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ATI Med Surg Proctored Exam 2025 –
100% Verified NGN Questions and
Rationales | Actual Exam Content
Updated for Guaranteed Success
Question 1
A client with acute myocardial infarction (MI) presents with chest pain radiating to the left arm.
What is the nurse’s priority action?
A. Administer sublingual nitroglycerin as prescribed
B. Obtain a 12-lead ECG immediately
C. Provide supplemental oxygen at 6 L/min
D. Place the client in a supine position
Correct Answer: B
Rationale: Obtaining a 12-lead ECG within 10 minutes is the priority to confirm MI diagnosis
and guide treatment. Nitroglycerin and oxygen are important but secondary to diagnostic
confirmation. Supine positioning may increase cardiac workload. ATI 2025 Standard: Rapid
ECG for suspected MI aligns with current guidelines.
Question 2
A client post-coronary artery bypass graft (CABG) has 400 mL of bloody chest tube drainage in
2 hours. What should the nurse do first?
A. Document the drainage as normal
B. Notify the surgeon immediately
C. Increase chest tube suction pressure
D. Milk the chest tube to clear clots
Correct Answer: B
Rationale: Drainage exceeding 200 mL/hr post-CABG suggests hemorrhage, requiring
immediate surgeon notification. Milking or increasing suction is unsafe without orders, and this
drainage is not normal. ATI 2025 Standard: Early recognition of postoperative complications is
emphasized.
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Question 3
A client with heart failure is prescribed furosemide. Which laboratory value should the nurse
monitor closely?
A. Serum potassium
B. Serum sodium
C. Blood glucose
D. Platelet count
Correct Answer: A
Rationale: Furosemide, a loop diuretic, increases potassium excretion, risking hypokalemia,
which can lead to arrhythmias. Sodium, glucose, and platelets are less directly affected. ATI 2025
Standard: Electrolyte monitoring with diuretics is a core focus.
Question 4
A client with chronic obstructive pulmonary disease (COPD) has an SpO2 of 88%. What is the
nurse’s best action?
A. Increase oxygen to 6 L/min via nasal cannula
B. Encourage pursed-lip breathing
C. Administer albuterol nebulizer as prescribed
D. Place the client in a supine position
Correct Answer: B
Rationale: SpO2 of 88% is acceptable in COPD to avoid suppressing respiratory drive. Pursed -
lip breathing improves oxygenation. Increasing oxygen or albuterol is unnecessary without
further assessment, and supine positioning worsens dyspnea. ATI 2025 Standard: Non-invasive
COPD management is prioritized.
Question 5
A client with type 2 diabetes has a blood glucose of 400 mg/dL. What is the nurse’s priority
action?
A. Administer regular insulin as prescribed
B. Encourage oral fluid intake
C. Assess for signs of diabetic ketoacidosis (DKA)
D. Provide a high-carbohydrate snack
Correct Answer: C
Rationale: Hyperglycemia at 400 mg/dL risks DKA, requiring assessment for symptoms like
Kussmaul respirations or fruity breath. Insulin and fluids are secondary until DKA is ruled out. A
, 3
high-carbohydrate snack is contraindicated. ATI 2025 Standard: DKA assessment is critical in
hyperglycemia.
Question 6
A client post-total hip replacement reports sudden shortness of breath and chest pain. What is the
nurse’s priority action?
A. Administer pain medication
B. Notify the provider immediately
C. Elevate the head of the bed
D. Apply compression stockings
Correct Answer: B
Rationale: Sudden dyspnea and chest pain suggest pulmonary embolism, a life-threatening
emergency requiring immediate provider notification. Pain medication, elevation, or stockings
are secondary. ATI 2025 Standard: Postoperative complication recognition is emphasized.
Question 7
A client with acute pancreatitis reports severe abdominal pain. Which position should the nurse
encourage?
A. Supine with legs extended
B. Prone with head elevated
C. Fetal position with knees drawn up
D. Sitting upright at 90 degrees
Correct Answer: C
Rationale: The fetal position reduces pancreatic stimulation and pain by decreasing abdominal
tension. Other positions may exacerbate pain. ATI 2025 Standard: Comfort measures for
pancreatitis are highlighted.
Question 8
A client with a new colostomy reports no output for 24 hours. What is the nurse’s first action?
A. Irrigate the colostomy
B. Assess for bowel sounds
C. Notify the provider
D. Administer a laxative
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Correct Answer: B
Rationale: Assessing bowel sounds evaluates for obstruction or ileus, common causes of no
output. Irrigation, notification, or laxatives are premature without assessment. ATI 2025
Standard: Systematic assessment is a core competency.
Question 9
A client with chronic kidney disease (CKD) has a potassium level of 6.5 mEq/L. What is the
nurse’s priority action?
A. Administer potassium supplements
B. Notify the provider immediately
C. Encourage potassium-rich foods
D. Increase fluid intake
Correct Answer: B
Rationale: Hyperkalemia (6.5 mEq/L) risks cardiac arrhythmias, requiring immediate provider
notification for interventions like calcium gluconate or dialysis. Supplements or potassium-rich
foods worsen the condition, and fluids alone are insufficient. ATI 2025 Standard: Electrolyte
management in CKD is critical.
Question 10
A client with a traumatic brain injury (TBI) has an intracranial pressure (ICP) of 25 mmHg.
What is the nurse’s priority action?
A. Administer mannitol as prescribed
B. Elevate the head of the bed to 30 degrees
C. Increase oxygen to 10 L/min
D. Encourage deep breathing exercises
Correct Answer: B
Rationale: Elevating the head to 30 degrees promotes venous drainage, reducing ICP. Mannitol
requires a prescription, high oxygen is unnecessary without hypoxia, and deep breathing may
increase ICP. ATI 2025 Standard: Non-invasive ICP management is prioritized.
Question 11
A client with peptic ulcer disease is prescribed omeprazole. What should the nurse teach the
client?
A. Take with antacids for best effect
B. Take 30 minutes before meals
ATI Med Surg Proctored Exam 2025 –
100% Verified NGN Questions and
Rationales | Actual Exam Content
Updated for Guaranteed Success
Question 1
A client with acute myocardial infarction (MI) presents with chest pain radiating to the left arm.
What is the nurse’s priority action?
A. Administer sublingual nitroglycerin as prescribed
B. Obtain a 12-lead ECG immediately
C. Provide supplemental oxygen at 6 L/min
D. Place the client in a supine position
Correct Answer: B
Rationale: Obtaining a 12-lead ECG within 10 minutes is the priority to confirm MI diagnosis
and guide treatment. Nitroglycerin and oxygen are important but secondary to diagnostic
confirmation. Supine positioning may increase cardiac workload. ATI 2025 Standard: Rapid
ECG for suspected MI aligns with current guidelines.
Question 2
A client post-coronary artery bypass graft (CABG) has 400 mL of bloody chest tube drainage in
2 hours. What should the nurse do first?
A. Document the drainage as normal
B. Notify the surgeon immediately
C. Increase chest tube suction pressure
D. Milk the chest tube to clear clots
Correct Answer: B
Rationale: Drainage exceeding 200 mL/hr post-CABG suggests hemorrhage, requiring
immediate surgeon notification. Milking or increasing suction is unsafe without orders, and this
drainage is not normal. ATI 2025 Standard: Early recognition of postoperative complications is
emphasized.
, 2
Question 3
A client with heart failure is prescribed furosemide. Which laboratory value should the nurse
monitor closely?
A. Serum potassium
B. Serum sodium
C. Blood glucose
D. Platelet count
Correct Answer: A
Rationale: Furosemide, a loop diuretic, increases potassium excretion, risking hypokalemia,
which can lead to arrhythmias. Sodium, glucose, and platelets are less directly affected. ATI 2025
Standard: Electrolyte monitoring with diuretics is a core focus.
Question 4
A client with chronic obstructive pulmonary disease (COPD) has an SpO2 of 88%. What is the
nurse’s best action?
A. Increase oxygen to 6 L/min via nasal cannula
B. Encourage pursed-lip breathing
C. Administer albuterol nebulizer as prescribed
D. Place the client in a supine position
Correct Answer: B
Rationale: SpO2 of 88% is acceptable in COPD to avoid suppressing respiratory drive. Pursed -
lip breathing improves oxygenation. Increasing oxygen or albuterol is unnecessary without
further assessment, and supine positioning worsens dyspnea. ATI 2025 Standard: Non-invasive
COPD management is prioritized.
Question 5
A client with type 2 diabetes has a blood glucose of 400 mg/dL. What is the nurse’s priority
action?
A. Administer regular insulin as prescribed
B. Encourage oral fluid intake
C. Assess for signs of diabetic ketoacidosis (DKA)
D. Provide a high-carbohydrate snack
Correct Answer: C
Rationale: Hyperglycemia at 400 mg/dL risks DKA, requiring assessment for symptoms like
Kussmaul respirations or fruity breath. Insulin and fluids are secondary until DKA is ruled out. A
, 3
high-carbohydrate snack is contraindicated. ATI 2025 Standard: DKA assessment is critical in
hyperglycemia.
Question 6
A client post-total hip replacement reports sudden shortness of breath and chest pain. What is the
nurse’s priority action?
A. Administer pain medication
B. Notify the provider immediately
C. Elevate the head of the bed
D. Apply compression stockings
Correct Answer: B
Rationale: Sudden dyspnea and chest pain suggest pulmonary embolism, a life-threatening
emergency requiring immediate provider notification. Pain medication, elevation, or stockings
are secondary. ATI 2025 Standard: Postoperative complication recognition is emphasized.
Question 7
A client with acute pancreatitis reports severe abdominal pain. Which position should the nurse
encourage?
A. Supine with legs extended
B. Prone with head elevated
C. Fetal position with knees drawn up
D. Sitting upright at 90 degrees
Correct Answer: C
Rationale: The fetal position reduces pancreatic stimulation and pain by decreasing abdominal
tension. Other positions may exacerbate pain. ATI 2025 Standard: Comfort measures for
pancreatitis are highlighted.
Question 8
A client with a new colostomy reports no output for 24 hours. What is the nurse’s first action?
A. Irrigate the colostomy
B. Assess for bowel sounds
C. Notify the provider
D. Administer a laxative
, 4
Correct Answer: B
Rationale: Assessing bowel sounds evaluates for obstruction or ileus, common causes of no
output. Irrigation, notification, or laxatives are premature without assessment. ATI 2025
Standard: Systematic assessment is a core competency.
Question 9
A client with chronic kidney disease (CKD) has a potassium level of 6.5 mEq/L. What is the
nurse’s priority action?
A. Administer potassium supplements
B. Notify the provider immediately
C. Encourage potassium-rich foods
D. Increase fluid intake
Correct Answer: B
Rationale: Hyperkalemia (6.5 mEq/L) risks cardiac arrhythmias, requiring immediate provider
notification for interventions like calcium gluconate or dialysis. Supplements or potassium-rich
foods worsen the condition, and fluids alone are insufficient. ATI 2025 Standard: Electrolyte
management in CKD is critical.
Question 10
A client with a traumatic brain injury (TBI) has an intracranial pressure (ICP) of 25 mmHg.
What is the nurse’s priority action?
A. Administer mannitol as prescribed
B. Elevate the head of the bed to 30 degrees
C. Increase oxygen to 10 L/min
D. Encourage deep breathing exercises
Correct Answer: B
Rationale: Elevating the head to 30 degrees promotes venous drainage, reducing ICP. Mannitol
requires a prescription, high oxygen is unnecessary without hypoxia, and deep breathing may
increase ICP. ATI 2025 Standard: Non-invasive ICP management is prioritized.
Question 11
A client with peptic ulcer disease is prescribed omeprazole. What should the nurse teach the
client?
A. Take with antacids for best effect
B. Take 30 minutes before meals
