ATI Advanced Medical-Surgical Proctored Exam
Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
Question 1 — Acute Heart Failure
A nurse is caring for a client who has acute left-sided heart
failure. Which finding requires the nurse's immediate
intervention?
A. Bilateral ankle edema
B. Weight gain of 1 kg over 3 days
C. Crackles throughout both lung fields with severe dyspnea
D. Blood pressure of 148/88 mm Hg
Correct answer: C. Crackles throughout both lung fields with
severe dyspnea
Rationale: Crackles accompanied by severe dyspnea indicate
pulmonary congestion and possible acute pulmonary edema,
which can rapidly impair oxygenation and become life-
threatening. The nurse should prioritize airway and breathing,
position the client upright, administer oxygen as prescribed, and
,rapidly notify the provider or activate the appropriate
emergency response. Peripheral edema and short-term weight
gain are important manifestations of fluid retention but are
generally less immediately life-threatening than acute
respiratory compromise. A moderately elevated blood pressure
also requires monitoring but does not take priority over severe
impaired oxygenation.
Question 2 — Myocardial Infarction
A client reports crushing substernal chest pain that began 20
minutes ago and radiates to the left arm. Which action should
the nurse take first?
A. Obtain a dietary history
B. Place the client in a supine position
C. Obtain a 12-lead ECG
D. Encourage the client to ambulate to reduce anxiety
Correct answer: C. Obtain a 12-lead ECG
Rationale: A 12-lead ECG should be obtained rapidly in a client
with suspected acute coronary syndrome because it can identify
myocardial ischemia or infarction and guide urgent treatment.
The nurse should simultaneously assess vital signs, oxygenation,
symptoms, and overall stability while following the facility's
chest-pain protocol. Ambulation increases myocardial oxygen
,demand and is inappropriate. A dietary history is not a priority
during an acute cardiac event, and a supine position can worsen
dyspnea in some clients.
Question 3 — Anticoagulation
A client is receiving an unfractionated heparin infusion for a
pulmonary embolism. Which laboratory test is most useful for
evaluating the therapeutic effect of the infusion?
A. INR
B. aPTT
C. Serum potassium
D. Serum creatinine
Correct answer: B. aPTT
Rationale: Activated partial thromboplastin time (aPTT) is
commonly used to monitor the anticoagulant effect of
unfractionated heparin. The dose may be adjusted according to
the institution's protocol and therapeutic target. INR is primarily
used to monitor warfarin therapy. Potassium and creatinine are
important laboratory values for overall medication and organ-
function assessment but do not directly measure the
anticoagulant effect of unfractionated heparin.
Question 4 — Atrial Fibrillation
, A client with atrial fibrillation is prescribed warfarin. Which
laboratory result should the nurse recognize as being within the
usual therapeutic range for many clients with nonvalvular atrial
fibrillation?
A. INR 0.8
B. INR 1.2
C. INR 2.5
D. INR 5.8
Correct answer: C. INR 2.5
Rationale: For many clients receiving warfarin for atrial
fibrillation, the therapeutic INR range is approximately 2.0 to
3.0. An INR of 2.5 falls within this range. An INR below the
therapeutic range may indicate inadequate anticoagulation and
increased thromboembolic risk, whereas a markedly elevated
INR such as 5.8 indicates substantially increased bleeding risk
and requires prompt evaluation.
Question 5 — Peripheral Arterial Disease
Which assessment finding is most characteristic of peripheral
arterial disease?
A. Warm skin with bounding pulses
B. Dependent edema that improves with standing
Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
Question 1 — Acute Heart Failure
A nurse is caring for a client who has acute left-sided heart
failure. Which finding requires the nurse's immediate
intervention?
A. Bilateral ankle edema
B. Weight gain of 1 kg over 3 days
C. Crackles throughout both lung fields with severe dyspnea
D. Blood pressure of 148/88 mm Hg
Correct answer: C. Crackles throughout both lung fields with
severe dyspnea
Rationale: Crackles accompanied by severe dyspnea indicate
pulmonary congestion and possible acute pulmonary edema,
which can rapidly impair oxygenation and become life-
threatening. The nurse should prioritize airway and breathing,
position the client upright, administer oxygen as prescribed, and
,rapidly notify the provider or activate the appropriate
emergency response. Peripheral edema and short-term weight
gain are important manifestations of fluid retention but are
generally less immediately life-threatening than acute
respiratory compromise. A moderately elevated blood pressure
also requires monitoring but does not take priority over severe
impaired oxygenation.
Question 2 — Myocardial Infarction
A client reports crushing substernal chest pain that began 20
minutes ago and radiates to the left arm. Which action should
the nurse take first?
A. Obtain a dietary history
B. Place the client in a supine position
C. Obtain a 12-lead ECG
D. Encourage the client to ambulate to reduce anxiety
Correct answer: C. Obtain a 12-lead ECG
Rationale: A 12-lead ECG should be obtained rapidly in a client
with suspected acute coronary syndrome because it can identify
myocardial ischemia or infarction and guide urgent treatment.
The nurse should simultaneously assess vital signs, oxygenation,
symptoms, and overall stability while following the facility's
chest-pain protocol. Ambulation increases myocardial oxygen
,demand and is inappropriate. A dietary history is not a priority
during an acute cardiac event, and a supine position can worsen
dyspnea in some clients.
Question 3 — Anticoagulation
A client is receiving an unfractionated heparin infusion for a
pulmonary embolism. Which laboratory test is most useful for
evaluating the therapeutic effect of the infusion?
A. INR
B. aPTT
C. Serum potassium
D. Serum creatinine
Correct answer: B. aPTT
Rationale: Activated partial thromboplastin time (aPTT) is
commonly used to monitor the anticoagulant effect of
unfractionated heparin. The dose may be adjusted according to
the institution's protocol and therapeutic target. INR is primarily
used to monitor warfarin therapy. Potassium and creatinine are
important laboratory values for overall medication and organ-
function assessment but do not directly measure the
anticoagulant effect of unfractionated heparin.
Question 4 — Atrial Fibrillation
, A client with atrial fibrillation is prescribed warfarin. Which
laboratory result should the nurse recognize as being within the
usual therapeutic range for many clients with nonvalvular atrial
fibrillation?
A. INR 0.8
B. INR 1.2
C. INR 2.5
D. INR 5.8
Correct answer: C. INR 2.5
Rationale: For many clients receiving warfarin for atrial
fibrillation, the therapeutic INR range is approximately 2.0 to
3.0. An INR of 2.5 falls within this range. An INR below the
therapeutic range may indicate inadequate anticoagulation and
increased thromboembolic risk, whereas a markedly elevated
INR such as 5.8 indicates substantially increased bleeding risk
and requires prompt evaluation.
Question 5 — Peripheral Arterial Disease
Which assessment finding is most characteristic of peripheral
arterial disease?
A. Warm skin with bounding pulses
B. Dependent edema that improves with standing
