ATI RN Adult Medical-Surgical Proctored Exam
Comprehensive actual Exam Questions with Answers
& Detailed Rationales
ATI RN Adult Medical-Surgical Content Areas:
• Cardiovascular
• Respiratory
• Neurological
• Musculoskeletal
• Gastrointestinal
• Renal and Urinary
• Endocrine
• Hematological
• Immune and Infectious Disease
• Integumentary
• Perioperative Care
• Emergency and Disaster Nursing
• Oncology
• Fluid and Electrolyte Balance
Section 1: Cardiovascular (Q1–Q15)
Q1. A nurse is assessing a client with heart failure. Which finding
indicates worsening fluid overload?
,A. Weight loss of 1 kg
B. Crackles in the lung bases
C. Blood pressure 110/70 mm Hg
D. Heart rate 72/min
Answer: B
Rationale: Crackles in the lung bases indicate pulmonary congestion from
fluid overload. Daily weight monitoring is the most reliable indicator of fluid
status—a gain of 1 kg (2.2 lb) in 24 hours indicates fluid retention.
Q2. A client with atrial fibrillation is prescribed warfarin. Which
laboratory value should the nurse monitor?
A. aPTT
B. INR
C. Platelet count
D. Hemoglobin
Answer: B
Rationale: Warfarin therapy is monitored with INR (target 2–3 for atrial
fibrillation). aPTT monitors heparin therapy.
Q3. A nurse is caring for a client who has just returned from cardiac
catheterization. Which finding requires immediate intervention?
A. Small hematoma at the insertion site
B. Blood pressure 90/60 mm Hg with cool, pale extremity
C. Mild discomfort at the site
D. Heart rate 88/min
Answer: B
Rationale: Hypotension with a cool, pale extremity indicates bleeding or
hematoma formation at the catheterization site, possibly leading to
hypovolemic shock. This requires immediate intervention.
,Q4. A client is prescribed metoprolol. Which finding should the nurse
report to the provider before administering?
A. Heart rate 52/min
B. Blood pressure 128/78 mm Hg
C. Respiratory rate 18/min
D. Temperature 37.0°C
Answer: A
Rationale: Metoprolol is a beta-blocker that lowers heart rate. A heart rate
below 60/min may indicate bradycardia, and the medication should be held
and the provider notified.
Q5. A nurse is teaching a client about nitroglycerin sublingual tablets.
Which statement indicates understanding?
A. "I should swallow the tablet with water."
B. "I should call 911 if chest pain persists after 3 tablets."
C. "I can take up to 5 tablets."
D. "I should lie down after taking the tablet."
Answer: B
Rationale: If chest pain persists after 3 sublingual nitroglycerin tablets
(taken 5 minutes apart), the client should call 911. The tablets are placed
under the tongue, not swallowed.
Q6. A client with deep vein thrombosis (DVT) is prescribed heparin.
Which laboratory value should the nurse monitor?
A. INR
B. aPTT
C. Platelet count
D. Hematocrit
Answer: B
Rationale: Heparin therapy is monitored with aPTT (target 1.5–2.5 times
, control). INR monitors warfarin. Platelet count monitors for heparin-induced
thrombocytopenia (HIT).
Q7. A nurse is assessing a client with peripheral arterial disease
(PAD). Which finding is expected?
A. Warm, edematous extremities
B. Intermittent claudication
C. Bilateral pitting edema
D. Improved pulses with elevation
Answer: B
Rationale: PAD causes intermittent claudication (pain with exercise that
resolves with rest), decreased pulses, cool extremities, and pallor with
elevation. Venous insufficiency causes edema and warm extremities.
Q8. A client is prescribed furosemide. Which finding indicates a
therapeutic response?
A. Weight gain of 2 kg
B. Increased urine output and decreased edema
C. Crackles in the lungs
D. Blood pressure 160/90 mm Hg
Answer: B
Rationale: Furosemide is a loop diuretic that promotes diuresis, reducing
edema and fluid overload. Increased urine output and decreased edema
indicate therapeutic response.
Q9. A nurse is caring for a client with an abdominal aortic aneurysm
(AAA). Which finding requires immediate intervention?
A. Mild abdominal discomfort
B. Sudden severe back pain with hypotension
C. Blood pressure 130/80 mm Hg
D. Heart rate 80/min
Comprehensive actual Exam Questions with Answers
& Detailed Rationales
ATI RN Adult Medical-Surgical Content Areas:
• Cardiovascular
• Respiratory
• Neurological
• Musculoskeletal
• Gastrointestinal
• Renal and Urinary
• Endocrine
• Hematological
• Immune and Infectious Disease
• Integumentary
• Perioperative Care
• Emergency and Disaster Nursing
• Oncology
• Fluid and Electrolyte Balance
Section 1: Cardiovascular (Q1–Q15)
Q1. A nurse is assessing a client with heart failure. Which finding
indicates worsening fluid overload?
,A. Weight loss of 1 kg
B. Crackles in the lung bases
C. Blood pressure 110/70 mm Hg
D. Heart rate 72/min
Answer: B
Rationale: Crackles in the lung bases indicate pulmonary congestion from
fluid overload. Daily weight monitoring is the most reliable indicator of fluid
status—a gain of 1 kg (2.2 lb) in 24 hours indicates fluid retention.
Q2. A client with atrial fibrillation is prescribed warfarin. Which
laboratory value should the nurse monitor?
A. aPTT
B. INR
C. Platelet count
D. Hemoglobin
Answer: B
Rationale: Warfarin therapy is monitored with INR (target 2–3 for atrial
fibrillation). aPTT monitors heparin therapy.
Q3. A nurse is caring for a client who has just returned from cardiac
catheterization. Which finding requires immediate intervention?
A. Small hematoma at the insertion site
B. Blood pressure 90/60 mm Hg with cool, pale extremity
C. Mild discomfort at the site
D. Heart rate 88/min
Answer: B
Rationale: Hypotension with a cool, pale extremity indicates bleeding or
hematoma formation at the catheterization site, possibly leading to
hypovolemic shock. This requires immediate intervention.
,Q4. A client is prescribed metoprolol. Which finding should the nurse
report to the provider before administering?
A. Heart rate 52/min
B. Blood pressure 128/78 mm Hg
C. Respiratory rate 18/min
D. Temperature 37.0°C
Answer: A
Rationale: Metoprolol is a beta-blocker that lowers heart rate. A heart rate
below 60/min may indicate bradycardia, and the medication should be held
and the provider notified.
Q5. A nurse is teaching a client about nitroglycerin sublingual tablets.
Which statement indicates understanding?
A. "I should swallow the tablet with water."
B. "I should call 911 if chest pain persists after 3 tablets."
C. "I can take up to 5 tablets."
D. "I should lie down after taking the tablet."
Answer: B
Rationale: If chest pain persists after 3 sublingual nitroglycerin tablets
(taken 5 minutes apart), the client should call 911. The tablets are placed
under the tongue, not swallowed.
Q6. A client with deep vein thrombosis (DVT) is prescribed heparin.
Which laboratory value should the nurse monitor?
A. INR
B. aPTT
C. Platelet count
D. Hematocrit
Answer: B
Rationale: Heparin therapy is monitored with aPTT (target 1.5–2.5 times
, control). INR monitors warfarin. Platelet count monitors for heparin-induced
thrombocytopenia (HIT).
Q7. A nurse is assessing a client with peripheral arterial disease
(PAD). Which finding is expected?
A. Warm, edematous extremities
B. Intermittent claudication
C. Bilateral pitting edema
D. Improved pulses with elevation
Answer: B
Rationale: PAD causes intermittent claudication (pain with exercise that
resolves with rest), decreased pulses, cool extremities, and pallor with
elevation. Venous insufficiency causes edema and warm extremities.
Q8. A client is prescribed furosemide. Which finding indicates a
therapeutic response?
A. Weight gain of 2 kg
B. Increased urine output and decreased edema
C. Crackles in the lungs
D. Blood pressure 160/90 mm Hg
Answer: B
Rationale: Furosemide is a loop diuretic that promotes diuresis, reducing
edema and fluid overload. Increased urine output and decreased edema
indicate therapeutic response.
Q9. A nurse is caring for a client with an abdominal aortic aneurysm
(AAA). Which finding requires immediate intervention?
A. Mild abdominal discomfort
B. Sudden severe back pain with hypotension
C. Blood pressure 130/80 mm Hg
D. Heart rate 80/min
