ATI Medical-Surgical Nursing Practice Exam
| 2026–2027| Original Multiple-Choice Questions
with Detailed Answers And Rationales
1. A nurse is caring for a client admitted with acute myocardial infarction.
Which assessment finding requires immediate intervention?
A. Heart rate of 88 beats/min
B. Blood pressure of 136/82 mmHg
C. Oxygen saturation of 86% on room air
D. Pain rating of 4/10
CORRECT ANSWER: C. Oxygen saturation of 86% on room air
RATIONALE:
C is correct because hypoxemia increases myocardial oxygen demand and worsens cardiac
ischemia. Restoring oxygenation is the priority using the ABC approach.
2. A client with heart failure reports increasing shortness of breath while lying
flat. Which assessment finding should the nurse expect?
A. Dry mucous membranes
B. Bilateral crackles at the lung bases
C. Increased urine output
D. Bradycardia
CORRECT ANSWER: B. Bilateral crackles at the lung bases
RATIONALE:
B is correct because left-sided heart failure causes pulmonary congestion, resulting in crackles,
dyspnea, and orthopnea.
3. Which client should the nurse assess first?
,A. A client requesting pain medication after surgery
B. A client with sudden onset of slurred speech and right-sided weakness
C. A client awaiting discharge instructions
D. A client requesting assistance with bathing
CORRECT ANSWER: B. A client with sudden onset of slurred speech and right-sided
weakness
RATIONALE:
B is correct because these are classic signs of an acute stroke. Rapid assessment and treatment
are essential to reduce permanent neurological damage.
4. A nurse is caring for a client receiving IV potassium chloride. Which action
requires immediate correction?
A. Infusing the medication with an infusion pump
B. Diluting the medication before administration
C. Administering potassium by IV push
D. Monitoring the client's cardiac rhythm
CORRECT ANSWER: C. Administering potassium by IV push
RATIONALE:
C is correct because IV potassium must never be administered by IV push due to the risk of fatal
cardiac dysrhythmias.
5. Which assessment finding indicates that treatment for pneumonia is effective?
A. Oxygen saturation increases from 89% to 96%.
B. Respiratory rate increases from 18 to 30 breaths/min.
C. Temperature rises to 39.5°C (103.1°F).
D. Crackles become more pronounced.
, CORRECT ANSWER: A. Oxygen saturation increases from 89% to 96%.
RATIONALE:
A is correct because improved oxygen saturation reflects better gas exchange and a positive
response to therapy.
6. A nurse is caring for a client with chronic kidney disease. Which laboratory
value requires immediate intervention?
A. Sodium 139 mEq/L
B. Potassium 6.5 mEq/L
C. Calcium 9.1 mg/dL
D. Hemoglobin 12.2 g/dL
CORRECT ANSWER: B. Potassium 6.5 mEq/L
RATIONALE:
B is correct because severe hyperkalemia can cause life-threatening cardiac dysrhythmias and
cardiac arrest.
7. A client receiving morphine becomes difficult to arouse. Which action should
the nurse take first?
A. Document the finding.
B. Assess respiratory status and withhold additional opioid medication.
C. Encourage the client to sleep.
D. Administer the next scheduled dose.
CORRECT ANSWER: B. Assess respiratory status and withhold additional opioid
medication.
RATIONALE:
B is correct because respiratory depression is the most serious adverse effect of opioids.
Immediate assessment and intervention are necessary.
| 2026–2027| Original Multiple-Choice Questions
with Detailed Answers And Rationales
1. A nurse is caring for a client admitted with acute myocardial infarction.
Which assessment finding requires immediate intervention?
A. Heart rate of 88 beats/min
B. Blood pressure of 136/82 mmHg
C. Oxygen saturation of 86% on room air
D. Pain rating of 4/10
CORRECT ANSWER: C. Oxygen saturation of 86% on room air
RATIONALE:
C is correct because hypoxemia increases myocardial oxygen demand and worsens cardiac
ischemia. Restoring oxygenation is the priority using the ABC approach.
2. A client with heart failure reports increasing shortness of breath while lying
flat. Which assessment finding should the nurse expect?
A. Dry mucous membranes
B. Bilateral crackles at the lung bases
C. Increased urine output
D. Bradycardia
CORRECT ANSWER: B. Bilateral crackles at the lung bases
RATIONALE:
B is correct because left-sided heart failure causes pulmonary congestion, resulting in crackles,
dyspnea, and orthopnea.
3. Which client should the nurse assess first?
,A. A client requesting pain medication after surgery
B. A client with sudden onset of slurred speech and right-sided weakness
C. A client awaiting discharge instructions
D. A client requesting assistance with bathing
CORRECT ANSWER: B. A client with sudden onset of slurred speech and right-sided
weakness
RATIONALE:
B is correct because these are classic signs of an acute stroke. Rapid assessment and treatment
are essential to reduce permanent neurological damage.
4. A nurse is caring for a client receiving IV potassium chloride. Which action
requires immediate correction?
A. Infusing the medication with an infusion pump
B. Diluting the medication before administration
C. Administering potassium by IV push
D. Monitoring the client's cardiac rhythm
CORRECT ANSWER: C. Administering potassium by IV push
RATIONALE:
C is correct because IV potassium must never be administered by IV push due to the risk of fatal
cardiac dysrhythmias.
5. Which assessment finding indicates that treatment for pneumonia is effective?
A. Oxygen saturation increases from 89% to 96%.
B. Respiratory rate increases from 18 to 30 breaths/min.
C. Temperature rises to 39.5°C (103.1°F).
D. Crackles become more pronounced.
, CORRECT ANSWER: A. Oxygen saturation increases from 89% to 96%.
RATIONALE:
A is correct because improved oxygen saturation reflects better gas exchange and a positive
response to therapy.
6. A nurse is caring for a client with chronic kidney disease. Which laboratory
value requires immediate intervention?
A. Sodium 139 mEq/L
B. Potassium 6.5 mEq/L
C. Calcium 9.1 mg/dL
D. Hemoglobin 12.2 g/dL
CORRECT ANSWER: B. Potassium 6.5 mEq/L
RATIONALE:
B is correct because severe hyperkalemia can cause life-threatening cardiac dysrhythmias and
cardiac arrest.
7. A client receiving morphine becomes difficult to arouse. Which action should
the nurse take first?
A. Document the finding.
B. Assess respiratory status and withhold additional opioid medication.
C. Encourage the client to sleep.
D. Administer the next scheduled dose.
CORRECT ANSWER: B. Assess respiratory status and withhold additional opioid
medication.
RATIONALE:
B is correct because respiratory depression is the most serious adverse effect of opioids.
Immediate assessment and intervention are necessary.
