ATI ADULT MEDICAL-SURGICAL PROCTORED EXAM
2026/2027 – EXAM QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALE | 2027 Q&A |
INSTANT DOWNLOAD PDF
1. A nurse is assessing an adult client who reports shortness of breath. Which
finding requires the nurse's immediate attention?
A. Respiratory rate of 20/min
B. Oxygen saturation of 94% on room air
C. New-onset confusion and restlessness
D. Productive cough with clear sputum
Rationale: New confusion and restlessness can indicate inadequate oxygenation and early
hypoxia. These neurologic changes require prompt assessment and intervention. The other
findings are not, by themselves, indicators of an immediate respiratory emergency.
2. A client with chronic obstructive pulmonary disease is receiving oxygen therapy.
Which nursing action is appropriate?
A. Titrate oxygen according to the prescribed target saturation and clinical condition
B. Administer oxygen at the highest available flow rate
C. Discontinue oxygen if the respiratory rate decreases
D. Encourage the client to remain supine while receiving oxygen
Rationale: Oxygen should be administered and titrated according to the prescription, target
saturation, and clinical status. Excessive oxygen administration without clinical indication can
be harmful in some clients with chronic respiratory disease.
3. A client with pneumonia has thick respiratory secretions. Which intervention is
most appropriate to help mobilize the secretions?
A. Restrict oral fluids
B. Encourage adequate hydration if not contraindicated
C. Maintain strict bed rest
D. Limit coughing to reduce fatigue
Rationale: Adequate hydration helps thin respiratory secretions, making them easier to
expectorate. Coughing and appropriate activity also support secretion clearance when tolerated.
4. A client with asthma develops wheezing and difficulty breathing shortly after
exposure to a known allergen. Which medication should the nurse expect to
administer for rapid relief?
,A. Montelukast
B. Fluticasone
C. Tiotropium
D. Albuterol
Rationale: Albuterol is a short-acting beta2-adrenergic agonist used for rapid relief of acute
bronchospasm. Inhaled corticosteroids such as fluticasone are controller medications rather
than immediate rescue therapy.
5. A client with chronic obstructive pulmonary disease is learning pursed-lip
breathing. Which instruction should the nurse provide?
A. Inhale through pursed lips and exhale through the nose
B. Take rapid shallow breaths through the mouth
C. Inhale slowly through the nose and exhale slowly through pursed lips
D. Hold the breath for 10 seconds after each inhalation
Rationale: Pursed-lip breathing involves slow inhalation through the nose followed by
controlled exhalation through partially closed lips. This helps prolong exhalation and can
reduce air trapping.
6. A client with heart failure reports increasing shortness of breath and awakens at
night feeling unable to breathe. Which additional finding would the nurse expect?
A. Increased appetite
B. Bibasilar crackles
C. Dry mucous membranes
D. Decreased jugular venous pressure
Rationale: Pulmonary congestion from heart failure can produce crackles and orthopnea or
paroxysmal nocturnal dyspnea. Elevated jugular venous pressure may also occur with fluid
overload.
7. A client with left-sided heart failure suddenly develops severe dyspnea, pink
frothy sputum, and widespread crackles. What is the nurse's priority action?
A. Encourage oral fluids
B. Place the client flat
C. Obtain the client's daily weight
D. Position the client upright and administer oxygen as prescribed
Rationale: The findings are consistent with acute pulmonary edema. Upright positioning reduces
venous return and improves lung expansion, while oxygen supports impaired gas exchange.
8. A client is receiving digoxin for heart failure. Which finding should the nurse
report before administering the medication?
, A. Blood pressure of 128/74 mm Hg
B. Respiratory rate of 18/min
C. Apical pulse of 54/min
D. Oxygen saturation of 96%
Rationale: Digoxin can decrease heart rate. An adult apical pulse below the prescribed safe
threshold, commonly less than 60/min, warrants withholding the medication and notifying the
provider according to the medication order and facility policy.
9. A client with hypertension is prescribed an angiotensin-converting enzyme
inhibitor. Which adverse effect should the nurse teach the client to report?
A. Increased appetite
B. Persistent dry cough
C. Orange-colored urine
D. Increased salivation
Rationale: ACE inhibitors can cause a persistent dry cough because of increased bradykinin.
Angioedema is another serious adverse effect requiring immediate attention.
10. A client with chest pain has a prescription for sublingual nitroglycerin. Which
statement indicates correct understanding?
A. “I should swallow the tablet with water.”
B. “I should take all prescribed tablets at the same time.”
C. “I should sit or lie down before taking the medication.”
D. “I should store the tablets in an open container.”
Rationale: Nitroglycerin can cause hypotension and dizziness. Sitting or lying down reduces the
risk of injury from syncope. Sublingual tablets should be allowed to dissolve under the tongue
rather than swallowed.
11. A client arrives in the emergency department with crushing substernal chest pain
and diaphoresis. Which action should the nurse prioritize?
A. Encourage ambulation
B. Obtain a rapid cardiac assessment, including a 12-lead ECG
C. Provide a high-fat meal
D. Delay assessment until the pain resolves
Rationale: Acute coronary syndrome requires rapid identification and treatment. A 12-lead ECG
is an essential early assessment for suspected myocardial ischemia or infarction.
12. A client recovering from a myocardial infarction asks why cardiac rehabilitation is
recommended. Which response is appropriate?
2026/2027 – EXAM QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALE | 2027 Q&A |
INSTANT DOWNLOAD PDF
1. A nurse is assessing an adult client who reports shortness of breath. Which
finding requires the nurse's immediate attention?
A. Respiratory rate of 20/min
B. Oxygen saturation of 94% on room air
C. New-onset confusion and restlessness
D. Productive cough with clear sputum
Rationale: New confusion and restlessness can indicate inadequate oxygenation and early
hypoxia. These neurologic changes require prompt assessment and intervention. The other
findings are not, by themselves, indicators of an immediate respiratory emergency.
2. A client with chronic obstructive pulmonary disease is receiving oxygen therapy.
Which nursing action is appropriate?
A. Titrate oxygen according to the prescribed target saturation and clinical condition
B. Administer oxygen at the highest available flow rate
C. Discontinue oxygen if the respiratory rate decreases
D. Encourage the client to remain supine while receiving oxygen
Rationale: Oxygen should be administered and titrated according to the prescription, target
saturation, and clinical status. Excessive oxygen administration without clinical indication can
be harmful in some clients with chronic respiratory disease.
3. A client with pneumonia has thick respiratory secretions. Which intervention is
most appropriate to help mobilize the secretions?
A. Restrict oral fluids
B. Encourage adequate hydration if not contraindicated
C. Maintain strict bed rest
D. Limit coughing to reduce fatigue
Rationale: Adequate hydration helps thin respiratory secretions, making them easier to
expectorate. Coughing and appropriate activity also support secretion clearance when tolerated.
4. A client with asthma develops wheezing and difficulty breathing shortly after
exposure to a known allergen. Which medication should the nurse expect to
administer for rapid relief?
,A. Montelukast
B. Fluticasone
C. Tiotropium
D. Albuterol
Rationale: Albuterol is a short-acting beta2-adrenergic agonist used for rapid relief of acute
bronchospasm. Inhaled corticosteroids such as fluticasone are controller medications rather
than immediate rescue therapy.
5. A client with chronic obstructive pulmonary disease is learning pursed-lip
breathing. Which instruction should the nurse provide?
A. Inhale through pursed lips and exhale through the nose
B. Take rapid shallow breaths through the mouth
C. Inhale slowly through the nose and exhale slowly through pursed lips
D. Hold the breath for 10 seconds after each inhalation
Rationale: Pursed-lip breathing involves slow inhalation through the nose followed by
controlled exhalation through partially closed lips. This helps prolong exhalation and can
reduce air trapping.
6. A client with heart failure reports increasing shortness of breath and awakens at
night feeling unable to breathe. Which additional finding would the nurse expect?
A. Increased appetite
B. Bibasilar crackles
C. Dry mucous membranes
D. Decreased jugular venous pressure
Rationale: Pulmonary congestion from heart failure can produce crackles and orthopnea or
paroxysmal nocturnal dyspnea. Elevated jugular venous pressure may also occur with fluid
overload.
7. A client with left-sided heart failure suddenly develops severe dyspnea, pink
frothy sputum, and widespread crackles. What is the nurse's priority action?
A. Encourage oral fluids
B. Place the client flat
C. Obtain the client's daily weight
D. Position the client upright and administer oxygen as prescribed
Rationale: The findings are consistent with acute pulmonary edema. Upright positioning reduces
venous return and improves lung expansion, while oxygen supports impaired gas exchange.
8. A client is receiving digoxin for heart failure. Which finding should the nurse
report before administering the medication?
, A. Blood pressure of 128/74 mm Hg
B. Respiratory rate of 18/min
C. Apical pulse of 54/min
D. Oxygen saturation of 96%
Rationale: Digoxin can decrease heart rate. An adult apical pulse below the prescribed safe
threshold, commonly less than 60/min, warrants withholding the medication and notifying the
provider according to the medication order and facility policy.
9. A client with hypertension is prescribed an angiotensin-converting enzyme
inhibitor. Which adverse effect should the nurse teach the client to report?
A. Increased appetite
B. Persistent dry cough
C. Orange-colored urine
D. Increased salivation
Rationale: ACE inhibitors can cause a persistent dry cough because of increased bradykinin.
Angioedema is another serious adverse effect requiring immediate attention.
10. A client with chest pain has a prescription for sublingual nitroglycerin. Which
statement indicates correct understanding?
A. “I should swallow the tablet with water.”
B. “I should take all prescribed tablets at the same time.”
C. “I should sit or lie down before taking the medication.”
D. “I should store the tablets in an open container.”
Rationale: Nitroglycerin can cause hypotension and dizziness. Sitting or lying down reduces the
risk of injury from syncope. Sublingual tablets should be allowed to dissolve under the tongue
rather than swallowed.
11. A client arrives in the emergency department with crushing substernal chest pain
and diaphoresis. Which action should the nurse prioritize?
A. Encourage ambulation
B. Obtain a rapid cardiac assessment, including a 12-lead ECG
C. Provide a high-fat meal
D. Delay assessment until the pain resolves
Rationale: Acute coronary syndrome requires rapid identification and treatment. A 12-lead ECG
is an essential early assessment for suspected myocardial ischemia or infarction.
12. A client recovering from a myocardial infarction asks why cardiac rehabilitation is
recommended. Which response is appropriate?
