ATI Med-Surg Final Exam Questions with
Correct Answers (VerifiedAnswers) Plus
Rationales 2026 Q&A Instant Download PDF
1. A nurse is caring for a client who has chronic obstructive
pulmonary disease (COPD). Which assessment finding requires
the nurse's immediate attention?
A. Oxygen saturation of 90%
B. Barrel-shaped chest
C. Increasing drowsiness and difficulty awakening
D. Productive cough with clear sputum
The correct answer is C. Increasing drowsiness can indicate
worsening hypercapnia and respiratory failure in a client with
COPD. A declining level of consciousness is an especially
concerning sign because carbon dioxide retention can depress
the central nervous system. An oxygen saturation around 90%
can be an expected target for some clients with COPD, while a
barrel-shaped chest reflects chronic hyperinflation. A productive
cough can occur with chronic airway disease but is not, by itself,
the most urgent finding.
2. A client with heart failure reports sudden shortness of
breath and produces pink, frothy sputum. Which action should
the nurse take first?
,A. Encourage oral fluids
B. Place the client flat in bed
C. Place the client in high-Fowler's position
D. Encourage the client to ambulate
The correct answer is C. High-Fowler's positioning decreases
venous return to the heart and promotes maximal lung
expansion, which can improve oxygenation during acute
pulmonary edema. Pink, frothy sputum with severe dyspnea is
highly concerning for pulmonary edema. The client should not
be placed flat because this can worsen respiratory distress. Oral
fluids and ambulation are inappropriate during acute
pulmonary edema.
3. A nurse is assessing a client who has a suspected myocardial
infarction. Which finding is most concerning?
A. Mild fatigue
B. Heartburn after a meal
C. New-onset chest pressure with diaphoresis and nausea
D. Blood pressure of 128/76 mm Hg
The correct answer is C. New chest pressure accompanied by
diaphoresis and nausea is strongly concerning for acute
myocardial ischemia. The nurse should rapidly assess the client
and initiate the appropriate emergency response. Some clients,
particularly older adults and clients with diabetes, can have
,atypical symptoms, so chest discomfort should not be dismissed
as indigestion without further assessment.
4. A client receiving a blood transfusion develops chills, fever,
and low back pain. What is the nurse's priority action?
A. Slow the transfusion
B. Administer acetaminophen
C. Obtain another unit of blood
D. Stop the transfusion immediately
The correct answer is D. Fever, chills, and low back pain can
indicate an acute hemolytic transfusion reaction. The nurse
must stop the transfusion immediately to prevent additional
exposure to the incompatible blood product. The IV line should
generally be maintained with appropriate compatible solution
according to facility protocol, and the provider and blood bank
should be notified. Administering an antipyretic without
stopping the transfusion does not address the potentially life-
threatening cause.
5. A nurse is caring for a client who has hyperkalemia. Which
ECG change should the nurse expect?
A. Flattened T waves
B. Prolonged QT interval
C. Tall, peaked T waves
D. Prominent U waves
, The correct answer is C. Tall, peaked T waves are a classic ECG
manifestation of hyperkalemia. Increasing potassium levels can
progressively impair cardiac conduction and may lead to
widened QRS complexes, dysrhythmias, and cardiac arrest.
Flattened T waves and prominent U waves are more commonly
associated with hypokalemia. Because severe hyperkalemia can
rapidly become life-threatening, cardiac monitoring and prompt
treatment are important.
6. A client has a serum sodium level of 124 mEq/L. Which
assessment finding should the nurse anticipate?
A. Intense thirst and dry mucous membranes
B. Confusion and headache
C. Severe hypertension with bounding pulses
D. Increased deep-tendon reflexes
The correct answer is B. Hyponatremia can cause water to move
into cells, including brain cells, producing neurologic
manifestations such as headache, confusion, lethargy, seizures,
and decreased level of consciousness. A sodium level of 124
mEq/L represents significant hyponatremia. The nurse should
monitor neurologic status closely and institute seizure
precautions when clinically indicated.
7. A client has metabolic acidosis. Which respiratory pattern
should the nurse expect?
Correct Answers (VerifiedAnswers) Plus
Rationales 2026 Q&A Instant Download PDF
1. A nurse is caring for a client who has chronic obstructive
pulmonary disease (COPD). Which assessment finding requires
the nurse's immediate attention?
A. Oxygen saturation of 90%
B. Barrel-shaped chest
C. Increasing drowsiness and difficulty awakening
D. Productive cough with clear sputum
The correct answer is C. Increasing drowsiness can indicate
worsening hypercapnia and respiratory failure in a client with
COPD. A declining level of consciousness is an especially
concerning sign because carbon dioxide retention can depress
the central nervous system. An oxygen saturation around 90%
can be an expected target for some clients with COPD, while a
barrel-shaped chest reflects chronic hyperinflation. A productive
cough can occur with chronic airway disease but is not, by itself,
the most urgent finding.
2. A client with heart failure reports sudden shortness of
breath and produces pink, frothy sputum. Which action should
the nurse take first?
,A. Encourage oral fluids
B. Place the client flat in bed
C. Place the client in high-Fowler's position
D. Encourage the client to ambulate
The correct answer is C. High-Fowler's positioning decreases
venous return to the heart and promotes maximal lung
expansion, which can improve oxygenation during acute
pulmonary edema. Pink, frothy sputum with severe dyspnea is
highly concerning for pulmonary edema. The client should not
be placed flat because this can worsen respiratory distress. Oral
fluids and ambulation are inappropriate during acute
pulmonary edema.
3. A nurse is assessing a client who has a suspected myocardial
infarction. Which finding is most concerning?
A. Mild fatigue
B. Heartburn after a meal
C. New-onset chest pressure with diaphoresis and nausea
D. Blood pressure of 128/76 mm Hg
The correct answer is C. New chest pressure accompanied by
diaphoresis and nausea is strongly concerning for acute
myocardial ischemia. The nurse should rapidly assess the client
and initiate the appropriate emergency response. Some clients,
particularly older adults and clients with diabetes, can have
,atypical symptoms, so chest discomfort should not be dismissed
as indigestion without further assessment.
4. A client receiving a blood transfusion develops chills, fever,
and low back pain. What is the nurse's priority action?
A. Slow the transfusion
B. Administer acetaminophen
C. Obtain another unit of blood
D. Stop the transfusion immediately
The correct answer is D. Fever, chills, and low back pain can
indicate an acute hemolytic transfusion reaction. The nurse
must stop the transfusion immediately to prevent additional
exposure to the incompatible blood product. The IV line should
generally be maintained with appropriate compatible solution
according to facility protocol, and the provider and blood bank
should be notified. Administering an antipyretic without
stopping the transfusion does not address the potentially life-
threatening cause.
5. A nurse is caring for a client who has hyperkalemia. Which
ECG change should the nurse expect?
A. Flattened T waves
B. Prolonged QT interval
C. Tall, peaked T waves
D. Prominent U waves
, The correct answer is C. Tall, peaked T waves are a classic ECG
manifestation of hyperkalemia. Increasing potassium levels can
progressively impair cardiac conduction and may lead to
widened QRS complexes, dysrhythmias, and cardiac arrest.
Flattened T waves and prominent U waves are more commonly
associated with hypokalemia. Because severe hyperkalemia can
rapidly become life-threatening, cardiac monitoring and prompt
treatment are important.
6. A client has a serum sodium level of 124 mEq/L. Which
assessment finding should the nurse anticipate?
A. Intense thirst and dry mucous membranes
B. Confusion and headache
C. Severe hypertension with bounding pulses
D. Increased deep-tendon reflexes
The correct answer is B. Hyponatremia can cause water to move
into cells, including brain cells, producing neurologic
manifestations such as headache, confusion, lethargy, seizures,
and decreased level of consciousness. A sodium level of 124
mEq/L represents significant hyponatremia. The nurse should
monitor neurologic status closely and institute seizure
precautions when clinically indicated.
7. A client has metabolic acidosis. Which respiratory pattern
should the nurse expect?
