ATI MED-SURG PROCTORED EXAM –
COMPREHENSIVE STUDY GUIDE
EXAM OVERVIEW
| Component | Details |
|--||
| Exam | ATI RN Adult Medical-Surgical Proctored Exam (with NGN format) |
| Format | Multiple choice, SATA, NGN case studies (bow-tie, matrix, unfolding cases) |
| Key Content Areas | Cardiovascular, Respiratory, GI, Renal, Neurological, Endocrine,
Musculoskeletal, Oncology, Perioperative Care, Pharmacology |
| Scoring | Level 1, Level 2, Level 3 (Level 2+ typically required) |
| NGN Features | Clinical judgment questions with case scenarios, multiple tabs of data |
PRACTICE QUESTIONS WITH VERIFIED ANSWERS & RATIONALES
SECTION 1: CARDIAC & HEMODYNAMIC DISORDERS
Q1. A nurse is assessing a client who is 12 hours postoperative following a colon resection.
Which of the following findings should the nurse report to the surgeon?
A) Heart rate 90/min
B) Absent bowel sounds
C) Hgb 8.2 g/dL
D) Gastric pH of 3.0
Correct Answer: C
Rationale: A hemoglobin of 8.2 g/dL is significantly low and may indicate postoperative
hemorrhage. Normal hemoglobin for adults is 12-16 g/dL for females and 14-18 g/dL for males.
This finding should be reported immediately to the surgeon. Absent bowel sounds (B) are
expected in the immediate postoperative period due to anesthesia and should resolve in 24-72
hours. A heart rate of 90 (A) is within normal limits (60-100 bpm). A gastric pH of 3.0 (D) is
normal for gastric contents.
,Q2. A nurse is caring for a client who has diabetes insipidus. Which of the following medications
should the nurse plan to administer?
A) Desmopressin
B) Regular insulin
C) Furosemide
D) Lithium carbonate
Correct Answer: A
Rationale: Diabetes insipidus is caused by a deficiency of antidiuretic hormone (ADH) or the
kidney's inability to respond to ADH. Desmopressin (DDAVP) is a synthetic analog of ADH that
is used to replace the missing hormone and reduce excessive urination. Regular insulin (B) is
for diabetes mellitus, furosemide (C) is a diuretic, and lithium carbonate (D) is a mood stabilizer
that can actually cause nephrogenic diabetes insipidus.
Q3. A nurse is admitting a client who has arthritic pain and reports taking ibuprofen several
times daily for 3 years. Which of the following tests should the nurse monitor?
A) Fasting blood glucose
B) Stool for occult blood
C) Urine for white blood cells
D) Serum calcium
Correct Answer: B
Rationale: Long-term use of NSAIDs (such as ibuprofen) increases the risk of gastrointestinal
bleeding. The nurse should monitor the client for signs of GI bleeding, including occult blood in
the stool. Chronic NSAID use can cause gastric mucosal damage and ulceration.
Q4. A nurse is caring for a client who experienced a traumatic head injury and has an
intraventricular catheter (ventriculostomy) for ICP monitoring. The nurse should monitor the
client for which complication related to the ventriculostomy?
A) Headache
B) Infection
C) Aphasia
, D) Hypertension
Correct Answer: B
Rationale: The primary complication of an intraventricular catheter (ventriculostomy) is infection,
which can lead to life-threatening meningitis. The nurse should use strict aseptic technique
when caring for the ventriculostomy site and monitor for signs of infection such as fever, nuchal
rigidity, and changes in CSF appearance.
Q5. A client's telemetry monitor shows ventricular tachycardia. The client is alert and
hemodynamically stable. Which of the following medications should the nurse anticipate
administering?
A) Adenosine
B) Amiodarone
C) Epinephrine
D) Atropine
Correct Answer: B
Rationale: For hemodynamically stable ventricular tachycardia, amiodarone or lidocaine is the
treatment of choice. Amiodarone is a Class III antiarrhythmic that prolongs the action potential
and refractory period. Adenosine (A) is used for supraventricular tachycardia (SVT).
Epinephrine (C) and atropine (D) are used in cardiac arrest and symptomatic bradycardia.
Q6. A client with heart failure has a weight gain of 4 lbs in 24 hours. What is the priority nursing
action?
A) Increase the furosemide dose
B) Assess for edema and crackles and notify the provider
C) Restrict fluids to 1 L/day
D) Document and continue monitoring
Correct Answer: B
Rationale: Weight gain of 2-3 lbs in 24 hours suggests fluid overload. The nurse should assess
the client for signs of fluid overload (edema, lung sounds, JVD) and notify the provider. Do not
change the dose without an order.
COMPREHENSIVE STUDY GUIDE
EXAM OVERVIEW
| Component | Details |
|--||
| Exam | ATI RN Adult Medical-Surgical Proctored Exam (with NGN format) |
| Format | Multiple choice, SATA, NGN case studies (bow-tie, matrix, unfolding cases) |
| Key Content Areas | Cardiovascular, Respiratory, GI, Renal, Neurological, Endocrine,
Musculoskeletal, Oncology, Perioperative Care, Pharmacology |
| Scoring | Level 1, Level 2, Level 3 (Level 2+ typically required) |
| NGN Features | Clinical judgment questions with case scenarios, multiple tabs of data |
PRACTICE QUESTIONS WITH VERIFIED ANSWERS & RATIONALES
SECTION 1: CARDIAC & HEMODYNAMIC DISORDERS
Q1. A nurse is assessing a client who is 12 hours postoperative following a colon resection.
Which of the following findings should the nurse report to the surgeon?
A) Heart rate 90/min
B) Absent bowel sounds
C) Hgb 8.2 g/dL
D) Gastric pH of 3.0
Correct Answer: C
Rationale: A hemoglobin of 8.2 g/dL is significantly low and may indicate postoperative
hemorrhage. Normal hemoglobin for adults is 12-16 g/dL for females and 14-18 g/dL for males.
This finding should be reported immediately to the surgeon. Absent bowel sounds (B) are
expected in the immediate postoperative period due to anesthesia and should resolve in 24-72
hours. A heart rate of 90 (A) is within normal limits (60-100 bpm). A gastric pH of 3.0 (D) is
normal for gastric contents.
,Q2. A nurse is caring for a client who has diabetes insipidus. Which of the following medications
should the nurse plan to administer?
A) Desmopressin
B) Regular insulin
C) Furosemide
D) Lithium carbonate
Correct Answer: A
Rationale: Diabetes insipidus is caused by a deficiency of antidiuretic hormone (ADH) or the
kidney's inability to respond to ADH. Desmopressin (DDAVP) is a synthetic analog of ADH that
is used to replace the missing hormone and reduce excessive urination. Regular insulin (B) is
for diabetes mellitus, furosemide (C) is a diuretic, and lithium carbonate (D) is a mood stabilizer
that can actually cause nephrogenic diabetes insipidus.
Q3. A nurse is admitting a client who has arthritic pain and reports taking ibuprofen several
times daily for 3 years. Which of the following tests should the nurse monitor?
A) Fasting blood glucose
B) Stool for occult blood
C) Urine for white blood cells
D) Serum calcium
Correct Answer: B
Rationale: Long-term use of NSAIDs (such as ibuprofen) increases the risk of gastrointestinal
bleeding. The nurse should monitor the client for signs of GI bleeding, including occult blood in
the stool. Chronic NSAID use can cause gastric mucosal damage and ulceration.
Q4. A nurse is caring for a client who experienced a traumatic head injury and has an
intraventricular catheter (ventriculostomy) for ICP monitoring. The nurse should monitor the
client for which complication related to the ventriculostomy?
A) Headache
B) Infection
C) Aphasia
, D) Hypertension
Correct Answer: B
Rationale: The primary complication of an intraventricular catheter (ventriculostomy) is infection,
which can lead to life-threatening meningitis. The nurse should use strict aseptic technique
when caring for the ventriculostomy site and monitor for signs of infection such as fever, nuchal
rigidity, and changes in CSF appearance.
Q5. A client's telemetry monitor shows ventricular tachycardia. The client is alert and
hemodynamically stable. Which of the following medications should the nurse anticipate
administering?
A) Adenosine
B) Amiodarone
C) Epinephrine
D) Atropine
Correct Answer: B
Rationale: For hemodynamically stable ventricular tachycardia, amiodarone or lidocaine is the
treatment of choice. Amiodarone is a Class III antiarrhythmic that prolongs the action potential
and refractory period. Adenosine (A) is used for supraventricular tachycardia (SVT).
Epinephrine (C) and atropine (D) are used in cardiac arrest and symptomatic bradycardia.
Q6. A client with heart failure has a weight gain of 4 lbs in 24 hours. What is the priority nursing
action?
A) Increase the furosemide dose
B) Assess for edema and crackles and notify the provider
C) Restrict fluids to 1 L/day
D) Document and continue monitoring
Correct Answer: B
Rationale: Weight gain of 2-3 lbs in 24 hours suggests fluid overload. The nurse should assess
the client for signs of fluid overload (edema, lung sounds, JVD) and notify the provider. Do not
change the dose without an order.
