ATI Comprehensive Predictor: Med-Surg Critical Thinking
Practice Pack 2026 UPDATED ACTUAL Exam Questions
and CORRECT Answers
1. A nurse is assessing a client with chronic venous insufficiency. Which of the
following findings should the nurse expect?
A. Thin, shiny skin
B. Diminished pedal pulses
C. Cool skin temperature
D. Dependent edema
Answer: D
Rationale: Chronic venous insufficiency leads to blood pooling in the lower extremities,
causing dependent edema. Thin, shiny skin and diminished pulses are more characteristic
of peripheral arterial disease.
2. A nurse is caring for a client with a prescription for furosemide. Which
laboratory value should the nurse monitor closely?
A. Serum sodium
B. Serum magnesium
C. Serum calcium
D. Serum potassium
Answer: D
Rationale: Furosemide is a loop diuretic that causes the excretion of potassium, putting
the client at risk for hypokalemia.
,3. A client is 24 hours post-operative following a total hip arthroplasty. Which of
the following actions should the nurse take?
A. Maintain the client’s legs in an adducted position
B. Keep the affected leg internally rotated
C. Place an abduction pillow between the client’s legs
D. Instruct the client to bend more than 90 degrees at the waist
Answer: C
Rationale: An abduction pillow is used post-operatively to prevent adduction and
dislocation of the new hip prosthesis.
4. A nurse is caring for a client with Type 1 Diabetes Mellitus who is shaky and
diaphoretic. What is the priority action?
A. Administer the scheduled dose of insulin
B. Administer 15g of simple carbohydrates
C. Call the provider immediately
D. Check the client’s blood glucose level
Answer: D
Rationale: The nurse should first verify hypoglycemia by checking the blood glucose level
before intervening, according to the nursing process (assessment first).
5. Which of the following findings is an early sign of a tension pneumothorax?
A. Tracheal deviation
B. Distended neck veins
C. Respiratory distress
D. Bradycardia
Answer: C
Rationale: Respiratory distress is an early sign; tracheal deviation is a late sign that occurs
when the pressure is high enough to shift the mediastinum.
, 6. A nurse is teaching a client about a low-purine diet for gout. Which food
should the client avoid?
A. Whole grain bread
B. Organ meats
C. Skim milk
D. Fresh berries
Answer: B
Rationale: Organ meats are high in purines, which can increase uric acid levels and trigger
gout attacks.
7. A client has a new diagnosis of hyperthyroidism. Which of the following
clinical manifestations should the nurse expect?
A. Bradycardia
B. Weight gain
C. Heat intolerance
D. Constipation
Answer: C
Rationale: Hyperthyroidism increases metabolic rate, leading to heat intolerance,
tachycardia, and weight loss.
8. A nurse is assessing a client with a chest tube. The nurse notes continuous
bubbling in the water seal chamber. This indicates:
A. An air leak
B. Normal function
C. The lung has re-expanded
D. Excessive suction
Answer: A
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the
system; intermittent bubbling is normal during expiration or coughing.
Practice Pack 2026 UPDATED ACTUAL Exam Questions
and CORRECT Answers
1. A nurse is assessing a client with chronic venous insufficiency. Which of the
following findings should the nurse expect?
A. Thin, shiny skin
B. Diminished pedal pulses
C. Cool skin temperature
D. Dependent edema
Answer: D
Rationale: Chronic venous insufficiency leads to blood pooling in the lower extremities,
causing dependent edema. Thin, shiny skin and diminished pulses are more characteristic
of peripheral arterial disease.
2. A nurse is caring for a client with a prescription for furosemide. Which
laboratory value should the nurse monitor closely?
A. Serum sodium
B. Serum magnesium
C. Serum calcium
D. Serum potassium
Answer: D
Rationale: Furosemide is a loop diuretic that causes the excretion of potassium, putting
the client at risk for hypokalemia.
,3. A client is 24 hours post-operative following a total hip arthroplasty. Which of
the following actions should the nurse take?
A. Maintain the client’s legs in an adducted position
B. Keep the affected leg internally rotated
C. Place an abduction pillow between the client’s legs
D. Instruct the client to bend more than 90 degrees at the waist
Answer: C
Rationale: An abduction pillow is used post-operatively to prevent adduction and
dislocation of the new hip prosthesis.
4. A nurse is caring for a client with Type 1 Diabetes Mellitus who is shaky and
diaphoretic. What is the priority action?
A. Administer the scheduled dose of insulin
B. Administer 15g of simple carbohydrates
C. Call the provider immediately
D. Check the client’s blood glucose level
Answer: D
Rationale: The nurse should first verify hypoglycemia by checking the blood glucose level
before intervening, according to the nursing process (assessment first).
5. Which of the following findings is an early sign of a tension pneumothorax?
A. Tracheal deviation
B. Distended neck veins
C. Respiratory distress
D. Bradycardia
Answer: C
Rationale: Respiratory distress is an early sign; tracheal deviation is a late sign that occurs
when the pressure is high enough to shift the mediastinum.
, 6. A nurse is teaching a client about a low-purine diet for gout. Which food
should the client avoid?
A. Whole grain bread
B. Organ meats
C. Skim milk
D. Fresh berries
Answer: B
Rationale: Organ meats are high in purines, which can increase uric acid levels and trigger
gout attacks.
7. A client has a new diagnosis of hyperthyroidism. Which of the following
clinical manifestations should the nurse expect?
A. Bradycardia
B. Weight gain
C. Heat intolerance
D. Constipation
Answer: C
Rationale: Hyperthyroidism increases metabolic rate, leading to heat intolerance,
tachycardia, and weight loss.
8. A nurse is assessing a client with a chest tube. The nurse notes continuous
bubbling in the water seal chamber. This indicates:
A. An air leak
B. Normal function
C. The lung has re-expanded
D. Excessive suction
Answer: A
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the
system; intermittent bubbling is normal during expiration or coughing.
