Approved ATI RN Adult Medical Surgical 2023 Actual &
Retake Proctored Exam with NGN 100 Clear Questions to Pass
Level 3 RN ATI Adult Med-Surg 2023–2026 Proctored Exam
with NGN
,Cardiovascular Disorders
Question 1
A nurse is administering digoxin 0.25 mg orally to a client with atrial fibrillation. Prior to
administration, the nurse obtains an apical pulse of 52 beats per minute. Which action
should the nurse take?
A. Administer the medication as prescribed
B. Hold the medication and document the finding
C. Hold the medication and notify the healthcare provider
D. Administer the medication and then notify the provider
Answer: C. Hold the medication and notify the healthcare provider
Rationale: The standard hold parameter for digoxin is an apical pulse less than 60 bpm
in adults. A pulse of 52 is below this threshold, indicating potential digoxin toxicity or
,bradycardia. The nurse must hold the dose and notify the provider for further
instructions.
Question 2
A client with hypertension is started on lisinopril, an ACE inhibitor. Which finding
requires immediate discontinuation of the medication and emergency intervention?
A. Dry, persistent cough
B. Angioedema with swelling of the lips and tongue
C. Serum potassium level of 4.2 mEq/L
D. Orthostatic hypotension upon standing
Answer: B. Angioedema with swelling of the lips and tongue
Rationale: Angioedema is a life-threatening allergic reaction to ACE inhibitors
characterized by swelling of the lips, tongue, pharynx, and larynx, which can cause rapid
airway compromise. Dry cough is a common but not life-threatening side effect.
Question 3
A nurse is providing discharge teaching to a client who had a mechanical heart valve
replacement. Which statement by the client indicates understanding?
A. "I will stop taking my warfarin if I notice any bruising on my arms."
B. "I will take my blood pressure daily and report readings over 140/90."
C. "I need to take antibiotics before any dental procedures."
D. "I can resume heavy lifting and yard work in 2 weeks."
Answer: C. "I need to take antibiotics before any dental procedures."
Rationale: Clients with mechanical heart valves are at high risk for infective endocarditis.
The American Heart Association recommends prophylactic antibiotics before dental
procedures. Warfarin is lifelong therapy; bruising is expected and does not warrant
stopping the medication.
, Question 4
A nurse is assessing a client with right-sided heart failure. Which finding should the
nurse expect?
A. Crackles in the lung bases
B. Paroxysmal nocturnal dyspnea
C. Jugular venous distension (JVD)
D. Frothy sputum
Answer: C. Jugular venous distension (JVD)
Rationale: Right-sided heart failure results from fluid backup into the systemic venous
system. Manifestations include JVD, peripheral edema, hepatomegaly, and ascites.
Crackles and frothy sputum are characteristic of left-sided heart failure (pulmonary
congestion).
Question 5
A nurse is administering IV heparin to a client with deep vein thrombosis. Which
laboratory value should the nurse monitor to evaluate therapeutic effectiveness?
A. Prothrombin time (PT)
B. International normalized ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
Answer: C. Activated partial thromboplastin time (aPTT)
Rationale: Heparin therapy is monitored using aPTT, with a therapeutic goal typically 1.5
to 2.5 times the normal control value. PT and INR monitor warfarin therapy. Platelet
count monitors for heparin-induced thrombocytopenia (HIT).
Question 6
A client receiving furosemide complains of muscle weakness and cramps. Which
laboratory value requires immediate attention?
Retake Proctored Exam with NGN 100 Clear Questions to Pass
Level 3 RN ATI Adult Med-Surg 2023–2026 Proctored Exam
with NGN
,Cardiovascular Disorders
Question 1
A nurse is administering digoxin 0.25 mg orally to a client with atrial fibrillation. Prior to
administration, the nurse obtains an apical pulse of 52 beats per minute. Which action
should the nurse take?
A. Administer the medication as prescribed
B. Hold the medication and document the finding
C. Hold the medication and notify the healthcare provider
D. Administer the medication and then notify the provider
Answer: C. Hold the medication and notify the healthcare provider
Rationale: The standard hold parameter for digoxin is an apical pulse less than 60 bpm
in adults. A pulse of 52 is below this threshold, indicating potential digoxin toxicity or
,bradycardia. The nurse must hold the dose and notify the provider for further
instructions.
Question 2
A client with hypertension is started on lisinopril, an ACE inhibitor. Which finding
requires immediate discontinuation of the medication and emergency intervention?
A. Dry, persistent cough
B. Angioedema with swelling of the lips and tongue
C. Serum potassium level of 4.2 mEq/L
D. Orthostatic hypotension upon standing
Answer: B. Angioedema with swelling of the lips and tongue
Rationale: Angioedema is a life-threatening allergic reaction to ACE inhibitors
characterized by swelling of the lips, tongue, pharynx, and larynx, which can cause rapid
airway compromise. Dry cough is a common but not life-threatening side effect.
Question 3
A nurse is providing discharge teaching to a client who had a mechanical heart valve
replacement. Which statement by the client indicates understanding?
A. "I will stop taking my warfarin if I notice any bruising on my arms."
B. "I will take my blood pressure daily and report readings over 140/90."
C. "I need to take antibiotics before any dental procedures."
D. "I can resume heavy lifting and yard work in 2 weeks."
Answer: C. "I need to take antibiotics before any dental procedures."
Rationale: Clients with mechanical heart valves are at high risk for infective endocarditis.
The American Heart Association recommends prophylactic antibiotics before dental
procedures. Warfarin is lifelong therapy; bruising is expected and does not warrant
stopping the medication.
, Question 4
A nurse is assessing a client with right-sided heart failure. Which finding should the
nurse expect?
A. Crackles in the lung bases
B. Paroxysmal nocturnal dyspnea
C. Jugular venous distension (JVD)
D. Frothy sputum
Answer: C. Jugular venous distension (JVD)
Rationale: Right-sided heart failure results from fluid backup into the systemic venous
system. Manifestations include JVD, peripheral edema, hepatomegaly, and ascites.
Crackles and frothy sputum are characteristic of left-sided heart failure (pulmonary
congestion).
Question 5
A nurse is administering IV heparin to a client with deep vein thrombosis. Which
laboratory value should the nurse monitor to evaluate therapeutic effectiveness?
A. Prothrombin time (PT)
B. International normalized ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
Answer: C. Activated partial thromboplastin time (aPTT)
Rationale: Heparin therapy is monitored using aPTT, with a therapeutic goal typically 1.5
to 2.5 times the normal control value. PT and INR monitor warfarin therapy. Platelet
count monitors for heparin-induced thrombocytopenia (HIT).
Question 6
A client receiving furosemide complains of muscle weakness and cramps. Which
laboratory value requires immediate attention?
