ATI RN Adult Medical-Surgical 2026/2027
Proctored Exam Study Guide | Level 3 NGN
Questions & Answers Bundle
Question 1
A nurse is caring for a client who has heart failure and reports increasing shortness
of breath. Which finding should the nurse recognize as an indication of worsening
fluid overload?
A. Dry mucous membranes
B. Weight loss of 1 kg (2.2 lb)
C. Bilateral crackles in the lung bases
D. Decreased jugular venous pressure
Answer: _C. Bilateral crackles in the lung bases_
Rationale: Bilateral crackles can indicate pulmonary congestion caused by excess
fluid volume, a common manifestation of worsening heart failure.
Question 2
A nurse is assessing a client who has chronic obstructive pulmonary disease
(COPD). Which finding should the nurse expect?
A. Bradycardia
B. Barrel-shaped chest
C. Increased vital capacity
D. Respiratory alkalosis
Answer: _B. Barrel-shaped chest_
Rationale: Chronic hyperinflation associated with COPD can cause an increased
anterior-posterior chest diameter, producing a barrel-shaped appearance.
Question 3
,A nurse is caring for a client who has diabetes mellitus and is receiving insulin.
Which finding is most indicative of hypoglycemia?
A. Polyuria
B. Warm, dry skin
C. Tremors and diaphoresis
D. Fruity breath odor
Answer: _C. Tremors and diaphoresis_
Rationale: Adrenergic manifestations of hypoglycemia include tremors, sweating,
palpitations, anxiety, and tachycardia. Immediate treatment with an appropriate
source of glucose is indicated.
Question 4
A client who is receiving warfarin asks the nurse which food should be consumed
consistently rather than avoided completely. Which food should the nurse identify?
A. Spinach
B. White rice
C. Apples
D. Chicken
Answer: _A. Spinach_
Rationale: Spinach contains a high amount of vitamin K, which can decrease the
effectiveness of warfarin. Clients should maintain a consistent intake of vitamin K
rather than making major changes in consumption.
Question 5
A nurse is caring for a client who has a potassium level of 2.9 mEq/L (2.9
mmol/L). Which finding should the nurse expect?
A. Muscle weakness
B. Hyperactive reflexes
C. Peaked T waves
D. Facial twitching
Answer: _A. Muscle weakness_
,Rationale: Hypokalemia can cause muscle weakness, fatigue, constipation, and
cardiac dysrhythmias. ECG changes can include flattened T waves and prominent
U waves.
Question 6
A nurse is assessing a client who has a suspected stroke. Which finding requires
immediate intervention?
A. Difficulty finding words
B. Facial drooping
C. Sudden unilateral weakness
D. Decreased level of consciousness
Answer: _D. Decreased level of consciousness_
Rationale: A decreased level of consciousness can indicate increased intracranial
pressure or deterioration in neurologic status and requires immediate assessment
and intervention.
Question 7
A nurse is teaching a client who has gastroesophageal reflux disease (GERD).
Which statement indicates an understanding of the teaching?
A. “I will lie down immediately after meals.”
B. “I will eat large meals before bedtime.”
C. “I will avoid foods that trigger my symptoms.”
D. “I will drink peppermint tea whenever I have reflux.”
Answer: _C. “I will avoid foods that trigger my symptoms.”_**
Rationale: Clients with GERD should identify and avoid individual trigger foods
and beverages. They should also avoid lying down shortly after eating and should
consider smaller meals.
Question 8
A nurse is caring for a client who has chronic kidney disease. Which laboratory
value should the nurse expect to be elevated?
, A. Hemoglobin
B. Serum creatinine
C. Serum calcium
D. Hematocrit
Answer: _B. Serum creatinine_
Rationale: Reduced kidney function decreases the ability to excrete creatinine,
resulting in an elevated serum creatinine level.
Question 9
A nurse is caring for a client who has pneumonia. Which intervention should the
nurse implement to promote respiratory function?
A. Encourage incentive spirometry
B. Restrict all oral fluids
C. Maintain strict bed rest
D. Place the client in a supine position
Answer: _A. Encourage incentive spirometry_
Rationale: Incentive spirometry promotes lung expansion and helps prevent
atelectasis. Positioning the client upright and encouraging coughing and deep
breathing can also improve ventilation.
Question 10
A nurse is assessing a client who has an intestinal obstruction. Which finding
should the nurse anticipate?
A. Absent or high-pitched bowel sounds
B. Increased appetite
C. Frequent formed stools
D. Bradycardia with hypotension only
Answer: _A. Absent or high-pitched bowel sounds_
Rationale: Mechanical intestinal obstruction can initially produce high-pitched,
tinkling bowel sounds as the intestine attempts to move contents past the
obstruction. Bowel sounds can become absent as the condition progresses.
Proctored Exam Study Guide | Level 3 NGN
Questions & Answers Bundle
Question 1
A nurse is caring for a client who has heart failure and reports increasing shortness
of breath. Which finding should the nurse recognize as an indication of worsening
fluid overload?
A. Dry mucous membranes
B. Weight loss of 1 kg (2.2 lb)
C. Bilateral crackles in the lung bases
D. Decreased jugular venous pressure
Answer: _C. Bilateral crackles in the lung bases_
Rationale: Bilateral crackles can indicate pulmonary congestion caused by excess
fluid volume, a common manifestation of worsening heart failure.
Question 2
A nurse is assessing a client who has chronic obstructive pulmonary disease
(COPD). Which finding should the nurse expect?
A. Bradycardia
B. Barrel-shaped chest
C. Increased vital capacity
D. Respiratory alkalosis
Answer: _B. Barrel-shaped chest_
Rationale: Chronic hyperinflation associated with COPD can cause an increased
anterior-posterior chest diameter, producing a barrel-shaped appearance.
Question 3
,A nurse is caring for a client who has diabetes mellitus and is receiving insulin.
Which finding is most indicative of hypoglycemia?
A. Polyuria
B. Warm, dry skin
C. Tremors and diaphoresis
D. Fruity breath odor
Answer: _C. Tremors and diaphoresis_
Rationale: Adrenergic manifestations of hypoglycemia include tremors, sweating,
palpitations, anxiety, and tachycardia. Immediate treatment with an appropriate
source of glucose is indicated.
Question 4
A client who is receiving warfarin asks the nurse which food should be consumed
consistently rather than avoided completely. Which food should the nurse identify?
A. Spinach
B. White rice
C. Apples
D. Chicken
Answer: _A. Spinach_
Rationale: Spinach contains a high amount of vitamin K, which can decrease the
effectiveness of warfarin. Clients should maintain a consistent intake of vitamin K
rather than making major changes in consumption.
Question 5
A nurse is caring for a client who has a potassium level of 2.9 mEq/L (2.9
mmol/L). Which finding should the nurse expect?
A. Muscle weakness
B. Hyperactive reflexes
C. Peaked T waves
D. Facial twitching
Answer: _A. Muscle weakness_
,Rationale: Hypokalemia can cause muscle weakness, fatigue, constipation, and
cardiac dysrhythmias. ECG changes can include flattened T waves and prominent
U waves.
Question 6
A nurse is assessing a client who has a suspected stroke. Which finding requires
immediate intervention?
A. Difficulty finding words
B. Facial drooping
C. Sudden unilateral weakness
D. Decreased level of consciousness
Answer: _D. Decreased level of consciousness_
Rationale: A decreased level of consciousness can indicate increased intracranial
pressure or deterioration in neurologic status and requires immediate assessment
and intervention.
Question 7
A nurse is teaching a client who has gastroesophageal reflux disease (GERD).
Which statement indicates an understanding of the teaching?
A. “I will lie down immediately after meals.”
B. “I will eat large meals before bedtime.”
C. “I will avoid foods that trigger my symptoms.”
D. “I will drink peppermint tea whenever I have reflux.”
Answer: _C. “I will avoid foods that trigger my symptoms.”_**
Rationale: Clients with GERD should identify and avoid individual trigger foods
and beverages. They should also avoid lying down shortly after eating and should
consider smaller meals.
Question 8
A nurse is caring for a client who has chronic kidney disease. Which laboratory
value should the nurse expect to be elevated?
, A. Hemoglobin
B. Serum creatinine
C. Serum calcium
D. Hematocrit
Answer: _B. Serum creatinine_
Rationale: Reduced kidney function decreases the ability to excrete creatinine,
resulting in an elevated serum creatinine level.
Question 9
A nurse is caring for a client who has pneumonia. Which intervention should the
nurse implement to promote respiratory function?
A. Encourage incentive spirometry
B. Restrict all oral fluids
C. Maintain strict bed rest
D. Place the client in a supine position
Answer: _A. Encourage incentive spirometry_
Rationale: Incentive spirometry promotes lung expansion and helps prevent
atelectasis. Positioning the client upright and encouraging coughing and deep
breathing can also improve ventilation.
Question 10
A nurse is assessing a client who has an intestinal obstruction. Which finding
should the nurse anticipate?
A. Absent or high-pitched bowel sounds
B. Increased appetite
C. Frequent formed stools
D. Bradycardia with hypotension only
Answer: _A. Absent or high-pitched bowel sounds_
Rationale: Mechanical intestinal obstruction can initially produce high-pitched,
tinkling bowel sounds as the intestine attempts to move contents past the
obstruction. Bowel sounds can become absent as the condition progresses.
