ATI Adult Medical-Surgical Nursing | ATI RN Adult
Medical-Surgical Proctored Exam 2026–2027 | ATI
Adult Medical-Surgical Content Mastery Series
Study Guide, Practice Questions & Answers, Adult
Health Nursing, Cardiovascular, Respiratory,
Neurological, Gastrointestinal, Renal, Endocrine,
Hematologic, Musculoskeletal, Oncology,
Pharmacology, Prioritization, Clinical Judgment &
NGN Exam Review
Question 1: A nurse is caring for a client who has heart failure and
is prescribed furosemide. The client reports muscle cramps and has
a potassium level of 3.0 mEq/L. Which of the following actions
should the nurse take first?
A. Administer the furosemide as prescribed
B. Encourage the client to increase potassium-rich foods
C. Hold the medication and notify the provider
D. Administer potassium supplements as ordered
CORRECT ANSWER: C. Hold the medication and notify the provider
Rationale: Furosemide is a loop diuretic that causes potassium loss. A
potassium level of 3.0 mEq/L indicates hypokalemia, which can potentiate
digoxin toxicity and cause cardiac dysrhythmias. The nurse should hold the
medication and notify the provider because continuing furosemide would
worsen hypokalemia. Potassium supplementation requires a prescription,
and dietary measures alone are insufficient for correcting moderate
hypokalemia.
Question 2: A nurse is assessing a client who is receiving a blood
transfusion. The client develops fever, chills, flank pain, and
nausea. Which of the following actions should the nurse take first?
A. Slow the transfusion rate and reassess in 15 minutes
B. Stop the transfusion immediately and maintain IV access with normal
saline
C. Administer prescribed acetaminophen for fever
D. Obtain a urine specimen for hemoglobinuria
CORRECT ANSWER: B. Stop the transfusion immediately and
maintain IV access with normal saline
,Rationale: These findings suggest an acute hemolytic transfusion reaction.
The first priority is to stop the transfusion immediately to prevent further
infusion of incompatible blood. IV access should be maintained with new
tubing and normal saline to support renal perfusion and treat potential
hypotension. Slowing the transfusion does not stop the ongoing reaction.
Question 3: A nurse is caring for a client who has peripheral
arterial disease. Which of the following findings should the nurse
expect?
A. Dependent edema
B. Absent pedal pulses
C. Brown discoloration of the skin
D. Pain relieved by elevation
CORRECT ANSWER: B. Absent pedal pulses
Rationale: Peripheral arterial disease results from inadequate arterial
perfusion to the extremities. Classic findings include diminished or absent
pulses, intermittent claudication, dependent rubor, shiny hairless skin, and
cool extremities. Dependent edema and brown discoloration are associated
with venous insufficiency.
Question 4: A nurse is caring for a client following a cardiac
catheterization via the right femoral artery. Which of the following
findings should the nurse report immediately?
A. Small bruise at the insertion site
B. Pedal pulse +1 on the right foot
C. Warm, dry skin on the right extremity
D. Back pain with a drop in blood pressure
CORRECT ANSWER: D. Back pain with a drop in blood pressure
Rationale: Back pain accompanied by hypotension after femoral cardiac
catheterization may indicate retroperitoneal bleeding, a serious
complication that can lead to hypovolemic shock. A small bruise is an
expected finding. A +1 pedal pulse may be baseline or indicate mild
impairment but is not immediately life-threatening.
Question 5: A nurse is caring for a client who has a new
prescription for sublingual nitroglycerin. Which of the following
client statements indicates an understanding of the teaching?
,A. "I should lie down when I take this medication"
B. "I should take it with a full glass of water"
C. "I should chew the tablet for faster absorption"
D. "I can take it every 10 minutes up to 5 doses"
CORRECT ANSWER: A. "I should lie down when I take this
medication"
Rationale: Sublingual nitroglycerin causes vasodilation and can lead to
hypotension and syncope. Clients should lie down when taking the
medication to prevent falls. The tablet should be placed under the tongue
and allowed to dissolve, not chewed. The standard dosing is every 5
minutes up to 3 doses, not every 10 minutes up to 5 doses.
Question 6: A nurse is evaluating a client who is receiving digoxin
for heart failure. The client reports nausea, vomiting, and blurred
vision with yellow halos. Which of the following actions should the
nurse take first?
A. Check apical pulse and hold medication if less than 60 bpm
B. Administer the next dose as scheduled
C. Administer antiemetics
D. Notify the provider immediately
CORRECT ANSWER: A. Check apical pulse and hold medication if
less than 60 bpm
Rationale: Nausea, vomiting, and visual disturbances such as yellow halos
are classic signs of digoxin toxicity. The nurse should first check the apical
pulse for one full minute and hold the medication if the heart rate is less
than 60 bpm. This is a critical safety action before notifying the provider.
Question 7: A nurse is admitting a client who reports chest pain
and has been placed on a telemetry monitor. Which of the following
should the nurse analyze to determine whether the client is
experiencing a myocardial infarction?
A. PR interval
B. QRS duration
C. T wave
D. ST segment
CORRECT ANSWER: D. ST segment
, Rationale: ST elevation indicates myocardial infarction, while ST depression
indicates ischemia. PR interval relates to first-degree heart block. QRS
duration indicates ventricular conduction delay. T wave changes may
indicate electrolyte imbalances or ischemia but are not diagnostic for
myocardial infarction.
Question 8: A nurse is caring for a client who is receiving a blood
transfusion and develops bounding peripheral pulses,
hypertension, and distended jugular veins. The nurse should
anticipate administering which of the following prescribed
medications?
A. Diphenhydramine
B. Acetaminophen
C. Pantoprazole
D. Furosemide
CORRECT ANSWER: D. Furosemide
Rationale: These findings indicate circulatory overload from the blood
transfusion. Furosemide, a loop diuretic, reduces preload and pulmonary
congestion. Diphenhydramine and acetaminophen are used for allergic
reactions, not fluid overload.
Question 9: A nurse is caring for a client who is experiencing
anxiety with numbness and tingling of the lips and fingers. The
client's ABGs are: pH 7.48, PCO2 30 mm Hg, HCO3- 24 mEq/L,
PaO2 85 mm Hg. Which of the following acid-base imbalances
should the nurse identify?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
CORRECT ANSWER: B. Respiratory alkalosis
Rationale: The pH is alkalotic (elevated), and the PCO2 is decreased,
representing alveolar hyperventilation. The HCO3- is within the expected
range of 21 to 28 mEq/L, ruling out metabolic causes. This is consistent
with hyperventilation due to anxiety.
Medical-Surgical Proctored Exam 2026–2027 | ATI
Adult Medical-Surgical Content Mastery Series
Study Guide, Practice Questions & Answers, Adult
Health Nursing, Cardiovascular, Respiratory,
Neurological, Gastrointestinal, Renal, Endocrine,
Hematologic, Musculoskeletal, Oncology,
Pharmacology, Prioritization, Clinical Judgment &
NGN Exam Review
Question 1: A nurse is caring for a client who has heart failure and
is prescribed furosemide. The client reports muscle cramps and has
a potassium level of 3.0 mEq/L. Which of the following actions
should the nurse take first?
A. Administer the furosemide as prescribed
B. Encourage the client to increase potassium-rich foods
C. Hold the medication and notify the provider
D. Administer potassium supplements as ordered
CORRECT ANSWER: C. Hold the medication and notify the provider
Rationale: Furosemide is a loop diuretic that causes potassium loss. A
potassium level of 3.0 mEq/L indicates hypokalemia, which can potentiate
digoxin toxicity and cause cardiac dysrhythmias. The nurse should hold the
medication and notify the provider because continuing furosemide would
worsen hypokalemia. Potassium supplementation requires a prescription,
and dietary measures alone are insufficient for correcting moderate
hypokalemia.
Question 2: A nurse is assessing a client who is receiving a blood
transfusion. The client develops fever, chills, flank pain, and
nausea. Which of the following actions should the nurse take first?
A. Slow the transfusion rate and reassess in 15 minutes
B. Stop the transfusion immediately and maintain IV access with normal
saline
C. Administer prescribed acetaminophen for fever
D. Obtain a urine specimen for hemoglobinuria
CORRECT ANSWER: B. Stop the transfusion immediately and
maintain IV access with normal saline
,Rationale: These findings suggest an acute hemolytic transfusion reaction.
The first priority is to stop the transfusion immediately to prevent further
infusion of incompatible blood. IV access should be maintained with new
tubing and normal saline to support renal perfusion and treat potential
hypotension. Slowing the transfusion does not stop the ongoing reaction.
Question 3: A nurse is caring for a client who has peripheral
arterial disease. Which of the following findings should the nurse
expect?
A. Dependent edema
B. Absent pedal pulses
C. Brown discoloration of the skin
D. Pain relieved by elevation
CORRECT ANSWER: B. Absent pedal pulses
Rationale: Peripheral arterial disease results from inadequate arterial
perfusion to the extremities. Classic findings include diminished or absent
pulses, intermittent claudication, dependent rubor, shiny hairless skin, and
cool extremities. Dependent edema and brown discoloration are associated
with venous insufficiency.
Question 4: A nurse is caring for a client following a cardiac
catheterization via the right femoral artery. Which of the following
findings should the nurse report immediately?
A. Small bruise at the insertion site
B. Pedal pulse +1 on the right foot
C. Warm, dry skin on the right extremity
D. Back pain with a drop in blood pressure
CORRECT ANSWER: D. Back pain with a drop in blood pressure
Rationale: Back pain accompanied by hypotension after femoral cardiac
catheterization may indicate retroperitoneal bleeding, a serious
complication that can lead to hypovolemic shock. A small bruise is an
expected finding. A +1 pedal pulse may be baseline or indicate mild
impairment but is not immediately life-threatening.
Question 5: A nurse is caring for a client who has a new
prescription for sublingual nitroglycerin. Which of the following
client statements indicates an understanding of the teaching?
,A. "I should lie down when I take this medication"
B. "I should take it with a full glass of water"
C. "I should chew the tablet for faster absorption"
D. "I can take it every 10 minutes up to 5 doses"
CORRECT ANSWER: A. "I should lie down when I take this
medication"
Rationale: Sublingual nitroglycerin causes vasodilation and can lead to
hypotension and syncope. Clients should lie down when taking the
medication to prevent falls. The tablet should be placed under the tongue
and allowed to dissolve, not chewed. The standard dosing is every 5
minutes up to 3 doses, not every 10 minutes up to 5 doses.
Question 6: A nurse is evaluating a client who is receiving digoxin
for heart failure. The client reports nausea, vomiting, and blurred
vision with yellow halos. Which of the following actions should the
nurse take first?
A. Check apical pulse and hold medication if less than 60 bpm
B. Administer the next dose as scheduled
C. Administer antiemetics
D. Notify the provider immediately
CORRECT ANSWER: A. Check apical pulse and hold medication if
less than 60 bpm
Rationale: Nausea, vomiting, and visual disturbances such as yellow halos
are classic signs of digoxin toxicity. The nurse should first check the apical
pulse for one full minute and hold the medication if the heart rate is less
than 60 bpm. This is a critical safety action before notifying the provider.
Question 7: A nurse is admitting a client who reports chest pain
and has been placed on a telemetry monitor. Which of the following
should the nurse analyze to determine whether the client is
experiencing a myocardial infarction?
A. PR interval
B. QRS duration
C. T wave
D. ST segment
CORRECT ANSWER: D. ST segment
, Rationale: ST elevation indicates myocardial infarction, while ST depression
indicates ischemia. PR interval relates to first-degree heart block. QRS
duration indicates ventricular conduction delay. T wave changes may
indicate electrolyte imbalances or ischemia but are not diagnostic for
myocardial infarction.
Question 8: A nurse is caring for a client who is receiving a blood
transfusion and develops bounding peripheral pulses,
hypertension, and distended jugular veins. The nurse should
anticipate administering which of the following prescribed
medications?
A. Diphenhydramine
B. Acetaminophen
C. Pantoprazole
D. Furosemide
CORRECT ANSWER: D. Furosemide
Rationale: These findings indicate circulatory overload from the blood
transfusion. Furosemide, a loop diuretic, reduces preload and pulmonary
congestion. Diphenhydramine and acetaminophen are used for allergic
reactions, not fluid overload.
Question 9: A nurse is caring for a client who is experiencing
anxiety with numbness and tingling of the lips and fingers. The
client's ABGs are: pH 7.48, PCO2 30 mm Hg, HCO3- 24 mEq/L,
PaO2 85 mm Hg. Which of the following acid-base imbalances
should the nurse identify?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
CORRECT ANSWER: B. Respiratory alkalosis
Rationale: The pH is alkalotic (elevated), and the PCO2 is decreased,
representing alveolar hyperventilation. The HCO3- is within the expected
range of 21 to 28 mEq/L, ruling out metabolic causes. This is consistent
with hyperventilation due to anxiety.
