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ATI RN MEDICAL SURGICAL CMS Original Questions with
Answers & Rationales
SECTION 1: CARDIOVASCULAR NURSING
1. A nurse is caring for a patient with heart failure who reports a
weight gain of 3 pounds in 24 hours. The nurse's priority action
is to:
A) Document the finding and continue monitoring
B) Notify the healthcare provider and assess for other signs of
fluid overload
C) Encourage the patient to increase fluid intake
D) Administer a diuretic without an order
Answer: B
Rationale: Weight gain of 2–3 pounds in 24 hours indicates
worsening fluid retention and heart failure. The nurse should
notify the provider and assess for other signs (crackles,
dyspnea, edema). Diuretics require an order.
2. A nurse is monitoring a patient after cardiac catheterization
via the femoral artery. Which finding requires immediate
intervention?
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A) Pain at the insertion site rated 2/10
B) Blood pressure of 90/60 mm Hg with tachycardia
C) A small bruise at the insertion site
D) Patient reports feeling anxious
Answer: B
Rationale: Hypotension with tachycardia after a femoral
puncture suggests retroperitoneal bleeding or vascular injury—
an emergency. Pain and small bruises are expected findings.
3. A patient with atrial fibrillation has a CHA₂DS₂-VASc score of
4. The nurse should anticipate an order for:
A) Aspirin only
B) Oral anticoagulation (DOAC or warfarin)
C) No anticoagulation
D) Clopidogrel only
Answer: B
Rationale: CHA₂DS₂-VASc ≥ 2 in men (≥ 3 in women) indicates
significant stroke risk warranting oral anticoagulation.
4. A nurse is teaching a patient about warfarin. Which
statement indicates understanding?
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A) "I should increase my intake of leafy green vegetables."
B) "I need to have my INR checked regularly."
C) "I can stop taking it if I feel fine."
D) "I should take it only when I have symptoms."
Answer: B
Rationale: Warfarin requires regular INR monitoring to ensure
therapeutic levels and prevent bleeding/thrombosis.
5. A patient with peripheral artery disease (PAD) reports calf
pain that occurs with walking and is relieved by rest. The nurse
recognizes this as:
A) Deep vein thrombosis
B) Intermittent claudication
C) Venous insufficiency
D) Muscle spasm only
Answer: B
Rationale: Intermittent claudication: exertional calf pain from
arterial insufficiency, relieved by rest—classic PAD symptom.
6. A patient with PAD should be taught to:
A) Use heating pads on the legs
B) Perform supervised exercise and stop smoking
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C) Elevate the legs above heart level
D) Wear tight stockings only
Answer: B
Rationale: PAD management: smoking cessation, supervised
exercise, antiplatelet therapy, and statin.
7. A nurse assesses a patient with suspected DVT. Which finding
is most concerning?
A) Bilateral leg swelling
B) Unilateral leg swelling, warmth, and pain
C) Varicose veins
D) Cool, pale feet only
Answer: B
Rationale: Unilateral leg swelling, warmth, and pain are classic
DVT signs.
8. The nurse should NOT massage a patient's calf with
suspected DVT because:
A) It causes pain
B) Massage could dislodge the clot, causing pulmonary
embolism
ATI RN MEDICAL SURGICAL CMS Original Questions with
Answers & Rationales
SECTION 1: CARDIOVASCULAR NURSING
1. A nurse is caring for a patient with heart failure who reports a
weight gain of 3 pounds in 24 hours. The nurse's priority action
is to:
A) Document the finding and continue monitoring
B) Notify the healthcare provider and assess for other signs of
fluid overload
C) Encourage the patient to increase fluid intake
D) Administer a diuretic without an order
Answer: B
Rationale: Weight gain of 2–3 pounds in 24 hours indicates
worsening fluid retention and heart failure. The nurse should
notify the provider and assess for other signs (crackles,
dyspnea, edema). Diuretics require an order.
2. A nurse is monitoring a patient after cardiac catheterization
via the femoral artery. Which finding requires immediate
intervention?
, Page |2
A) Pain at the insertion site rated 2/10
B) Blood pressure of 90/60 mm Hg with tachycardia
C) A small bruise at the insertion site
D) Patient reports feeling anxious
Answer: B
Rationale: Hypotension with tachycardia after a femoral
puncture suggests retroperitoneal bleeding or vascular injury—
an emergency. Pain and small bruises are expected findings.
3. A patient with atrial fibrillation has a CHA₂DS₂-VASc score of
4. The nurse should anticipate an order for:
A) Aspirin only
B) Oral anticoagulation (DOAC or warfarin)
C) No anticoagulation
D) Clopidogrel only
Answer: B
Rationale: CHA₂DS₂-VASc ≥ 2 in men (≥ 3 in women) indicates
significant stroke risk warranting oral anticoagulation.
4. A nurse is teaching a patient about warfarin. Which
statement indicates understanding?
, Page |3
A) "I should increase my intake of leafy green vegetables."
B) "I need to have my INR checked regularly."
C) "I can stop taking it if I feel fine."
D) "I should take it only when I have symptoms."
Answer: B
Rationale: Warfarin requires regular INR monitoring to ensure
therapeutic levels and prevent bleeding/thrombosis.
5. A patient with peripheral artery disease (PAD) reports calf
pain that occurs with walking and is relieved by rest. The nurse
recognizes this as:
A) Deep vein thrombosis
B) Intermittent claudication
C) Venous insufficiency
D) Muscle spasm only
Answer: B
Rationale: Intermittent claudication: exertional calf pain from
arterial insufficiency, relieved by rest—classic PAD symptom.
6. A patient with PAD should be taught to:
A) Use heating pads on the legs
B) Perform supervised exercise and stop smoking
, Page |4
C) Elevate the legs above heart level
D) Wear tight stockings only
Answer: B
Rationale: PAD management: smoking cessation, supervised
exercise, antiplatelet therapy, and statin.
7. A nurse assesses a patient with suspected DVT. Which finding
is most concerning?
A) Bilateral leg swelling
B) Unilateral leg swelling, warmth, and pain
C) Varicose veins
D) Cool, pale feet only
Answer: B
Rationale: Unilateral leg swelling, warmth, and pain are classic
DVT signs.
8. The nurse should NOT massage a patient's calf with
suspected DVT because:
A) It causes pain
B) Massage could dislodge the clot, causing pulmonary
embolism
