ATI PN ADULT MEDICAL-SURGICAL
CMS EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF.
Core Domains
• Respiratory System Disorders
• Cardiovascular and Hematologic Disorders
• Neurological Disorders
• Renal and Urinary Disorders
• Gastrointestinal Disorders
• Endocrine and Metabolic Disorders
• Musculoskeletal Disorders
• Perioperative Nursing and Emergency Care
Introduction
The ATI PN Adult Medical-Surgical CMS Exam assesses the
knowledge and clinical judgment required for safe, effective
practical nursing care of adult clients with acute and chronic
health conditions. The examination evaluates respiratory,
cardiovascular, neurological, renal, gastrointestinal, endocrine,
musculoskeletal, and perioperative nursing concepts. Questions
incorporate multiple-choice and Next Generation NCLEX (NGN)
,formats emphasizing prioritization, clinical decision-making, and
evidence-based interventions. Candidates must demonstrate
competency in pathophysiology, medication administration,
patient safety, and therapeutic communication within the LPN/LVN
scope of practice. The assessment underscores critical thinking,
collaboration, and ethical practice in adult medical-surgical
nursing.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client with COPD who is receiving
2 L/min of oxygen via nasal cannula. The client reports
increased dyspnea. Which of the following actions should
the nurse take first?
A. Increase the oxygen flow rate to 4 L/min to relieve dyspnea
B. Obtain a pulse oximetry reading to assess oxygen saturation
C. Assess the client's respiratory rate, depth, and pattern
D. Instruct the client to purse-lip breathe and use diaphragmatic
breathing
C. Assess the client's respiratory rate, depth, and pattern
RATIONALE: The nurse should first assess the client's
respiratory status before making any changes to the oxygen
therapy. Clients with COPD rely on a hypoxic drive to breathe;
increasing oxygen flow rate can suppress ventilation and cause
respiratory acidosis .
2. A nurse is teaching a client with asthma about the
proper use of a metered-dose inhaler (MDI) with a spacer.
Which of the following statements by the client indicates
an understanding of the teaching?
,A. "I will shake the inhaler, attach the spacer, exhale fully, then
inhale slowly and deeply."
B. "I will take two quick breaths after pressing the inhaler to get
the full dose."
C. "I will hold my breath for 5 seconds after inhaling the
medication."
D. "I will rinse my mouth with water before using the inhaler to
moisten my airway."
A. "I will shake the inhaler, attach the spacer, exhale fully,
then inhale slowly and deeply."
RATIONALE: Correct technique for MDI use with a spacer
includes shaking the inhaler, attaching the spacer, exhaling fully,
pressing the inhaler, and inhaling slowly and deeply. The client
should hold their breath for 10 seconds (not 5) to allow
medication deposition .
3. A nurse is reviewing the arterial blood gas (ABG) results
of a client with pneumonia: pH 7.30, PaCO2 50 mm Hg,
HCO3- 24 mEq/L. The nurse should interpret these
findings as which of the following?
A. Respiratory alkalosis with partial compensation
B. Respiratory acidosis without compensation
C. Metabolic acidosis with respiratory compensation
D. Metabolic alkalosis without compensation
B. Respiratory acidosis without compensation
RATIONALE: The pH of 7.30 indicates acidosis. The elevated
PaCO2 of 50 mm Hg indicates a respiratory origin. The normal
HCO3- indicates the kidneys have not yet compensated. This is
uncompensated respiratory acidosis, commonly seen in
pneumonia due to alveolar hypoventilation .
, 4. A client who is postoperative following a total knee
replacement develops sudden onset dyspnea, chest pain,
and tachycardia. Which of the following actions should the
nurse take first?
A. Administer prescribed pain medication to relieve chest
discomfort
B. Elevate the client's legs to promote venous return
C. Apply oxygen and notify the provider immediately
D. Encourage the client to cough and deep breathe
C. Apply oxygen and notify the provider immediately
RATIONALE: The client exhibits signs of pulmonary embolism,
a life-threatening complication after orthopedic surgery. Applying
oxygen addresses hypoxemia and provider notification is the
immediate priority .
5. A nurse is admitting a client who reports chest pain and
has been placed on telemetry. Which finding should the
nurse analyze to determine myocardial infarction?
A. PR interval
B. QRS duration
C. T wave
D. ST segment
D. ST segment
RATIONALE: ST elevation indicates myocardial infarction; ST
depression indicates ischemia. PR interval relates to first-degree
heart block; QRS duration indicates ventricular conduction delay.
6. A nurse is caring for a client receiving a blood
transfusion who develops bounding peripheral pulses,
hypertension, and distended jugular veins. Which
complication should the nurse suspect?
CMS EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF.
Core Domains
• Respiratory System Disorders
• Cardiovascular and Hematologic Disorders
• Neurological Disorders
• Renal and Urinary Disorders
• Gastrointestinal Disorders
• Endocrine and Metabolic Disorders
• Musculoskeletal Disorders
• Perioperative Nursing and Emergency Care
Introduction
The ATI PN Adult Medical-Surgical CMS Exam assesses the
knowledge and clinical judgment required for safe, effective
practical nursing care of adult clients with acute and chronic
health conditions. The examination evaluates respiratory,
cardiovascular, neurological, renal, gastrointestinal, endocrine,
musculoskeletal, and perioperative nursing concepts. Questions
incorporate multiple-choice and Next Generation NCLEX (NGN)
,formats emphasizing prioritization, clinical decision-making, and
evidence-based interventions. Candidates must demonstrate
competency in pathophysiology, medication administration,
patient safety, and therapeutic communication within the LPN/LVN
scope of practice. The assessment underscores critical thinking,
collaboration, and ethical practice in adult medical-surgical
nursing.
SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client with COPD who is receiving
2 L/min of oxygen via nasal cannula. The client reports
increased dyspnea. Which of the following actions should
the nurse take first?
A. Increase the oxygen flow rate to 4 L/min to relieve dyspnea
B. Obtain a pulse oximetry reading to assess oxygen saturation
C. Assess the client's respiratory rate, depth, and pattern
D. Instruct the client to purse-lip breathe and use diaphragmatic
breathing
C. Assess the client's respiratory rate, depth, and pattern
RATIONALE: The nurse should first assess the client's
respiratory status before making any changes to the oxygen
therapy. Clients with COPD rely on a hypoxic drive to breathe;
increasing oxygen flow rate can suppress ventilation and cause
respiratory acidosis .
2. A nurse is teaching a client with asthma about the
proper use of a metered-dose inhaler (MDI) with a spacer.
Which of the following statements by the client indicates
an understanding of the teaching?
,A. "I will shake the inhaler, attach the spacer, exhale fully, then
inhale slowly and deeply."
B. "I will take two quick breaths after pressing the inhaler to get
the full dose."
C. "I will hold my breath for 5 seconds after inhaling the
medication."
D. "I will rinse my mouth with water before using the inhaler to
moisten my airway."
A. "I will shake the inhaler, attach the spacer, exhale fully,
then inhale slowly and deeply."
RATIONALE: Correct technique for MDI use with a spacer
includes shaking the inhaler, attaching the spacer, exhaling fully,
pressing the inhaler, and inhaling slowly and deeply. The client
should hold their breath for 10 seconds (not 5) to allow
medication deposition .
3. A nurse is reviewing the arterial blood gas (ABG) results
of a client with pneumonia: pH 7.30, PaCO2 50 mm Hg,
HCO3- 24 mEq/L. The nurse should interpret these
findings as which of the following?
A. Respiratory alkalosis with partial compensation
B. Respiratory acidosis without compensation
C. Metabolic acidosis with respiratory compensation
D. Metabolic alkalosis without compensation
B. Respiratory acidosis without compensation
RATIONALE: The pH of 7.30 indicates acidosis. The elevated
PaCO2 of 50 mm Hg indicates a respiratory origin. The normal
HCO3- indicates the kidneys have not yet compensated. This is
uncompensated respiratory acidosis, commonly seen in
pneumonia due to alveolar hypoventilation .
, 4. A client who is postoperative following a total knee
replacement develops sudden onset dyspnea, chest pain,
and tachycardia. Which of the following actions should the
nurse take first?
A. Administer prescribed pain medication to relieve chest
discomfort
B. Elevate the client's legs to promote venous return
C. Apply oxygen and notify the provider immediately
D. Encourage the client to cough and deep breathe
C. Apply oxygen and notify the provider immediately
RATIONALE: The client exhibits signs of pulmonary embolism,
a life-threatening complication after orthopedic surgery. Applying
oxygen addresses hypoxemia and provider notification is the
immediate priority .
5. A nurse is admitting a client who reports chest pain and
has been placed on telemetry. Which finding should the
nurse analyze to determine myocardial infarction?
A. PR interval
B. QRS duration
C. T wave
D. ST segment
D. ST segment
RATIONALE: ST elevation indicates myocardial infarction; ST
depression indicates ischemia. PR interval relates to first-degree
heart block; QRS duration indicates ventricular conduction delay.
6. A nurse is caring for a client receiving a blood
transfusion who develops bounding peripheral pulses,
hypertension, and distended jugular veins. Which
complication should the nurse suspect?
