ATI Adult Medical-Surgical Nursing 200
New Practice Questions with Rationales
Table of Contents
Question
Section Content Area
Numbers
1 Cardiovascular and Hematologic Disorders 1–30
2 Respiratory Disorders and Oxygen Therapy 31–55
3 Neurological Disorders and Patient Safety 56–80
4 Gastrointestinal and Nutritional Disorders 81–105
5 Renal and Urinary System Management 106–130
Endocrine Disorders (Diabetes, Thyroid,
6 131–155
Adrenal)
7 Musculoskeletal Injuries and Rehabilitation 156–180
Perioperative Care and Fluid/Electrolyte
8 181–200
Balance
SECTION 1: CARDIOVASCULAR AND HEMATOLOGIC
DISORDERS (Questions 1–30)
,1. A nurse is caring for a client who reports crushing chest pain
radiating to the left arm. Vital signs are BP 158/94 mm Hg, HR
102/min, RR 22/min, and SpO₂ 94% on room air. Which action
should the nurse take FIRST?
• A) Administer prescribed nitroglycerin sublingually
• B) Obtain a 12-lead ECG
• C) Apply supplemental oxygen at 2 L/min via nasal cannula
• D) Administer prescribed morphine sulfate IV
Rationale: Obtaining a 12-lead ECG is the priority first action
because it rapidly identifies ST-elevation myocardial infarction
(STEMI), which determines the need for emergent reperfusion.
The nurse must obtain the ECG within 10 minutes of symptom
onset. While nitroglycerin, oxygen, and morphine are
appropriate, the ECG guides the entire treatment trajectory.
2. A nurse is caring for a client who has left-sided heart failure.
Which manifestation should the nurse expect?
• A) Pedal edema
• B) Neck vein distention
• C) Daytime oliguria
• D) Enlarged liver
Rationale: Left-sided heart failure causes decreased cardiac
output, leading to decreased renal perfusion and oliguria
during the day when the client is active. Pedal edema, neck vein
distention, and enlarged liver are manifestations of right-sided
heart failure.
,3. Which laboratory value is MOST specific for myocardial
injury?
• A) CK
• B) Troponin
• C) Myoglobin
• D) LDH
Rationale: Troponin is the most specific cardiac marker for
myocardial injury. CK-MB is less specific, myoglobin rises early
but is not cardiac-specific, and LDH is a late and nonspecific
marker.
4. A patient in atrial fibrillation is at risk for:
• A) Hypotension
• B) Clot formation and embolism
• C) Bradycardia
• D) Cardiac tamponade
Rationale: Atrial fibrillation causes blood stasis in the atria,
leading to clot formation and risk of embolism, particularly
stroke. Anticoagulation is indicated based on CHA₂DS₂-VASc
score.
5. A nurse is caring for a client who is postoperative following a
right nephrectomy. The client's initial vital signs were HR
80/min, BP 130/70 mm Hg, RR 16/min, and temperature 36°C
(96.8°F). Which vital sign change should alert the nurse that the
client might be hemorrhaging?
, • A) Heart rate 110/min
• B) Blood pressure 110/60 mm Hg
• C) Respiratory rate 20/min
• D) Temperature 37.2°C (99°F)
Rationale: Tachycardia is an early compensatory sign of
hemorrhage as the body attempts to maintain cardiac output.
Blood pressure may initially remain normal or drop slightly as
compensatory mechanisms engage. The rising heart rate is the
earliest indicator of hypovolemia.
6. A nurse is teaching a client about a low-sodium diet for heart
failure. Which statement by the client indicates correct
understanding?
• A) "I will use salt substitutes containing potassium."
• B) "I will read food labels and choose items with less than
140 mg per serving."
• C) "I will add salt only when cooking, not at the table."
• D) "I will avoid all fluids."
Rationale: A low-sodium diet for heart failure typically restricts
sodium to less than 2,300 mg/day (some guidelines
recommend 1,500 mg/day). Reading labels and choosing low-
sodium items is essential. Salt substitutes containing potassium
may be dangerous if the client is on potassium-sparing
diuretics or has renal impairment. Fluid restriction is only
indicated in specific cases.
New Practice Questions with Rationales
Table of Contents
Question
Section Content Area
Numbers
1 Cardiovascular and Hematologic Disorders 1–30
2 Respiratory Disorders and Oxygen Therapy 31–55
3 Neurological Disorders and Patient Safety 56–80
4 Gastrointestinal and Nutritional Disorders 81–105
5 Renal and Urinary System Management 106–130
Endocrine Disorders (Diabetes, Thyroid,
6 131–155
Adrenal)
7 Musculoskeletal Injuries and Rehabilitation 156–180
Perioperative Care and Fluid/Electrolyte
8 181–200
Balance
SECTION 1: CARDIOVASCULAR AND HEMATOLOGIC
DISORDERS (Questions 1–30)
,1. A nurse is caring for a client who reports crushing chest pain
radiating to the left arm. Vital signs are BP 158/94 mm Hg, HR
102/min, RR 22/min, and SpO₂ 94% on room air. Which action
should the nurse take FIRST?
• A) Administer prescribed nitroglycerin sublingually
• B) Obtain a 12-lead ECG
• C) Apply supplemental oxygen at 2 L/min via nasal cannula
• D) Administer prescribed morphine sulfate IV
Rationale: Obtaining a 12-lead ECG is the priority first action
because it rapidly identifies ST-elevation myocardial infarction
(STEMI), which determines the need for emergent reperfusion.
The nurse must obtain the ECG within 10 minutes of symptom
onset. While nitroglycerin, oxygen, and morphine are
appropriate, the ECG guides the entire treatment trajectory.
2. A nurse is caring for a client who has left-sided heart failure.
Which manifestation should the nurse expect?
• A) Pedal edema
• B) Neck vein distention
• C) Daytime oliguria
• D) Enlarged liver
Rationale: Left-sided heart failure causes decreased cardiac
output, leading to decreased renal perfusion and oliguria
during the day when the client is active. Pedal edema, neck vein
distention, and enlarged liver are manifestations of right-sided
heart failure.
,3. Which laboratory value is MOST specific for myocardial
injury?
• A) CK
• B) Troponin
• C) Myoglobin
• D) LDH
Rationale: Troponin is the most specific cardiac marker for
myocardial injury. CK-MB is less specific, myoglobin rises early
but is not cardiac-specific, and LDH is a late and nonspecific
marker.
4. A patient in atrial fibrillation is at risk for:
• A) Hypotension
• B) Clot formation and embolism
• C) Bradycardia
• D) Cardiac tamponade
Rationale: Atrial fibrillation causes blood stasis in the atria,
leading to clot formation and risk of embolism, particularly
stroke. Anticoagulation is indicated based on CHA₂DS₂-VASc
score.
5. A nurse is caring for a client who is postoperative following a
right nephrectomy. The client's initial vital signs were HR
80/min, BP 130/70 mm Hg, RR 16/min, and temperature 36°C
(96.8°F). Which vital sign change should alert the nurse that the
client might be hemorrhaging?
, • A) Heart rate 110/min
• B) Blood pressure 110/60 mm Hg
• C) Respiratory rate 20/min
• D) Temperature 37.2°C (99°F)
Rationale: Tachycardia is an early compensatory sign of
hemorrhage as the body attempts to maintain cardiac output.
Blood pressure may initially remain normal or drop slightly as
compensatory mechanisms engage. The rising heart rate is the
earliest indicator of hypovolemia.
6. A nurse is teaching a client about a low-sodium diet for heart
failure. Which statement by the client indicates correct
understanding?
• A) "I will use salt substitutes containing potassium."
• B) "I will read food labels and choose items with less than
140 mg per serving."
• C) "I will add salt only when cooking, not at the table."
• D) "I will avoid all fluids."
Rationale: A low-sodium diet for heart failure typically restricts
sodium to less than 2,300 mg/day (some guidelines
recommend 1,500 mg/day). Reading labels and choosing low-
sodium items is essential. Salt substitutes containing potassium
may be dangerous if the client is on potassium-sparing
diuretics or has renal impairment. Fluid restriction is only
indicated in specific cases.
