Genuine ATI RN Adult Medical Surgical 2026 NGN
Level 3 Score Proctored Exam Actual and Retake
Versions 100 Screenshot Questions Answers
Rationales
1. A nurse is caring for a client who has had a stroke and is experiencing dysphagia. Which of
the following actions should the nurse take first?
A. Place the client in a semi-Fowler's position
B. Perform a bedside swallowing evaluation
C. Request a speech-language pathologist consultation
D. Thicken all oral fluids
Correct Answer: B. Perform a bedside swallowing evaluation
Rationale: The nurse should first perform a bedside swallowing evaluation to assess the
client's ability to swallow safely before initiating any oral intake. This is a nursing assessment
priority. Placing the client upright is important but comes after assessment. A speech-language
pathologist consult may follow, but the nurse must first identify the risk. Thickening fluids is an
intervention, not the first action.
2. A nurse is assessing a client who has increased intracranial pressure (ICP). Which of the
following findings should the nurse report immediately?
A. Pupils equal and reactive to light
B. Glasgow Coma Scale score of 15
C. Decerebrate posturing
D. Urine output of 50 mL/hr
Correct Answer: C. Decerebrate posturing
Rationale: Decerebrate posturing (extension of arms and legs) indicates severe brainstem
damage and is a late sign of increased ICP. This requires immediate intervention. Equal and
reactive pupils, a GCS of 15, and adequate urine output are expected findings.
,3. A nurse is teaching a client who has Parkinson's disease about levodopa-carbidopa. Which
of the following statements by the client indicates understanding?
A. "I should take this medication with a high-protein meal."
B. "I should report any darkening of my urine."
C. "I should change positions slowly when getting up."
D. "I can stop this medication once my tremors improve."
Correct Answer: C. "I should change positions slowly when getting up."
Rationale: Levodopa-carbidopa can cause orthostatic hypotension, so clients should change
positions slowly. High-protein meals can interfere with absorption. Darkening of urine and
sweat is a harmless side effect, not requiring reporting. The medication should never be
stopped abruptly.
4. A nurse is caring for a client who is 2 days postoperative following a craniotomy. Which of
the following findings should the nurse report to the provider?
A. Temperature of 37.2°C (99°F)
B. Clear drainage from the nose
C. Incisional pain rated 3/10
D. Blood pressure 118/76 mm Hg
Correct Answer: B. Clear drainage from the nose
Rationale: Clear drainage from the nose may indicate cerebrospinal fluid (CSF) leak, which
places the client at risk for infection (meningitis). This must be reported immediately. A low-
grade temperature, mild incisional pain, and a normal blood pressure are expected findings.
5. A nurse is assessing a client who has a new onset of seizures. Which of the following should
the nurse do during a tonic-clonic seizure? (SATA)
A. Place a padded tongue blade in the client's mouth
B. Turn the client to the side
C. Loosen restrictive clothing
D. Restrain the client's extremities
E. Time the duration of the seizure
Correct Answers: B, C, E
, Rationale: During a seizure, the nurse should turn the client to the side to maintain airway
patency, loosen restrictive clothing, and time the seizure. Never place anything in the mouth or
restrain the client, as this can cause injury.
6. A nurse is caring for a client who has myasthenia gravis and is experiencing difficulty
swallowing. Which of the following medications should the nurse anticipate administering?
A. Atropine
B. Pyridostigmine
C. Levodopa
D. Baclofen
Correct Answer: B. Pyridostigmine
Rationale: Pyridostigmine is a cholinesterase inhibitor that increases acetylcholine at the
neuromuscular junction, improving muscle strength and swallowing in clients with myasthenia
gravis. Atropine is an antidote for cholinergic crisis. Levodopa is for Parkinson's disease.
Baclofen is a muscle relaxant.
7. A nurse is assessing a client who has a head injury. Which of the following findings indicates
the earliest sign of increased ICP?
A. Decreased level of consciousness
B. Fixed and dilated pupils
C. Cushing's triad
D. Decerebrate posturing
Correct Answer: A. Decreased level of consciousness
Rationale: A decrease in level of consciousness is the earliest and most reliable indicator of
increased ICP. Fixed and dilated pupils, Cushing's triad, and decerebrate posturing are later
signs.
8. A nurse is teaching a client who has a new diagnosis of migraine headaches. Which of the
following should the nurse include in the teaching?
A. "You should take ergotamine at the first sign of a headache."
B. "You should take sumatriptan daily to prevent headaches."
, C. "You should avoid caffeine completely."
D. "You should take aspirin every day."
Correct Answer: A. "You should take ergotamine at the first sign of a headache."
Rationale: Ergotamine is most effective when taken at the first sign of a migraine.
Sumatriptan is taken at the onset of a migraine, not daily for prevention. Caffeine can be helpful
in some migraine medications. Daily aspirin is not a standard migraine treatment.
9. A nurse is caring for a client who has Guillain-Barré syndrome. Which of the following
complications should the nurse monitor for?
A. Hyperreflexia
B. Respiratory failure
C. Increased appetite
D. Hypertension
Correct Answer: B. Respiratory failure
Rationale: Guillain-Barré syndrome causes ascending paralysis that can affect the
respiratory muscles, leading to respiratory failure. The nurse should monitor vital capacity and
respiratory status closely. Hyporeflexia, not hyperreflexia, is expected.
10. A nurse is assessing a client who has a brain tumor. Which of the following findings should
the nurse expect?
A. Bradycardia
B. Headache that is worse in the morning
C. Hypotension
D. Improved vision
Correct Answer: B. Headache that is worse in the morning
Rationale: Headaches that are worse in the morning are a classic sign of a brain tumor due
to increased ICP when lying flat. Bradycardia and hypotension are not typical. Visual changes,
such as blurred vision, are more common than improved vision.
11. A nurse is caring for a client who has a spinal cord injury at T6. Which of the following
findings indicates autonomic dysreflexia?
Level 3 Score Proctored Exam Actual and Retake
Versions 100 Screenshot Questions Answers
Rationales
1. A nurse is caring for a client who has had a stroke and is experiencing dysphagia. Which of
the following actions should the nurse take first?
A. Place the client in a semi-Fowler's position
B. Perform a bedside swallowing evaluation
C. Request a speech-language pathologist consultation
D. Thicken all oral fluids
Correct Answer: B. Perform a bedside swallowing evaluation
Rationale: The nurse should first perform a bedside swallowing evaluation to assess the
client's ability to swallow safely before initiating any oral intake. This is a nursing assessment
priority. Placing the client upright is important but comes after assessment. A speech-language
pathologist consult may follow, but the nurse must first identify the risk. Thickening fluids is an
intervention, not the first action.
2. A nurse is assessing a client who has increased intracranial pressure (ICP). Which of the
following findings should the nurse report immediately?
A. Pupils equal and reactive to light
B. Glasgow Coma Scale score of 15
C. Decerebrate posturing
D. Urine output of 50 mL/hr
Correct Answer: C. Decerebrate posturing
Rationale: Decerebrate posturing (extension of arms and legs) indicates severe brainstem
damage and is a late sign of increased ICP. This requires immediate intervention. Equal and
reactive pupils, a GCS of 15, and adequate urine output are expected findings.
,3. A nurse is teaching a client who has Parkinson's disease about levodopa-carbidopa. Which
of the following statements by the client indicates understanding?
A. "I should take this medication with a high-protein meal."
B. "I should report any darkening of my urine."
C. "I should change positions slowly when getting up."
D. "I can stop this medication once my tremors improve."
Correct Answer: C. "I should change positions slowly when getting up."
Rationale: Levodopa-carbidopa can cause orthostatic hypotension, so clients should change
positions slowly. High-protein meals can interfere with absorption. Darkening of urine and
sweat is a harmless side effect, not requiring reporting. The medication should never be
stopped abruptly.
4. A nurse is caring for a client who is 2 days postoperative following a craniotomy. Which of
the following findings should the nurse report to the provider?
A. Temperature of 37.2°C (99°F)
B. Clear drainage from the nose
C. Incisional pain rated 3/10
D. Blood pressure 118/76 mm Hg
Correct Answer: B. Clear drainage from the nose
Rationale: Clear drainage from the nose may indicate cerebrospinal fluid (CSF) leak, which
places the client at risk for infection (meningitis). This must be reported immediately. A low-
grade temperature, mild incisional pain, and a normal blood pressure are expected findings.
5. A nurse is assessing a client who has a new onset of seizures. Which of the following should
the nurse do during a tonic-clonic seizure? (SATA)
A. Place a padded tongue blade in the client's mouth
B. Turn the client to the side
C. Loosen restrictive clothing
D. Restrain the client's extremities
E. Time the duration of the seizure
Correct Answers: B, C, E
, Rationale: During a seizure, the nurse should turn the client to the side to maintain airway
patency, loosen restrictive clothing, and time the seizure. Never place anything in the mouth or
restrain the client, as this can cause injury.
6. A nurse is caring for a client who has myasthenia gravis and is experiencing difficulty
swallowing. Which of the following medications should the nurse anticipate administering?
A. Atropine
B. Pyridostigmine
C. Levodopa
D. Baclofen
Correct Answer: B. Pyridostigmine
Rationale: Pyridostigmine is a cholinesterase inhibitor that increases acetylcholine at the
neuromuscular junction, improving muscle strength and swallowing in clients with myasthenia
gravis. Atropine is an antidote for cholinergic crisis. Levodopa is for Parkinson's disease.
Baclofen is a muscle relaxant.
7. A nurse is assessing a client who has a head injury. Which of the following findings indicates
the earliest sign of increased ICP?
A. Decreased level of consciousness
B. Fixed and dilated pupils
C. Cushing's triad
D. Decerebrate posturing
Correct Answer: A. Decreased level of consciousness
Rationale: A decrease in level of consciousness is the earliest and most reliable indicator of
increased ICP. Fixed and dilated pupils, Cushing's triad, and decerebrate posturing are later
signs.
8. A nurse is teaching a client who has a new diagnosis of migraine headaches. Which of the
following should the nurse include in the teaching?
A. "You should take ergotamine at the first sign of a headache."
B. "You should take sumatriptan daily to prevent headaches."
, C. "You should avoid caffeine completely."
D. "You should take aspirin every day."
Correct Answer: A. "You should take ergotamine at the first sign of a headache."
Rationale: Ergotamine is most effective when taken at the first sign of a migraine.
Sumatriptan is taken at the onset of a migraine, not daily for prevention. Caffeine can be helpful
in some migraine medications. Daily aspirin is not a standard migraine treatment.
9. A nurse is caring for a client who has Guillain-Barré syndrome. Which of the following
complications should the nurse monitor for?
A. Hyperreflexia
B. Respiratory failure
C. Increased appetite
D. Hypertension
Correct Answer: B. Respiratory failure
Rationale: Guillain-Barré syndrome causes ascending paralysis that can affect the
respiratory muscles, leading to respiratory failure. The nurse should monitor vital capacity and
respiratory status closely. Hyporeflexia, not hyperreflexia, is expected.
10. A nurse is assessing a client who has a brain tumor. Which of the following findings should
the nurse expect?
A. Bradycardia
B. Headache that is worse in the morning
C. Hypotension
D. Improved vision
Correct Answer: B. Headache that is worse in the morning
Rationale: Headaches that are worse in the morning are a classic sign of a brain tumor due
to increased ICP when lying flat. Bradycardia and hypotension are not typical. Visual changes,
such as blurred vision, are more common than improved vision.
11. A nurse is caring for a client who has a spinal cord injury at T6. Which of the following
findings indicates autonomic dysreflexia?
