Master the ATI Med-Surg NGN: 150 Practice
Questions with Clinical Rationales for 2026–
2027 Success
## SECTION 1: CARDIOVASCULAR DISORDERS
**1. A client using a morphine PCA pump postoperatively is drowsy with a respiratory rate of 8
breaths/min. What is the nurse's priority action?**
A) Encourage deep breathing and coughing
B) Administer naloxone
C) Notify the provider and prepare to reduce PCA dose
D) Increase oxygen flow rate
**Answer: C**
**Rationale:** Respiratory depression with sedation requires dose adjustment and close monitoring
before naloxone administration. Naloxone is reserved for severe respiratory depression or apnea.
The priority is to address the underlying cause by reducing the PCA dose while notifying the provider
.
---
**2. Which adverse effects should the nurse monitor for in a client receiving heparin? (Select all that
apply.)**
A) Bleeding gums
B) Bruising
C) Hypertension
,D) Thrombocytopenia
E) Hyperkalemia
**Answer: A, B, D**
**Rationale:** Heparin can cause bleeding (bleeding gums, bruising) and heparin-induced
thrombocytopenia (HIT). Heparin does not typically cause hypertension or hyperkalemia. Monitor for
signs of bleeding and obtain baseline platelet counts .
---
**3. A client receiving IV heparin has a platelet count of 80,000/mm³. What should the nurse do?**
A) Continue therapy and monitor labs
B) Hold heparin and notify provider
C) Increase heparin dose
D) Administer vitamin K
**Answer: B**
**Rationale:** Thrombocytopenia (platelet count < 100,000/mm³) may indicate heparin-induced
thrombocytopenia (HIT), a life-threatening complication. Heparin must be held immediately, and the
provider should be notified for alternative anticoagulation .
---
**4. A client is prescribed spironolactone for heart failure. Lab results show potassium 5.8 mEq/L.
What is the nurse's priority action?**
A) Administer the medication as prescribed
B) Hold the medication and notify the provider
C) Encourage intake of high-potassium foods
D) Repeat potassium level in 24 hours
,**Answer: B**
**Rationale:** Spironolactone is a potassium-sparing diuretic. Hyperkalemia (potassium > 5.0
mEq/L) is a dangerous side effect requiring immediate attention. The medication should be held and
the provider notified .
---
**5. Which symptoms should the nurse monitor in clients taking amlodipine? (Select all that
apply.)**
A) Peripheral edema
B) Bradycardia
C) Constipation
D) Hypotension
E) Hyperglycemia
**Answer: A, B, C, D**
**Rationale:** Calcium channel blockers (amlodipine) can cause peripheral edema, bradycardia,
constipation, and hypotension. They do not typically cause hyperglycemia; that is more common
with corticosteroids .
---
**6. A client on digoxin has nausea, vomiting, and HR 45 bpm. What should the nurse do?**
A) Administer digoxin as ordered
B) Hold medication and notify provider
C) Encourage fluids and monitor
D) Check potassium level and give potassium supplement
, **Answer: B**
**Rationale:** Symptoms of nausea, vomiting, and bradycardia suggest digoxin toxicity. The
medication should be held, and the provider notified. Potassium levels should be checked, but
supplementation should not be given without an order .
---
**7. A client with heart failure has jugular venous distention and peripheral edema. Which
medication classification is most appropriate?**
A) Beta-blockers
B) Diuretics
C) ACE inhibitors
D) Calcium channel blockers
**Answer: B**
**Rationale:** Diuretics reduce fluid volume overload, decreasing jugular venous distention and
peripheral edema. They are first-line treatment for fluid management in heart failure.
---
**8. A client is prescribed warfarin. Which client statement indicates understanding of teaching?**
A) "I will avoid foods high in vitamin K."
B) "I will stop taking warfarin if I bruise easily."
C) "I will use a soft toothbrush to prevent bleeding."
D) "I can take ibuprofen for headaches."
**Answer: C**
Questions with Clinical Rationales for 2026–
2027 Success
## SECTION 1: CARDIOVASCULAR DISORDERS
**1. A client using a morphine PCA pump postoperatively is drowsy with a respiratory rate of 8
breaths/min. What is the nurse's priority action?**
A) Encourage deep breathing and coughing
B) Administer naloxone
C) Notify the provider and prepare to reduce PCA dose
D) Increase oxygen flow rate
**Answer: C**
**Rationale:** Respiratory depression with sedation requires dose adjustment and close monitoring
before naloxone administration. Naloxone is reserved for severe respiratory depression or apnea.
The priority is to address the underlying cause by reducing the PCA dose while notifying the provider
.
---
**2. Which adverse effects should the nurse monitor for in a client receiving heparin? (Select all that
apply.)**
A) Bleeding gums
B) Bruising
C) Hypertension
,D) Thrombocytopenia
E) Hyperkalemia
**Answer: A, B, D**
**Rationale:** Heparin can cause bleeding (bleeding gums, bruising) and heparin-induced
thrombocytopenia (HIT). Heparin does not typically cause hypertension or hyperkalemia. Monitor for
signs of bleeding and obtain baseline platelet counts .
---
**3. A client receiving IV heparin has a platelet count of 80,000/mm³. What should the nurse do?**
A) Continue therapy and monitor labs
B) Hold heparin and notify provider
C) Increase heparin dose
D) Administer vitamin K
**Answer: B**
**Rationale:** Thrombocytopenia (platelet count < 100,000/mm³) may indicate heparin-induced
thrombocytopenia (HIT), a life-threatening complication. Heparin must be held immediately, and the
provider should be notified for alternative anticoagulation .
---
**4. A client is prescribed spironolactone for heart failure. Lab results show potassium 5.8 mEq/L.
What is the nurse's priority action?**
A) Administer the medication as prescribed
B) Hold the medication and notify the provider
C) Encourage intake of high-potassium foods
D) Repeat potassium level in 24 hours
,**Answer: B**
**Rationale:** Spironolactone is a potassium-sparing diuretic. Hyperkalemia (potassium > 5.0
mEq/L) is a dangerous side effect requiring immediate attention. The medication should be held and
the provider notified .
---
**5. Which symptoms should the nurse monitor in clients taking amlodipine? (Select all that
apply.)**
A) Peripheral edema
B) Bradycardia
C) Constipation
D) Hypotension
E) Hyperglycemia
**Answer: A, B, C, D**
**Rationale:** Calcium channel blockers (amlodipine) can cause peripheral edema, bradycardia,
constipation, and hypotension. They do not typically cause hyperglycemia; that is more common
with corticosteroids .
---
**6. A client on digoxin has nausea, vomiting, and HR 45 bpm. What should the nurse do?**
A) Administer digoxin as ordered
B) Hold medication and notify provider
C) Encourage fluids and monitor
D) Check potassium level and give potassium supplement
, **Answer: B**
**Rationale:** Symptoms of nausea, vomiting, and bradycardia suggest digoxin toxicity. The
medication should be held, and the provider notified. Potassium levels should be checked, but
supplementation should not be given without an order .
---
**7. A client with heart failure has jugular venous distention and peripheral edema. Which
medication classification is most appropriate?**
A) Beta-blockers
B) Diuretics
C) ACE inhibitors
D) Calcium channel blockers
**Answer: B**
**Rationale:** Diuretics reduce fluid volume overload, decreasing jugular venous distention and
peripheral edema. They are first-line treatment for fluid management in heart failure.
---
**8. A client is prescribed warfarin. Which client statement indicates understanding of teaching?**
A) "I will avoid foods high in vitamin K."
B) "I will stop taking warfarin if I bruise easily."
C) "I will use a soft toothbrush to prevent bleeding."
D) "I can take ibuprofen for headaches."
**Answer: C**
