Medical-Surgical NGN ATI Proctored
Exam 2 2024: 220 Questions Study
Guide
Versions A and B: 220 NGN-Style Questions with
Correct Answers and Detailed Rationales
Comprehensive Preparation for Nursing Students to Excel in
Medical-Surgical Nursing
Aligned with ATI Guidelines, NGN Formats, and Clinical Judgment Standards
June 19, 2025
,Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2 Version A: Questions 1110 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.1 Cardiovascular Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.2 Respiratory Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.3 Gastrointestinal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2.4 Endocrine Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
2.5 Neurological Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.6 Musculoskeletal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2.7 Case Study 1: Heart Failure (Questions 6165) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
2.8 Case Study 2: Gastrointestinal Bleeding (Questions 6670) . . . . . . . . . . . . . . . . . . . . . . 10
2.9 Case Study 3: Diabetic Ketoacidosis (Questions 7175) . . . . . . . . . . . . . . . . . . . . . . . . 10
2.10 Bow-Tie Question: Sepsis Management (Questions 7681) . . . . . . . . . . . . . . . . . . . . . . . 11
2.11 Matrix Question: Postoperative Care (Questions 8286) . . . . . . . . . . . . . . . . . . . . . . . . 12
2.12 Additional Questions (87110) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
3 Version B: Questions 111220 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.1 Cardiovascular Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.2 Respiratory Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
3.3 Gastrointestinal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4 Study Tips and Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
1
, Med Surg NGN ATI Proctored Exam 2 2024: 220 Questions Study Guide 2
1 Introduction
This study guide prepares nursing students for the Medical-Surgical NGN ATI Proctored Exam 2, 2024, Versions
A and B, with 100 NGN-style questions (110 per version) in multiple-choice, case study, bow-tie, and matrix
formats. Covering cardiovascular, respiratory, gastrointestinal, endocrine, neurological, and musculoskeletal sys-
tems, it aligns with ATI guidelines and the NCSBN Clinical Judgment Measurement Model to enhance clinical
reasoning skills. The document contains exactly 100 questions to match the exam structure specified.
2 Version A: Questions 1110
2.1 Cardiovascular Disorders
1. A client with angina is prescribed sublingual nitroglycerin. Which statement indicates understanding?
A) "Ill take up to three tablets, 5 minutes apart, for chest pain."
B) "I should stand upright when taking it to stay alert."
C) "Ill store it in a warm, humid bathroom."
D) "Ill replace it every 12 months."
Answer: A) "Ill take up to three tablets, 5 minutes apart, for chest pain."
Rationale: Up to three doses, 5 minutes apart, is correct for angina relief. Clients should sit or lie down
to avoid hypotension. Nitroglycerin is stored at room temperature and replaced every 6 months.
2. A client with chest pain arrives at the ED. What is the nurses first action?
A) Obtain vital signs
B) Administer aspirin 325 mg orally
C) Perform a 12-lead ECG
D) Give sublingual nitroglycerin
Answer: A) Obtain vital signs
Rationale: Vital signs assess stability and guide interventions in acute chest pain.
3. A client with heart failure reports dyspnea and 4 kg weight gain in 48 hours. What is the priority action?
A) Notify the healthcare provider
B) Administer furosemide IV
C) Encourage fluid intake
D) Apply oxygen at 4 L/min
Answer: A) Notify the healthcare provider
Rationale: Rapid weight gain and dyspnea indicate worsening heart failure, requiring provider interven-
tion.
4. A client post-myocardial infarction develops atrial fibrillation. What is the priority assessment?
A) Risk for thromboembolism
B) Blood pressure
C) Chest pain severity
D) Respiratory rate
Answer: A) Risk for thromboembolism
Rationale: Atrial fibrillation increases thromboembolism risk due to atrial stasis.
5. A client on lisinopril reports a persistent dry cough. What should the nurse advise?
A) "Discuss a medication change with your provider."
B) "Drink more water to soothe the cough."
C) "Use cough syrup to manage it."
D) "Continue; the cough will resolve."
Answer: A) "Discuss a medication change with your provider."
Rationale: A dry cough often requires switching from an ACE inhibitor to an ARB.
6. A client with hypertension on metoprolol has a heart rate of 45 bpm. What should the nurse do?
A) Withhold the dose and notify the provider
B) Administer the dose as prescribed
C) Monitor for 1 hour
D) Encourage physical activity
Answer: A) Withhold the dose and notify the provider
Rationale: Bradycardia (<50 bpm) is a serious beta-blocker side effect requiring intervention.
7. A client post-cardiac catheterization reports groin pain. Which finding requires immediate action?
A) Hard swelling at the insertion site
B) Mild bruising around the site
C) Warm distal extremity
D) Strong distal pulse
Exam 2 2024: 220 Questions Study
Guide
Versions A and B: 220 NGN-Style Questions with
Correct Answers and Detailed Rationales
Comprehensive Preparation for Nursing Students to Excel in
Medical-Surgical Nursing
Aligned with ATI Guidelines, NGN Formats, and Clinical Judgment Standards
June 19, 2025
,Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2 Version A: Questions 1110 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.1 Cardiovascular Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.2 Respiratory Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.3 Gastrointestinal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2.4 Endocrine Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
2.5 Neurological Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.6 Musculoskeletal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2.7 Case Study 1: Heart Failure (Questions 6165) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
2.8 Case Study 2: Gastrointestinal Bleeding (Questions 6670) . . . . . . . . . . . . . . . . . . . . . . 10
2.9 Case Study 3: Diabetic Ketoacidosis (Questions 7175) . . . . . . . . . . . . . . . . . . . . . . . . 10
2.10 Bow-Tie Question: Sepsis Management (Questions 7681) . . . . . . . . . . . . . . . . . . . . . . . 11
2.11 Matrix Question: Postoperative Care (Questions 8286) . . . . . . . . . . . . . . . . . . . . . . . . 12
2.12 Additional Questions (87110) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
3 Version B: Questions 111220 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.1 Cardiovascular Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.2 Respiratory Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
3.3 Gastrointestinal Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
4 Study Tips and Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
1
, Med Surg NGN ATI Proctored Exam 2 2024: 220 Questions Study Guide 2
1 Introduction
This study guide prepares nursing students for the Medical-Surgical NGN ATI Proctored Exam 2, 2024, Versions
A and B, with 100 NGN-style questions (110 per version) in multiple-choice, case study, bow-tie, and matrix
formats. Covering cardiovascular, respiratory, gastrointestinal, endocrine, neurological, and musculoskeletal sys-
tems, it aligns with ATI guidelines and the NCSBN Clinical Judgment Measurement Model to enhance clinical
reasoning skills. The document contains exactly 100 questions to match the exam structure specified.
2 Version A: Questions 1110
2.1 Cardiovascular Disorders
1. A client with angina is prescribed sublingual nitroglycerin. Which statement indicates understanding?
A) "Ill take up to three tablets, 5 minutes apart, for chest pain."
B) "I should stand upright when taking it to stay alert."
C) "Ill store it in a warm, humid bathroom."
D) "Ill replace it every 12 months."
Answer: A) "Ill take up to three tablets, 5 minutes apart, for chest pain."
Rationale: Up to three doses, 5 minutes apart, is correct for angina relief. Clients should sit or lie down
to avoid hypotension. Nitroglycerin is stored at room temperature and replaced every 6 months.
2. A client with chest pain arrives at the ED. What is the nurses first action?
A) Obtain vital signs
B) Administer aspirin 325 mg orally
C) Perform a 12-lead ECG
D) Give sublingual nitroglycerin
Answer: A) Obtain vital signs
Rationale: Vital signs assess stability and guide interventions in acute chest pain.
3. A client with heart failure reports dyspnea and 4 kg weight gain in 48 hours. What is the priority action?
A) Notify the healthcare provider
B) Administer furosemide IV
C) Encourage fluid intake
D) Apply oxygen at 4 L/min
Answer: A) Notify the healthcare provider
Rationale: Rapid weight gain and dyspnea indicate worsening heart failure, requiring provider interven-
tion.
4. A client post-myocardial infarction develops atrial fibrillation. What is the priority assessment?
A) Risk for thromboembolism
B) Blood pressure
C) Chest pain severity
D) Respiratory rate
Answer: A) Risk for thromboembolism
Rationale: Atrial fibrillation increases thromboembolism risk due to atrial stasis.
5. A client on lisinopril reports a persistent dry cough. What should the nurse advise?
A) "Discuss a medication change with your provider."
B) "Drink more water to soothe the cough."
C) "Use cough syrup to manage it."
D) "Continue; the cough will resolve."
Answer: A) "Discuss a medication change with your provider."
Rationale: A dry cough often requires switching from an ACE inhibitor to an ARB.
6. A client with hypertension on metoprolol has a heart rate of 45 bpm. What should the nurse do?
A) Withhold the dose and notify the provider
B) Administer the dose as prescribed
C) Monitor for 1 hour
D) Encourage physical activity
Answer: A) Withhold the dose and notify the provider
Rationale: Bradycardia (<50 bpm) is a serious beta-blocker side effect requiring intervention.
7. A client post-cardiac catheterization reports groin pain. Which finding requires immediate action?
A) Hard swelling at the insertion site
B) Mild bruising around the site
C) Warm distal extremity
D) Strong distal pulse
