C) Dyspnea with exertion indicating expected heart failure symptoms
D) Dizziness when rising quickly indicating orthostatic hypotension
Answer: A
Rationale: Weight gain of 2 pounds (0.9 kg) in 24 hours indicates fluid retention
and worsening heart failure. This requires immediate provider notification. Dyspnea
with exertion and dizziness with position changes are important but not the priority.
Question 3
A client with a history of deep-vein thrombosis is receiving Warfarin. Which of the
following findings should indicate to the nurse that the medication is effective?
1
,A) Hemoglobin 14 g/dL indicating adequate oxygen carrying capacity
B) Minimal bruising of extremities indicating normal platelet function
C) Decreased blood pressure indicating reduced cardiac workload
D) INR of 2.0 to 3.0 indicating therapeutic anticoagulation
Answer: D
Rationale: Warfarin is an anticoagulant that works by inhibiting vitamin K-
dependent clotting factors. The therapeutic effect is measured by the International
Normalized Ratio (INR). A therapeutic INR range for most indications is 2.0 to 3.0.
Hemoglobin, bruising, and blood pressure are not indicators of Warfarin effectiveness.
Question 4
A client is receiving heparin therapy and develops hematuria. The nurse notes the
aPTT is 96 seconds. Which of the following actions should the nurse take?
A) Increase the heparin infusion flow rate by 2 mL/hr to achieve therapeutic range
B) Continue to monitor the heparin infusion as prescribed without intervention
C) Request a prothrombin time (PT) to evaluate clotting factors
D) Stop the heparin infusion and notify the provider immediately
Answer: D
Rationale: The normal aPTT is approximately 30-40 seconds. A value of 96 seconds
indicates excessive anticoagulation and increased bleeding risk. Hematuria (blood in
urine) is a sign of bleeding. The nurse should stop the heparin infusion and notify the
provider immediately.
Question 5
A client with heart failure and atrial fibrillation reports slurred speech. Which of the
following actions should the nurse take?
A) Document the finding as an expected symptom of atrial fibrillation
B) Continue to monitor the client's irregular pulse without intervention
C) Assess for dependent edema as a sign of worsening heart failure
D) Report this finding to the provider immediately as it may indicate a stroke
Answer: D
Rationale: Slurred speech in a client with atrial fibrillation and heart failure is a
critical finding that may indicate a cerebrovascular accident (stroke) due to emboli
from atrial fibrillation. This finding requires immediate provider notification.
2
,Question 6
A client's laboratory results show Cholesterol 190 mg/dL, HDL 25 mg/dL, and LDL
160 mg/dL. The nurse should recognize that dietary teaching is needed because:
A) Cholesterol 190 mg/dL is within normal range requiring no intervention
B) HDL 25 mg/dL is low and LDL 160 mg/dL is high, increasing cardiac risk
C) Cholesterol 190 mg/dL is high but HDL and LDL are acceptable
D) HDL 25 mg/dL is high indicating good cardiovascular health
Answer: B
Rationale: A normal HDL is 40-60 mg/dL, and an LDL below 130 mg/dL is
desirable. HDL 25 mg/dL is low (increased risk), and LDL 160 mg/dL is high
(increased risk). Total cholesterol 190 mg/dL is borderline high. The nurse should
plan to provide dietary teaching.
Question 7
A client with bradycardia is being assessed by the nurse. Which of the following
findings should the nurse monitor for?
A) Confusion and altered mental status indicating decreased cerebral perfusion
B) Friction rub indicating pericardial inflammation
C) Hypertension indicating increased cardiac output
D) Dry skin indicating decreased peripheral perfusion
Answer: A
Rationale: Bradycardia can lead to decreased cardiac output and reduced cerebral
perfusion, resulting in confusion, dizziness, and syncope. Friction rub is associated
with pericarditis, hypertension is not typically associated with bradycardia, and dry
skin is not a primary finding in bradycardia.
Question 8
A client following permanent pacemaker insertion states, "I can't get rid of these
hiccups." Which of the following should the nurse recognize as a potential
complication?
A) Normal postoperative recovery requiring no intervention
B) Dizziness when standing indicating orthostatic hypotension
C) Incision site stinging indicating normal healing
D) Potential pacemaker lead displacement or phrenic nerve stimulation
Answer: D
3
, Rationale: Persistent hiccups following pacemaker insertion may indicate lead
displacement or phrenic nerve stimulation. The nurse should report this finding to
the provider.
Question 9
A nurse is planning a presentation for a group of clients who have hypertension.
Which of the following lifestyle modifications should the nurse include? (Select all
that apply)
A) Limited alcohol intake
B) Regular exercise program
C) Decreased magnesium intake
D) Reduced potassium intake
E) Tobacco cessation
Answer: A, B, E
Rationale: Lifestyle modifications for hypertension include limited alcohol intake,
regular exercise, reduced sodium intake, increased potassium intake, and tobacco
cessation. Magnesium intake should be adequate, not decreased, and potassium
intake should be increased, not reduced.
Question 10
A nurse is providing health teaching to a group of clients. Which of the following
clients is at risk for developing peripheral arterial disease?
A) A client who has hypothyroidism
B) A client who has diabetes mellitus
C) A client whose daily caloric intake consists of 25% fat
D) A client who consumes two 12-oz bottles of beer a day
Answer: B
Rationale: Diabetes mellitus is a major risk factor for peripheral arterial disease due
to accelerated atherosclerosis. Hypothyroidism is a separate endocrine condition, and
while diet and alcohol affect cardiovascular risk, diabetes specifically increases PAD
risk.
Question 11
A client's ECG monitor shows a change from normal sinus rhythm to supraventricular
tachycardia (SVT). The nurse should prepare to assist with which of the following
interventions?
4
