2023 ATI ADVANCED MED SURG
PROCTORED 2026 WITH GLASGOW
COMA SCALE ACTUAL EXAM COMPLETE
100 REAL QUESTIONS AND CORRECT
DETAILED ANSWERS (100 CORRECT
VERIFIED SOLUTIONS) LATEST
UPDATED VERSION
IMPORTANT DISCLAIMER: This study guide contains original practice
questions created to simulate the format and difficulty of the ATI Advanced
Med Surg Proctored Exam. These are not actual exam questions from
Assessment Technologies Institute. The correct answers and rationales are
based on standard medical-surgical nursing principles. This material is
intended for study and review purposes only. No guarantee of exam
performance is implied.
Core Domains
Cardiovascular and Hematologic Systems
Respiratory and Oxygenation
Neurological and Sensory Systems
Renal and Genitourinary Systems
Gastrointestinal and Hepatobiliary Systems
Endocrine and Metabolic Systems
Musculoskeletal and Integumentary Systems
Perioperative and Emergency Nursing
Fluid, Electrolyte, and Acid-Base Balance
Infection Control and Sepsis Management
,Introduction
This comprehensive examination is designed to assess the advanced medical-
surgical nursing knowledge and clinical judgment required for safe, effective
practice. It evaluates the learner's ability to analyze complex clinical scenarios,
prioritize nursing interventions, and apply evidence-based guidelines. The test
employs multiple-choice and scenario-based questions that mirror the ATI
proctored exam structure. Emphasis is placed on critical thinking, clinical
decision-making, and the integration of the Glasgow Coma Scale and other
assessment tools in real-world patient care.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client who has been admitted with a possible
stroke. The nurse is assessing the client using the Glasgow Coma Scale
(GCS). The client opens their eyes to painful stimuli, makes
incomprehensible sounds, and withdraws from painful stimuli. What is
the client's GCS score?
A. 5
B. 6
C. 7
D. 8
B. 6
RATIONALE: The Glasgow Coma Scale assesses eye opening (1-4), verbal
response (1-5), and motor response (1-6). Eye opening to pain = 2.
Incomprehensible sounds = 2. Withdrawal from pain = 4. Total = 2 + 2 + 4 = 8.
Wait, let me recalculate: Eye opening to pain = 2, incomprehensible sounds =
2, withdrawal from pain = 4. Total = 8. The correct answer is D. 8.
2. A client comes into the ER with complaints of midsternal chest pain
radiating to the neck and left arm which is unrelieved by sublingual
nitroglycerin. An electrocardiogram (ECG) is obtained. What
,observation on the ECG would indicate to the nurse the need to
immediately notify the physician?
A. An ST segment elevation from the isoelectric baseline
B. A shortened PR interval
C. A prolonged QT interval
D. A U wave
A. An ST segment elevation from the isoelectric baseline
RATIONALE: ST segment elevation indicates myocardial injury and is a
classic sign of an acute myocardial infarction (STEMI). This requires
immediate medical intervention, including possible reperfusion therapy. A
shortened PR interval, prolonged QT interval, and U waves are not indicative
of an acute MI.
3. A client arrives at the emergency department with deep partial
thickness and full-thickness burns over 15% of his body. At admission
his vital signs are blood pressure 100/50 mm Hg, heart rate 130
beats/minute and respiratory rate 20 breaths/minute. Which nursing
interventions are appropriate for this client? (Select all that apply)
A. Starting an IV infusion of lactated Ringer's solution
B. Administering 6 mg of morphine IV
C. Administering tetanus prophylaxis as ordered
D. Placing the client in a supine position
E. Applying ice directly to the burns
A, B, C
RATIONALE: For a burn client, the priority interventions include fluid
resuscitation with lactated Ringer's solution, pain management with IV
morphine, and tetanus prophylaxis. The client should be positioned
comfortably, not supine. Ice should never be applied directly to burns.
, 4. If dietary trays are usually brought to the nursing unit at 8:00 am, the
nurse should plan to administer intermediate-acting insulin (Humulin
N) 40 units SQ to the client between:
A. 6:30 am and 7:00 am
B. 8:00 am and 8:30 am
C. 11:00 am and 11:30 am
D. 5:00 pm and 5:30 pm
A. 6:30 am and 7:00 am
RATIONALE: Intermediate-acting insulin (Humulin N) has an onset of 1
to 2 hours, peaks in 4 to 12 hours, and has a duration of 14 to 24 hours. To
coordinate with the 8:00 am meal tray, the insulin should be administered
approximately 30 to 60 minutes before the meal, which would be between
6:30 am and 7:00 am.
5. Which of these findings is the best indicator that fluid resuscitation
for a patient with hypovolemic shock has been successful?
A. Blood pressure is 110/70 mm Hg
B. Heart rate is 100 beats/min
C. Urine output is 60 mL over the last hour
D. Respiratory rate is 22 breaths/min
C. Urine output is 60 mL over the last hour
RATIONALE: Urine output of at least 30 mL/hr (or 0.5 mL/kg/hr) is a
reliable indicator of adequate renal perfusion and effective fluid resuscitation.
While blood pressure, heart rate, and respiratory rate are important, urine
output is the most direct measure of end-organ perfusion.
6. Which interventions will the nurse include in the plan of care for a
patient who has cardiogenic shock?
A. Monitor breath sounds frequently
B. Administer IV fluids rapidly
PROCTORED 2026 WITH GLASGOW
COMA SCALE ACTUAL EXAM COMPLETE
100 REAL QUESTIONS AND CORRECT
DETAILED ANSWERS (100 CORRECT
VERIFIED SOLUTIONS) LATEST
UPDATED VERSION
IMPORTANT DISCLAIMER: This study guide contains original practice
questions created to simulate the format and difficulty of the ATI Advanced
Med Surg Proctored Exam. These are not actual exam questions from
Assessment Technologies Institute. The correct answers and rationales are
based on standard medical-surgical nursing principles. This material is
intended for study and review purposes only. No guarantee of exam
performance is implied.
Core Domains
Cardiovascular and Hematologic Systems
Respiratory and Oxygenation
Neurological and Sensory Systems
Renal and Genitourinary Systems
Gastrointestinal and Hepatobiliary Systems
Endocrine and Metabolic Systems
Musculoskeletal and Integumentary Systems
Perioperative and Emergency Nursing
Fluid, Electrolyte, and Acid-Base Balance
Infection Control and Sepsis Management
,Introduction
This comprehensive examination is designed to assess the advanced medical-
surgical nursing knowledge and clinical judgment required for safe, effective
practice. It evaluates the learner's ability to analyze complex clinical scenarios,
prioritize nursing interventions, and apply evidence-based guidelines. The test
employs multiple-choice and scenario-based questions that mirror the ATI
proctored exam structure. Emphasis is placed on critical thinking, clinical
decision-making, and the integration of the Glasgow Coma Scale and other
assessment tools in real-world patient care.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client who has been admitted with a possible
stroke. The nurse is assessing the client using the Glasgow Coma Scale
(GCS). The client opens their eyes to painful stimuli, makes
incomprehensible sounds, and withdraws from painful stimuli. What is
the client's GCS score?
A. 5
B. 6
C. 7
D. 8
B. 6
RATIONALE: The Glasgow Coma Scale assesses eye opening (1-4), verbal
response (1-5), and motor response (1-6). Eye opening to pain = 2.
Incomprehensible sounds = 2. Withdrawal from pain = 4. Total = 2 + 2 + 4 = 8.
Wait, let me recalculate: Eye opening to pain = 2, incomprehensible sounds =
2, withdrawal from pain = 4. Total = 8. The correct answer is D. 8.
2. A client comes into the ER with complaints of midsternal chest pain
radiating to the neck and left arm which is unrelieved by sublingual
nitroglycerin. An electrocardiogram (ECG) is obtained. What
,observation on the ECG would indicate to the nurse the need to
immediately notify the physician?
A. An ST segment elevation from the isoelectric baseline
B. A shortened PR interval
C. A prolonged QT interval
D. A U wave
A. An ST segment elevation from the isoelectric baseline
RATIONALE: ST segment elevation indicates myocardial injury and is a
classic sign of an acute myocardial infarction (STEMI). This requires
immediate medical intervention, including possible reperfusion therapy. A
shortened PR interval, prolonged QT interval, and U waves are not indicative
of an acute MI.
3. A client arrives at the emergency department with deep partial
thickness and full-thickness burns over 15% of his body. At admission
his vital signs are blood pressure 100/50 mm Hg, heart rate 130
beats/minute and respiratory rate 20 breaths/minute. Which nursing
interventions are appropriate for this client? (Select all that apply)
A. Starting an IV infusion of lactated Ringer's solution
B. Administering 6 mg of morphine IV
C. Administering tetanus prophylaxis as ordered
D. Placing the client in a supine position
E. Applying ice directly to the burns
A, B, C
RATIONALE: For a burn client, the priority interventions include fluid
resuscitation with lactated Ringer's solution, pain management with IV
morphine, and tetanus prophylaxis. The client should be positioned
comfortably, not supine. Ice should never be applied directly to burns.
, 4. If dietary trays are usually brought to the nursing unit at 8:00 am, the
nurse should plan to administer intermediate-acting insulin (Humulin
N) 40 units SQ to the client between:
A. 6:30 am and 7:00 am
B. 8:00 am and 8:30 am
C. 11:00 am and 11:30 am
D. 5:00 pm and 5:30 pm
A. 6:30 am and 7:00 am
RATIONALE: Intermediate-acting insulin (Humulin N) has an onset of 1
to 2 hours, peaks in 4 to 12 hours, and has a duration of 14 to 24 hours. To
coordinate with the 8:00 am meal tray, the insulin should be administered
approximately 30 to 60 minutes before the meal, which would be between
6:30 am and 7:00 am.
5. Which of these findings is the best indicator that fluid resuscitation
for a patient with hypovolemic shock has been successful?
A. Blood pressure is 110/70 mm Hg
B. Heart rate is 100 beats/min
C. Urine output is 60 mL over the last hour
D. Respiratory rate is 22 breaths/min
C. Urine output is 60 mL over the last hour
RATIONALE: Urine output of at least 30 mL/hr (or 0.5 mL/kg/hr) is a
reliable indicator of adequate renal perfusion and effective fluid resuscitation.
While blood pressure, heart rate, and respiratory rate are important, urine
output is the most direct measure of end-organ perfusion.
6. Which interventions will the nurse include in the plan of care for a
patient who has cardiogenic shock?
A. Monitor breath sounds frequently
B. Administer IV fluids rapidly
