SURGICAL EXAM 2026/2027 |
NURSING | MED SURG | 100
VERIFIED Q&A | DETAILED
RATIONALES | NGN-ALIGNED
| PASS GUARANTEED – A+
GRADED
STUDYGUIDESOLUTIONS
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ATI ADULT MEDICAL-SURGICAL EXAM 2026/2027 | NURSING | MED SURG | 100 VERIFIED
Q&A | DETAILED RATIONALES | NGN-ALIGNED | PASS GUARANTEED – A+ GRADED
SECTION 1: CARDIOVASCULAR SYSTEM – Questions 1-15
Q1: Acute Myocardial Infarction Priority
A 68-year-old male is admitted with crushing substernal chest pain radiating to his left arm. He is
diaphoretic and nauseated. Vital signs show BP 88/56 mmHg, HR 110 bpm, RR 24/min, SpO₂ 91% on
room air. Which intervention is the nurse's HIGHEST priority?
A. Administer sublingual nitroglycerin
B. Obtain a 12-lead ECG within 10 minutes
C. Start supplemental oxygen at 2 L/min via nasal cannula
D. Insert a large-bore IV and prepare for fibrinolytics
Correct Answer: B
Rationale: A 12-lead ECG obtained within 10 minutes of arrival is the priority to identify STEMI
versus NSTEMI and guide reperfusion decisions.
Q2: Heart Failure Hypokalemia
A patient with heart failure is receiving IV furosemide 40 mg twice daily. The nurse notes a serum
potassium of 3.1 mEq/L. Which action should the nurse take FIRST?
A. Hold the next dose of furosemide and notify the provider
B. Administer oral potassium chloride 20 mEq immediately
C. Increase the patient's fluid intake to 3 L per day
D. Continue furosemide and recheck potassium in 24 hours
Correct Answer: A
Rationale: Hypokalemia below 3.5 mEq/L increases the risk of cardiac dysrhythmias. Hold the loop
diuretic and notify the provider before administering replacement.
Q3: Warfarin Dietary Teaching
A patient with atrial fibrillation is started on warfarin 5 mg daily. Which statement by the patient
indicates understanding?
A. "I will completely avoid all green vegetables while on this medication."
B. "I should keep my vitamin K intake consistent from week to week."
C. "I can eat as much spinach as I want because it is healthy."
D. "I will stop eating lettuce and broccoli permanently."
Correct Answer: B
Rationale: Warfarin antagonizes vitamin K; consistency in dietary vitamin K intake is more important
than avoidance.
Q4: CABG Chest Tube Drainage
A 55-year-old patient post-CABG on postoperative day 2 has a chest tube draining 150 mL of bright
red blood in the last hour. The patient is tachycardic with a dropping blood pressure. What is the
priority nursing action?
A. Milk the chest tube to maintain patency
B. Clamp the chest tube and call the surgeon
C. Notify the surgeon immediately and prepare for emergency re-exploration
D. Increase the suction pressure to -40 cmH₂O
, 2
Correct Answer: C
Rationale: Bright red drainage exceeding 100–150 mL/hour with signs of hemodynamic instability
indicates active hemorrhage.
Q5: Acute Pulmonary Edema
A patient with heart failure suddenly develops severe dyspnea, crackles throughout both lung fields,
and an oxygen saturation of 84%. Which action should the nurse take FIRST?
A. Administer IV furosemide
B. Place the patient in high Fowler's position
C. Apply supplemental oxygen
D. Obtain an arterial blood gas
Correct Answer: B
Rationale: Positioning the patient upright immediately improves ventilation by reducing venous
return and easing the work of breathing.
Q6: Digoxin Toxicity
Which finding in a client receiving digoxin requires the nurse's IMMEDIATE attention?
A. Heart rate of 72 bpm
B. Nausea and visual disturbances
C. Blood pressure of 118/76 mmHg
D. Serum potassium of 4.2 mEq/L
Correct Answer: B
Rationale: Nausea and visual disturbances (yellow-green halos) are classic signs of digoxin toxicity.
Q7: Warfarin INR Interpretation
A patient on warfarin has an INR of 6.0. What is the nurse's priority action?
A. Administer vitamin K as ordered
B. Hold the warfarin dose and notify the provider
C. Continue the current dose
D. Encourage green leafy vegetables
Correct Answer: B
Rationale: An INR of 6.0 is critically elevated, indicating high bleeding risk. Hold warfarin and notify
the provider.
Q8: Atrial Fibrillation Rate Control
A patient with atrial fibrillation has a heart rate of 148 bpm. Which medication does the nurse
anticipate being ordered for rate control?
A. Adenosine
B. Diltiazem
C. Atropine
D. Epinephrine
Correct Answer: B
Rationale: Diltiazem is a calcium channel blocker used for rate control in atrial fibrillation.
Q9: DVT Prevention
Which intervention is MOST effective for preventing deep vein thrombosis in a postoperative
patient?
A. Bed rest with pillows under the knees