ATI RN Med-Surg Proctored Exam | Complete Exam Questions
with Verified Correct Answers and Detailed Explanations –
Latest Update 2026/2027| Already Graded A+
1. A nurse is caring for a client who was admitted with acute heart
failure. The client suddenly develops severe dyspnea, pink frothy
sputum, bilateral crackles, and an oxygen saturation of 82% on room air.
Which action should the nurse take first?
A. Administer the prescribed oral diuretic
B. Place the client in high-Fowler's position and apply oxygen
C. Obtain the client's daily weight
D. Encourage the client to increase oral fluid intake
Answer: B. Place the client in high-Fowler's position and apply oxygen
Explanation: The findings indicate acute pulmonary edema, a life-threatening
complication of heart failure. The priority is to improve oxygenation and
reduce the work of breathing. High-Fowler's positioning promotes lung
expansion and can decrease venous return to the heart, while supplemental
oxygen addresses severe hypoxemia. Diuretics and other prescribed therapies
are important but should not delay immediate support of airway and
breathing.
2. A nurse is caring for a client with chronic obstructive pulmonary
disease (COPD) who is receiving oxygen at 2 L/min by nasal cannula.
Which finding requires the nurse's immediate attention?
A. Oxygen saturation of 90%
B. Respiratory rate of 20/min
C. Increasing drowsiness and difficulty arousing the client
D. Productive cough with clear sputum
Answer: C. Increasing drowsiness and difficulty arousing the client
Explanation: Increasing drowsiness in a client with COPD can indicate
worsening carbon dioxide retention and respiratory failure. The nurse should
immediately assess airway, breathing, respiratory status, and level of
pg. 1
,consciousness and follow the prescribed oxygen and respiratory-support
plan. A saturation around 90% may be acceptable for some clients with
chronic respiratory disease depending on the prescribed target, but a
significant change in mental status is a major warning sign.
3. A client with diabetic ketoacidosis (DKA) is receiving IV fluids and an
insulin infusion. Which laboratory value requires the nurse to monitor
especially closely during treatment?
A. Potassium
B. Hemoglobin
C. Platelet count
D. Calcium
Answer: A. Potassium
Explanation: DKA causes significant shifts in potassium. Although the serum
potassium may initially be normal or elevated because of acidosis and insulin
deficiency, total body potassium is often depleted. As insulin therapy and
correction of acidosis occur, potassium moves back into cells and the serum
level can fall rapidly. Severe hypokalemia can cause dangerous cardiac
dysrhythmias, making close monitoring essential.
4. A nurse is caring for a client who has a serum potassium level of 2.8
mEq/L (2.8 mmol/L). Which finding should the nurse anticipate?
A. Muscle weakness and dysrhythmias
B. Hyperactive bowel sounds and diarrhea
C. Peaked T waves
D. Increased deep tendon reflexes
Answer: A. Muscle weakness and dysrhythmias
Explanation: Hypokalemia can cause muscle weakness, fatigue, decreased
gastrointestinal motility, and potentially life-threatening cardiac
dysrhythmias. ECG changes may include flattened or inverted T waves and
prominent U waves. Peaked T waves are more characteristic of hyperkalemia.
pg. 2
,5. A nurse is assessing a client who has a serum potassium level of 6.4
mEq/L (6.4 mmol/L). Which ECG finding should the nurse expect?
A. Peaked T waves
B. Prominent U waves
C. Prolonged QT interval
D. ST-segment elevation caused by hypokalemia
Answer: A. Peaked T waves
Explanation: Hyperkalemia can produce characteristic ECG changes,
particularly tall, peaked T waves in early stages. As potassium levels become
more severe, conduction abnormalities, widening of the QRS complex, and
potentially lethal dysrhythmias can occur. A significantly elevated potassium
level requires prompt assessment and treatment according to the clinical
situation.
6. A client receiving a blood transfusion reports chills, low back pain,
and a feeling of impending doom. What is the nurse's priority action?
A. Slow the transfusion rate
B. Stop the transfusion immediately
C. Administer acetaminophen
D. Continue the transfusion and reassess in 15 minutes
Answer: B. Stop the transfusion immediately
Explanation: Chills, back pain, and a sense of impending doom can indicate an
acute hemolytic transfusion reaction. The nurse should stop the transfusion
immediately and maintain IV access with appropriate compatible fluid
according to facility protocol. The nurse should notify the provider and blood
bank and closely monitor the client. Continuing the transfusion could worsen
the reaction.
pg. 3
, 7. A nurse is caring for a client who has a chest tube connected to a
water-seal drainage system. Which finding requires further assessment?
A. Tidaling in the water-seal chamber
B. Small amount of drainage in the collection chamber
C. Continuous bubbling in the water-seal chamber
D. Mild discomfort at the insertion site
Answer: C. Continuous bubbling in the water-seal chamber
Explanation: Continuous bubbling in the water-seal chamber may indicate an
air leak somewhere in the system. The nurse should assess the tubing,
connections, dressing, and insertion site according to facility procedure to
identify the source. Tidaling can occur normally with respirations, although its
presence or absence must be interpreted with the client's overall condition.
8. A client with a history of asthma develops severe wheezing and
increasing difficulty breathing. The nurse notes that the client's
wheezing suddenly becomes absent while respiratory effort increases.
How should the nurse interpret this finding?
A. The client's asthma has completely resolved
B. The absence of wheezing may indicate severely decreased airflow
C. The client is experiencing improved ventilation
D. The finding indicates that bronchodilator therapy is unnecessary
Answer: B. The absence of wheezing may indicate severely decreased
airflow
Explanation: A sudden decrease or absence of wheezing in a client with
severe respiratory distress can be ominous. Severe bronchoconstriction may
reduce airflow so significantly that little air movement is heard. This can
indicate impending respiratory failure rather than improvement and requires
immediate assessment and intervention.
9. A nurse is assessing a client who has a suspected stroke. Which finding
should the nurse recognize as a possible manifestation?
pg. 4
with Verified Correct Answers and Detailed Explanations –
Latest Update 2026/2027| Already Graded A+
1. A nurse is caring for a client who was admitted with acute heart
failure. The client suddenly develops severe dyspnea, pink frothy
sputum, bilateral crackles, and an oxygen saturation of 82% on room air.
Which action should the nurse take first?
A. Administer the prescribed oral diuretic
B. Place the client in high-Fowler's position and apply oxygen
C. Obtain the client's daily weight
D. Encourage the client to increase oral fluid intake
Answer: B. Place the client in high-Fowler's position and apply oxygen
Explanation: The findings indicate acute pulmonary edema, a life-threatening
complication of heart failure. The priority is to improve oxygenation and
reduce the work of breathing. High-Fowler's positioning promotes lung
expansion and can decrease venous return to the heart, while supplemental
oxygen addresses severe hypoxemia. Diuretics and other prescribed therapies
are important but should not delay immediate support of airway and
breathing.
2. A nurse is caring for a client with chronic obstructive pulmonary
disease (COPD) who is receiving oxygen at 2 L/min by nasal cannula.
Which finding requires the nurse's immediate attention?
A. Oxygen saturation of 90%
B. Respiratory rate of 20/min
C. Increasing drowsiness and difficulty arousing the client
D. Productive cough with clear sputum
Answer: C. Increasing drowsiness and difficulty arousing the client
Explanation: Increasing drowsiness in a client with COPD can indicate
worsening carbon dioxide retention and respiratory failure. The nurse should
immediately assess airway, breathing, respiratory status, and level of
pg. 1
,consciousness and follow the prescribed oxygen and respiratory-support
plan. A saturation around 90% may be acceptable for some clients with
chronic respiratory disease depending on the prescribed target, but a
significant change in mental status is a major warning sign.
3. A client with diabetic ketoacidosis (DKA) is receiving IV fluids and an
insulin infusion. Which laboratory value requires the nurse to monitor
especially closely during treatment?
A. Potassium
B. Hemoglobin
C. Platelet count
D. Calcium
Answer: A. Potassium
Explanation: DKA causes significant shifts in potassium. Although the serum
potassium may initially be normal or elevated because of acidosis and insulin
deficiency, total body potassium is often depleted. As insulin therapy and
correction of acidosis occur, potassium moves back into cells and the serum
level can fall rapidly. Severe hypokalemia can cause dangerous cardiac
dysrhythmias, making close monitoring essential.
4. A nurse is caring for a client who has a serum potassium level of 2.8
mEq/L (2.8 mmol/L). Which finding should the nurse anticipate?
A. Muscle weakness and dysrhythmias
B. Hyperactive bowel sounds and diarrhea
C. Peaked T waves
D. Increased deep tendon reflexes
Answer: A. Muscle weakness and dysrhythmias
Explanation: Hypokalemia can cause muscle weakness, fatigue, decreased
gastrointestinal motility, and potentially life-threatening cardiac
dysrhythmias. ECG changes may include flattened or inverted T waves and
prominent U waves. Peaked T waves are more characteristic of hyperkalemia.
pg. 2
,5. A nurse is assessing a client who has a serum potassium level of 6.4
mEq/L (6.4 mmol/L). Which ECG finding should the nurse expect?
A. Peaked T waves
B. Prominent U waves
C. Prolonged QT interval
D. ST-segment elevation caused by hypokalemia
Answer: A. Peaked T waves
Explanation: Hyperkalemia can produce characteristic ECG changes,
particularly tall, peaked T waves in early stages. As potassium levels become
more severe, conduction abnormalities, widening of the QRS complex, and
potentially lethal dysrhythmias can occur. A significantly elevated potassium
level requires prompt assessment and treatment according to the clinical
situation.
6. A client receiving a blood transfusion reports chills, low back pain,
and a feeling of impending doom. What is the nurse's priority action?
A. Slow the transfusion rate
B. Stop the transfusion immediately
C. Administer acetaminophen
D. Continue the transfusion and reassess in 15 minutes
Answer: B. Stop the transfusion immediately
Explanation: Chills, back pain, and a sense of impending doom can indicate an
acute hemolytic transfusion reaction. The nurse should stop the transfusion
immediately and maintain IV access with appropriate compatible fluid
according to facility protocol. The nurse should notify the provider and blood
bank and closely monitor the client. Continuing the transfusion could worsen
the reaction.
pg. 3
, 7. A nurse is caring for a client who has a chest tube connected to a
water-seal drainage system. Which finding requires further assessment?
A. Tidaling in the water-seal chamber
B. Small amount of drainage in the collection chamber
C. Continuous bubbling in the water-seal chamber
D. Mild discomfort at the insertion site
Answer: C. Continuous bubbling in the water-seal chamber
Explanation: Continuous bubbling in the water-seal chamber may indicate an
air leak somewhere in the system. The nurse should assess the tubing,
connections, dressing, and insertion site according to facility procedure to
identify the source. Tidaling can occur normally with respirations, although its
presence or absence must be interpreted with the client's overall condition.
8. A client with a history of asthma develops severe wheezing and
increasing difficulty breathing. The nurse notes that the client's
wheezing suddenly becomes absent while respiratory effort increases.
How should the nurse interpret this finding?
A. The client's asthma has completely resolved
B. The absence of wheezing may indicate severely decreased airflow
C. The client is experiencing improved ventilation
D. The finding indicates that bronchodilator therapy is unnecessary
Answer: B. The absence of wheezing may indicate severely decreased
airflow
Explanation: A sudden decrease or absence of wheezing in a client with
severe respiratory distress can be ominous. Severe bronchoconstriction may
reduce airflow so significantly that little air movement is heard. This can
indicate impending respiratory failure rather than improvement and requires
immediate assessment and intervention.
9. A nurse is assessing a client who has a suspected stroke. Which finding
should the nurse recognize as a possible manifestation?
pg. 4
