CMS MED SURG PROCTORED EXAM| 2026/2027 Questions and Verified Answers| Latest Update 2026/2027 | Page 1 | Passing Score: Pass/Fail
ATI NURSING EDUCATION
CMS MED SURG PROCTORED EXAM| 2026/2027
Questions and Verified Answers| Latest Update
2026/2027 Edition - Official Exam 2026/2027
85 P/F N/A
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Cardiovascular Disorders Q1-Q11
Section 2 Respiratory Disorders Q12-Q22
Section 3 Gastrointestinal Disorders Q23-Q33
Section 4 Renal and Urinary Disorders Q34-Q43
Section 5 Endocrine Disorders Q44-Q53
Section 6 Neurologic Disorders Q54-Q63
Section 7 Musculoskeletal and Integumentary Q64-Q74
Section 8 Hematologic and Immunologic Q75-Q85
Instructions: Select the single best answer for each question. This exam is designed for CMS Med Surg Proctored Exam
certification preparation. Passing score determined by ATI standard.
CMS MED SURG PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 1 of 47
,CMS MED SURG PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 2 of 47
, SECTION 1 | Cardiovascular Disorders | Q1-Q11 | CMS MED SURG PROCTORED EXAM 2026/2027
Q1 Question 1 of 85
Q1. A 73-year-old female with a history of hypertension and hyperlipidemia awakens with substernal
chest pressure rated 7 out of 10 that radiates to her jaw and is accompanied by diaphoresis and
nausea. Her 12-lead ECG reveals ST depression in leads V3 through V6 and her troponin T is 0.08
ng/mL, rising to 0.24 ng/mL three hours later. The nurse identifies that these findings are most
consistent with which diagnosis?
A. Non-ST elevation myocardial infarction
B. Stable angina pectoris
C. Acute pericarditis
D. Aortic dissection
Correct Answer: A
Rationale:
ST depression with a rise and fall of troponin levels indicates a non-ST elevation myocardial infarction. Stable
angina would not cause troponin elevation, and pericarditis typically causes diffuse ST elevation rather than
depression.
Q2 Question 2 of 85
Q2. A 58-year-old male with dilated cardiomyopathy has an ejection fraction of 25% and is being
discharged on carvedilol, lisinopril, and spironolactone. He reports waking up breathless at night and
needing three pillows to sleep comfortably. The nurse recognizes that adding which medication would
most effectively reduce his hospitalization risk?
A. Sacubitril-valsartan
B. Amlodipine
C. Digoxin
D. Hydralazine alone
Correct Answer: A
Rationale:
Sacubitril-valsartan is an ARNI that reduces mortality and heart failure hospitalizations in patients with
reduced ejection fraction. Amlodipine does not improve outcomes in HFrEF, and digoxin only reduces
hospitalizations without improving survival.
CMS MED SURG PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 3 of 47
, Q3 Question 3 of 85
Q3. A 64-year-old male is admitted with new-onset atrial fibrillation with rapid ventricular response at
a rate of 156/min. He is hemodynamically stable with a blood pressure of 128/78 mm Hg but
complains of lightheadedness and palpitations. The nurse should anticipate which initial
pharmacologic intervention?
A. Intravenous diltiazem for rate control
B. Immediate synchronized cardioversion
C. Intravenous amiodarone for rhythm control
D. Subcutaneous enoxaparin alone
Correct Answer: A
Rationale:
In a hemodynamically stable patient with atrial fibrillation with rapid ventricular response, the initial priority is
rate control with a calcium channel blocker or beta-blocker. Cardioversion is reserved for hemodynamic
instability, and anticoagulation alone does not address the rate.
Q4 Question 4 of 85
Q4. A 50-year-old male presents with sudden onset tearing chest pain radiating to his back between
his shoulder blades. His blood pressure is 182/110 mm Hg in the right arm and 138/82 mm Hg in the
left arm. Chest x-ray shows a widened mediastinum. The nurse should anticipate which diagnostic
study as the highest priority?
A. Computed tomography angiography of the chest
B. Transthoracic echocardiography
C. Exercise stress test
D. Cardiac catheterization
Correct Answer: A
Rationale:
Tearing chest pain with blood pressure discrepancy between arms and widened mediastinum is classic for
aortic dissection, which requires immediate CT angiography for definitive diagnosis. Stress testing is
contraindicated in suspected dissection.
CMS MED SURG PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 4 of 47
ATI NURSING EDUCATION
CMS MED SURG PROCTORED EXAM| 2026/2027
Questions and Verified Answers| Latest Update
2026/2027 Edition - Official Exam 2026/2027
85 P/F N/A
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Cardiovascular Disorders Q1-Q11
Section 2 Respiratory Disorders Q12-Q22
Section 3 Gastrointestinal Disorders Q23-Q33
Section 4 Renal and Urinary Disorders Q34-Q43
Section 5 Endocrine Disorders Q44-Q53
Section 6 Neurologic Disorders Q54-Q63
Section 7 Musculoskeletal and Integumentary Q64-Q74
Section 8 Hematologic and Immunologic Q75-Q85
Instructions: Select the single best answer for each question. This exam is designed for CMS Med Surg Proctored Exam
certification preparation. Passing score determined by ATI standard.
CMS MED SURG PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 1 of 47
,CMS MED SURG PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 2 of 47
, SECTION 1 | Cardiovascular Disorders | Q1-Q11 | CMS MED SURG PROCTORED EXAM 2026/2027
Q1 Question 1 of 85
Q1. A 73-year-old female with a history of hypertension and hyperlipidemia awakens with substernal
chest pressure rated 7 out of 10 that radiates to her jaw and is accompanied by diaphoresis and
nausea. Her 12-lead ECG reveals ST depression in leads V3 through V6 and her troponin T is 0.08
ng/mL, rising to 0.24 ng/mL three hours later. The nurse identifies that these findings are most
consistent with which diagnosis?
A. Non-ST elevation myocardial infarction
B. Stable angina pectoris
C. Acute pericarditis
D. Aortic dissection
Correct Answer: A
Rationale:
ST depression with a rise and fall of troponin levels indicates a non-ST elevation myocardial infarction. Stable
angina would not cause troponin elevation, and pericarditis typically causes diffuse ST elevation rather than
depression.
Q2 Question 2 of 85
Q2. A 58-year-old male with dilated cardiomyopathy has an ejection fraction of 25% and is being
discharged on carvedilol, lisinopril, and spironolactone. He reports waking up breathless at night and
needing three pillows to sleep comfortably. The nurse recognizes that adding which medication would
most effectively reduce his hospitalization risk?
A. Sacubitril-valsartan
B. Amlodipine
C. Digoxin
D. Hydralazine alone
Correct Answer: A
Rationale:
Sacubitril-valsartan is an ARNI that reduces mortality and heart failure hospitalizations in patients with
reduced ejection fraction. Amlodipine does not improve outcomes in HFrEF, and digoxin only reduces
hospitalizations without improving survival.
CMS MED SURG PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 3 of 47
, Q3 Question 3 of 85
Q3. A 64-year-old male is admitted with new-onset atrial fibrillation with rapid ventricular response at
a rate of 156/min. He is hemodynamically stable with a blood pressure of 128/78 mm Hg but
complains of lightheadedness and palpitations. The nurse should anticipate which initial
pharmacologic intervention?
A. Intravenous diltiazem for rate control
B. Immediate synchronized cardioversion
C. Intravenous amiodarone for rhythm control
D. Subcutaneous enoxaparin alone
Correct Answer: A
Rationale:
In a hemodynamically stable patient with atrial fibrillation with rapid ventricular response, the initial priority is
rate control with a calcium channel blocker or beta-blocker. Cardioversion is reserved for hemodynamic
instability, and anticoagulation alone does not address the rate.
Q4 Question 4 of 85
Q4. A 50-year-old male presents with sudden onset tearing chest pain radiating to his back between
his shoulder blades. His blood pressure is 182/110 mm Hg in the right arm and 138/82 mm Hg in the
left arm. Chest x-ray shows a widened mediastinum. The nurse should anticipate which diagnostic
study as the highest priority?
A. Computed tomography angiography of the chest
B. Transthoracic echocardiography
C. Exercise stress test
D. Cardiac catheterization
Correct Answer: A
Rationale:
Tearing chest pain with blood pressure discrepancy between arms and widened mediastinum is classic for
aortic dissection, which requires immediate CT angiography for definitive diagnosis. Stress testing is
contraindicated in suspected dissection.
CMS MED SURG PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 4 of 47
