ATI MedIcAl-SurgIcAl cMS AcTuAl exAM – ASSeSSMenT
TechnologIeS InSTITuTe (ATI) – 2026/2027 AcAdeMIc YeAr –
VerIfIed QueSTIonS And AnSwerS || juST releASed.
This comprehensive practice exam is designed for nursing students preparing for the ATI
Medical-Surgical CMS (Content Mastery Series) Examination. The questions align with the
ATI RN Medical-Surgical Nursing Content Mastery Series® 11.0 and reflect the NCLEX test plan,
emphasizing clinical judgment, prioritization, pharmacology, lab interpretation, and safe
management of acute and chronic adult health conditions.
SECTION 1: CARDIOVASCULAR
Question 1
A client with left-sided heart failure is exhibiting which assessment finding?
• A) Jugular vein distention
• B) Frothy, pink sputum
• C) Peripheral edema
• D) Hepatomegaly
AnSwer: B — Frothy, pink sputum
rATIonAle: Left-sided heart failure causes blood to back up into the lungs, leading to
pulmonary edema and the classic finding of frothy, pink-tinged sputum. Jugular vein
distention (A), peripheral edema (C), and hepatomegaly (D) are signs of right-sided heart
failure, which causes systemic venous congestion.
Question 2
A client with right-sided heart failure is expected to have which of the following signs?
• A) Crackles in the lung bases
• B) Jugular vein distention
• C) Frothy, pink sputum
• D) Orthopnea
,AnSwer: B — Jugular vein distention
rATIonAle: Right-sided heart failure causes systemic venous congestion, leading to jugular
vein distention, peripheral edema, and hepatomegaly. Crackles (A), frothy pink sputum (C), and
orthopnea (D) are signs of left-sided heart failure.
Question 3
A client is receiving a continuous IV heparin infusion. The nurse notes the aPTT is 110
seconds. What is the most appropriate nursing action?
• A) Continue the infusion at the same rate
• B) Increase the heparin dose
• C) Hold the infusion per protocol
• D) Administer vitamin K
AnSwer: C — Hold the infusion per protocol
rATIonAle: A therapeutic aPTT for heparin is typically 60–80 seconds (1.5–2.5 times normal).
An aPTT of 110 seconds indicates excessive anticoagulation and risk of bleeding. The nurse
should hold the infusion per protocol and notify the provider. Vitamin K (D) is the antidote for
warfarin, not heparin (protamine sulfate is the antidote for heparin).
Question 4
A client on warfarin has an INR of 4.5 with no signs of bleeding. What is the nurse's
priority action?
• A) Administer vitamin K 10 mg subcutaneously
• B) Hold the warfarin and notify the provider
• C) Administer fresh frozen plasma
• D) Continue the warfarin as prescribed
AnSwer: B — Hold the warfarin and notify the provider
rATIonAle: An INR of 4.5 exceeds the therapeutic range (2.0–3.0 for atrial fibrillation) and
increases bleeding risk. The nurse should hold the dose and notify the provider. Vitamin K (A) is
reserved for INR > 10 or active bleeding. Fresh frozen plasma (C) is for life-threatening bleeding.
,Question 5
A client with heart failure is prescribed furosemide. Which finding indicates the
medication is effective?
• A) Weight gain of 2 kg in 24 hours
• B) Decreased crackles in the lung bases
• C) Increased jugular vein distention
• D) Decreased urine output
AnSwer: B — Decreased crackles in the lung bases
rATIonAle: Furosemide is a loop diuretic used to reduce fluid overload in heart
failure. Decreased crackles in the lung bases indicates that pulmonary congestion is resolving,
demonstrating medication effectiveness. Weight gain (A), increased JVD (C), and decreased
urine output (D) indicate worsening fluid overload.
Question 6
A client is prescribed amiodarone for the management of ventricular arrhythmias. Which
adverse effect should the nurse monitor for during long-term therapy?
• A) Hypothyroidism and pulmonary toxicity
• B) Hyperglycemia and weight gain
• C) Nephrotoxicity and hepatotoxicity
• D) Ototoxicity and nephrotoxicity
AnSwer: A — Hypothyroidism and pulmonary toxicity
rATIonAle: Amiodarone contains iodine and can cause hypothyroidism or
hyperthyroidism due to its effects on thyroid function. It is also associated with pulmonary
toxicity (pulmonary fibrosis), which requires monitoring of pulmonary function and symptoms
such as cough and dyspnea.
Question 7
A client with a history of heart failure is prescribed lisinopril. Which finding requires
immediate discontinuation of the medication?
• A) Dry cough
, • B) Serum potassium 4.8 mEq/L
• C) Angioedema (swelling of tongue and lips)
• D) Headache
AnSwer: C — Angioedema (swelling of tongue and lips)
rATIonAle: Angioedema is a life-threatening allergic reaction to ACE inhibitors (lisinopril,
enalapril). It requires immediate discontinuation and emergency medical attention. Dry cough
(A) is a common but non-life-threatening side effect. Hyperkalemia (K+ > 5.0) would also
require monitoring, but 4.8 mEq/L is within normal limits.
Question 8
A client is receiving oxygen via a non-rebreather mask. Which finding indicates the mask
is functioning properly?
• A) The reservoir bag deflates completely during inspiration
• B) The reservoir bag remains partially inflated during inspiration
• C) The flow rate is set at 2 L/min
• D) The mask is applied loosely
AnSwer: B — The reservoir bag remains partially inflated during inspiration
rATIonAle: A non-rebreather mask delivers high-flow oxygen (up to 90% FiO₂). The reservoir
bag should remain partially inflated during inspiration to ensure the client is receiving
oxygen from the reservoir rather than room air. The flow rate should be at least 10–15 L/min (C).
The mask should fit snugly to prevent entrainment of room air (D).
Question 9
A client with pulmonary embolism is receiving heparin therapy. Which finding indicates
the therapy is effective?
• A) INR 2.0–3.0
• B) aPTT 1.5–2.5 times the control value
• C) Platelet count > 150,000
• D) Hemoglobin > 12 g/dL
AnSwer: B — aPTT 1.5–2.5 times the control value
TechnologIeS InSTITuTe (ATI) – 2026/2027 AcAdeMIc YeAr –
VerIfIed QueSTIonS And AnSwerS || juST releASed.
This comprehensive practice exam is designed for nursing students preparing for the ATI
Medical-Surgical CMS (Content Mastery Series) Examination. The questions align with the
ATI RN Medical-Surgical Nursing Content Mastery Series® 11.0 and reflect the NCLEX test plan,
emphasizing clinical judgment, prioritization, pharmacology, lab interpretation, and safe
management of acute and chronic adult health conditions.
SECTION 1: CARDIOVASCULAR
Question 1
A client with left-sided heart failure is exhibiting which assessment finding?
• A) Jugular vein distention
• B) Frothy, pink sputum
• C) Peripheral edema
• D) Hepatomegaly
AnSwer: B — Frothy, pink sputum
rATIonAle: Left-sided heart failure causes blood to back up into the lungs, leading to
pulmonary edema and the classic finding of frothy, pink-tinged sputum. Jugular vein
distention (A), peripheral edema (C), and hepatomegaly (D) are signs of right-sided heart
failure, which causes systemic venous congestion.
Question 2
A client with right-sided heart failure is expected to have which of the following signs?
• A) Crackles in the lung bases
• B) Jugular vein distention
• C) Frothy, pink sputum
• D) Orthopnea
,AnSwer: B — Jugular vein distention
rATIonAle: Right-sided heart failure causes systemic venous congestion, leading to jugular
vein distention, peripheral edema, and hepatomegaly. Crackles (A), frothy pink sputum (C), and
orthopnea (D) are signs of left-sided heart failure.
Question 3
A client is receiving a continuous IV heparin infusion. The nurse notes the aPTT is 110
seconds. What is the most appropriate nursing action?
• A) Continue the infusion at the same rate
• B) Increase the heparin dose
• C) Hold the infusion per protocol
• D) Administer vitamin K
AnSwer: C — Hold the infusion per protocol
rATIonAle: A therapeutic aPTT for heparin is typically 60–80 seconds (1.5–2.5 times normal).
An aPTT of 110 seconds indicates excessive anticoagulation and risk of bleeding. The nurse
should hold the infusion per protocol and notify the provider. Vitamin K (D) is the antidote for
warfarin, not heparin (protamine sulfate is the antidote for heparin).
Question 4
A client on warfarin has an INR of 4.5 with no signs of bleeding. What is the nurse's
priority action?
• A) Administer vitamin K 10 mg subcutaneously
• B) Hold the warfarin and notify the provider
• C) Administer fresh frozen plasma
• D) Continue the warfarin as prescribed
AnSwer: B — Hold the warfarin and notify the provider
rATIonAle: An INR of 4.5 exceeds the therapeutic range (2.0–3.0 for atrial fibrillation) and
increases bleeding risk. The nurse should hold the dose and notify the provider. Vitamin K (A) is
reserved for INR > 10 or active bleeding. Fresh frozen plasma (C) is for life-threatening bleeding.
,Question 5
A client with heart failure is prescribed furosemide. Which finding indicates the
medication is effective?
• A) Weight gain of 2 kg in 24 hours
• B) Decreased crackles in the lung bases
• C) Increased jugular vein distention
• D) Decreased urine output
AnSwer: B — Decreased crackles in the lung bases
rATIonAle: Furosemide is a loop diuretic used to reduce fluid overload in heart
failure. Decreased crackles in the lung bases indicates that pulmonary congestion is resolving,
demonstrating medication effectiveness. Weight gain (A), increased JVD (C), and decreased
urine output (D) indicate worsening fluid overload.
Question 6
A client is prescribed amiodarone for the management of ventricular arrhythmias. Which
adverse effect should the nurse monitor for during long-term therapy?
• A) Hypothyroidism and pulmonary toxicity
• B) Hyperglycemia and weight gain
• C) Nephrotoxicity and hepatotoxicity
• D) Ototoxicity and nephrotoxicity
AnSwer: A — Hypothyroidism and pulmonary toxicity
rATIonAle: Amiodarone contains iodine and can cause hypothyroidism or
hyperthyroidism due to its effects on thyroid function. It is also associated with pulmonary
toxicity (pulmonary fibrosis), which requires monitoring of pulmonary function and symptoms
such as cough and dyspnea.
Question 7
A client with a history of heart failure is prescribed lisinopril. Which finding requires
immediate discontinuation of the medication?
• A) Dry cough
, • B) Serum potassium 4.8 mEq/L
• C) Angioedema (swelling of tongue and lips)
• D) Headache
AnSwer: C — Angioedema (swelling of tongue and lips)
rATIonAle: Angioedema is a life-threatening allergic reaction to ACE inhibitors (lisinopril,
enalapril). It requires immediate discontinuation and emergency medical attention. Dry cough
(A) is a common but non-life-threatening side effect. Hyperkalemia (K+ > 5.0) would also
require monitoring, but 4.8 mEq/L is within normal limits.
Question 8
A client is receiving oxygen via a non-rebreather mask. Which finding indicates the mask
is functioning properly?
• A) The reservoir bag deflates completely during inspiration
• B) The reservoir bag remains partially inflated during inspiration
• C) The flow rate is set at 2 L/min
• D) The mask is applied loosely
AnSwer: B — The reservoir bag remains partially inflated during inspiration
rATIonAle: A non-rebreather mask delivers high-flow oxygen (up to 90% FiO₂). The reservoir
bag should remain partially inflated during inspiration to ensure the client is receiving
oxygen from the reservoir rather than room air. The flow rate should be at least 10–15 L/min (C).
The mask should fit snugly to prevent entrainment of room air (D).
Question 9
A client with pulmonary embolism is receiving heparin therapy. Which finding indicates
the therapy is effective?
• A) INR 2.0–3.0
• B) aPTT 1.5–2.5 times the control value
• C) Platelet count > 150,000
• D) Hemoglobin > 12 g/dL
AnSwer: B — aPTT 1.5–2.5 times the control value
