ATI Adult Medical-Surgical Practice
Assessment A Adult Medical-Surgical
Nursing Practice Examination 2026
STANDARD EDITION
1. A nurse is assessing a client admitted with left-sided heart
failure. Which finding requires immediate intervention?
A. Bilateral ankle edema
B. Fatigue with activity
C. Crackles throughout both lung fields
D. Weight gain of 1 kg (2.2 lb)
Answer: C. Crackles throughout both lung fields
Rationale: Diffuse crackles indicate pulmonary edema and
impaired gas exchange, requiring immediate treatment to
prevent respiratory failure.
,2. A client with chronic obstructive pulmonary disease (COPD)
is receiving oxygen. Which finding indicates oxygen therapy is
effective?
A. Respiratory rate increases to 32/min
B. Oxygen saturation improves to 90%
C. Heart rate rises to 118/min
D. Client becomes increasingly restless
Answer: B. Oxygen saturation improves to 90%
Rationale: Maintaining oxygen saturation around 88%–92% is
an appropriate target for many clients with COPD.
3. Which laboratory value should the nurse report
immediately for a client receiving warfarin?
A. Hemoglobin 13 g/dL
B. Platelets 250,000/mm³
C. INR 5.2
D. Potassium 4.1 mEq/L
Answer: C. INR 5.2
Rationale: An INR of 5.2 indicates excessive anticoagulation and
significantly increases bleeding risk.
,4. A client with type 1 diabetes becomes confused and
diaphoretic. What is the nurse's priority action?
A. Administer insulin
B. Notify the provider
C. Encourage exercise
D. Check the blood glucose level
Answer: D. Check the blood glucose level
Rationale: Symptoms suggest hypoglycemia, which should be
confirmed immediately before intervention when possible.
5. Which assessment finding is expected in a client with
hyperthyroidism?
A. Bradycardia
B. Weight gain
C. Cold intolerance
D. Heat intolerance
Answer: D. Heat intolerance
Rationale: Increased metabolic activity causes heat intolerance,
weight loss, and tachycardia.
6. A client with chronic kidney disease has a potassium level of
6.4 mEq/L. Which action is the priority?
, A. Encourage fluids
B. Restrict sodium
C. Place the client on cardiac monitoring
D. Administer iron supplements
Answer: C. Place the client on cardiac monitoring
Rationale: Severe hyperkalemia can cause life-threatening
cardiac dysrhythmias.
7. Which food selection demonstrates understanding of a low-
sodium diet?
A. Ham sandwich
B. Canned soup
C. Pickles
D. Fresh grilled chicken with steamed vegetables
Answer: D. Fresh grilled chicken with steamed vegetables
Rationale: Fresh foods generally contain much less sodium than
processed foods.
8. A nurse is caring for a client 24 hours after abdominal
surgery. Which finding is most concerning?
A. Pain rated 4/10
B. Temperature 37.4°C (99.3°F)
Assessment A Adult Medical-Surgical
Nursing Practice Examination 2026
STANDARD EDITION
1. A nurse is assessing a client admitted with left-sided heart
failure. Which finding requires immediate intervention?
A. Bilateral ankle edema
B. Fatigue with activity
C. Crackles throughout both lung fields
D. Weight gain of 1 kg (2.2 lb)
Answer: C. Crackles throughout both lung fields
Rationale: Diffuse crackles indicate pulmonary edema and
impaired gas exchange, requiring immediate treatment to
prevent respiratory failure.
,2. A client with chronic obstructive pulmonary disease (COPD)
is receiving oxygen. Which finding indicates oxygen therapy is
effective?
A. Respiratory rate increases to 32/min
B. Oxygen saturation improves to 90%
C. Heart rate rises to 118/min
D. Client becomes increasingly restless
Answer: B. Oxygen saturation improves to 90%
Rationale: Maintaining oxygen saturation around 88%–92% is
an appropriate target for many clients with COPD.
3. Which laboratory value should the nurse report
immediately for a client receiving warfarin?
A. Hemoglobin 13 g/dL
B. Platelets 250,000/mm³
C. INR 5.2
D. Potassium 4.1 mEq/L
Answer: C. INR 5.2
Rationale: An INR of 5.2 indicates excessive anticoagulation and
significantly increases bleeding risk.
,4. A client with type 1 diabetes becomes confused and
diaphoretic. What is the nurse's priority action?
A. Administer insulin
B. Notify the provider
C. Encourage exercise
D. Check the blood glucose level
Answer: D. Check the blood glucose level
Rationale: Symptoms suggest hypoglycemia, which should be
confirmed immediately before intervention when possible.
5. Which assessment finding is expected in a client with
hyperthyroidism?
A. Bradycardia
B. Weight gain
C. Cold intolerance
D. Heat intolerance
Answer: D. Heat intolerance
Rationale: Increased metabolic activity causes heat intolerance,
weight loss, and tachycardia.
6. A client with chronic kidney disease has a potassium level of
6.4 mEq/L. Which action is the priority?
, A. Encourage fluids
B. Restrict sodium
C. Place the client on cardiac monitoring
D. Administer iron supplements
Answer: C. Place the client on cardiac monitoring
Rationale: Severe hyperkalemia can cause life-threatening
cardiac dysrhythmias.
7. Which food selection demonstrates understanding of a low-
sodium diet?
A. Ham sandwich
B. Canned soup
C. Pickles
D. Fresh grilled chicken with steamed vegetables
Answer: D. Fresh grilled chicken with steamed vegetables
Rationale: Fresh foods generally contain much less sodium than
processed foods.
8. A nurse is caring for a client 24 hours after abdominal
surgery. Which finding is most concerning?
A. Pain rated 4/10
B. Temperature 37.4°C (99.3°F)
