ATI RN Capstone Adult Medical-Surgical 1
Comprehensive Questions with Answers & Detailed
Rationales
ATI RN Capstone Adult Medical-Surgical 1 Content Areas:
• Cardiovascular Disorders
• Respiratory Disorders
• Gastrointestinal Disorders
• Renal & Urinary Disorders
• Neurological Disorders
• Musculoskeletal Disorders
• Endocrine Disorders
• Hematologic Disorders
• Immunologic Disorders
• Integumentary Disorders
• Perioperative Care
• Emergency & Disaster Nursing
• Oncology
• Fluid & Electrolyte Balance
• Acid-Base Balance
Section 1: Cardiovascular Disorders (Q1–Q20)
Q1. A nurse is assessing a client admitted with acute decompensated
heart failure. Which finding indicates left-sided heart failure?
,A. Ascites and right upper quadrant tenderness
B. Jugular venous distention and hepatojugular reflux
C. Dependent bilateral edema of the lower extremities
D. Bilateral crackles in the lung bases and dyspnea on exertion
Answer: D
Rationale: Left-sided heart failure causes blood to back up into the
pulmonary circulation, producing pulmonary congestion manifested by
crackles, dyspnea, orthopnea, and cough with frothy sputum. The other
options describe right-sided failure findings, where blood backs up into the
systemic circulation, causing jugular venous distention, dependent edema,
ascites, and hepatomegaly. Recognizing the difference guides the nurse in
monitoring for pulmonary edema, the most urgent complication of left-sided
failure.
Q2. A client with heart failure is receiving digoxin. Which finding
indicates digoxin toxicity?
A. Heart rate of 62 bpm
B. Blood pressure of 118/76 mm Hg
C. Nausea and yellow-tinged vision
D. Urine output of 50 mL/hour
Answer: C
Rationale: Classic signs of digoxin toxicity include GI symptoms (nausea,
vomiting, anorexia) and visual disturbances (yellow-green halos, blurred
vision). Bradycardia and cardiac dysrhythmias may also occur.
Hypokalemia increases toxicity risk. The other options are within normal
limits or expected findings.
Q3. A client with a new prescription for sublingual nitroglycerin
indicates understanding by stating:
A. "I should take this medication while standing."
B. "I should lie down when I take this medication."
C. "I should discontinue this medication if I develop a headache."
,D. "I can take up to 5 tablets in 15 minutes before seeking medical
attention."
Answer: B
Rationale: Sublingual nitroglycerin can cause hypotension; the client
should lie down to minimize fall risk. Headache is an expected side effect
and does not indicate the need to discontinue the medication. The client
should call 911 if chest pain persists after 3 tablets taken 5 minutes apart.
Q4. A nurse is caring for a client who was admitted 4 hours ago with
acute decompensated heart failure and is receiving dobutamine and
furosemide. Which assessment finding requires immediate
intervention?
A. Heart rate increase from 88 to 102 bpm
B. Urine output of 180 mL over the past 4 hours
C. Blood pressure decrease from 142/88 to 108/64 mm Hg
D. Crackles in bilateral lung bases
Answer: C
Rationale: A systolic BP below 110 mm Hg in a client receiving dobutamine
suggests inadequate perfusion and potential cardiogenic shock. In ADHF,
maintaining adequate perfusion pressure is critical for end-organ function,
and this finding requires immediate intervention. Dobutamine can cause
hypotension due to beta-2 mediated vasodilation. The other findings are
expected or within acceptable range.
Q5. A nurse is teaching a client who had a myocardial infarction about
discharge instructions. Which statement indicates understanding?
A. "I should take nitroglycerin daily to prevent chest pain."
B. "I should avoid sexual activity for at least 6 months."
C. "I should report any chest pain not relieved by rest or nitroglycerin."
D. "I should stop taking aspirin once I feel better."
, Answer: C
Rationale: Chest pain unrelieved by rest or nitroglycerin could indicate
reinfarction and requires immediate medical attention. Aspirin should be
taken daily as prescribed to reduce platelet aggregation. Nitroglycerin is for
acute angina, not daily prophylaxis. Sexual activity can typically resume
within 2–6 weeks depending on the client's condition and provider
guidance.
Q6. 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.
Q7. 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
Answer: B
Rationale: Sudden severe back pain with hypotension indicates AAA
rupture, a life-threatening emergency requiring immediate surgical
intervention.
Comprehensive Questions with Answers & Detailed
Rationales
ATI RN Capstone Adult Medical-Surgical 1 Content Areas:
• Cardiovascular Disorders
• Respiratory Disorders
• Gastrointestinal Disorders
• Renal & Urinary Disorders
• Neurological Disorders
• Musculoskeletal Disorders
• Endocrine Disorders
• Hematologic Disorders
• Immunologic Disorders
• Integumentary Disorders
• Perioperative Care
• Emergency & Disaster Nursing
• Oncology
• Fluid & Electrolyte Balance
• Acid-Base Balance
Section 1: Cardiovascular Disorders (Q1–Q20)
Q1. A nurse is assessing a client admitted with acute decompensated
heart failure. Which finding indicates left-sided heart failure?
,A. Ascites and right upper quadrant tenderness
B. Jugular venous distention and hepatojugular reflux
C. Dependent bilateral edema of the lower extremities
D. Bilateral crackles in the lung bases and dyspnea on exertion
Answer: D
Rationale: Left-sided heart failure causes blood to back up into the
pulmonary circulation, producing pulmonary congestion manifested by
crackles, dyspnea, orthopnea, and cough with frothy sputum. The other
options describe right-sided failure findings, where blood backs up into the
systemic circulation, causing jugular venous distention, dependent edema,
ascites, and hepatomegaly. Recognizing the difference guides the nurse in
monitoring for pulmonary edema, the most urgent complication of left-sided
failure.
Q2. A client with heart failure is receiving digoxin. Which finding
indicates digoxin toxicity?
A. Heart rate of 62 bpm
B. Blood pressure of 118/76 mm Hg
C. Nausea and yellow-tinged vision
D. Urine output of 50 mL/hour
Answer: C
Rationale: Classic signs of digoxin toxicity include GI symptoms (nausea,
vomiting, anorexia) and visual disturbances (yellow-green halos, blurred
vision). Bradycardia and cardiac dysrhythmias may also occur.
Hypokalemia increases toxicity risk. The other options are within normal
limits or expected findings.
Q3. A client with a new prescription for sublingual nitroglycerin
indicates understanding by stating:
A. "I should take this medication while standing."
B. "I should lie down when I take this medication."
C. "I should discontinue this medication if I develop a headache."
,D. "I can take up to 5 tablets in 15 minutes before seeking medical
attention."
Answer: B
Rationale: Sublingual nitroglycerin can cause hypotension; the client
should lie down to minimize fall risk. Headache is an expected side effect
and does not indicate the need to discontinue the medication. The client
should call 911 if chest pain persists after 3 tablets taken 5 minutes apart.
Q4. A nurse is caring for a client who was admitted 4 hours ago with
acute decompensated heart failure and is receiving dobutamine and
furosemide. Which assessment finding requires immediate
intervention?
A. Heart rate increase from 88 to 102 bpm
B. Urine output of 180 mL over the past 4 hours
C. Blood pressure decrease from 142/88 to 108/64 mm Hg
D. Crackles in bilateral lung bases
Answer: C
Rationale: A systolic BP below 110 mm Hg in a client receiving dobutamine
suggests inadequate perfusion and potential cardiogenic shock. In ADHF,
maintaining adequate perfusion pressure is critical for end-organ function,
and this finding requires immediate intervention. Dobutamine can cause
hypotension due to beta-2 mediated vasodilation. The other findings are
expected or within acceptable range.
Q5. A nurse is teaching a client who had a myocardial infarction about
discharge instructions. Which statement indicates understanding?
A. "I should take nitroglycerin daily to prevent chest pain."
B. "I should avoid sexual activity for at least 6 months."
C. "I should report any chest pain not relieved by rest or nitroglycerin."
D. "I should stop taking aspirin once I feel better."
, Answer: C
Rationale: Chest pain unrelieved by rest or nitroglycerin could indicate
reinfarction and requires immediate medical attention. Aspirin should be
taken daily as prescribed to reduce platelet aggregation. Nitroglycerin is for
acute angina, not daily prophylaxis. Sexual activity can typically resume
within 2–6 weeks depending on the client's condition and provider
guidance.
Q6. 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.
Q7. 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
Answer: B
Rationale: Sudden severe back pain with hypotension indicates AAA
rupture, a life-threatening emergency requiring immediate surgical
intervention.
