ATI PN Adult Medical-Surgical 2026 (Med-Surg) ATI PN Adult
Medical-Surgical 2026 (Med-Surg) - Questions and Answers
Already Graded A+ Premium Exam Tested And Verified
Subject Area Adult Medical-Surgical Nursing (ATI PN Adult Medical-Surgical 2026)
Description A proctored, content-mastery assessment covering the 2026 ATI PN Adult
Medical-Surgical blueprint: neurological/sensory, cardiovascular/hematologic,
respiratory, gastrointestinal/hepatobiliary, renal/genitourinary,
musculoskeletal/integumentary, endocrine/metabolic, reproductive,
immune/infectious, perioperative and fluid/electrolyte/acid-base, and
oncologic/emergency-trauma care. Items require clinical judgment per the
NCSBN CJMM and NCLEX-PN 2026 client-need categories.
Expected Grade A+
Total Questions 148
Duration 2 hours
Learning Outcomes 1. Apply the NCSBN Clinical Judgment Measurement Model to prioritize and
evaluate care for adults with multi-system medical-surgical conditions.
2. Interpret laboratory, diagnostic, and hemodynamic data to detect subtle
deterioration and select safe nursing actions.
3. Differentiate anticipated, nonessential, and contraindicated prescriptions across
diverse adult med-surg scenarios.
Accreditation Aligned with ACEN/CCNE practical nursing program standards and the
NCLEX-PN 2026 Test Plan (NCSBN); ATI content-mastery scoring and
remediation guidelines apply.
Page 1
,Question 1 of 148
Which finding most specifically signals increased intracranial pressure rather than pain-related
agitation?
A. Widened pulse pressure with bradycardia and irregular respirations
B. Tachycardia with diaphoresis during repositioning
C. Pupils equal and reactive with voluntary guarding
D. Complaint of throbbing headache relieved by dark room
The correct answer is:
Correct Action: Widened pulse pressure with bradycardia and irregular respirations
Rationales
• Widened pulse pressure with bradycardia and irregular respirations (Correct):
This is the correct action. Cushing's triad-widened pulse pressure, bradycardia, and irregular respirations-reflects brainstem
compression and is the most specific ICP indicator. Tachycardia with diaphoresis suggests pain or sympathetic surge,
reactive pupils and guarding are benign, and a relieved headache suggests migraine rather than rising ICP.
• Tachycardia with diaphoresis during repositioning (Incorrect):
This option is not appropriate. Tachycardia with diaphoresis suggests pain or sympathetic surge, reactive pupils and
guarding are benign, and a relieved headache suggests migraine rather than rising ICP.
• Pupils equal and reactive with voluntary guarding (Incorrect):
This option is not appropriate. Tachycardia with diaphoresis suggests pain or sympathetic surge, reactive pupils and
guarding are benign, and a relieved headache suggests migraine rather than rising ICP.
• Complaint of throbbing headache relieved by dark room (Incorrect):
This option is not appropriate. Tachycardia with diaphoresis suggests pain or sympathetic surge, reactive pupils and
guarding are benign, and a relieved headache suggests migraine rather than rising ICP.
Page 2
,Question 2 of 148
A client on heparin has platelets falling 40% from baseline with new thrombosis. Which action is
priority?
A. Stop heparin and notify the provider for alternative anticoagulation
B. Increase the heparin infusion to maintain therapeutic aPTT
C. Administer vitamin K and continue heparin at current rate
D. Transfuse platelets and continue heparin unchanged
The correct answer is:
Correct Action: Stop heparin and notify the provider for alternative anticoagulation
Rationales
• Stop heparin and notify the provider for alternative anticoagulation (Correct):
This is the correct action. This is heparin-induced thrombocytopenia (HIT), a prothrombotic disorder requiring immediate
heparin discontinuation and non-heparin anticoagulation. Increasing heparin worsens thrombosis, vitamin K reverses
warfarin not heparin, and platelet transfusion does not treat HIT and may worsen thrombosis.
• Increase the heparin infusion to maintain therapeutic aPTT (Incorrect):
This option is not appropriate. Increasing heparin worsens thrombosis, vitamin K reverses warfarin not heparin, and platelet
transfusion does not treat HIT and may worsen thrombosis.
• Administer vitamin K and continue heparin at current rate (Incorrect):
This option is not appropriate. Increasing heparin worsens thrombosis, vitamin K reverses warfarin not heparin, and platelet
transfusion does not treat HIT and may worsen thrombosis.
• Transfuse platelets and continue heparin unchanged (Incorrect):
This option is not appropriate. Increasing heparin worsens thrombosis, vitamin K reverses warfarin not heparin, and platelet
transfusion does not treat HIT and may worsen thrombosis.
Page 3
, Question 3 of 148
Which arterial blood gas pattern best fits a client with COPD retaining CO2 chronically?
A. pH 7.34, PaCO2 58, HCO3 30, PaO2 62
B. pH 7.50, PaCO2 30, HCO3 24, PaO2 90
C. pH 7.28, PaCO2 30, HCO3 14, PaO2 80
D. pH 7.46, PaCO2 48, HCO3 32, PaO2 70
The correct answer is:
Correct Action: pH 7.34, PaCO2 58, HCO3 30, PaO2 62
Rationales
• pH 7.34, PaCO2 58, HCO3 30, PaO2 62 (Correct):
This is the correct action. Chronic CO2 retention produces compensated respiratory acidosis: near-normal pH with elevated
PaCO2 and elevated bicarbonate from renal compensation. Option B is respiratory alkalosis, C is metabolic acidosis, and D
is metabolic alkalosis with inadequate compensation.
• pH 7.50, PaCO2 30, HCO3 24, PaO2 90 (Incorrect):
This option is not appropriate. Option B is respiratory alkalosis, C is metabolic acidosis, and D is metabolic alkalosis with
inadequate compensation.
• pH 7.28, PaCO2 30, HCO3 14, PaO2 80 (Incorrect):
This option is not appropriate. Option B is respiratory alkalosis, C is metabolic acidosis, and D is metabolic alkalosis with
inadequate compensation.
• pH 7.46, PaCO2 48, HCO3 32, PaO2 70 (Incorrect):
This option is not appropriate. Option B is respiratory alkalosis, C is metabolic acidosis, and D is metabolic alkalosis with
inadequate compensation.
Page 4
Medical-Surgical 2026 (Med-Surg) - Questions and Answers
Already Graded A+ Premium Exam Tested And Verified
Subject Area Adult Medical-Surgical Nursing (ATI PN Adult Medical-Surgical 2026)
Description A proctored, content-mastery assessment covering the 2026 ATI PN Adult
Medical-Surgical blueprint: neurological/sensory, cardiovascular/hematologic,
respiratory, gastrointestinal/hepatobiliary, renal/genitourinary,
musculoskeletal/integumentary, endocrine/metabolic, reproductive,
immune/infectious, perioperative and fluid/electrolyte/acid-base, and
oncologic/emergency-trauma care. Items require clinical judgment per the
NCSBN CJMM and NCLEX-PN 2026 client-need categories.
Expected Grade A+
Total Questions 148
Duration 2 hours
Learning Outcomes 1. Apply the NCSBN Clinical Judgment Measurement Model to prioritize and
evaluate care for adults with multi-system medical-surgical conditions.
2. Interpret laboratory, diagnostic, and hemodynamic data to detect subtle
deterioration and select safe nursing actions.
3. Differentiate anticipated, nonessential, and contraindicated prescriptions across
diverse adult med-surg scenarios.
Accreditation Aligned with ACEN/CCNE practical nursing program standards and the
NCLEX-PN 2026 Test Plan (NCSBN); ATI content-mastery scoring and
remediation guidelines apply.
Page 1
,Question 1 of 148
Which finding most specifically signals increased intracranial pressure rather than pain-related
agitation?
A. Widened pulse pressure with bradycardia and irregular respirations
B. Tachycardia with diaphoresis during repositioning
C. Pupils equal and reactive with voluntary guarding
D. Complaint of throbbing headache relieved by dark room
The correct answer is:
Correct Action: Widened pulse pressure with bradycardia and irregular respirations
Rationales
• Widened pulse pressure with bradycardia and irregular respirations (Correct):
This is the correct action. Cushing's triad-widened pulse pressure, bradycardia, and irregular respirations-reflects brainstem
compression and is the most specific ICP indicator. Tachycardia with diaphoresis suggests pain or sympathetic surge,
reactive pupils and guarding are benign, and a relieved headache suggests migraine rather than rising ICP.
• Tachycardia with diaphoresis during repositioning (Incorrect):
This option is not appropriate. Tachycardia with diaphoresis suggests pain or sympathetic surge, reactive pupils and
guarding are benign, and a relieved headache suggests migraine rather than rising ICP.
• Pupils equal and reactive with voluntary guarding (Incorrect):
This option is not appropriate. Tachycardia with diaphoresis suggests pain or sympathetic surge, reactive pupils and
guarding are benign, and a relieved headache suggests migraine rather than rising ICP.
• Complaint of throbbing headache relieved by dark room (Incorrect):
This option is not appropriate. Tachycardia with diaphoresis suggests pain or sympathetic surge, reactive pupils and
guarding are benign, and a relieved headache suggests migraine rather than rising ICP.
Page 2
,Question 2 of 148
A client on heparin has platelets falling 40% from baseline with new thrombosis. Which action is
priority?
A. Stop heparin and notify the provider for alternative anticoagulation
B. Increase the heparin infusion to maintain therapeutic aPTT
C. Administer vitamin K and continue heparin at current rate
D. Transfuse platelets and continue heparin unchanged
The correct answer is:
Correct Action: Stop heparin and notify the provider for alternative anticoagulation
Rationales
• Stop heparin and notify the provider for alternative anticoagulation (Correct):
This is the correct action. This is heparin-induced thrombocytopenia (HIT), a prothrombotic disorder requiring immediate
heparin discontinuation and non-heparin anticoagulation. Increasing heparin worsens thrombosis, vitamin K reverses
warfarin not heparin, and platelet transfusion does not treat HIT and may worsen thrombosis.
• Increase the heparin infusion to maintain therapeutic aPTT (Incorrect):
This option is not appropriate. Increasing heparin worsens thrombosis, vitamin K reverses warfarin not heparin, and platelet
transfusion does not treat HIT and may worsen thrombosis.
• Administer vitamin K and continue heparin at current rate (Incorrect):
This option is not appropriate. Increasing heparin worsens thrombosis, vitamin K reverses warfarin not heparin, and platelet
transfusion does not treat HIT and may worsen thrombosis.
• Transfuse platelets and continue heparin unchanged (Incorrect):
This option is not appropriate. Increasing heparin worsens thrombosis, vitamin K reverses warfarin not heparin, and platelet
transfusion does not treat HIT and may worsen thrombosis.
Page 3
, Question 3 of 148
Which arterial blood gas pattern best fits a client with COPD retaining CO2 chronically?
A. pH 7.34, PaCO2 58, HCO3 30, PaO2 62
B. pH 7.50, PaCO2 30, HCO3 24, PaO2 90
C. pH 7.28, PaCO2 30, HCO3 14, PaO2 80
D. pH 7.46, PaCO2 48, HCO3 32, PaO2 70
The correct answer is:
Correct Action: pH 7.34, PaCO2 58, HCO3 30, PaO2 62
Rationales
• pH 7.34, PaCO2 58, HCO3 30, PaO2 62 (Correct):
This is the correct action. Chronic CO2 retention produces compensated respiratory acidosis: near-normal pH with elevated
PaCO2 and elevated bicarbonate from renal compensation. Option B is respiratory alkalosis, C is metabolic acidosis, and D
is metabolic alkalosis with inadequate compensation.
• pH 7.50, PaCO2 30, HCO3 24, PaO2 90 (Incorrect):
This option is not appropriate. Option B is respiratory alkalosis, C is metabolic acidosis, and D is metabolic alkalosis with
inadequate compensation.
• pH 7.28, PaCO2 30, HCO3 14, PaO2 80 (Incorrect):
This option is not appropriate. Option B is respiratory alkalosis, C is metabolic acidosis, and D is metabolic alkalosis with
inadequate compensation.
• pH 7.46, PaCO2 48, HCO3 32, PaO2 70 (Incorrect):
This option is not appropriate. Option B is respiratory alkalosis, C is metabolic acidosis, and D is metabolic alkalosis with
inadequate compensation.
Page 4
