ATI MED SURG CMS PROCTORED EXAM 2026/2027 PAGE 1-80 AND
ATI MATERNAL NEWBORN CMS PROCTORED EXAM 2026/2027 PAGE
81-133
Comprehensive Practice Question Bank
360 Questions with Detailed Rationales
SECTION 1 : ATI MED SURG CMS PROCTORED EXAM 2026/2027
Topics Covered:
1. Cardiovascular Disorders (25 questions)
2. Respiratory Disorders (20 questions)
3. Gastrointestinal Disorders (20 questions)
4. Renal & Urinary Disorders (18 questions)
5. Endocrine & Metabolic Disorders (20 questions)
6. Neurological Disorders (18 questions)
7. Hematologic & Immunologic Disorders (15 questions)
8. Musculoskeletal & Integumentary Disorders (12 questions)
9. Fluid, Electrolyte & Acid-Base Imbalances (12 questions)
10. Pain Management, Safety & Perioperative Care (20 questions)
,Question 1
Domain: Cardiovascular Disorders
A nurse is caring for a client with acute myocardial infarction who reports chest pain rated 8/10.
Which action should the nurse take FIRST?
A) Document the pain in the client's medical record
B) Administer prescribed nitroglycerin and reassess
C) Notify the client's family members
D) Offer the client a light snack
Answer: B
Rationale: Chest pain in acute myocardial infarction indicates ongoing myocardial ischemia and
is life-threatening. Administering prescribed nitroglycerin addresses the ischemia by dilating
coronary arteries and reducing preload. Documentation (A) is important but does not treat the
patient. Food intake (C) is irrelevant and potentially harmful during acute MI. Family notification
(D) is secondary to immediate patient stabilization.
Question 2
Domain: Cardiovascular Disorders
A client with heart failure has an ejection fraction of 25% and reports waking up breathless at
night, requiring three pillows to sleep comfortably. The nurse recognizes that adding which
medication would most effectively reduce hospitalization risk?
A) Amlodipine
B) Digoxin
C) Sacubitril-valsartan
D) Hydralazine alone
Answer: C
Rationale: Sacubitril-valsartan is an ARNI (angiotensin receptor-neprilysin inhibitor) that reduces
mortality and heart failure hospitalizations in patients with reduced ejection fraction.
Amlodipine (A) does not improve outcomes in HFrEF. Digoxin (B) reduces hospitalizations but
does not improve survival. Hydralazine alone (D) is not as effective as the combination with
isosorbide dinitrate in certain populations.
,Question 3
Domain: Cardiovascular Disorders
A client with new-onset atrial fibrillation has a ventricular rate of 156/min and is
hemodynamically stable with blood pressure 128/78 mm Hg. The client reports lightheadedness
and palpitations. Which intervention should the nurse anticipate?
A) Immediate synchronized cardioversion
B) Administration of intravenous amiodarone
C) Administration of intravenous diltiazem
D) Insertion of a temporary pacemaker
Answer: C
Rationale: In hemodynamically stable atrial fibrillation with rapid ventricular response, rate
control with a calcium channel blocker (diltiazem) or beta-blocker is indicated. Immediate
synchronized cardioversion (A) is indicated for unstable patients. Amiodarone (B) may be used
but is not typically first-line for rate control. A pacemaker (D) is not indicated for atrial
fibrillation.
Question 4
Domain: Cardiovascular Disorders
A nurse is assessing a client with pericarditis. Which ECG finding is most consistent with this
diagnosis?
A) ST depression in leads V3 through V6
B) Diffuse ST elevation
C) Pathologic Q waves
D) Prolonged PR interval
Answer: B
Rationale: Acute pericarditis typically causes diffuse ST elevation across multiple leads due to
inflammation of the pericardial sac. ST depression (A) with troponin elevation suggests non-ST
elevation MI. Pathologic Q waves (C) indicate prior infarction. Prolonged PR interval (D) may be
seen in first-degree heart block, not specifically pericarditis.
Question 5
, Domain: Cardiovascular Disorders
A client with hypertension is prescribed hydrochlorothiazide. Which laboratory value should the
nurse monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B
Rationale: Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia by increasing
potassium excretion in the distal tubule. While sodium (A) and calcium (C) may also be affected,
potassium is the most clinically significant and requires close monitoring. Magnesium (D) is less
commonly affected by thiazides.
Question 6
Domain: Cardiovascular Disorders
A client is receiving IV heparin for treatment of deep vein thrombosis. Which laboratory value
should the nurse monitor to evaluate therapeutic effectiveness?
A) International Normalized Ratio (INR)
B) Prothrombin Time (PT)
C) Activated Partial Thromboplastin Time (aPTT)
D) Platelet count
Answer: C
Rationale: Heparin therapy is monitored using activated partial thromboplastin time (aPTT),
with a therapeutic goal typically 1.5-2.5 times the control value. INR and PT (A, B) are used to
monitor warfarin therapy. Platelet count (D) is monitored to detect heparin-induced
thrombocytopenia but does not measure therapeutic effect.
Question 7
Domain: Cardiovascular Disorders
A client with heart failure has crackles in bilateral lung bases, jugular venous distention, and 3+
pitting edema in the lower extremities. Which nursing intervention is the priority?
ATI MATERNAL NEWBORN CMS PROCTORED EXAM 2026/2027 PAGE
81-133
Comprehensive Practice Question Bank
360 Questions with Detailed Rationales
SECTION 1 : ATI MED SURG CMS PROCTORED EXAM 2026/2027
Topics Covered:
1. Cardiovascular Disorders (25 questions)
2. Respiratory Disorders (20 questions)
3. Gastrointestinal Disorders (20 questions)
4. Renal & Urinary Disorders (18 questions)
5. Endocrine & Metabolic Disorders (20 questions)
6. Neurological Disorders (18 questions)
7. Hematologic & Immunologic Disorders (15 questions)
8. Musculoskeletal & Integumentary Disorders (12 questions)
9. Fluid, Electrolyte & Acid-Base Imbalances (12 questions)
10. Pain Management, Safety & Perioperative Care (20 questions)
,Question 1
Domain: Cardiovascular Disorders
A nurse is caring for a client with acute myocardial infarction who reports chest pain rated 8/10.
Which action should the nurse take FIRST?
A) Document the pain in the client's medical record
B) Administer prescribed nitroglycerin and reassess
C) Notify the client's family members
D) Offer the client a light snack
Answer: B
Rationale: Chest pain in acute myocardial infarction indicates ongoing myocardial ischemia and
is life-threatening. Administering prescribed nitroglycerin addresses the ischemia by dilating
coronary arteries and reducing preload. Documentation (A) is important but does not treat the
patient. Food intake (C) is irrelevant and potentially harmful during acute MI. Family notification
(D) is secondary to immediate patient stabilization.
Question 2
Domain: Cardiovascular Disorders
A client with heart failure has an ejection fraction of 25% and reports waking up breathless at
night, requiring three pillows to sleep comfortably. The nurse recognizes that adding which
medication would most effectively reduce hospitalization risk?
A) Amlodipine
B) Digoxin
C) Sacubitril-valsartan
D) Hydralazine alone
Answer: C
Rationale: Sacubitril-valsartan is an ARNI (angiotensin receptor-neprilysin inhibitor) that reduces
mortality and heart failure hospitalizations in patients with reduced ejection fraction.
Amlodipine (A) does not improve outcomes in HFrEF. Digoxin (B) reduces hospitalizations but
does not improve survival. Hydralazine alone (D) is not as effective as the combination with
isosorbide dinitrate in certain populations.
,Question 3
Domain: Cardiovascular Disorders
A client with new-onset atrial fibrillation has a ventricular rate of 156/min and is
hemodynamically stable with blood pressure 128/78 mm Hg. The client reports lightheadedness
and palpitations. Which intervention should the nurse anticipate?
A) Immediate synchronized cardioversion
B) Administration of intravenous amiodarone
C) Administration of intravenous diltiazem
D) Insertion of a temporary pacemaker
Answer: C
Rationale: In hemodynamically stable atrial fibrillation with rapid ventricular response, rate
control with a calcium channel blocker (diltiazem) or beta-blocker is indicated. Immediate
synchronized cardioversion (A) is indicated for unstable patients. Amiodarone (B) may be used
but is not typically first-line for rate control. A pacemaker (D) is not indicated for atrial
fibrillation.
Question 4
Domain: Cardiovascular Disorders
A nurse is assessing a client with pericarditis. Which ECG finding is most consistent with this
diagnosis?
A) ST depression in leads V3 through V6
B) Diffuse ST elevation
C) Pathologic Q waves
D) Prolonged PR interval
Answer: B
Rationale: Acute pericarditis typically causes diffuse ST elevation across multiple leads due to
inflammation of the pericardial sac. ST depression (A) with troponin elevation suggests non-ST
elevation MI. Pathologic Q waves (C) indicate prior infarction. Prolonged PR interval (D) may be
seen in first-degree heart block, not specifically pericarditis.
Question 5
, Domain: Cardiovascular Disorders
A client with hypertension is prescribed hydrochlorothiazide. Which laboratory value should the
nurse monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B
Rationale: Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia by increasing
potassium excretion in the distal tubule. While sodium (A) and calcium (C) may also be affected,
potassium is the most clinically significant and requires close monitoring. Magnesium (D) is less
commonly affected by thiazides.
Question 6
Domain: Cardiovascular Disorders
A client is receiving IV heparin for treatment of deep vein thrombosis. Which laboratory value
should the nurse monitor to evaluate therapeutic effectiveness?
A) International Normalized Ratio (INR)
B) Prothrombin Time (PT)
C) Activated Partial Thromboplastin Time (aPTT)
D) Platelet count
Answer: C
Rationale: Heparin therapy is monitored using activated partial thromboplastin time (aPTT),
with a therapeutic goal typically 1.5-2.5 times the control value. INR and PT (A, B) are used to
monitor warfarin therapy. Platelet count (D) is monitored to detect heparin-induced
thrombocytopenia but does not measure therapeutic effect.
Question 7
Domain: Cardiovascular Disorders
A client with heart failure has crackles in bilateral lung bases, jugular venous distention, and 3+
pitting edema in the lower extremities. Which nursing intervention is the priority?
