AT I M E D - S U R G 2 0 2 3 A · C O M P R E H E N S I V E R E V I E W
ATI Med-Surg 2023 A
Practice Question Bank
NCLEX-Style Practice Questions with Rationales
Topics: Cardiovascular · Respiratory · Endocrine · Oncology · Gastrointestinal ·
Emergency · & More
Edition 1 · August 2026
Table of Contents
1. Instructions for Use 2
2. Cardiovascular & Cardiac Care 2
3. Respiratory & Pulmonary Care 3
4. Endocrine & Metabolic Disorders 4
,5. Gastrointestinal & Digestive Disorders 4
6. Oncology & Cancer Care 5
7. Neurological & Emergency Care 6
8. Infectious Disease & Immune 6
9. Pharmacology & Medication Management 7
ATI Med-Surg 2023 A · Nursing Review Page 1
,ATI MED-SURG 2023 A PRACTICE GUIDE INSTRUCTIONS & CARDIOVASCULAR
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is. Items marked NEEDS RATIONALE had limited source detail; treat those as flags
for independent review.
Cardiovascular & Cardiac Care
1 A client receiving a blood transfusion is restless, dyspneic, and has crackles. What is
the priority nursing action?
A Slow the infusion rate
B Stop the transfusion
C Notify the provider
D Administer oxygen
Why A is correct: These are signs of fluid overload (transfusion-associated circulatory
overload). Slowing the infusion rate is the first intervention, followed by notifying the
provider.
B — Stopping is for transfusion reactions, not fluid overload.
C — Provider is notified after slowing the rate.
D — Oxygen may be needed but is not the first action.
, 2 A client has portal hypertension and is vomiting mixed blood with food after a meal.
What is the priority nursing action?
A Obtain vital signs
B Call the provider
C Place the client in Trendelenburg
D Start an IV
Why A is correct: Vomiting blood with portal hypertension may indicate esophageal
variceal bleeding. Obtaining vital signs is the priority to assess hemodynamic stability.
B — Provider is notified after assessment.
C — Trendelenburg is not indicated.
D — IV access is important but after vitals.
3 A client with hypertension and taking propranolol reports a night cough. What
should the nurse suspect?
A Heart failure
B Asthma exacerbation
C GERD
D Allergic reaction
Why A is correct: Night cough is a common symptom of left-sided heart failure
(orthopnea). Propranolol is a beta-blocker that can worsen heart failure.
B — Propranolol is contraindicated in asthma.
C — GERD is less likely with this medication.
D — Allergic reaction is not the primary concern.
ATI Med-Surg 2023 A
Practice Question Bank
NCLEX-Style Practice Questions with Rationales
Topics: Cardiovascular · Respiratory · Endocrine · Oncology · Gastrointestinal ·
Emergency · & More
Edition 1 · August 2026
Table of Contents
1. Instructions for Use 2
2. Cardiovascular & Cardiac Care 2
3. Respiratory & Pulmonary Care 3
4. Endocrine & Metabolic Disorders 4
,5. Gastrointestinal & Digestive Disorders 4
6. Oncology & Cancer Care 5
7. Neurological & Emergency Care 6
8. Infectious Disease & Immune 6
9. Pharmacology & Medication Management 7
ATI Med-Surg 2023 A · Nursing Review Page 1
,ATI MED-SURG 2023 A PRACTICE GUIDE INSTRUCTIONS & CARDIOVASCULAR
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is. Items marked NEEDS RATIONALE had limited source detail; treat those as flags
for independent review.
Cardiovascular & Cardiac Care
1 A client receiving a blood transfusion is restless, dyspneic, and has crackles. What is
the priority nursing action?
A Slow the infusion rate
B Stop the transfusion
C Notify the provider
D Administer oxygen
Why A is correct: These are signs of fluid overload (transfusion-associated circulatory
overload). Slowing the infusion rate is the first intervention, followed by notifying the
provider.
B — Stopping is for transfusion reactions, not fluid overload.
C — Provider is notified after slowing the rate.
D — Oxygen may be needed but is not the first action.
, 2 A client has portal hypertension and is vomiting mixed blood with food after a meal.
What is the priority nursing action?
A Obtain vital signs
B Call the provider
C Place the client in Trendelenburg
D Start an IV
Why A is correct: Vomiting blood with portal hypertension may indicate esophageal
variceal bleeding. Obtaining vital signs is the priority to assess hemodynamic stability.
B — Provider is notified after assessment.
C — Trendelenburg is not indicated.
D — IV access is important but after vitals.
3 A client with hypertension and taking propranolol reports a night cough. What
should the nurse suspect?
A Heart failure
B Asthma exacerbation
C GERD
D Allergic reaction
Why A is correct: Night cough is a common symptom of left-sided heart failure
(orthopnea). Propranolol is a beta-blocker that can worsen heart failure.
B — Propranolol is contraindicated in asthma.
C — GERD is less likely with this medication.
D — Allergic reaction is not the primary concern.
