ATI Med-Surg Exam Practice
Questions with Verified Answers
SECTION 1: CARDIOVASCULAR SYSTEM
Question 1
A nurse is assessing a client with heart failure. Which finding is the earliest sign of left-
sided heart failure?
A) Peripheral edema
B) Jugular venous distention
C) Dyspnea on exertion
D) Hepatomegaly
,Correct Answer: C
Rationale: Dyspnea on exertion is the earliest sign of left-sided heart failure due to
pulmonary congestion from the left ventricle's inability to pump blood forward. As left
ventricular function declines, blood backs up into the pulmonary circulation, causing
dyspnea. Peripheral edema, JVD, and hepatomegaly are signs of right-sided heart failure .
Question 2
A nurse is providing discharge teaching to a client with a new diagnosis of heart failure.
Which statement indicates the client understands the teaching?
A) "I will weigh myself daily at the same time wearing the same amount of clothing."
B) "I can stop taking my medications when I feel better."
C) "I should limit my fluid intake to 4 liters per day."
D) "I will only exercise when I feel short of breath."
Correct Answer: A
Rationale: Daily weight monitoring is essential for early detection of fluid retention. A
weight gain of 2-3 lb (1-1.5 kg) in 24 hours or 5 lb (2.3 kg) in a week should be reported.
Medications should not be stopped without provider guidance, fluid is typically restricted
to 1.5-2 L/day, and exercise should be regular but not when short of breath .
Question 3
A client with hypertension is prescribed a thiazide diuretic. Which adverse effect should
the nurse monitor?
A) Hyperkalemia
B) Hypokalemia
C) Hyponatremia
D) Hypercalcemia
Correct Answer: B
,Rationale: Thiazide diuretics cause potassium wasting, leading to hypokalemia. The nurse
should monitor serum potassium levels and assess for signs of hypokalemia (muscle
weakness, fatigue, cardiac dysrhythmias). Potassium supplements or potassium-sparing
diuretics may be prescribed. Thiazides can also cause hyponatremia, hypercalcemia, and
hyperglycemia .
Question 4
A client with heart failure is prescribed furosemide (Lasix). Which assessment finding
indicates the medication is effective?
A) Decreased blood pressure
B) Weight loss of 2 kg in 24 hours
C) Increased heart rate
D) Presence of crackles in lung bases
Correct Answer: B
Rationale: Weight loss is the most reliable indicator of fluid loss in heart failure. Each
kilogram (2.2 lb) of weight loss represents approximately 1 liter of fluid loss. Diuresis
should result in decreased peripheral edema, improved breath sounds, and reduced
dyspnea. Crackles should decrease, not increase .
Question 5
A nurse is reviewing the medication record of a client who is taking digoxin. Which
medication should the nurse identify as increasing the risk for digoxin toxicity?
A) Potassium chloride
B) Famotidine
C) Levothyroxine
D) Furosemide
Correct Answer: D
, Rationale: Loop diuretics, such as furosemide, increase the urinary excretion of potassium,
which can lead to hypokalemia. Hypokalemia increases the risk for the development of
digoxin toxicity .
Question 6
A nurse is reinforcing discharge teaching for a client who had a mechanical mitral
valve replacement. Which statement by the client indicates an understanding of the
teaching?
A) "I will notify my dentist about this procedure."
B) "I will take an enteric-coated aspirin daily."
C) "I will use a firm-bristled toothbrush."
D) "I will weigh myself once a week."
Correct Answer: A
Rationale: The nurse should instruct the client to notify the dentist about the mechanical
mitral valve replacement before any procedures so antibiotic therapy can be initiated to
reduce the risk of endocardial infection. Mechanical valves require lifelong
anticoagulation, not just aspirin. A soft-bristled toothbrush should be used to prevent
bleeding .
Question 7
A nurse is providing information regarding transmission-based precautions for a client
who has Clostridium difficile. Which instructions should the nurse include? (Select all
that apply)
A) "Provide the client with disposable utensils and dishes for meals."
B) "Leave blood pressure equipment in the client's room."
C) "Clean contaminated surfaces with a bleach solution."
D) "Use an alcohol-based hand sanitizer after client care."
E) "Wear a face mask when in the client's room."
Questions with Verified Answers
SECTION 1: CARDIOVASCULAR SYSTEM
Question 1
A nurse is assessing a client with heart failure. Which finding is the earliest sign of left-
sided heart failure?
A) Peripheral edema
B) Jugular venous distention
C) Dyspnea on exertion
D) Hepatomegaly
,Correct Answer: C
Rationale: Dyspnea on exertion is the earliest sign of left-sided heart failure due to
pulmonary congestion from the left ventricle's inability to pump blood forward. As left
ventricular function declines, blood backs up into the pulmonary circulation, causing
dyspnea. Peripheral edema, JVD, and hepatomegaly are signs of right-sided heart failure .
Question 2
A nurse is providing discharge teaching to a client with a new diagnosis of heart failure.
Which statement indicates the client understands the teaching?
A) "I will weigh myself daily at the same time wearing the same amount of clothing."
B) "I can stop taking my medications when I feel better."
C) "I should limit my fluid intake to 4 liters per day."
D) "I will only exercise when I feel short of breath."
Correct Answer: A
Rationale: Daily weight monitoring is essential for early detection of fluid retention. A
weight gain of 2-3 lb (1-1.5 kg) in 24 hours or 5 lb (2.3 kg) in a week should be reported.
Medications should not be stopped without provider guidance, fluid is typically restricted
to 1.5-2 L/day, and exercise should be regular but not when short of breath .
Question 3
A client with hypertension is prescribed a thiazide diuretic. Which adverse effect should
the nurse monitor?
A) Hyperkalemia
B) Hypokalemia
C) Hyponatremia
D) Hypercalcemia
Correct Answer: B
,Rationale: Thiazide diuretics cause potassium wasting, leading to hypokalemia. The nurse
should monitor serum potassium levels and assess for signs of hypokalemia (muscle
weakness, fatigue, cardiac dysrhythmias). Potassium supplements or potassium-sparing
diuretics may be prescribed. Thiazides can also cause hyponatremia, hypercalcemia, and
hyperglycemia .
Question 4
A client with heart failure is prescribed furosemide (Lasix). Which assessment finding
indicates the medication is effective?
A) Decreased blood pressure
B) Weight loss of 2 kg in 24 hours
C) Increased heart rate
D) Presence of crackles in lung bases
Correct Answer: B
Rationale: Weight loss is the most reliable indicator of fluid loss in heart failure. Each
kilogram (2.2 lb) of weight loss represents approximately 1 liter of fluid loss. Diuresis
should result in decreased peripheral edema, improved breath sounds, and reduced
dyspnea. Crackles should decrease, not increase .
Question 5
A nurse is reviewing the medication record of a client who is taking digoxin. Which
medication should the nurse identify as increasing the risk for digoxin toxicity?
A) Potassium chloride
B) Famotidine
C) Levothyroxine
D) Furosemide
Correct Answer: D
, Rationale: Loop diuretics, such as furosemide, increase the urinary excretion of potassium,
which can lead to hypokalemia. Hypokalemia increases the risk for the development of
digoxin toxicity .
Question 6
A nurse is reinforcing discharge teaching for a client who had a mechanical mitral
valve replacement. Which statement by the client indicates an understanding of the
teaching?
A) "I will notify my dentist about this procedure."
B) "I will take an enteric-coated aspirin daily."
C) "I will use a firm-bristled toothbrush."
D) "I will weigh myself once a week."
Correct Answer: A
Rationale: The nurse should instruct the client to notify the dentist about the mechanical
mitral valve replacement before any procedures so antibiotic therapy can be initiated to
reduce the risk of endocardial infection. Mechanical valves require lifelong
anticoagulation, not just aspirin. A soft-bristled toothbrush should be used to prevent
bleeding .
Question 7
A nurse is providing information regarding transmission-based precautions for a client
who has Clostridium difficile. Which instructions should the nurse include? (Select all
that apply)
A) "Provide the client with disposable utensils and dishes for meals."
B) "Leave blood pressure equipment in the client's room."
C) "Clean contaminated surfaces with a bleach solution."
D) "Use an alcohol-based hand sanitizer after client care."
E) "Wear a face mask when in the client's room."
