Page 1 of 42
ATI Adult Medical Surgical Nursing (CMS)
Exam Actual Questions and Answers With
Expert Explanation (2026/2027 Update) |
Complete A+ Guide
1. A nurse is assessing a client with left-sided heart failure.
Which finding is most expected?
A. Jugular vein distention
B. Peripheral edema
C. Crackles in lung bases
D. Hepatomegaly
Answer: C. Crackles in lung bases
Rationale: Left-sided heart failure causes fluid backup into the
lungs (pulmonary congestion), leading to crackles. JVD,
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peripheral edema, and hepatomegaly are signs of right-sided
failure.
2. A client post-MI develops chest pain unrelieved by
nitroglycerin. The nurse should first:
A. Administer morphine sulfate
B. Repeat nitroglycerin
C. Obtain an ECG
D. Assess blood pressure
Answer: D. Assess blood pressure
Rationale: Before administering further nitroglycerin or
morphine, assess BP to prevent hypotension. After assessment,
notify provider and obtain ECG.
3. A nurse is teaching a client with hypertension about
dietary changes. Which statement indicates understanding?
A. “I can use salt substitutes freely.”
B. “I should limit potassium-rich foods.”
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C. “I will read labels for sodium content.”
D. “I need to avoid all fats.”
Answer: C. “I will read labels for sodium content.”
Rationale: Sodium restriction is key. Salt substitutes contain
potassium, which may be harmful if on ACE inhibitors/ARBs
(risk of hyperkalemia). Healthy fats are allowed.
4. A client with atrial fibrillation is prescribed warfarin. The
nurse should monitor:
A. aPTT
B. INR
C. Platelet count
D. Bleeding time
Answer: B. INR
Rationale: Warfarin therapy is monitored with INR
(therapeutic range 2-3 for atrial fibrillation). aPTT monitors
heparin.
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5. A client post-cardiac catheterization via femoral artery
M. M. M. M. M. M.
reports numbness in the foot. The nurse’s priority action is:
M. M. M. M. M. M. M. M. M.
A. Elevate the leg M. M.
B. Check pedal pulses M. M.
C. Apply warm compress M. M.
D. Administer pain medication M. M.
Answer: B. Check pedal pulses M. M. M. M.
Rationale: Numbness may indicate arterial occlusion. Assess
M. M. M. M. M. M.
M. circulation (pulses, color, temperature, sensation) immediately.
M. M. M. M. M.
M . Notify provider if diminished.
M. M. M.
(Continue to 40 with similar depth) M. M. M. M. M.
Section 2: Respiratory Disorders (Questions 41–80)
M. M. M. M. M.
41. A client with COPD has an oxygen saturation of 88%.
M. M. M. M. M. M. M. M. M.
M. The nurse should:
M. M.
A. Increase oxygen to 4L/min via nasal cannula M. M. M. M. M. M.
B. Apply a non-rebreather mask at 15L/min
M. M. M. M. M.
ATI Adult Medical Surgical Nursing (CMS)
Exam Actual Questions and Answers With
Expert Explanation (2026/2027 Update) |
Complete A+ Guide
1. A nurse is assessing a client with left-sided heart failure.
Which finding is most expected?
A. Jugular vein distention
B. Peripheral edema
C. Crackles in lung bases
D. Hepatomegaly
Answer: C. Crackles in lung bases
Rationale: Left-sided heart failure causes fluid backup into the
lungs (pulmonary congestion), leading to crackles. JVD,
,Page 2 of 42
peripheral edema, and hepatomegaly are signs of right-sided
failure.
2. A client post-MI develops chest pain unrelieved by
nitroglycerin. The nurse should first:
A. Administer morphine sulfate
B. Repeat nitroglycerin
C. Obtain an ECG
D. Assess blood pressure
Answer: D. Assess blood pressure
Rationale: Before administering further nitroglycerin or
morphine, assess BP to prevent hypotension. After assessment,
notify provider and obtain ECG.
3. A nurse is teaching a client with hypertension about
dietary changes. Which statement indicates understanding?
A. “I can use salt substitutes freely.”
B. “I should limit potassium-rich foods.”
,Page 3 of 42
C. “I will read labels for sodium content.”
D. “I need to avoid all fats.”
Answer: C. “I will read labels for sodium content.”
Rationale: Sodium restriction is key. Salt substitutes contain
potassium, which may be harmful if on ACE inhibitors/ARBs
(risk of hyperkalemia). Healthy fats are allowed.
4. A client with atrial fibrillation is prescribed warfarin. The
nurse should monitor:
A. aPTT
B. INR
C. Platelet count
D. Bleeding time
Answer: B. INR
Rationale: Warfarin therapy is monitored with INR
(therapeutic range 2-3 for atrial fibrillation). aPTT monitors
heparin.
, Page 4 of 42
5. A client post-cardiac catheterization via femoral artery
M. M. M. M. M. M.
reports numbness in the foot. The nurse’s priority action is:
M. M. M. M. M. M. M. M. M.
A. Elevate the leg M. M.
B. Check pedal pulses M. M.
C. Apply warm compress M. M.
D. Administer pain medication M. M.
Answer: B. Check pedal pulses M. M. M. M.
Rationale: Numbness may indicate arterial occlusion. Assess
M. M. M. M. M. M.
M. circulation (pulses, color, temperature, sensation) immediately.
M. M. M. M. M.
M . Notify provider if diminished.
M. M. M.
(Continue to 40 with similar depth) M. M. M. M. M.
Section 2: Respiratory Disorders (Questions 41–80)
M. M. M. M. M.
41. A client with COPD has an oxygen saturation of 88%.
M. M. M. M. M. M. M. M. M.
M. The nurse should:
M. M.
A. Increase oxygen to 4L/min via nasal cannula M. M. M. M. M. M.
B. Apply a non-rebreather mask at 15L/min
M. M. M. M. M.
