,ATI Medical-Surgical Nursing Assessment - PN Exam Questions And
Answers 2026/2027
1.** A practical nurse is caring for a client who has heart failure. Which
assessment finding indicates that the client's condition is worsening?
A) Weight loss of 1 kg in 24 hours
B) Crackles auscultated in the lung bases
C) Decreased jugular venous distention
D) Peripheral edema that is improving
**Correct Answer:** B) Crackles auscultated in the lung bases
**Rationale:** Crackles in the lung bases indicate pulmonary congestion, a
sign of worsening heart failure due to fluid overload. Weight loss, decreased
JVD, and improving edema indicate improvement. The nurse should report
new or worsening crackles to the provider immediately.
**2.** A client with heart failure is prescribed furosemide (Lasix). Which
finding indicates the medication is having its intended therapeutic effect?
A) Blood pressure increases to 150/90 mmHg
B) Weight loss of 2 pounds in 24 hours
C) Development of a dry cough
D) Serum potassium level of 3.0 mEq/L
**Correct Answer:** B) Weight loss of 2 pounds in 24 hours
**Rationale:** Furosemide is a loop diuretic that promotes fluid excretion.
Weight loss indicates effective diuresis and fluid removal. Hypertension (A)
,would suggest inadequate diuresis; a dry cough (C) is associated with ACE
inhibitors, not furosemide; hypokalemia (D) is a potential adverse effect, not
a therapeutic outcome.
**3.** A client receiving IV heparin therapy has an aPTT of 120 seconds
(control 30 seconds). Which action should the nurse take?
A) Continue the infusion at the current rate
B) Increase the infusion rate
C) Stop the infusion and notify the healthcare provider
D) Decrease the infusion rate by half
**Correct Answer:** C) Stop the infusion and notify the healthcare provider
**Rationale:** Therapeutic aPTT for heparin is 1.5-2.5 times control (45-75
seconds). An aPTT of 120 seconds indicates excessive anticoagulation and
significant bleeding risk. The infusion should be stopped immediately, and
the provider notified. The antidote protamine sulfate may be ordered.
**4.** A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which
laboratory value should the nurse monitor to evaluate therapeutic
effectiveness?
A) aPTT
B) INR
C) Platelet count
D) Hemoglobin
**Correct Answer:** B) INR
, **Rationale:** INR (international normalized ratio) is used to monitor warfarin
therapy. The therapeutic INR for atrial fibrillation is typically 2-3. aPTT is used
to monitor heparin therapy. Platelet count and hemoglobin monitor for
bleeding complications but do not evaluate therapeutic effect.
**5.** A client is prescribed warfarin and has an INR of 4.8. Which action
should the nurse take first?
A) Administer the warfarin as prescribed
B) Hold the warfarin and notify the healthcare provider
C) Increase the warfarin dose
D) Administer vitamin K immediately
**Correct Answer:** B) Hold the warfarin and notify the healthcare provider
**Rationale:** An INR of 4.8 indicates excessive anticoagulation and
increased bleeding risk. The nurse should hold the dose and notify the
provider. Vitamin K may be ordered but requires a provider prescription and
is not the nurse's first action.
**6.** A client who is 1 day post-myocardial infarction reports chest pain that
is unrelieved by sublingual nitroglycerin. Which action should the nurse take
first?
A) Administer a second dose of nitroglycerin
B) Assess the client's vital signs
C) Notify the healthcare provider
D) Administer morphine sulfate as prescribed
Answers 2026/2027
1.** A practical nurse is caring for a client who has heart failure. Which
assessment finding indicates that the client's condition is worsening?
A) Weight loss of 1 kg in 24 hours
B) Crackles auscultated in the lung bases
C) Decreased jugular venous distention
D) Peripheral edema that is improving
**Correct Answer:** B) Crackles auscultated in the lung bases
**Rationale:** Crackles in the lung bases indicate pulmonary congestion, a
sign of worsening heart failure due to fluid overload. Weight loss, decreased
JVD, and improving edema indicate improvement. The nurse should report
new or worsening crackles to the provider immediately.
**2.** A client with heart failure is prescribed furosemide (Lasix). Which
finding indicates the medication is having its intended therapeutic effect?
A) Blood pressure increases to 150/90 mmHg
B) Weight loss of 2 pounds in 24 hours
C) Development of a dry cough
D) Serum potassium level of 3.0 mEq/L
**Correct Answer:** B) Weight loss of 2 pounds in 24 hours
**Rationale:** Furosemide is a loop diuretic that promotes fluid excretion.
Weight loss indicates effective diuresis and fluid removal. Hypertension (A)
,would suggest inadequate diuresis; a dry cough (C) is associated with ACE
inhibitors, not furosemide; hypokalemia (D) is a potential adverse effect, not
a therapeutic outcome.
**3.** A client receiving IV heparin therapy has an aPTT of 120 seconds
(control 30 seconds). Which action should the nurse take?
A) Continue the infusion at the current rate
B) Increase the infusion rate
C) Stop the infusion and notify the healthcare provider
D) Decrease the infusion rate by half
**Correct Answer:** C) Stop the infusion and notify the healthcare provider
**Rationale:** Therapeutic aPTT for heparin is 1.5-2.5 times control (45-75
seconds). An aPTT of 120 seconds indicates excessive anticoagulation and
significant bleeding risk. The infusion should be stopped immediately, and
the provider notified. The antidote protamine sulfate may be ordered.
**4.** A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which
laboratory value should the nurse monitor to evaluate therapeutic
effectiveness?
A) aPTT
B) INR
C) Platelet count
D) Hemoglobin
**Correct Answer:** B) INR
, **Rationale:** INR (international normalized ratio) is used to monitor warfarin
therapy. The therapeutic INR for atrial fibrillation is typically 2-3. aPTT is used
to monitor heparin therapy. Platelet count and hemoglobin monitor for
bleeding complications but do not evaluate therapeutic effect.
**5.** A client is prescribed warfarin and has an INR of 4.8. Which action
should the nurse take first?
A) Administer the warfarin as prescribed
B) Hold the warfarin and notify the healthcare provider
C) Increase the warfarin dose
D) Administer vitamin K immediately
**Correct Answer:** B) Hold the warfarin and notify the healthcare provider
**Rationale:** An INR of 4.8 indicates excessive anticoagulation and
increased bleeding risk. The nurse should hold the dose and notify the
provider. Vitamin K may be ordered but requires a provider prescription and
is not the nurse's first action.
**6.** A client who is 1 day post-myocardial infarction reports chest pain that
is unrelieved by sublingual nitroglycerin. Which action should the nurse take
first?
A) Administer a second dose of nitroglycerin
B) Assess the client's vital signs
C) Notify the healthcare provider
D) Administer morphine sulfate as prescribed
