ATI C ONTENT M A STERY SERI ES · ED I TI ON 1 2 . 0
RN Adult
Medical-Surgical
Nursing
Comprehensive examination featuring 200 verified
questions with correct answers and rationales, aligned with
the NCLEX-RN Test Plan and evidence-based medical-
surgical nursing standards for the 2026/2027 academic
year.
Edition 12.0 | 2026/2027
Verified Questions and Correct Answers with Rationales
NCLEX-RN Aligned | Evidence-Based Practice
200 QUE STIONS · 10 C LINIC AL SE C TIONS ·
C O M P L E T E E X A M I N AT I O N
,RN Adult Medical-Surgical Nursing | Edition 12.0 | 2026/2027 ATI Content Mastery Series
Section 1: Cardiovascular Disorders (30 Questions)
Q1:
A nurse is caring for a client with heart failure who is receiving furosemide (Lasix) IV. Which of the following
laboratory values should the nurse monitor most closely?
A. Serum sodium 138 mEq/L
B. Serum potassium 3.0 mEq/L *[CORRECT]*
C. Serum calcium 9.2 mg/dL
D. Serum chloride 100 mEq/L
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes significant potassium wasting, placing the client at risk for hypokalemia. A
serum potassium of 3.0 mEq/L is below the normal range of 3.5-5.0 mEq/L and requires immediate intervention. Hypokalemia can
precipitate lethal dysrhythmias, particularly in clients with heart failure who may also be receiving digoxin. The other values are
within normal limits. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Pharmacological Therapies)
Q2:
A nurse is assessing a client who is 6 hours post-MI. The client reports new-onset chest pain rated 7/10. Which of the
following actions should the nurse take first?
A. Administer prescribed sublingual nitroglycerin
B. Obtain a 12-lead ECG *[CORRECT]*
C. Auscultate heart sounds
D. Check the cardiac enzyme levels
Correct Answer: B
Rationale: New-onset chest pain 6 hours post-MI may indicate extension of the infarction. Obtaining a 12-lead ECG is the priority
because it provides immediate information about cardiac electrical activity and can identify ST-segment changes. While
nitroglycerin may be needed, the ECG should be obtained first to guide treatment. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN:
Reduction of Risk)
Q3:
A nurse is providing discharge teaching to a client who has a new prescription for warfarin (Coumadin). Which of the
following statements by the client indicates an understanding of the teaching?
A. I will increase my intake of dark green leafy vegetables
B. I will use a soft-bristled toothbrush *[CORRECT]*
C. I will take ibuprofen for headaches
D. I will have my INR checked every 6 months
Correct Answer: B
Rationale: Using a soft-bristled toothbrush reduces the risk of bleeding, the primary adverse effect of warfarin. Increasing vitamin
K-rich foods counteracts warfarin's effect. Ibuprofen increases bleeding risk and should be avoided. INR should be monitored
weekly initially then monthly, not every 6 months. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Pharmacological Therapies)
Q4:
A nurse is reviewing the medical record of a client with deep vein thrombosis (DVT). Which of the following findings
should the nurse expect?
A. Decreased D-dimer level
B. Positive Homans sign *[CORRECT]*
C. Cool and pale affected extremity
D. Bounding pedal pulses in the affected leg
Correct Answer: B
Page 1
,RN Adult Medical-Surgical Nursing | Edition 12.0 | 2026/2027 ATI Content Mastery Series
Rationale: A positive Homans sign (calf pain on dorsiflexion) is a classic finding of DVT. DVT presents with a warm, red, swollen
extremity, not cool and pale. D-dimer levels are elevated in DVT. Pedal pulses are normal or difficult to palpate due to edema but
are not bounding. (ATI Med-Surg Ed. 12.0, Ch. 13; NCLEX-RN: Reduction of Risk)
Q5:
A nurse is caring for a client with aortic stenosis. Which of the following findings should the nurse expect?
A. Bounding peripheral pulses
B. Widened pulse pressure
C. A systolic ejection murmur heard at the right second intercostal space *[CORRECT]*
D. A diastolic murmur heard at the left sternal border
Correct Answer: C
Rationale: Aortic stenosis produces a systolic ejection murmur best heard at the right second intercostal space. It causes narrow
pulse pressure and weak, delayed peripheral pulses (pulsus parvus et tardus). A diastolic murmur is associated with aortic
regurgitation. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Reduction of Risk)
Q6:
A nurse is monitoring a client who is receiving heparin by continuous IV infusion for a pulmonary embolism. Which of
the following findings should the nurse report to the provider immediately?
A. aPTT of 50 seconds
B. aPTT of 90 seconds *[CORRECT]*
C. Platelet count of 200,000/mm3
D. Partial thromboplastin time of 40 seconds
Correct Answer: B
Rationale: The therapeutic aPTT range for heparin is 1.5-2.5 times control (46-70 seconds). An aPTT of 90 seconds is critically
high and indicates significant bleeding risk requiring immediate intervention. An aPTT of 50 is therapeutic. Platelets of 200,000 are
normal. An aPTT of 40 is subtherapeutic. (ATI Med-Surg Ed. 12.0, Ch. 13; NCLEX-RN: Pharmacological Therapies)
Q7:
A nurse is caring for a client who has hypertension and a new prescription for lisinopril (Zestril). Which of the following
adverse effects should the nurse monitor for?
A. Tachycardia
B. Hyperkalemia *[CORRECT]*
C. Hypoglycemia
D. Constipation
Correct Answer: B
Rationale: Lisinopril is an ACE inhibitor that blocks angiotensin II production, reducing aldosterone secretion. Decreased
aldosterone leads to potassium retention and hyperkalemia. ACE inhibitors cause a dry cough, not tachycardia. They do not cause
hypoglycemia or constipation. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Pharmacological Therapies)
Q8:
A nurse is assessing a client with left-sided heart failure. Which of the following findings is a priority to report?
A. Fatigue and weakness
B. Crackles in bilateral lung bases *[CORRECT]*
C. Dependent edema in lower extremities
D. Weight gain of 1 kg over 2 days
Correct Answer: B
Rationale: Bilateral crackles indicate pulmonary congestion from the left ventricle's inability to pump effectively, suggesting
impending acute pulmonary edema, a life-threatening complication. Fatigue, edema, and gradual weight gain are important but not
as immediately dangerous. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Reduction of Risk)
Page 2
, RN Adult Medical-Surgical Nursing | Edition 12.0 | 2026/2027 ATI Content Mastery Series
Q9:
A nurse is teaching a client about the use of a Holter monitor. Which of the following instructions should the nurse
include?
A. Avoid taking showers while wearing the monitor
B. Remove the monitor during sleep
C. Keep a diary of activities and symptoms *[CORRECT]*
D. Limit physical activity during the monitoring period
Correct Answer: C
Rationale: The client should keep a detailed diary of activities, symptoms, and exact times so the provider can correlate ECG
findings with the client's activities. The monitor should be worn continuously including during sleep. Clients can shower with the
device covered in plastic. Physical activity should not be limited. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Health Promotion)
Q10:
A nurse is caring for a client who has peripheral arterial disease (PAD). Which of the following manifestations should
the nurse expect in the affected extremity?
A. Warm, red skin
B. Pain that worsens with elevation and improves with dependency *[CORRECT]*
C. Bounding pulses
D. Edema in the affected extremity
Correct Answer: B
Rationale: In PAD, elevation further reduces arterial perfusion worsening pain, while dependency improves it. The affected
extremity appears cool and pale with diminished pulses. Edema is characteristic of venous insufficiency, not arterial disease. (ATI
Med-Surg Ed. 12.0, Ch. 13; NCLEX-RN: Reduction of Risk)
Q11:
A nurse is reviewing the laboratory results of a client who had a myocardial infarction 4 hours ago. Which cardiac
biomarker is expected to be elevated at this time?
A. Lactate dehydrogenase (LDH)
B. Myoglobin *[CORRECT]*
C. Homocysteine
D. C-reactive protein (CRP)
Correct Answer: B
Rationale: Myoglobin is the earliest cardiac biomarker to rise after MI, typically within 1-3 hours, peaking at 6-12 hours. It is highly
sensitive but not cardiac-specific. Troponin also rises within 3-4 hours. LDH rises later (8-12 hours). Homocysteine and CRP are
risk markers, not acute injury markers. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Reduction of Risk)
Q12:
A nurse is caring for a client being discharged after coronary artery bypass graft (CABG) surgery. Which statement
indicates a need for further teaching?
A. I will avoid lifting anything heavier than 10 pounds for 6 weeks
B. I will call my provider if I develop a fever above 101F
C. I will drive my car as soon as I feel able to *[CORRECT]*
D. I will perform my leg exercises daily to prevent blood clots
Correct Answer: C
Rationale: The client should not drive for 4-6 weeks after CABG to allow the sternum to heal. Sudden arm movements for steering
could disrupt sternal wound healing. Avoiding heavy lifting, reporting fever, and performing leg exercises are all appropriate
instructions. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Health Promotion)
Q13:
Page 3
RN Adult
Medical-Surgical
Nursing
Comprehensive examination featuring 200 verified
questions with correct answers and rationales, aligned with
the NCLEX-RN Test Plan and evidence-based medical-
surgical nursing standards for the 2026/2027 academic
year.
Edition 12.0 | 2026/2027
Verified Questions and Correct Answers with Rationales
NCLEX-RN Aligned | Evidence-Based Practice
200 QUE STIONS · 10 C LINIC AL SE C TIONS ·
C O M P L E T E E X A M I N AT I O N
,RN Adult Medical-Surgical Nursing | Edition 12.0 | 2026/2027 ATI Content Mastery Series
Section 1: Cardiovascular Disorders (30 Questions)
Q1:
A nurse is caring for a client with heart failure who is receiving furosemide (Lasix) IV. Which of the following
laboratory values should the nurse monitor most closely?
A. Serum sodium 138 mEq/L
B. Serum potassium 3.0 mEq/L *[CORRECT]*
C. Serum calcium 9.2 mg/dL
D. Serum chloride 100 mEq/L
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes significant potassium wasting, placing the client at risk for hypokalemia. A
serum potassium of 3.0 mEq/L is below the normal range of 3.5-5.0 mEq/L and requires immediate intervention. Hypokalemia can
precipitate lethal dysrhythmias, particularly in clients with heart failure who may also be receiving digoxin. The other values are
within normal limits. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Pharmacological Therapies)
Q2:
A nurse is assessing a client who is 6 hours post-MI. The client reports new-onset chest pain rated 7/10. Which of the
following actions should the nurse take first?
A. Administer prescribed sublingual nitroglycerin
B. Obtain a 12-lead ECG *[CORRECT]*
C. Auscultate heart sounds
D. Check the cardiac enzyme levels
Correct Answer: B
Rationale: New-onset chest pain 6 hours post-MI may indicate extension of the infarction. Obtaining a 12-lead ECG is the priority
because it provides immediate information about cardiac electrical activity and can identify ST-segment changes. While
nitroglycerin may be needed, the ECG should be obtained first to guide treatment. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN:
Reduction of Risk)
Q3:
A nurse is providing discharge teaching to a client who has a new prescription for warfarin (Coumadin). Which of the
following statements by the client indicates an understanding of the teaching?
A. I will increase my intake of dark green leafy vegetables
B. I will use a soft-bristled toothbrush *[CORRECT]*
C. I will take ibuprofen for headaches
D. I will have my INR checked every 6 months
Correct Answer: B
Rationale: Using a soft-bristled toothbrush reduces the risk of bleeding, the primary adverse effect of warfarin. Increasing vitamin
K-rich foods counteracts warfarin's effect. Ibuprofen increases bleeding risk and should be avoided. INR should be monitored
weekly initially then monthly, not every 6 months. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Pharmacological Therapies)
Q4:
A nurse is reviewing the medical record of a client with deep vein thrombosis (DVT). Which of the following findings
should the nurse expect?
A. Decreased D-dimer level
B. Positive Homans sign *[CORRECT]*
C. Cool and pale affected extremity
D. Bounding pedal pulses in the affected leg
Correct Answer: B
Page 1
,RN Adult Medical-Surgical Nursing | Edition 12.0 | 2026/2027 ATI Content Mastery Series
Rationale: A positive Homans sign (calf pain on dorsiflexion) is a classic finding of DVT. DVT presents with a warm, red, swollen
extremity, not cool and pale. D-dimer levels are elevated in DVT. Pedal pulses are normal or difficult to palpate due to edema but
are not bounding. (ATI Med-Surg Ed. 12.0, Ch. 13; NCLEX-RN: Reduction of Risk)
Q5:
A nurse is caring for a client with aortic stenosis. Which of the following findings should the nurse expect?
A. Bounding peripheral pulses
B. Widened pulse pressure
C. A systolic ejection murmur heard at the right second intercostal space *[CORRECT]*
D. A diastolic murmur heard at the left sternal border
Correct Answer: C
Rationale: Aortic stenosis produces a systolic ejection murmur best heard at the right second intercostal space. It causes narrow
pulse pressure and weak, delayed peripheral pulses (pulsus parvus et tardus). A diastolic murmur is associated with aortic
regurgitation. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Reduction of Risk)
Q6:
A nurse is monitoring a client who is receiving heparin by continuous IV infusion for a pulmonary embolism. Which of
the following findings should the nurse report to the provider immediately?
A. aPTT of 50 seconds
B. aPTT of 90 seconds *[CORRECT]*
C. Platelet count of 200,000/mm3
D. Partial thromboplastin time of 40 seconds
Correct Answer: B
Rationale: The therapeutic aPTT range for heparin is 1.5-2.5 times control (46-70 seconds). An aPTT of 90 seconds is critically
high and indicates significant bleeding risk requiring immediate intervention. An aPTT of 50 is therapeutic. Platelets of 200,000 are
normal. An aPTT of 40 is subtherapeutic. (ATI Med-Surg Ed. 12.0, Ch. 13; NCLEX-RN: Pharmacological Therapies)
Q7:
A nurse is caring for a client who has hypertension and a new prescription for lisinopril (Zestril). Which of the following
adverse effects should the nurse monitor for?
A. Tachycardia
B. Hyperkalemia *[CORRECT]*
C. Hypoglycemia
D. Constipation
Correct Answer: B
Rationale: Lisinopril is an ACE inhibitor that blocks angiotensin II production, reducing aldosterone secretion. Decreased
aldosterone leads to potassium retention and hyperkalemia. ACE inhibitors cause a dry cough, not tachycardia. They do not cause
hypoglycemia or constipation. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Pharmacological Therapies)
Q8:
A nurse is assessing a client with left-sided heart failure. Which of the following findings is a priority to report?
A. Fatigue and weakness
B. Crackles in bilateral lung bases *[CORRECT]*
C. Dependent edema in lower extremities
D. Weight gain of 1 kg over 2 days
Correct Answer: B
Rationale: Bilateral crackles indicate pulmonary congestion from the left ventricle's inability to pump effectively, suggesting
impending acute pulmonary edema, a life-threatening complication. Fatigue, edema, and gradual weight gain are important but not
as immediately dangerous. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Reduction of Risk)
Page 2
, RN Adult Medical-Surgical Nursing | Edition 12.0 | 2026/2027 ATI Content Mastery Series
Q9:
A nurse is teaching a client about the use of a Holter monitor. Which of the following instructions should the nurse
include?
A. Avoid taking showers while wearing the monitor
B. Remove the monitor during sleep
C. Keep a diary of activities and symptoms *[CORRECT]*
D. Limit physical activity during the monitoring period
Correct Answer: C
Rationale: The client should keep a detailed diary of activities, symptoms, and exact times so the provider can correlate ECG
findings with the client's activities. The monitor should be worn continuously including during sleep. Clients can shower with the
device covered in plastic. Physical activity should not be limited. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Health Promotion)
Q10:
A nurse is caring for a client who has peripheral arterial disease (PAD). Which of the following manifestations should
the nurse expect in the affected extremity?
A. Warm, red skin
B. Pain that worsens with elevation and improves with dependency *[CORRECT]*
C. Bounding pulses
D. Edema in the affected extremity
Correct Answer: B
Rationale: In PAD, elevation further reduces arterial perfusion worsening pain, while dependency improves it. The affected
extremity appears cool and pale with diminished pulses. Edema is characteristic of venous insufficiency, not arterial disease. (ATI
Med-Surg Ed. 12.0, Ch. 13; NCLEX-RN: Reduction of Risk)
Q11:
A nurse is reviewing the laboratory results of a client who had a myocardial infarction 4 hours ago. Which cardiac
biomarker is expected to be elevated at this time?
A. Lactate dehydrogenase (LDH)
B. Myoglobin *[CORRECT]*
C. Homocysteine
D. C-reactive protein (CRP)
Correct Answer: B
Rationale: Myoglobin is the earliest cardiac biomarker to rise after MI, typically within 1-3 hours, peaking at 6-12 hours. It is highly
sensitive but not cardiac-specific. Troponin also rises within 3-4 hours. LDH rises later (8-12 hours). Homocysteine and CRP are
risk markers, not acute injury markers. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Reduction of Risk)
Q12:
A nurse is caring for a client being discharged after coronary artery bypass graft (CABG) surgery. Which statement
indicates a need for further teaching?
A. I will avoid lifting anything heavier than 10 pounds for 6 weeks
B. I will call my provider if I develop a fever above 101F
C. I will drive my car as soon as I feel able to *[CORRECT]*
D. I will perform my leg exercises daily to prevent blood clots
Correct Answer: C
Rationale: The client should not drive for 4-6 weeks after CABG to allow the sternum to heal. Sudden arm movements for steering
could disrupt sternal wound healing. Avoiding heavy lifting, reporting fever, and performing leg exercises are all appropriate
instructions. (ATI Med-Surg Ed. 12.0, Ch. 12; NCLEX-RN: Health Promotion)
Q13:
Page 3
