ATI PN Comprehensive Predictor Adult Medical-
Surgical Nursing Review 2026/2027 | ATI PN
Study Guide, Practice Questions & Answers,
Detailed Rationales, NCLEX-PN Exam Prep &
Med-Surg Review
Question 1: A nurse is caring for a client who has a new prescription for
digoxin. Which of the following findings should the nurse identify as an
indication of digoxin toxicity?
A. Heart rate of 58/min
B. Blood pressure of 148/88 mm Hg
C. Respiratory rate of 22/min
D. Temperature of 37.8° C (100° F)
CORRECT ANSWER: A. Heart rate of 58/min
Rationale: Bradycardia, defined as a heart rate below 60/min, is a classic
sign of digoxin toxicity. Digoxin is a cardiac glycoside that slows conduction
through the AV node and increases vagal tone. Other manifestations of
toxicity include nausea, vomiting, visual disturbances (yellow-green halos),
and dysrhythmias. Blood pressure, respiratory rate, and temperature are
not directly indicative of digoxin toxicity.
Question 2: A nurse is assessing a client who has been taking
levothyroxine for hypothyroidism. Which of the following findings
indicates the medication is effective?
A. Weight gain of 2 kg (4.4 lb)
B. Heart rate of 58/min
C. Increased energy level
D. Decreased appetite
CORRECT ANSWER: C. Increased energy level
Rationale: Levothyroxine is a thyroid hormone replacement used to treat
hypothyroidism. Effectiveness is indicated by resolution of hypothyroid
symptoms, including fatigue, lethargy, weight gain, cold intolerance, and
bradycardia. An increased energy level demonstrates therapeutic
response. Weight gain, bradycardia, and decreased appetite are
manifestations of hypothyroidism, indicating the medication is not yet
effective.
,Question 3: A nurse is caring for a client who has a prescription for
furosemide. Which of the following laboratory values should the nurse
monitor most closely?
A. Serum calcium
B. Serum potassium
C. Serum sodium
D. Serum magnesium
CORRECT ANSWER: B. Serum potassium
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride
reabsorption in the ascending loop of Henle, leading to increased excretion
of potassium. Hypokalemia is a common and potentially dangerous
adverse effect that can precipitate dysrhythmias, especially in clients
taking digoxin. While sodium, calcium, and magnesium can also be
affected, potassium is the most critical to monitor due to the risk of cardiac
dysrhythmias.
Question 4: A nurse is teaching a client who has a new prescription for
warfarin. Which of the following statements by the client indicates an
understanding of the teaching?
A. "I should increase my intake of leafy green vegetables."
B. "I will take aspirin for headaches."
C. "I will use a soft toothbrush to brush my teeth."
D. "I should double my dose if I miss one."
CORRECT ANSWER: C. "I will use a soft toothbrush to brush my teeth."
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding.
Using a soft toothbrush reduces the risk of gum bleeding and injury. Clients
should maintain consistent, not increased, intake of vitamin K-rich foods
(leafy greens). Aspirin increases bleeding risk and should be avoided
unless prescribed. Clients should never double a dose of warfarin; they
should contact the provider for missed doses.
Question 5: A nurse is assessing a client who has heart failure and is
taking lisinopril. Which of the following findings should the nurse
report to the provider immediately?
A. Dry, persistent cough
B. Blood pressure of 118/76 mm Hg
,C. Swelling of the tongue and lips
D. Potassium level of 4.2 mEq/L
CORRECT ANSWER: C. Swelling of the tongue and lips
Rationale: Lisinopril is an ACE inhibitor that can cause angioedema,
characterized by swelling of the face, tongue, lips, and throat. This is a life-
threatening emergency that requires immediate intervention because it can
obstruct the airway. A dry cough is a common but non-urgent adverse
effect. A blood pressure of 118/76 mm Hg and potassium of 4.2 mEq/L are
within normal limits.
Question 6: A nurse is caring for a client who has diabetic ketoacidosis
(DKA). Which of the following findings should the nurse expect?
A. Blood glucose of 180 mg/dL
B. pH of 7.48
C. Kussmaul respirations
D. Serum bicarbonate of 28 mEq/L
CORRECT ANSWER: C. Kussmaul respirations
Rationale: DKA is characterized by hyperglycemia (blood glucose greater
than 250 mg/dL), metabolic acidosis (pH less than 7.35), and ketonemia.
Kussmaul respirations are deep, rapid breaths that occur as the body
attempts to blow off carbon dioxide to compensate for metabolic acidosis.
A pH of 7.48 indicates alkalosis, and a bicarbonate of 28 mEq/L is elevated,
both inconsistent with DKA.
Question 7: A nurse is reviewing the medication history of a client who
has peptic ulcer disease. Which of the following medications should
the nurse identify as a risk factor for ulcer formation?
A. Acetaminophen
B. Ibuprofen
C. Omeprazole
D. Sucralfate
CORRECT ANSWER: B. Ibuprofen
Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that
inhibits prostaglandin synthesis, reducing the protective mucus lining of
the stomach and increasing the risk of peptic ulcer formation and
, gastrointestinal bleeding. Acetaminophen does not have this effect.
Omeprazole and sucralfate are used to treat and prevent peptic ulcers.
Question 8: A nurse is assessing a client who has a new onset of atrial
fibrillation. Which of the following findings is the priority for the nurse
to report?
A. Heart rate of 110/min
B. Blood pressure of 88/54 mm Hg
C. Respiratory rate of 20/min
D. Oxygen saturation of 95%
CORRECT ANSWER: B. Blood pressure of 88/54 mm Hg
Rationale: Atrial fibrillation can cause rapid ventricular rates that impair
cardiac output, leading to hypotension and hemodynamic instability. A
blood pressure of 88/54 mm Hg indicates inadequate perfusion and is the
priority finding. While a heart rate of 110/min is elevated, it is not
immediately life-threatening. Respiratory rate and oxygen saturation are
within acceptable limits.
Question 9: A nurse is teaching a client who has chronic obstructive
pulmonary disease (COPD) about pursed-lip breathing. Which of the
following statements indicates the client understands the teaching?
A. "I will inhale through my nose and exhale slowly through pursed lips."
B. "I will inhale quickly through my mouth and exhale forcefully."
C. "I will hold my breath for 10 seconds after each exhale."
D. "I will breathe only through my mouth at all times."
CORRECT ANSWER: A. "I will inhale through my nose and exhale slowly
through pursed lips."
Rationale: Pursed-lip breathing helps clients with COPD by creating
positive pressure in the airways during exhalation, preventing airway
collapse and improving gas exchange. The correct technique involves
inhaling through the nose and exhaling slowly through pursed lips, typically
with a 1:2 or 1:3 ratio. Inhaling quickly through the mouth, holding the
breath, or breathing only through the mouth are incorrect techniques.
Question 10: A nurse is caring for a client who is postoperative
following a total hip arthroplasty. Which of the following actions should
the nurse take to prevent dislocation of the hip prosthesis?
Surgical Nursing Review 2026/2027 | ATI PN
Study Guide, Practice Questions & Answers,
Detailed Rationales, NCLEX-PN Exam Prep &
Med-Surg Review
Question 1: A nurse is caring for a client who has a new prescription for
digoxin. Which of the following findings should the nurse identify as an
indication of digoxin toxicity?
A. Heart rate of 58/min
B. Blood pressure of 148/88 mm Hg
C. Respiratory rate of 22/min
D. Temperature of 37.8° C (100° F)
CORRECT ANSWER: A. Heart rate of 58/min
Rationale: Bradycardia, defined as a heart rate below 60/min, is a classic
sign of digoxin toxicity. Digoxin is a cardiac glycoside that slows conduction
through the AV node and increases vagal tone. Other manifestations of
toxicity include nausea, vomiting, visual disturbances (yellow-green halos),
and dysrhythmias. Blood pressure, respiratory rate, and temperature are
not directly indicative of digoxin toxicity.
Question 2: A nurse is assessing a client who has been taking
levothyroxine for hypothyroidism. Which of the following findings
indicates the medication is effective?
A. Weight gain of 2 kg (4.4 lb)
B. Heart rate of 58/min
C. Increased energy level
D. Decreased appetite
CORRECT ANSWER: C. Increased energy level
Rationale: Levothyroxine is a thyroid hormone replacement used to treat
hypothyroidism. Effectiveness is indicated by resolution of hypothyroid
symptoms, including fatigue, lethargy, weight gain, cold intolerance, and
bradycardia. An increased energy level demonstrates therapeutic
response. Weight gain, bradycardia, and decreased appetite are
manifestations of hypothyroidism, indicating the medication is not yet
effective.
,Question 3: A nurse is caring for a client who has a prescription for
furosemide. Which of the following laboratory values should the nurse
monitor most closely?
A. Serum calcium
B. Serum potassium
C. Serum sodium
D. Serum magnesium
CORRECT ANSWER: B. Serum potassium
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride
reabsorption in the ascending loop of Henle, leading to increased excretion
of potassium. Hypokalemia is a common and potentially dangerous
adverse effect that can precipitate dysrhythmias, especially in clients
taking digoxin. While sodium, calcium, and magnesium can also be
affected, potassium is the most critical to monitor due to the risk of cardiac
dysrhythmias.
Question 4: A nurse is teaching a client who has a new prescription for
warfarin. Which of the following statements by the client indicates an
understanding of the teaching?
A. "I should increase my intake of leafy green vegetables."
B. "I will take aspirin for headaches."
C. "I will use a soft toothbrush to brush my teeth."
D. "I should double my dose if I miss one."
CORRECT ANSWER: C. "I will use a soft toothbrush to brush my teeth."
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding.
Using a soft toothbrush reduces the risk of gum bleeding and injury. Clients
should maintain consistent, not increased, intake of vitamin K-rich foods
(leafy greens). Aspirin increases bleeding risk and should be avoided
unless prescribed. Clients should never double a dose of warfarin; they
should contact the provider for missed doses.
Question 5: A nurse is assessing a client who has heart failure and is
taking lisinopril. Which of the following findings should the nurse
report to the provider immediately?
A. Dry, persistent cough
B. Blood pressure of 118/76 mm Hg
,C. Swelling of the tongue and lips
D. Potassium level of 4.2 mEq/L
CORRECT ANSWER: C. Swelling of the tongue and lips
Rationale: Lisinopril is an ACE inhibitor that can cause angioedema,
characterized by swelling of the face, tongue, lips, and throat. This is a life-
threatening emergency that requires immediate intervention because it can
obstruct the airway. A dry cough is a common but non-urgent adverse
effect. A blood pressure of 118/76 mm Hg and potassium of 4.2 mEq/L are
within normal limits.
Question 6: A nurse is caring for a client who has diabetic ketoacidosis
(DKA). Which of the following findings should the nurse expect?
A. Blood glucose of 180 mg/dL
B. pH of 7.48
C. Kussmaul respirations
D. Serum bicarbonate of 28 mEq/L
CORRECT ANSWER: C. Kussmaul respirations
Rationale: DKA is characterized by hyperglycemia (blood glucose greater
than 250 mg/dL), metabolic acidosis (pH less than 7.35), and ketonemia.
Kussmaul respirations are deep, rapid breaths that occur as the body
attempts to blow off carbon dioxide to compensate for metabolic acidosis.
A pH of 7.48 indicates alkalosis, and a bicarbonate of 28 mEq/L is elevated,
both inconsistent with DKA.
Question 7: A nurse is reviewing the medication history of a client who
has peptic ulcer disease. Which of the following medications should
the nurse identify as a risk factor for ulcer formation?
A. Acetaminophen
B. Ibuprofen
C. Omeprazole
D. Sucralfate
CORRECT ANSWER: B. Ibuprofen
Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that
inhibits prostaglandin synthesis, reducing the protective mucus lining of
the stomach and increasing the risk of peptic ulcer formation and
, gastrointestinal bleeding. Acetaminophen does not have this effect.
Omeprazole and sucralfate are used to treat and prevent peptic ulcers.
Question 8: A nurse is assessing a client who has a new onset of atrial
fibrillation. Which of the following findings is the priority for the nurse
to report?
A. Heart rate of 110/min
B. Blood pressure of 88/54 mm Hg
C. Respiratory rate of 20/min
D. Oxygen saturation of 95%
CORRECT ANSWER: B. Blood pressure of 88/54 mm Hg
Rationale: Atrial fibrillation can cause rapid ventricular rates that impair
cardiac output, leading to hypotension and hemodynamic instability. A
blood pressure of 88/54 mm Hg indicates inadequate perfusion and is the
priority finding. While a heart rate of 110/min is elevated, it is not
immediately life-threatening. Respiratory rate and oxygen saturation are
within acceptable limits.
Question 9: A nurse is teaching a client who has chronic obstructive
pulmonary disease (COPD) about pursed-lip breathing. Which of the
following statements indicates the client understands the teaching?
A. "I will inhale through my nose and exhale slowly through pursed lips."
B. "I will inhale quickly through my mouth and exhale forcefully."
C. "I will hold my breath for 10 seconds after each exhale."
D. "I will breathe only through my mouth at all times."
CORRECT ANSWER: A. "I will inhale through my nose and exhale slowly
through pursed lips."
Rationale: Pursed-lip breathing helps clients with COPD by creating
positive pressure in the airways during exhalation, preventing airway
collapse and improving gas exchange. The correct technique involves
inhaling through the nose and exhaling slowly through pursed lips, typically
with a 1:2 or 1:3 ratio. Inhaling quickly through the mouth, holding the
breath, or breathing only through the mouth are incorrect techniques.
Question 10: A nurse is caring for a client who is postoperative
following a total hip arthroplasty. Which of the following actions should
the nurse take to prevent dislocation of the hip prosthesis?
