Page 1 of 99
RN ATI CAPSTONE ADULT MEDICAL SURGICAL EXAM LATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
RN ATI CAPSTONE ADULT MEDICAL SURGICAL EXAM - 250 QUESTIONS WITH
RATIONALES
QUESTIONS 1-50: CARDIOVASCULAR DISORDERS
1. A nurse is providing discharge teaching to a client who has heart failure and a
new prescription for furosemide 20 mg orally twice daily. Which of the following
instructions should the nurse include in the teaching?
A. "You should decrease your intake of foods that are high in potassium."
B. "You should monitor your blood pressure for episodes of hypotension."
C. "You should increase your intake of foods that are high in potassium."
D. "You should take the second dose of medication at bedtime each evening."
Correct Answer: C
Rationale: Furosemide is a loop diuretic that causes potassium wasting through the
kidneys, which can lead to hypokalemia. Clients taking loop diuretics should increase
their intake of potassium-rich foods such as bananas, oranges, and potatoes to prevent
hypokalemia, which can cause cardiac arrhythmias. Monitoring for hypotension is
important because furosemide lowers blood pressure, but the key dietary teaching is
potassium supplementation. Taking the medication at bedtime is not recommended
because it would increase nocturia and disrupt sleep .
2. A nurse is assessing a client who has heart failure and is receiving digoxin
therapy. Which of the following findings should indicate to the nurse that the client
is experiencing digoxin toxicity?
A. Heart rate of 62 beats per minute and blood pressure of 118/76 mm Hg
B. Visual disturbances including blurred vision and seeing yellow halos around lights
C. Serum potassium level of 4.2 mEq/L and serum digoxin level of 1.2 ng/mL
D. Urine output of 50 mL per hour and clear breath sounds upon auscultation
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Correct Answer: B
Rationale: Digoxin toxicity presents with classic signs including visual disturbances
such as blurred vision, yellow-green halos around lights (xanthopsia), and photophobia.
Other manifestations include gastrointestinal symptoms (nausea, vomiting, anorexia)
and cardiac dysrhythmias. A heart rate of 62 is within normal limits and does not
indicate toxicity. A serum digoxin level of 1.2 ng/mL is within the therapeutic range (0.8-
2.0 ng/mL), and a potassium level of 4.2 mEq/L is normal. Adequate urine output and
clear breath sounds indicate effective cardiac function rather than toxicity.
3. A nurse is caring for a client who is 2 hours postoperative following a cardiac
catheterization through the femoral artery. Which of the following assessment
findings should the nurse report to the provider immediately?
A. Blood pressure of 118/72 mm Hg and heart rate of 78 beats per minute
B. The insertion site dressing is dry and intact with no visible bleeding
C. The client reports numbness and tingling in the affected extremity
D. The client has a pedal pulse of +2 and warm skin on the affected extremity
Correct Answer: C
Rationale: Numbness and tingling in the extremity following femoral artery
catheterization indicate neurovascular compromise, which could be caused by
hematoma formation, arterial thrombosis, or pseudoaneurysm compressing the
femoral nerve. This finding requires immediate provider notification because delayed
intervention could lead to permanent nerve damage or limb ischemia. The other options
represent normal postoperative findings: stable vital signs, dry intact dressing, and
adequate peripheral perfusion (warm skin with palpable pulses) are expected.
4. A nurse is teaching a client who has a new diagnosis of hypertension about
dietary modifications. Which of the following food choices by the client indicates
an understanding of the teaching?
A. A sandwich with processed ham and cheese on white bread
B. A grilled chicken breast with steamed vegetables and brown rice
C. A bowl of canned vegetable soup with saltine crackers
D. A frozen dinner containing 1,200 mg of sodium per serving
Correct Answer: B
Rationale: The Dietary Approaches to Stop Hypertension (DASH) diet emphasizes low
sodium intake (less than 2,300 mg/day) and includes lean proteins such as grilled
chicken, fresh vegetables, and whole grains like brown rice. Processed meats (ham),
canned soups, and frozen dinners are typically high in sodium and should be avoided. A
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grilled chicken breast with steamed vegetables and brown rice represents the best
choice for blood pressure control .
5. A nurse is assessing a client who has unstable angina and reports chest pain.
Which of the following findings should the nurse report to the provider
immediately?
A. The client's chest pain is relieved by sublingual nitroglycerin
B. The client has bilateral crackles heard at the bases of the lungs
C. The client's heart rate is 88 beats per minute and regular
D. The client's blood pressure is 132/84 mm Hg
Correct Answer: B
Rationale: Bilateral crackles (rales) heard at the lung bases in a client with unstable
angina indicate pulmonary congestion, suggesting that the client may be developing
heart failure as a complication of myocardial ischemia. This finding requires immediate
provider notification because it represents a worsening clinical status that may require
aggressive diuretic therapy and afterload reduction. Chest pain relieved by nitroglycerin
is an expected response, and the vital signs are stable .
6. A nurse is caring for a client who has heart failure and is receiving an IV infusion
of dopamine. Which of the following assessment findings indicates that the
medication is having the desired therapeutic effect?
A. The client's urine output increases from 20 mL/hr to 45 mL/hr
B. The client's heart rate decreases from 110 to 88 beats per minute
C. The client's blood pressure decreases from 160/90 to 140/80 mm Hg
D. The client's respiratory rate increases from 18 to 24 breaths per minute
Correct Answer: A
Rationale: Dopamine is a vasopressor and inotropic agent used in heart failure to
increase cardiac output and improve renal perfusion. The desired therapeutic effect is
improved urine output (greater than 30 mL/hr), which indicates adequate renal
perfusion and cardiac output. Heart rate decrease and blood pressure decrease are not
primary therapeutic effects of dopamine; dopamine typically increases heart rate and
blood pressure. An increased respiratory rate is not a therapeutic effect and could
indicate worsening respiratory status.
7. A nurse is preparing to administer a unit of packed red blood cells to a client who
has anemia. Which of the following actions should the nurse take first?
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A. Obtain the client's baseline vital signs and document them in the medical record
B. Verify the blood product with another registered nurse at the client's bedside
C. Prime the blood administration tubing with 0.9% sodium chloride solution
D. Assess the client's IV site for signs of infiltration or phlebitis
Correct Answer: B
Rationale: The FIRST and most critical action before administering blood products is
two-nurse verification at the client's bedside. This process involves checking the blood
type, Rh factor, unit number, expiration date, and client identification against the
medical record to prevent potentially fatal transfusion reactions from blood type
mismatches. All other steps (vital signs, priming tubing, assessing IV site) are important
but should follow the verification process to ensure patient safety .
8. A nurse is providing teaching to a client who has a new prescription for warfarin.
Which of the following statements by the client indicates an understanding of the
teaching?
A. "I should take aspirin for pain relief while I am taking this medication."
B. "I will need to have my INR checked regularly while taking this medication."
C. "I can eat as many leafy green vegetables as I want on this medication."
D. "I should stop taking this medication if I notice any bruising on my skin."
Correct Answer: B
Rationale: Warfarin (Coumadin) requires regular monitoring of the International
Normalized Ratio (INR) to ensure the therapeutic range is maintained (typically 2.0-3.0
for most indications). Aspirin combined with warfarin significantly increases bleeding
risk and is contraindicated without provider guidance. Vitamin K found in leafy green
vegetables antagonizes the effects of warfarin, so intake must remain consistent rather
than unrestricted. Warfarin should never be stopped abruptly without provider
instruction, even if bruising occurs .
9. A nurse is caring for a client who is receiving a continuous heparin infusion for
treatment of a deep vein thrombosis. The client's aPTT level is 120 seconds. Which
of the following actions should the nurse take?
A. Increase the heparin infusion rate according to the protocol
B. Continue the heparin infusion at the current rate and reassess in 4 hours
C. Notify the provider because the aPTT level is above the therapeutic range
D. Administer protamine sulfate as a reversal agent for the heparin therapy
Correct Answer: C
RN ATI CAPSTONE ADULT MEDICAL SURGICAL EXAM LATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
RN ATI CAPSTONE ADULT MEDICAL SURGICAL EXAM - 250 QUESTIONS WITH
RATIONALES
QUESTIONS 1-50: CARDIOVASCULAR DISORDERS
1. A nurse is providing discharge teaching to a client who has heart failure and a
new prescription for furosemide 20 mg orally twice daily. Which of the following
instructions should the nurse include in the teaching?
A. "You should decrease your intake of foods that are high in potassium."
B. "You should monitor your blood pressure for episodes of hypotension."
C. "You should increase your intake of foods that are high in potassium."
D. "You should take the second dose of medication at bedtime each evening."
Correct Answer: C
Rationale: Furosemide is a loop diuretic that causes potassium wasting through the
kidneys, which can lead to hypokalemia. Clients taking loop diuretics should increase
their intake of potassium-rich foods such as bananas, oranges, and potatoes to prevent
hypokalemia, which can cause cardiac arrhythmias. Monitoring for hypotension is
important because furosemide lowers blood pressure, but the key dietary teaching is
potassium supplementation. Taking the medication at bedtime is not recommended
because it would increase nocturia and disrupt sleep .
2. A nurse is assessing a client who has heart failure and is receiving digoxin
therapy. Which of the following findings should indicate to the nurse that the client
is experiencing digoxin toxicity?
A. Heart rate of 62 beats per minute and blood pressure of 118/76 mm Hg
B. Visual disturbances including blurred vision and seeing yellow halos around lights
C. Serum potassium level of 4.2 mEq/L and serum digoxin level of 1.2 ng/mL
D. Urine output of 50 mL per hour and clear breath sounds upon auscultation
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Correct Answer: B
Rationale: Digoxin toxicity presents with classic signs including visual disturbances
such as blurred vision, yellow-green halos around lights (xanthopsia), and photophobia.
Other manifestations include gastrointestinal symptoms (nausea, vomiting, anorexia)
and cardiac dysrhythmias. A heart rate of 62 is within normal limits and does not
indicate toxicity. A serum digoxin level of 1.2 ng/mL is within the therapeutic range (0.8-
2.0 ng/mL), and a potassium level of 4.2 mEq/L is normal. Adequate urine output and
clear breath sounds indicate effective cardiac function rather than toxicity.
3. A nurse is caring for a client who is 2 hours postoperative following a cardiac
catheterization through the femoral artery. Which of the following assessment
findings should the nurse report to the provider immediately?
A. Blood pressure of 118/72 mm Hg and heart rate of 78 beats per minute
B. The insertion site dressing is dry and intact with no visible bleeding
C. The client reports numbness and tingling in the affected extremity
D. The client has a pedal pulse of +2 and warm skin on the affected extremity
Correct Answer: C
Rationale: Numbness and tingling in the extremity following femoral artery
catheterization indicate neurovascular compromise, which could be caused by
hematoma formation, arterial thrombosis, or pseudoaneurysm compressing the
femoral nerve. This finding requires immediate provider notification because delayed
intervention could lead to permanent nerve damage or limb ischemia. The other options
represent normal postoperative findings: stable vital signs, dry intact dressing, and
adequate peripheral perfusion (warm skin with palpable pulses) are expected.
4. A nurse is teaching a client who has a new diagnosis of hypertension about
dietary modifications. Which of the following food choices by the client indicates
an understanding of the teaching?
A. A sandwich with processed ham and cheese on white bread
B. A grilled chicken breast with steamed vegetables and brown rice
C. A bowl of canned vegetable soup with saltine crackers
D. A frozen dinner containing 1,200 mg of sodium per serving
Correct Answer: B
Rationale: The Dietary Approaches to Stop Hypertension (DASH) diet emphasizes low
sodium intake (less than 2,300 mg/day) and includes lean proteins such as grilled
chicken, fresh vegetables, and whole grains like brown rice. Processed meats (ham),
canned soups, and frozen dinners are typically high in sodium and should be avoided. A
, Page 3 of 99
grilled chicken breast with steamed vegetables and brown rice represents the best
choice for blood pressure control .
5. A nurse is assessing a client who has unstable angina and reports chest pain.
Which of the following findings should the nurse report to the provider
immediately?
A. The client's chest pain is relieved by sublingual nitroglycerin
B. The client has bilateral crackles heard at the bases of the lungs
C. The client's heart rate is 88 beats per minute and regular
D. The client's blood pressure is 132/84 mm Hg
Correct Answer: B
Rationale: Bilateral crackles (rales) heard at the lung bases in a client with unstable
angina indicate pulmonary congestion, suggesting that the client may be developing
heart failure as a complication of myocardial ischemia. This finding requires immediate
provider notification because it represents a worsening clinical status that may require
aggressive diuretic therapy and afterload reduction. Chest pain relieved by nitroglycerin
is an expected response, and the vital signs are stable .
6. A nurse is caring for a client who has heart failure and is receiving an IV infusion
of dopamine. Which of the following assessment findings indicates that the
medication is having the desired therapeutic effect?
A. The client's urine output increases from 20 mL/hr to 45 mL/hr
B. The client's heart rate decreases from 110 to 88 beats per minute
C. The client's blood pressure decreases from 160/90 to 140/80 mm Hg
D. The client's respiratory rate increases from 18 to 24 breaths per minute
Correct Answer: A
Rationale: Dopamine is a vasopressor and inotropic agent used in heart failure to
increase cardiac output and improve renal perfusion. The desired therapeutic effect is
improved urine output (greater than 30 mL/hr), which indicates adequate renal
perfusion and cardiac output. Heart rate decrease and blood pressure decrease are not
primary therapeutic effects of dopamine; dopamine typically increases heart rate and
blood pressure. An increased respiratory rate is not a therapeutic effect and could
indicate worsening respiratory status.
7. A nurse is preparing to administer a unit of packed red blood cells to a client who
has anemia. Which of the following actions should the nurse take first?
, Page 4 of 99
A. Obtain the client's baseline vital signs and document them in the medical record
B. Verify the blood product with another registered nurse at the client's bedside
C. Prime the blood administration tubing with 0.9% sodium chloride solution
D. Assess the client's IV site for signs of infiltration or phlebitis
Correct Answer: B
Rationale: The FIRST and most critical action before administering blood products is
two-nurse verification at the client's bedside. This process involves checking the blood
type, Rh factor, unit number, expiration date, and client identification against the
medical record to prevent potentially fatal transfusion reactions from blood type
mismatches. All other steps (vital signs, priming tubing, assessing IV site) are important
but should follow the verification process to ensure patient safety .
8. A nurse is providing teaching to a client who has a new prescription for warfarin.
Which of the following statements by the client indicates an understanding of the
teaching?
A. "I should take aspirin for pain relief while I am taking this medication."
B. "I will need to have my INR checked regularly while taking this medication."
C. "I can eat as many leafy green vegetables as I want on this medication."
D. "I should stop taking this medication if I notice any bruising on my skin."
Correct Answer: B
Rationale: Warfarin (Coumadin) requires regular monitoring of the International
Normalized Ratio (INR) to ensure the therapeutic range is maintained (typically 2.0-3.0
for most indications). Aspirin combined with warfarin significantly increases bleeding
risk and is contraindicated without provider guidance. Vitamin K found in leafy green
vegetables antagonizes the effects of warfarin, so intake must remain consistent rather
than unrestricted. Warfarin should never be stopped abruptly without provider
instruction, even if bruising occurs .
9. A nurse is caring for a client who is receiving a continuous heparin infusion for
treatment of a deep vein thrombosis. The client's aPTT level is 120 seconds. Which
of the following actions should the nurse take?
A. Increase the heparin infusion rate according to the protocol
B. Continue the heparin infusion at the current rate and reassess in 4 hours
C. Notify the provider because the aPTT level is above the therapeutic range
D. Administer protamine sulfate as a reversal agent for the heparin therapy
Correct Answer: C
