ATI PN MED SURG PROCTORED EXAM 200 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
ALREADY GRADED A+ NEW!!!!!!!!!!!!!!!!!!!!!
This comprehensive 200-question practice set is designed for ATI PN Medical-
Surgical proctored exam preparation. Every question is completely unique,
with no repetition of clinical scenarios, medications, lab values, or disease
processes. The set covers cardiovascular, respiratory, endocrine,
gastrointestinal, renal, neurological, musculoskeletal, oncology,
fluid/electrolyte, perioperative, and infectious disease topics. Each question
includes four multiple-choice options, a correct answer, and a detailed
rationale explaining the underlying pathophysiology, nursing intervention, or
medication mechanism. The questions range from basic assessment findings to
complex prioritization and medication teaching. This resource is intended for
supplemental practice only and is not affiliated with or endorsed by ATI
Testing. Use it to identify knowledge gaps and reinforce critical thinking for
exam success.
1. A client with a history of coronary artery disease reports crushing chest pain that
radiates to the jaw. The nurse administers sublingual nitroglycerin, but the pain
persists after 5 minutes. What is the nurse's priority action?
A) Administer a second dose of nitroglycerin and call the provider.
B) Apply oxygen at 2 L/min via nasal cannula.
C) Call 911 or activate the emergency response system.
D) Have the client lie flat to increase venous return.
Answer: C) Call 911 or activate the emergency response system.
Rationale: Persistent chest pain after one nitroglycerin dose that does not resolve
indicates a possible acute myocardial infarction. The priority is to activate
emergency medical services immediately. A second dose can be given after calling
for help, not before. Oxygen may be applied, but activating emergency response
takes priority.
2. A client with heart failure is prescribed furosemide (Lasix). Which of the
following laboratory values should the nurse monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
,D) Serum magnesium
Answer: B) Serum potassium.
Rationale: Furosemide is a loop diuretic that causes potassium wasting through the
kidneys, leading to hypokalemia. The nurse should monitor serum potassium levels
closely to prevent complications such as cardiac arrhythmias.
3. A client with angina pectoris is prescribed sublingual nitroglycerin. Which
instruction should the nurse include in client teaching?
A) Take one tablet every 15 minutes for up to three doses.
B) Take one tablet at the onset of chest pain and call 911 if pain is not relieved
after one tablet.
C) Take one tablet 30 minutes before physical activity to prevent chest pain.
D) Chew the tablet for faster absorption.
Answer: B) Take one tablet at the onset of chest pain and call 911 if pain is not
relieved after one tablet.
Rationale: The standard protocol is to take one nitroglycerin tablet sublingually at
the first sign of chest pain. If pain persists after 5 minutes, call 911, then take a
second tablet if prescribed. Waiting for three doses before calling 911 delays
emergency care.
4. A client with cirrhosis is experiencing severe pruritus (itching). Which nursing
intervention is most appropriate to provide comfort?
A) Apply alcohol-based lotion to the skin twice daily.
B) Encourage the client to take hot baths to soothe the skin.
C) Keep the client's fingernails short and apply cool compresses.
D) Administer diphenhydramine (Benadryl) as the first-line treatment.
Answer: C) Keep the client's fingernails short and apply cool compresses.
Rationale: Pruritus in cirrhosis is caused by bile salt accumulation under the skin.
Keeping nails short prevents skin breakdown from scratching, and cool compresses
can soothe itching without causing further irritation. Hot baths and alcohol-based
lotions dry the skin and worsen itching. Antihistamines are sometimes used, but
they are not considered first-line and may not be effective for bile-salt pruritus.
5. A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 88%. Which oxygen delivery method should the nurse use?
A) Non-rebreather mask at 15 L/min
B) Venturi mask at 40%
C) Nasal cannula at 1-2 L/min
D) Simple face mask at 6 L/min
Answer: C) Nasal cannula at 1-2 L/min.
,Rationale: Clients with COPD often have a hypoxic drive to breathe. High-flow
oxygen can suppress this drive and lead to respiratory depression. Low-flow
oxygen via nasal cannula at 1-2 L/min is the safest initial approach.
6. A nurse is providing discharge teaching to a client with a new colostomy. Which
food should the client be instructed to avoid to prevent gas formation?
A) Applesauce
B) Cabbage
C) White rice
D) Yogurt
Answer: B) Cabbage.
Rationale: Gas-forming foods such as cabbage, broccoli, onions, and beans should
be avoided to prevent excessive flatus and discomfort. Applesauce, white rice, and
yogurt are generally well-tolerated and less likely to cause gas.
7. A client with diabetes mellitus type 2 has a blood glucose level of 210 mg/dL.
Which symptom would the nurse expect the client to report?
A) Diaphoresis and tremors
B) Polyuria and polydipsia
C) Muscle cramps and fatigue
D) Headache and blurred vision
Answer: B) Polyuria and polydipsia.
Rationale: Hyperglycemia leads to osmotic diuresis, causing polyuria (frequent
urination), which in turn leads to polydipsia (excessive thirst). Diaphoresis and
tremors are signs of hypoglycemia.
8. A nurse is preparing to administer insulin to a client with type 1 diabetes. Which
insulin should be given 30 minutes before a meal?
A) Regular insulin
B) NPH insulin
C) Insulin glargine (Lantus)
D) Insulin detemir (Levemir)
Answer: A) Regular insulin.
Rationale: Regular insulin is a short-acting insulin that should be administered 30
minutes before meals to ensure peak action coincides with postprandial glucose
rise. NPH is intermediate-acting, and glargine/detemir are long-acting basal
insulins.
9. A client is admitted with acute pancreatitis. Which laboratory value is most
indicative of this condition?
, A) Elevated serum amylase
B) Elevated serum potassium
C) Decreased serum calcium
D) Decreased serum glucose
Answer: A) Elevated serum amylase.
Rationale: Serum amylase and lipase are the primary markers for acute
pancreatitis, with amylase typically rising within 24 hours of onset. Lipase is more
specific, but amylase is the classic elevation seen.
10. A postoperative client reports sudden shortness of breath and chest pain. The
nurse notes tachycardia and hypotension. What is the priority nursing action?
A) Administer oxygen via face mask
B) Place the client in a high-Fowler's position
C) Call the rapid response team
D) Check the client's oxygen saturation
Answer: C) Call the rapid response team.
Rationale: Sudden onset of dyspnea, chest pain, tachycardia, and hypotension in a
postoperative client suggests a pulmonary embolism, which is a life-threatening
emergency. The priority is to activate the rapid response team or call for
emergency assistance immediately while providing supportive care.
11. A client with chronic kidney disease (CKD) is on a restricted potassium diet.
Which food should the nurse instruct the client to avoid?
A) Apples
B) Bananas
C) Cabbage
D) Green beans
Answer: B) Bananas.
Rationale: Bananas are high in potassium and should be avoided in clients with
CKD who are on a potassium-restricted diet. Apples, cabbage, and green beans are
lower in potassium.
12. A nurse is caring for a client with cirrhosis of the liver. Which finding indicates
worsening hepatic encephalopathy?
A) Asterixis (liver flap)
B) Increased appetite
C) Clear speech
D) Oriented to person, place, and time
Answer: A) Asterixis (liver flap).
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
ALREADY GRADED A+ NEW!!!!!!!!!!!!!!!!!!!!!
This comprehensive 200-question practice set is designed for ATI PN Medical-
Surgical proctored exam preparation. Every question is completely unique,
with no repetition of clinical scenarios, medications, lab values, or disease
processes. The set covers cardiovascular, respiratory, endocrine,
gastrointestinal, renal, neurological, musculoskeletal, oncology,
fluid/electrolyte, perioperative, and infectious disease topics. Each question
includes four multiple-choice options, a correct answer, and a detailed
rationale explaining the underlying pathophysiology, nursing intervention, or
medication mechanism. The questions range from basic assessment findings to
complex prioritization and medication teaching. This resource is intended for
supplemental practice only and is not affiliated with or endorsed by ATI
Testing. Use it to identify knowledge gaps and reinforce critical thinking for
exam success.
1. A client with a history of coronary artery disease reports crushing chest pain that
radiates to the jaw. The nurse administers sublingual nitroglycerin, but the pain
persists after 5 minutes. What is the nurse's priority action?
A) Administer a second dose of nitroglycerin and call the provider.
B) Apply oxygen at 2 L/min via nasal cannula.
C) Call 911 or activate the emergency response system.
D) Have the client lie flat to increase venous return.
Answer: C) Call 911 or activate the emergency response system.
Rationale: Persistent chest pain after one nitroglycerin dose that does not resolve
indicates a possible acute myocardial infarction. The priority is to activate
emergency medical services immediately. A second dose can be given after calling
for help, not before. Oxygen may be applied, but activating emergency response
takes priority.
2. A client with heart failure is prescribed furosemide (Lasix). Which of the
following laboratory values should the nurse monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
,D) Serum magnesium
Answer: B) Serum potassium.
Rationale: Furosemide is a loop diuretic that causes potassium wasting through the
kidneys, leading to hypokalemia. The nurse should monitor serum potassium levels
closely to prevent complications such as cardiac arrhythmias.
3. A client with angina pectoris is prescribed sublingual nitroglycerin. Which
instruction should the nurse include in client teaching?
A) Take one tablet every 15 minutes for up to three doses.
B) Take one tablet at the onset of chest pain and call 911 if pain is not relieved
after one tablet.
C) Take one tablet 30 minutes before physical activity to prevent chest pain.
D) Chew the tablet for faster absorption.
Answer: B) Take one tablet at the onset of chest pain and call 911 if pain is not
relieved after one tablet.
Rationale: The standard protocol is to take one nitroglycerin tablet sublingually at
the first sign of chest pain. If pain persists after 5 minutes, call 911, then take a
second tablet if prescribed. Waiting for three doses before calling 911 delays
emergency care.
4. A client with cirrhosis is experiencing severe pruritus (itching). Which nursing
intervention is most appropriate to provide comfort?
A) Apply alcohol-based lotion to the skin twice daily.
B) Encourage the client to take hot baths to soothe the skin.
C) Keep the client's fingernails short and apply cool compresses.
D) Administer diphenhydramine (Benadryl) as the first-line treatment.
Answer: C) Keep the client's fingernails short and apply cool compresses.
Rationale: Pruritus in cirrhosis is caused by bile salt accumulation under the skin.
Keeping nails short prevents skin breakdown from scratching, and cool compresses
can soothe itching without causing further irritation. Hot baths and alcohol-based
lotions dry the skin and worsen itching. Antihistamines are sometimes used, but
they are not considered first-line and may not be effective for bile-salt pruritus.
5. A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 88%. Which oxygen delivery method should the nurse use?
A) Non-rebreather mask at 15 L/min
B) Venturi mask at 40%
C) Nasal cannula at 1-2 L/min
D) Simple face mask at 6 L/min
Answer: C) Nasal cannula at 1-2 L/min.
,Rationale: Clients with COPD often have a hypoxic drive to breathe. High-flow
oxygen can suppress this drive and lead to respiratory depression. Low-flow
oxygen via nasal cannula at 1-2 L/min is the safest initial approach.
6. A nurse is providing discharge teaching to a client with a new colostomy. Which
food should the client be instructed to avoid to prevent gas formation?
A) Applesauce
B) Cabbage
C) White rice
D) Yogurt
Answer: B) Cabbage.
Rationale: Gas-forming foods such as cabbage, broccoli, onions, and beans should
be avoided to prevent excessive flatus and discomfort. Applesauce, white rice, and
yogurt are generally well-tolerated and less likely to cause gas.
7. A client with diabetes mellitus type 2 has a blood glucose level of 210 mg/dL.
Which symptom would the nurse expect the client to report?
A) Diaphoresis and tremors
B) Polyuria and polydipsia
C) Muscle cramps and fatigue
D) Headache and blurred vision
Answer: B) Polyuria and polydipsia.
Rationale: Hyperglycemia leads to osmotic diuresis, causing polyuria (frequent
urination), which in turn leads to polydipsia (excessive thirst). Diaphoresis and
tremors are signs of hypoglycemia.
8. A nurse is preparing to administer insulin to a client with type 1 diabetes. Which
insulin should be given 30 minutes before a meal?
A) Regular insulin
B) NPH insulin
C) Insulin glargine (Lantus)
D) Insulin detemir (Levemir)
Answer: A) Regular insulin.
Rationale: Regular insulin is a short-acting insulin that should be administered 30
minutes before meals to ensure peak action coincides with postprandial glucose
rise. NPH is intermediate-acting, and glargine/detemir are long-acting basal
insulins.
9. A client is admitted with acute pancreatitis. Which laboratory value is most
indicative of this condition?
, A) Elevated serum amylase
B) Elevated serum potassium
C) Decreased serum calcium
D) Decreased serum glucose
Answer: A) Elevated serum amylase.
Rationale: Serum amylase and lipase are the primary markers for acute
pancreatitis, with amylase typically rising within 24 hours of onset. Lipase is more
specific, but amylase is the classic elevation seen.
10. A postoperative client reports sudden shortness of breath and chest pain. The
nurse notes tachycardia and hypotension. What is the priority nursing action?
A) Administer oxygen via face mask
B) Place the client in a high-Fowler's position
C) Call the rapid response team
D) Check the client's oxygen saturation
Answer: C) Call the rapid response team.
Rationale: Sudden onset of dyspnea, chest pain, tachycardia, and hypotension in a
postoperative client suggests a pulmonary embolism, which is a life-threatening
emergency. The priority is to activate the rapid response team or call for
emergency assistance immediately while providing supportive care.
11. A client with chronic kidney disease (CKD) is on a restricted potassium diet.
Which food should the nurse instruct the client to avoid?
A) Apples
B) Bananas
C) Cabbage
D) Green beans
Answer: B) Bananas.
Rationale: Bananas are high in potassium and should be avoided in clients with
CKD who are on a potassium-restricted diet. Apples, cabbage, and green beans are
lower in potassium.
12. A nurse is caring for a client with cirrhosis of the liver. Which finding indicates
worsening hepatic encephalopathy?
A) Asterixis (liver flap)
B) Increased appetite
C) Clear speech
D) Oriented to person, place, and time
Answer: A) Asterixis (liver flap).
