ATI RN ADULT MEDICAL-SURGICAL
CMS EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Cardiovascular Disorders and Management
Respiratory Disorders and Mechanical Ventilation
Endocrine and Metabolic Disorders
Renal and Genitourinary Disorders
Gastrointestinal and Hepatic Disorders
Neurological and Neurosensory Disorders
Musculoskeletal and Connective Tissue Disorders
Hematologic and Oncologic Disorders
Perioperative Care and Surgical Complications
Emergency, Critical Care, and Fluid/Electrolyte Balance
Introduction
This comprehensive examination assesses the candidate's clinical
judgment and application of evidence-based nursing practice in
adult medical-surgical settings. It evaluates assessment skills,
prioritization, medication management, infection control, and
management of acute and chronic conditions. Multiple-choice and
scenario-based questions emphasize real-world decision-making,
critical thinking, and patient safety. Candidates must demonstrate
the ability to recognize changes in condition, intervene
appropriately, and collaborate within interdisciplinary teams. This
test bank supports exam readiness for the ATI RN Adult Medical-
Surgical CMS Proctored Assessment.
,SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client who is receiving continuous IV
heparin for venous thromboembolism. The client's aPTT is 96
seconds (therapeutic range 60-80 seconds). Which action
should the nurse take first?
A. Administer protamine sulfate as prescribed
B. Discontinue the heparin infusion immediately
C. Assess the client for signs of bleeding
D. Document the finding and continue to monitor
Correct answer: C
RATIONALE: The aPTT is supratherapeutic, indicating an
increased risk of bleeding. The nurse's first action is to assess the
client for any signs of bleeding before discontinuing the infusion
and notifying the provider.
2. A nurse is assessing a client who has been taking prednisone
for an extended period. Which finding requires immediate
attention?
A. Weight gain
B. Increased appetite
C. Fever and sore throat
D. Mood swings
Correct answer: C
RATIONALE: Long-term prednisone use suppresses the
immune system; fever and sore throat may indicate a serious
infection requiring immediate attention.
3. A nurse is caring for a client with a new diagnosis of type 1
diabetes mellitus. Which statement by the client indicates
understanding of sick-day rules?
,A. "I will stop taking my insulin if I can't eat."
B. "I will check my blood glucose every 4 hours."
C. "I will take my usual dose of insulin even if I'm not eating."
D. "I will drink less fluid to prevent frequent urination."
Correct answer: B
RATIONALE: During illness, blood glucose should be monitored
more frequently (every 4 hours). Insulin should never be
stopped, and fluids should be increased.
4. A nurse is assessing a client who has been prescribed lithium
carbonate. Which finding indicates possible lithium toxicity?
A. Increased appetite
B. Fine hand tremors
C. Coarse hand tremors and vomiting
D. Mild fatigue
Correct answer: C
RATIONALE: Coarse hand tremors, vomiting, and ataxia are
signs of lithium toxicity. Fine tremors may be a therapeutic side
effect.
5. A nurse is caring for a client who has been prescribed
metformin. Which finding requires immediate notification of
the provider?
A. Nausea
B. Diarrhea
C. Muscle pain and difficulty breathing
D. Metallic taste
Correct answer: C
RATIONALE: Muscle pain and difficulty breathing may indicate
lactic acidosis, a rare but serious adverse effect of metformin.
, 6. A nurse is assessing a client with a suspected myocardial
infarction. Which finding is expected?
A. Chest pain relieved by rest
B. Chest pain unrelieved by rest
C. Sharp pain with breathing
D. Pain relieved by antacids
Correct answer: B
RATIONALE: MI chest pain is typically unrelieved by rest or
nitroglycerin and may radiate to the arm, jaw, or back.
7. A nurse is caring for a client with heart failure. Which finding
indicates worsening condition?
A. Weight loss
B. Increased urine output
C. Crackles in the lungs
D. Decreased heart rate
Correct answer: C
RATIONALE: Crackles in the lungs indicate pulmonary edema
and worsening heart failure.
8. A nurse is assessing a client with a suspected abdominal
aortic aneurysm. Which finding is expected?
A. Pulsatile abdominal mass
B. Abdominal bruit
C. Severe abdominal pain
D. All of the above
Correct answer: D
RATIONALE: Abdominal aortic aneurysm may present with a
pulsatile mass, bruit, and severe pain if rupturing.
CMS EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Cardiovascular Disorders and Management
Respiratory Disorders and Mechanical Ventilation
Endocrine and Metabolic Disorders
Renal and Genitourinary Disorders
Gastrointestinal and Hepatic Disorders
Neurological and Neurosensory Disorders
Musculoskeletal and Connective Tissue Disorders
Hematologic and Oncologic Disorders
Perioperative Care and Surgical Complications
Emergency, Critical Care, and Fluid/Electrolyte Balance
Introduction
This comprehensive examination assesses the candidate's clinical
judgment and application of evidence-based nursing practice in
adult medical-surgical settings. It evaluates assessment skills,
prioritization, medication management, infection control, and
management of acute and chronic conditions. Multiple-choice and
scenario-based questions emphasize real-world decision-making,
critical thinking, and patient safety. Candidates must demonstrate
the ability to recognize changes in condition, intervene
appropriately, and collaborate within interdisciplinary teams. This
test bank supports exam readiness for the ATI RN Adult Medical-
Surgical CMS Proctored Assessment.
,SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client who is receiving continuous IV
heparin for venous thromboembolism. The client's aPTT is 96
seconds (therapeutic range 60-80 seconds). Which action
should the nurse take first?
A. Administer protamine sulfate as prescribed
B. Discontinue the heparin infusion immediately
C. Assess the client for signs of bleeding
D. Document the finding and continue to monitor
Correct answer: C
RATIONALE: The aPTT is supratherapeutic, indicating an
increased risk of bleeding. The nurse's first action is to assess the
client for any signs of bleeding before discontinuing the infusion
and notifying the provider.
2. A nurse is assessing a client who has been taking prednisone
for an extended period. Which finding requires immediate
attention?
A. Weight gain
B. Increased appetite
C. Fever and sore throat
D. Mood swings
Correct answer: C
RATIONALE: Long-term prednisone use suppresses the
immune system; fever and sore throat may indicate a serious
infection requiring immediate attention.
3. A nurse is caring for a client with a new diagnosis of type 1
diabetes mellitus. Which statement by the client indicates
understanding of sick-day rules?
,A. "I will stop taking my insulin if I can't eat."
B. "I will check my blood glucose every 4 hours."
C. "I will take my usual dose of insulin even if I'm not eating."
D. "I will drink less fluid to prevent frequent urination."
Correct answer: B
RATIONALE: During illness, blood glucose should be monitored
more frequently (every 4 hours). Insulin should never be
stopped, and fluids should be increased.
4. A nurse is assessing a client who has been prescribed lithium
carbonate. Which finding indicates possible lithium toxicity?
A. Increased appetite
B. Fine hand tremors
C. Coarse hand tremors and vomiting
D. Mild fatigue
Correct answer: C
RATIONALE: Coarse hand tremors, vomiting, and ataxia are
signs of lithium toxicity. Fine tremors may be a therapeutic side
effect.
5. A nurse is caring for a client who has been prescribed
metformin. Which finding requires immediate notification of
the provider?
A. Nausea
B. Diarrhea
C. Muscle pain and difficulty breathing
D. Metallic taste
Correct answer: C
RATIONALE: Muscle pain and difficulty breathing may indicate
lactic acidosis, a rare but serious adverse effect of metformin.
, 6. A nurse is assessing a client with a suspected myocardial
infarction. Which finding is expected?
A. Chest pain relieved by rest
B. Chest pain unrelieved by rest
C. Sharp pain with breathing
D. Pain relieved by antacids
Correct answer: B
RATIONALE: MI chest pain is typically unrelieved by rest or
nitroglycerin and may radiate to the arm, jaw, or back.
7. A nurse is caring for a client with heart failure. Which finding
indicates worsening condition?
A. Weight loss
B. Increased urine output
C. Crackles in the lungs
D. Decreased heart rate
Correct answer: C
RATIONALE: Crackles in the lungs indicate pulmonary edema
and worsening heart failure.
8. A nurse is assessing a client with a suspected abdominal
aortic aneurysm. Which finding is expected?
A. Pulsatile abdominal mass
B. Abdominal bruit
C. Severe abdominal pain
D. All of the above
Correct answer: D
RATIONALE: Abdominal aortic aneurysm may present with a
pulsatile mass, bruit, and severe pain if rupturing.
