ATI ADULT MEDICAL-SURGICAL FINAL
EXAM VERSION B | AND ANSWERS |
2026 UPDATE | 100% CORRECT .
150 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
ATI ADULT MEDICAL-SURGICAL FINAL EXAM VERSION B | AND ANSWERS | 2026 UPDATE | 100%
CORRECT .. It contains 150 carefully selected questions that reflect the most current exam content and testing
strategies. Each question is accompanied by a correct answer and a detailed rationale that explains the
underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 150 Questions
Foundations - Application - ATI Adult Medical-surgical Version B AND 2026 Update 100 Correct Adult
Medical-surgical Nursing Undergraduate YEAR 3 / Graduate
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Management OF CARE 1-25 Acute, Appropriate, Chronic, Disease, Intervention
Safety AND Infection Control 26-50 Finding, Acute, Appropriate, Syndrome, Intervention
Health Promotion AND 51-75 Medication, Pulmonary, Intervention, Chronic, Acute
Maintenance
Psychosocial Integrity 76-100 Pulmonary, Finding, Intervention, Acute, Disease
Basic CARE AND Comfort 101-125 Finding, Acute, Syndrome, Appropriate, Shock
Pharmacological Therapies 126-150 Acute, Intervention, Finding, Syndrome, Pressure
TOTAL 150 All questions include answers and detailed rationales
,Section A - Management OF CARE
Q1.
A patient with acute pancreatitis develops sudden worsening of abdominal pain,
abdominal distension, and a positive Cullen sign. Which pathophysiologic process most
likely underlies this change?
A. Activation of pancreatic enzymes leading B. Obstruction of the common bile duct by a
to retroperitoneal hemorrhage gallstone
C. Perforation of a peptic ulcer into the D. Infection of a pancreatic pseudocyst with
pancreatic bed gram-negative bacteria
Correct: A - Activation of pancreatic enzymes leading to retroperitoneal hemorrhage
Rationale:Cullen sign indicates hemorrhagic pancreatitis, caused by retroperitoneal bleeding
tracking to the umbilicus. This results from enzyme-induced vascular necrosis. Biliary
obstruction and pseudocyst infection do not directly cause this sign. Perforated ulcer is not
the primary mechanism.
Q2.
A patient with chronic heart failure (HFrEF) is prescribed sacubitril/valsartan. Which
combination of effects best explains the benefit of this drug over an ACE inhibitor?
A. Increases natriuretic peptide breakdown B. Inhibits neprilysin and blocks angiotensin
and blocks AT1 receptors II type 1 receptors
C. Promotes vasodilation via bradykinin and D. Blocks beta-1 receptors and inhibits renin
reduces aldosterone secretion release from the kidneys
Correct: B - Inhibits neprilysin and blocks angiotensin II type 1 receptors
Rationale:Sacubitril/valsartan is an ARNI: sacubitril inhibits neprilysin (increasing natriuretic
peptides), valsartan blocks AT1 receptors. It does not increase peptide breakdown; it prevents
degradation. It does not primarily affect bradykinin or beta receptors.
Q3.
A patient with sepsis develops acute respiratory distress syndrome (ARDS). Which
ventilator strategy is most consistent with the current evidence-based ARDSNet protocol?
A. Tidal volume 10 mL/kg ideal body weight, B. Tidal volume 6 mL/kg ideal body weight,
plateau pressure < 30 cm H2O plateau pressure 30 cm H2O
C. Tidal volume 8 mL/kg actual weight, D. Tidal volume 12 mL/kg ideal body weight,
PEEP adjusted to FiO2 permissive hypercapnia
Correct: B - Tidal volume 6 mL/kg ideal body weight, plateau pressure 30 cm H2O
Page 3
, Section A - Management OF CARE
Rationale: ARDSNet protocol recommends low tidal volume (4-8 mL/kg IBW, typically 6) and
plateau pressure 30 cm H2O to prevent ventilator-induced lung injury. Higher volumes and
actual weight dosing are not recommended.
Q4.
A patient with diabetic ketoacidosis (DKA) has a serum potassium of 5.2 mEq/L on
admission. Insulin therapy is initiated. Which potassium shift is expected during
treatment, and what is the priority nursing action?
A. Potassium will decrease as insulin drives B. Potassium will increase as intracellular
K+ into cells; monitor for hypokalemia and K+ shifts out; prepare for potassium-binding
replace when K+ < 4.0 mEq/L agents
C. Potassium will remain stable; no specific D. Potassium will decrease only if renal
monitoring is needed failure is present; monitor urine output
Correct: A - Potassium will decrease as insulin drives K+ into cells; monitor for
hypokalemia and replace when K+ < 4.0 mEq/L
Rationale:Insulin promotes cellular K+ uptake, causing serum K+ to fall. In DKA, total body
potassium is depleted even if initial K+ is elevated. Replacement is indicated when K+ drops
below 4.0 mEq/L to prevent arrhythmias.
Q5.
A patient with cirrhosis and ascites is started on spironolactone. Which laboratory finding
indicates the drug is effective but also requires monitoring for a common adverse effect?
A. Decreased serum sodium and increased B. Increased serum potassium and
urine sodium increased urine sodium
C. Decreased serum potassium and D. Increased serum creatinine and
increased urine potassium decreased urine output
Correct: B - Increased serum potassium and increased urine sodium
Rationale:Spironolactone blocks aldosterone, causing sodium and water excretion while
retaining potassium. Effective therapy increases urine sodium, but hyperkalemia is a common
adverse effect requiring monitoring. Hyponatremia is not expected.
Q6.
A patient with end-stage renal disease on hemodialysis presents with confusion and
asterixis. Which combination of findings is most consistent with uremic encephalopathy
rather than another dialysis complication?
A. Elevated BUN and creatinine, metabolic B. Elevated BUN, hyperkalemia, and ECG
acidosis, and normal serum osmolality changes
Page 4
EXAM VERSION B | AND ANSWERS |
2026 UPDATE | 100% CORRECT .
150 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
ATI ADULT MEDICAL-SURGICAL FINAL EXAM VERSION B | AND ANSWERS | 2026 UPDATE | 100%
CORRECT .. It contains 150 carefully selected questions that reflect the most current exam content and testing
strategies. Each question is accompanied by a correct answer and a detailed rationale that explains the
underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 150 Questions
Foundations - Application - ATI Adult Medical-surgical Version B AND 2026 Update 100 Correct Adult
Medical-surgical Nursing Undergraduate YEAR 3 / Graduate
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Management OF CARE 1-25 Acute, Appropriate, Chronic, Disease, Intervention
Safety AND Infection Control 26-50 Finding, Acute, Appropriate, Syndrome, Intervention
Health Promotion AND 51-75 Medication, Pulmonary, Intervention, Chronic, Acute
Maintenance
Psychosocial Integrity 76-100 Pulmonary, Finding, Intervention, Acute, Disease
Basic CARE AND Comfort 101-125 Finding, Acute, Syndrome, Appropriate, Shock
Pharmacological Therapies 126-150 Acute, Intervention, Finding, Syndrome, Pressure
TOTAL 150 All questions include answers and detailed rationales
,Section A - Management OF CARE
Q1.
A patient with acute pancreatitis develops sudden worsening of abdominal pain,
abdominal distension, and a positive Cullen sign. Which pathophysiologic process most
likely underlies this change?
A. Activation of pancreatic enzymes leading B. Obstruction of the common bile duct by a
to retroperitoneal hemorrhage gallstone
C. Perforation of a peptic ulcer into the D. Infection of a pancreatic pseudocyst with
pancreatic bed gram-negative bacteria
Correct: A - Activation of pancreatic enzymes leading to retroperitoneal hemorrhage
Rationale:Cullen sign indicates hemorrhagic pancreatitis, caused by retroperitoneal bleeding
tracking to the umbilicus. This results from enzyme-induced vascular necrosis. Biliary
obstruction and pseudocyst infection do not directly cause this sign. Perforated ulcer is not
the primary mechanism.
Q2.
A patient with chronic heart failure (HFrEF) is prescribed sacubitril/valsartan. Which
combination of effects best explains the benefit of this drug over an ACE inhibitor?
A. Increases natriuretic peptide breakdown B. Inhibits neprilysin and blocks angiotensin
and blocks AT1 receptors II type 1 receptors
C. Promotes vasodilation via bradykinin and D. Blocks beta-1 receptors and inhibits renin
reduces aldosterone secretion release from the kidneys
Correct: B - Inhibits neprilysin and blocks angiotensin II type 1 receptors
Rationale:Sacubitril/valsartan is an ARNI: sacubitril inhibits neprilysin (increasing natriuretic
peptides), valsartan blocks AT1 receptors. It does not increase peptide breakdown; it prevents
degradation. It does not primarily affect bradykinin or beta receptors.
Q3.
A patient with sepsis develops acute respiratory distress syndrome (ARDS). Which
ventilator strategy is most consistent with the current evidence-based ARDSNet protocol?
A. Tidal volume 10 mL/kg ideal body weight, B. Tidal volume 6 mL/kg ideal body weight,
plateau pressure < 30 cm H2O plateau pressure 30 cm H2O
C. Tidal volume 8 mL/kg actual weight, D. Tidal volume 12 mL/kg ideal body weight,
PEEP adjusted to FiO2 permissive hypercapnia
Correct: B - Tidal volume 6 mL/kg ideal body weight, plateau pressure 30 cm H2O
Page 3
, Section A - Management OF CARE
Rationale: ARDSNet protocol recommends low tidal volume (4-8 mL/kg IBW, typically 6) and
plateau pressure 30 cm H2O to prevent ventilator-induced lung injury. Higher volumes and
actual weight dosing are not recommended.
Q4.
A patient with diabetic ketoacidosis (DKA) has a serum potassium of 5.2 mEq/L on
admission. Insulin therapy is initiated. Which potassium shift is expected during
treatment, and what is the priority nursing action?
A. Potassium will decrease as insulin drives B. Potassium will increase as intracellular
K+ into cells; monitor for hypokalemia and K+ shifts out; prepare for potassium-binding
replace when K+ < 4.0 mEq/L agents
C. Potassium will remain stable; no specific D. Potassium will decrease only if renal
monitoring is needed failure is present; monitor urine output
Correct: A - Potassium will decrease as insulin drives K+ into cells; monitor for
hypokalemia and replace when K+ < 4.0 mEq/L
Rationale:Insulin promotes cellular K+ uptake, causing serum K+ to fall. In DKA, total body
potassium is depleted even if initial K+ is elevated. Replacement is indicated when K+ drops
below 4.0 mEq/L to prevent arrhythmias.
Q5.
A patient with cirrhosis and ascites is started on spironolactone. Which laboratory finding
indicates the drug is effective but also requires monitoring for a common adverse effect?
A. Decreased serum sodium and increased B. Increased serum potassium and
urine sodium increased urine sodium
C. Decreased serum potassium and D. Increased serum creatinine and
increased urine potassium decreased urine output
Correct: B - Increased serum potassium and increased urine sodium
Rationale:Spironolactone blocks aldosterone, causing sodium and water excretion while
retaining potassium. Effective therapy increases urine sodium, but hyperkalemia is a common
adverse effect requiring monitoring. Hyponatremia is not expected.
Q6.
A patient with end-stage renal disease on hemodialysis presents with confusion and
asterixis. Which combination of findings is most consistent with uremic encephalopathy
rather than another dialysis complication?
A. Elevated BUN and creatinine, metabolic B. Elevated BUN, hyperkalemia, and ECG
acidosis, and normal serum osmolality changes
Page 4
