ATI PN Adult Medical Surgical 2024
Proctored Exam with NGN | Extracted
from Real Exam
,SECTION 1: CARDIOVASCULAR SYSTEM (Questions 1-30)
1. A nurse is caring for a client who is 1 day postoperative following a hip
arthroplasty. The client exhibits hypotension, tachycardia, and tachypnea. The
nurse should recognize that these findings indicate which of the following
complications?
• A) Wound infection
• B) Pulmonary embolism
• C) Thrombophlebitis
• D) Paralytic ileus
Correct Answer: B. Pulmonary embolism.
Rationale: Manifestations of a pulmonary embolism (PE) include the sudden
onset of hypotension, tachycardia, and tachypnea. These symptoms arise from a
blockage in the pulmonary artery that impairs gas exchange and cardiac output.
A PE is a life-threatening complication following major surgery like a hip
arthroplasty.
2. A nurse is caring for a client who has heart failure and a new prescription for
metoprolol. Which of the following findings should the nurse identify as an
adverse effect of the medication?
• A) Heart rate 48/min
• B) Blood pressure 138/88 mmHg
• C) Respiratory rate 20/min
• D) Temperature 37.2°C (99°F)
Correct Answer: A. Heart rate 48/min.
Rationale: Metoprolol is a beta-blocker that works by decreasing the heart rate
and contractility. An adverse effect is bradycardia, defined as a heart rate of less
, than 60 beats per minute. The nurse should monitor for and report this to the
provider.
3. A nurse is providing teaching for a client who has cardiovascular disease. Which
of the following statements by the client indicates an understanding of the
teaching?
• A) "I will use canola oil when making salad dressing."
• B) "I will use butter instead of margarine."
• C) "I will avoid fish in my diet."
• D) "I will increase my intake of red meat."
Correct Answer: A. "I will use canola oil when making salad dressing."
Rationale: Canola oil is a heart-healthy unsaturated fat. Clients with
cardiovascular disease should limit their intake of saturated fats (found in butter
and red meat) and include omega-3 fatty acids from fish in their diet.
4. A nurse is assessing a client who has left-sided heart failure. Which of the
following findings should the nurse expect?
• A) Frothy sputum
• B) Jugular venous distention
• C) Peripheral edema
• D) Hepatomegaly
Correct Answer: A. Frothy sputum.
Rationale: Left-sided heart failure leads to a backup of blood in the pulmonary
circulation, causing pulmonary congestion. This can manifest as frothy, often
pink-tinged sputum. Jugular venous distention, peripheral edema, and
hepatomegaly are signs associated with right-sided heart failure.
5. A nurse is caring for a client immediately following a cardiac catheterization
through the right femoral artery. Which of the following actions should the nurse
take?
, • A) Instruct the client not to bend the affected leg.
• B) Keep the client in high Fowler's position.
• C) Ambulate the client in the hallway.
• D) Apply heat to the insertion site.
Correct Answer: A. Instruct the client not to bend the affected leg.
Rationale: After a femoral artery catheterization, the affected leg must remain
straight to prevent bleeding and hematoma formation at the puncture site. The
client should be on bed rest with the leg extended as prescribed by the provider.
6. A nurse is providing preoperative teaching to a client who is to undergo a
pneumonectomy. The client states, "I am afraid coughing will hurt after surgery".
Which of the following statements by the nurse is appropriate?
• A) "After the surgeon removes the lung, you will not need to cough."
• B) "I'll make sure you get cough suppressants to keep you from straining the
incision."
• C) "Don't worry. You will have a pump that delivers pain medication as needed,
so you will have very little pain."
• D) "I will show you how to splint your incision while coughing."
Correct Answer: D. "I will show you how to splint your incision while
coughing."
Rationale: Postoperative deep breathing and coughing are essential to prevent
complications like atelectasis and pneumonia. The nurse should teach the client
how to splint the incision with a pillow or hands to reduce pain and support the
surgical site during coughing.
7. A nurse is assessing a client who has heart failure. Which of the following
findings should the nurse expect?
• A) Dyspnea
• B) Bradycardia
• C) Hypertension
Proctored Exam with NGN | Extracted
from Real Exam
,SECTION 1: CARDIOVASCULAR SYSTEM (Questions 1-30)
1. A nurse is caring for a client who is 1 day postoperative following a hip
arthroplasty. The client exhibits hypotension, tachycardia, and tachypnea. The
nurse should recognize that these findings indicate which of the following
complications?
• A) Wound infection
• B) Pulmonary embolism
• C) Thrombophlebitis
• D) Paralytic ileus
Correct Answer: B. Pulmonary embolism.
Rationale: Manifestations of a pulmonary embolism (PE) include the sudden
onset of hypotension, tachycardia, and tachypnea. These symptoms arise from a
blockage in the pulmonary artery that impairs gas exchange and cardiac output.
A PE is a life-threatening complication following major surgery like a hip
arthroplasty.
2. A nurse is caring for a client who has heart failure and a new prescription for
metoprolol. Which of the following findings should the nurse identify as an
adverse effect of the medication?
• A) Heart rate 48/min
• B) Blood pressure 138/88 mmHg
• C) Respiratory rate 20/min
• D) Temperature 37.2°C (99°F)
Correct Answer: A. Heart rate 48/min.
Rationale: Metoprolol is a beta-blocker that works by decreasing the heart rate
and contractility. An adverse effect is bradycardia, defined as a heart rate of less
, than 60 beats per minute. The nurse should monitor for and report this to the
provider.
3. A nurse is providing teaching for a client who has cardiovascular disease. Which
of the following statements by the client indicates an understanding of the
teaching?
• A) "I will use canola oil when making salad dressing."
• B) "I will use butter instead of margarine."
• C) "I will avoid fish in my diet."
• D) "I will increase my intake of red meat."
Correct Answer: A. "I will use canola oil when making salad dressing."
Rationale: Canola oil is a heart-healthy unsaturated fat. Clients with
cardiovascular disease should limit their intake of saturated fats (found in butter
and red meat) and include omega-3 fatty acids from fish in their diet.
4. A nurse is assessing a client who has left-sided heart failure. Which of the
following findings should the nurse expect?
• A) Frothy sputum
• B) Jugular venous distention
• C) Peripheral edema
• D) Hepatomegaly
Correct Answer: A. Frothy sputum.
Rationale: Left-sided heart failure leads to a backup of blood in the pulmonary
circulation, causing pulmonary congestion. This can manifest as frothy, often
pink-tinged sputum. Jugular venous distention, peripheral edema, and
hepatomegaly are signs associated with right-sided heart failure.
5. A nurse is caring for a client immediately following a cardiac catheterization
through the right femoral artery. Which of the following actions should the nurse
take?
, • A) Instruct the client not to bend the affected leg.
• B) Keep the client in high Fowler's position.
• C) Ambulate the client in the hallway.
• D) Apply heat to the insertion site.
Correct Answer: A. Instruct the client not to bend the affected leg.
Rationale: After a femoral artery catheterization, the affected leg must remain
straight to prevent bleeding and hematoma formation at the puncture site. The
client should be on bed rest with the leg extended as prescribed by the provider.
6. A nurse is providing preoperative teaching to a client who is to undergo a
pneumonectomy. The client states, "I am afraid coughing will hurt after surgery".
Which of the following statements by the nurse is appropriate?
• A) "After the surgeon removes the lung, you will not need to cough."
• B) "I'll make sure you get cough suppressants to keep you from straining the
incision."
• C) "Don't worry. You will have a pump that delivers pain medication as needed,
so you will have very little pain."
• D) "I will show you how to splint your incision while coughing."
Correct Answer: D. "I will show you how to splint your incision while
coughing."
Rationale: Postoperative deep breathing and coughing are essential to prevent
complications like atelectasis and pneumonia. The nurse should teach the client
how to splint the incision with a pillow or hands to reduce pain and support the
surgical site during coughing.
7. A nurse is assessing a client who has heart failure. Which of the following
findings should the nurse expect?
• A) Dyspnea
• B) Bradycardia
• C) Hypertension
