ATI Med Surg CMS Proctored Exam Prep (2026
Ultimate Bundle) – Versions A, B, & C Mastery Test
Bank: 300 High-Yield Questions with Complete
Rationales
Supercharge your nursing school study and lock in a Level
3 score with this comprehensive, 300-question ATI
Medical-Surgical CMS Proctored Exam mastery test bank
mirroring Versions A, B, and C [user-provided-multiple-
choice-questions]. Every high-yield question features a
clear, evidence-based correct answer alongside an in-
depth rationale detailing critical nursing interventions,
laboratory priorities, and NCLEX-style clinical safety
guidelines. Perfect for rapid remediation, this high-density
study bundle isolates high-probability test areas to
streamline your preparation time and guarantee
conceptual mastery.
,Question 1: A nurse is caring for a client who is 4 hours postoperative following a subtotal
thyroidectomy. Which of the following signs should the nurse report to the provider
immediately as an indication of hypocalcemia?
A) Positive Chvostek's sign
B) Hypoactive deep tendon reflexes
C) Flushed, warm skin
D) Negative Trousseau's sign
• **Answer: A **
• Rationale: A subtotal thyroidectomy carries a high risk of accidental parathyroid gland
removal or injury, resulting in acute hypocalcemia. A positive Chvostek's sign (facial
muscle twitching when tapping the facial nerve) is a definitive clinical indicator of
neuromuscular irritability due to critically low serum calcium levels.
Question 2: A nurse is assessing a client who has a chest tube connected to a water-seal
drainage system. Which of the following findings requires immediate intervention by the
nurse?
A) Intermittent bubbling in the water-seal chamber during expiration
B) Continuous bubbling in the water-seal chamber
C) Fluctuations (tidaling) in the water-seal chamber with respiration
D) 50 mL of serosanguineous drainage in the collection chamber over the past hour
• **Answer: B **
• Rationale: Continuous bubbling in the water-seal chamber indicates a structural air
leak within the drainage system or at the client insertion site. Intermittent bubbling
during expiration and fluid tidaling are expected, normal physiological findings as the
lung re-expands.
Question 3: A nurse is preparing to administer packed red blood cells (PRBCs) to a client who
has severe anemia. Which of the following solutions must the nurse use to prime the blood
administration tubing?
A) Lactated Ringer's solution
B) 5% Dextrose in water (D5W)
C) 0.9% Sodium chloride (Normal Saline)
D) 0.45% Sodium chloride (Half-Normal Saline)
• **Answer: C **
• Rationale: 0.9% Sodium chloride is the only solution authorized for administration
alongside blood products. Dextrose solutions cause hemolysis (red blood cell
destruction), and Lactated Ringer's can cause clotting due to its calcium content.
Question 4: A nurse is reviewing the laboratory results of a client who is receiving a
continuous intravenous heparin infusion for a deep vein thrombosis (DVT). Which of the
following laboratory values indicates the therapy is effective and within the therapeutic
range?
,A) aPTT of 30 seconds
B) aPTT of 70 seconds
C) INR of 1.2
D) Prothrombin time (PT) of 11 seconds
• **Answer: B **
• Rationale: Continuous heparin infusions are monitored using activated partial
thromboplastin time (aPTT). The therapeutic target is typically 1.5 to 2.5 times the
normal baseline value, making 70 seconds an expected therapeutic finding (normal
baseline is roughly 25 to 35 seconds).
Question 5: A nurse is providing discharge teaching to a client who has a new diagnosis of
Type 1 Diabetes Mellitus. Which of the following instructions should the nurse include
regarding exercise safety?
A) Inject rapid-acting insulin directly into the primary muscle group being exercised.
B) Avoid consuming carbohydrates prior to exercising.
C) Check blood glucose levels before, during, and after exercise.
D) Exercise only when blood glucose levels are greater than 250 mg/dL with ketones present.
• **Answer: C **
• Rationale: Exercise increases insulin sensitivity and glucose uptake, raising the risk of
hypoglycemia. Clients must monitor blood glucose frequently around exercise and
avoid physical activity if ketones are present, as this indicates a lack of sufficient
insulin.
Question 6: A nurse is assessing a client who is recovering from an acute myocardial
infarction (MI). The nurse notes a new, high-pitched, scratchy sound on auscultation at the
left sternal border. Which of the following complications should the nurse suspect?
A) Acute pulmonary edema
B) Pericarditis
C) Left ventricular failure
D) Mitral valve prolapse
• **Answer: B **
• Rationale: Pericarditis is a common inflammatory complication following a myocardial
infarction. It manifests clinically as a pericardial friction rub, which produces a
characteristic scratchy, high-pitched scraping sound heard best at the left sternal
border.
Question 7: A nurse is evaluating a client who has a history of chronic obstructive pulmonary
disease (COPD) and is receiving oxygen therapy. Which of the following findings is the most
reliable indicators of oxygen toxicity?
A) Increased production of thick, green sputum
B) Substernal chest pain, nonproductive cough, and nasal stuffiness
, C) Bradypnea and extreme drowsiness
D) Clear breath sounds with equal chest expansion
• **Answer: B **
• Rationale: Prolonged exposure to high concentrations of oxygen causes tissue
damage. Early signs of oxygen toxicity include substernal chest discomfort, a dry
hacking cough, nasal congestion, and gastrointestinal upset.
Question 8: A nurse is caring for a client who has been admitted with acute pancreatitis.
Which of the following provider orders should the nurse implement first?
A) Administer an oral pancreatic enzyme supplement.
B) Maintain strict nothing-by-mouth (NPO) status.
C) Set up a physical therapy consultation.
D) Administer a scheduled dose of an oral antibiotic.
• **Answer: B **
• Rationale: The primary therapeutic goal in acute pancreatitis is to rest the pancreas
and minimize the secretion of pancreatic enzymes. Keeping the client NPO is the
priority action to prevent autodigestion of pancreatic tissue and manage pain.
Question 9: A nurse is monitoring a client who has a new diagnosis of chronic kidney disease
(CKD). Which of the following electrolyte imbalances should the nurse expect to find upon
reviewing the laboratory results?
A) Hypokalemia
B) Hypercalcemia
C) Hyperkalemia
D) Hypophosphatemia
• **Answer: C **
• Rationale: In chronic kidney disease, the kidneys lose the ability to adequately excrete
potassium, leading to dangerous systemic accumulations (hyperkalemia). Clients also
exhibit hyperphosphatemia and hypocalcemia.
Question 10: A nurse is providing dietary teaching to a client who has a history of calcium
oxalate renal calculi. Which of the following foods should the nurse instruct the client to
avoid?
A) Whole milk
B) Spinach and rhubarb
C) Bananas and apples
D) Poultry and white rice
• **Answer: B **
• Rationale: Spinach, rhubarb, beets, nuts, and chocolate are high in oxalate. Clients
prone to calcium oxalate kidney stones should strictly limit high-oxalate foods and
maintain high fluid intake.
Ultimate Bundle) – Versions A, B, & C Mastery Test
Bank: 300 High-Yield Questions with Complete
Rationales
Supercharge your nursing school study and lock in a Level
3 score with this comprehensive, 300-question ATI
Medical-Surgical CMS Proctored Exam mastery test bank
mirroring Versions A, B, and C [user-provided-multiple-
choice-questions]. Every high-yield question features a
clear, evidence-based correct answer alongside an in-
depth rationale detailing critical nursing interventions,
laboratory priorities, and NCLEX-style clinical safety
guidelines. Perfect for rapid remediation, this high-density
study bundle isolates high-probability test areas to
streamline your preparation time and guarantee
conceptual mastery.
,Question 1: A nurse is caring for a client who is 4 hours postoperative following a subtotal
thyroidectomy. Which of the following signs should the nurse report to the provider
immediately as an indication of hypocalcemia?
A) Positive Chvostek's sign
B) Hypoactive deep tendon reflexes
C) Flushed, warm skin
D) Negative Trousseau's sign
• **Answer: A **
• Rationale: A subtotal thyroidectomy carries a high risk of accidental parathyroid gland
removal or injury, resulting in acute hypocalcemia. A positive Chvostek's sign (facial
muscle twitching when tapping the facial nerve) is a definitive clinical indicator of
neuromuscular irritability due to critically low serum calcium levels.
Question 2: A nurse is assessing a client who has a chest tube connected to a water-seal
drainage system. Which of the following findings requires immediate intervention by the
nurse?
A) Intermittent bubbling in the water-seal chamber during expiration
B) Continuous bubbling in the water-seal chamber
C) Fluctuations (tidaling) in the water-seal chamber with respiration
D) 50 mL of serosanguineous drainage in the collection chamber over the past hour
• **Answer: B **
• Rationale: Continuous bubbling in the water-seal chamber indicates a structural air
leak within the drainage system or at the client insertion site. Intermittent bubbling
during expiration and fluid tidaling are expected, normal physiological findings as the
lung re-expands.
Question 3: A nurse is preparing to administer packed red blood cells (PRBCs) to a client who
has severe anemia. Which of the following solutions must the nurse use to prime the blood
administration tubing?
A) Lactated Ringer's solution
B) 5% Dextrose in water (D5W)
C) 0.9% Sodium chloride (Normal Saline)
D) 0.45% Sodium chloride (Half-Normal Saline)
• **Answer: C **
• Rationale: 0.9% Sodium chloride is the only solution authorized for administration
alongside blood products. Dextrose solutions cause hemolysis (red blood cell
destruction), and Lactated Ringer's can cause clotting due to its calcium content.
Question 4: A nurse is reviewing the laboratory results of a client who is receiving a
continuous intravenous heparin infusion for a deep vein thrombosis (DVT). Which of the
following laboratory values indicates the therapy is effective and within the therapeutic
range?
,A) aPTT of 30 seconds
B) aPTT of 70 seconds
C) INR of 1.2
D) Prothrombin time (PT) of 11 seconds
• **Answer: B **
• Rationale: Continuous heparin infusions are monitored using activated partial
thromboplastin time (aPTT). The therapeutic target is typically 1.5 to 2.5 times the
normal baseline value, making 70 seconds an expected therapeutic finding (normal
baseline is roughly 25 to 35 seconds).
Question 5: A nurse is providing discharge teaching to a client who has a new diagnosis of
Type 1 Diabetes Mellitus. Which of the following instructions should the nurse include
regarding exercise safety?
A) Inject rapid-acting insulin directly into the primary muscle group being exercised.
B) Avoid consuming carbohydrates prior to exercising.
C) Check blood glucose levels before, during, and after exercise.
D) Exercise only when blood glucose levels are greater than 250 mg/dL with ketones present.
• **Answer: C **
• Rationale: Exercise increases insulin sensitivity and glucose uptake, raising the risk of
hypoglycemia. Clients must monitor blood glucose frequently around exercise and
avoid physical activity if ketones are present, as this indicates a lack of sufficient
insulin.
Question 6: A nurse is assessing a client who is recovering from an acute myocardial
infarction (MI). The nurse notes a new, high-pitched, scratchy sound on auscultation at the
left sternal border. Which of the following complications should the nurse suspect?
A) Acute pulmonary edema
B) Pericarditis
C) Left ventricular failure
D) Mitral valve prolapse
• **Answer: B **
• Rationale: Pericarditis is a common inflammatory complication following a myocardial
infarction. It manifests clinically as a pericardial friction rub, which produces a
characteristic scratchy, high-pitched scraping sound heard best at the left sternal
border.
Question 7: A nurse is evaluating a client who has a history of chronic obstructive pulmonary
disease (COPD) and is receiving oxygen therapy. Which of the following findings is the most
reliable indicators of oxygen toxicity?
A) Increased production of thick, green sputum
B) Substernal chest pain, nonproductive cough, and nasal stuffiness
, C) Bradypnea and extreme drowsiness
D) Clear breath sounds with equal chest expansion
• **Answer: B **
• Rationale: Prolonged exposure to high concentrations of oxygen causes tissue
damage. Early signs of oxygen toxicity include substernal chest discomfort, a dry
hacking cough, nasal congestion, and gastrointestinal upset.
Question 8: A nurse is caring for a client who has been admitted with acute pancreatitis.
Which of the following provider orders should the nurse implement first?
A) Administer an oral pancreatic enzyme supplement.
B) Maintain strict nothing-by-mouth (NPO) status.
C) Set up a physical therapy consultation.
D) Administer a scheduled dose of an oral antibiotic.
• **Answer: B **
• Rationale: The primary therapeutic goal in acute pancreatitis is to rest the pancreas
and minimize the secretion of pancreatic enzymes. Keeping the client NPO is the
priority action to prevent autodigestion of pancreatic tissue and manage pain.
Question 9: A nurse is monitoring a client who has a new diagnosis of chronic kidney disease
(CKD). Which of the following electrolyte imbalances should the nurse expect to find upon
reviewing the laboratory results?
A) Hypokalemia
B) Hypercalcemia
C) Hyperkalemia
D) Hypophosphatemia
• **Answer: C **
• Rationale: In chronic kidney disease, the kidneys lose the ability to adequately excrete
potassium, leading to dangerous systemic accumulations (hyperkalemia). Clients also
exhibit hyperphosphatemia and hypocalcemia.
Question 10: A nurse is providing dietary teaching to a client who has a history of calcium
oxalate renal calculi. Which of the following foods should the nurse instruct the client to
avoid?
A) Whole milk
B) Spinach and rhubarb
C) Bananas and apples
D) Poultry and white rice
• **Answer: B **
• Rationale: Spinach, rhubarb, beets, nuts, and chocolate are high in oxalate. Clients
prone to calcium oxalate kidney stones should strictly limit high-oxalate foods and
maintain high fluid intake.
