ATI RN ADULT-MEDICAL SURGICAL EXAM
NEWEST EVALUATED PRACTICE EXAM 100
QUESTIONS 2026-2027|ORIGINAL QUESTIONS
& ANSWERS |DETAILED RATIONALES |HINTED
COMPLETE EXAM PREP GRADED A+*INSTANT
DOWNLOAD PDF*
1. A nurse is assessing a client who has heart failure. Which finding
indicates worsening left-sided heart failure?
A. Dependent edema
B. Jugular venous distention
C. Crackles in the lung bases
D. Hepatomegaly
Answer: Crackles in the lung bases
Rationale: Left-sided heart failure causes pulmonary congestion,
which can produce crackles, dyspnea, and pulmonary edema.
2. A client with COPD is receiving oxygen at 2 L/min via nasal cannula.
Which finding requires immediate intervention?
A. Oxygen saturation of 91%
B. Respiratory rate of 22/min
C. Increasing somnolence and confusion
D. Barrel-shaped chest
Answer: Increasing somnolence and confusion
,Rationale: Excessive oxygen administration in some clients with
chronic CO₂ retention can worsen hypercapnia. Acute changes in
mental status require prompt assessment.
3. A client with diabetic ketoacidosis (DKA) is receiving IV fluids and
regular insulin. Which laboratory value requires the nurse's greatest
attention?
A. Glucose 250 mg/dL
B. Potassium 3.1 mEq/L
C. Sodium 136 mEq/L
D. Chloride 100 mEq/L
Answer: Potassium 3.1 mEq/L
Rationale: Insulin drives potassium into cells. Significant hypokalemia
can cause life-threatening dysrhythmias and may require potassium
replacement before continuing insulin therapy.
4. A nurse is caring for a client with acute pancreatitis. Which
prescription should the nurse expect?
A. Regular diet
B. NPO status
C. High-fat diet
D. Increased oral fluids
Answer: NPO status
Rationale: With acute pancreatitis, withholding oral intake decreases
pancreatic stimulation and allows the pancreas to rest during the
acute phase.
,5. A client with a gastrointestinal hemorrhage has a blood pressure of
84/50 mm Hg and heart rate of 124/min. Which action should the nurse
take first?
A. Administer an antacid
B. Obtain a stool specimen
C. Establish or maintain large-bore IV access
D. Encourage oral fluids
Answer: Establish or maintain large-bore IV access
Rationale: The client is showing signs of hypovolemic shock. Rapid IV
access is essential for fluid and blood-product resuscitation.
6. A client with chronic kidney disease has a potassium level of 6.2
mEq/L. Which ECG finding should the nurse anticipate?
A. Flattened T waves
B. Peaked T waves
C. Prolonged QT interval
D. U waves
Answer: Peaked T waves
Rationale: Hyperkalemia commonly causes tall, peaked T waves and
can progress to widened QRS complexes and lethal dysrhythmias.
7. A nurse is caring for a client after thyroidectomy. Which finding
requires immediate action?
A. Mild incisional pain
B. Hoarse voice immediately after surgery
C. Stridor
D. Temperature of 37.2°C (99°F)
, Answer: Stridor
Rationale: Stridor can indicate airway obstruction from edema or
bleeding and requires immediate intervention.
8. A client with SIADH has a sodium level of 118 mEq/L. Which
intervention is appropriate?
A. Encourage free water intake
B. Restrict fluids
C. Administer hypotonic IV fluids
D. Encourage excessive oral fluids
Answer: Restrict fluids
Rationale: SIADH causes excessive water retention and dilutional
hyponatremia. Fluid restriction helps correct the water imbalance.
9. A client with Addison's disease is at risk for which electrolyte
imbalance?
A. Hypernatremia
B. Hypokalemia
C. Hyperkalemia
D. Hypercalcemia
Answer: Hyperkalemia
Rationale: Reduced aldosterone secretion causes sodium loss and
potassium retention, resulting in hyponatremia and hyperkalemia.
10. A nurse is assessing a client who has a pulmonary embolism. Which
finding is expected?
NEWEST EVALUATED PRACTICE EXAM 100
QUESTIONS 2026-2027|ORIGINAL QUESTIONS
& ANSWERS |DETAILED RATIONALES |HINTED
COMPLETE EXAM PREP GRADED A+*INSTANT
DOWNLOAD PDF*
1. A nurse is assessing a client who has heart failure. Which finding
indicates worsening left-sided heart failure?
A. Dependent edema
B. Jugular venous distention
C. Crackles in the lung bases
D. Hepatomegaly
Answer: Crackles in the lung bases
Rationale: Left-sided heart failure causes pulmonary congestion,
which can produce crackles, dyspnea, and pulmonary edema.
2. A client with COPD is receiving oxygen at 2 L/min via nasal cannula.
Which finding requires immediate intervention?
A. Oxygen saturation of 91%
B. Respiratory rate of 22/min
C. Increasing somnolence and confusion
D. Barrel-shaped chest
Answer: Increasing somnolence and confusion
,Rationale: Excessive oxygen administration in some clients with
chronic CO₂ retention can worsen hypercapnia. Acute changes in
mental status require prompt assessment.
3. A client with diabetic ketoacidosis (DKA) is receiving IV fluids and
regular insulin. Which laboratory value requires the nurse's greatest
attention?
A. Glucose 250 mg/dL
B. Potassium 3.1 mEq/L
C. Sodium 136 mEq/L
D. Chloride 100 mEq/L
Answer: Potassium 3.1 mEq/L
Rationale: Insulin drives potassium into cells. Significant hypokalemia
can cause life-threatening dysrhythmias and may require potassium
replacement before continuing insulin therapy.
4. A nurse is caring for a client with acute pancreatitis. Which
prescription should the nurse expect?
A. Regular diet
B. NPO status
C. High-fat diet
D. Increased oral fluids
Answer: NPO status
Rationale: With acute pancreatitis, withholding oral intake decreases
pancreatic stimulation and allows the pancreas to rest during the
acute phase.
,5. A client with a gastrointestinal hemorrhage has a blood pressure of
84/50 mm Hg and heart rate of 124/min. Which action should the nurse
take first?
A. Administer an antacid
B. Obtain a stool specimen
C. Establish or maintain large-bore IV access
D. Encourage oral fluids
Answer: Establish or maintain large-bore IV access
Rationale: The client is showing signs of hypovolemic shock. Rapid IV
access is essential for fluid and blood-product resuscitation.
6. A client with chronic kidney disease has a potassium level of 6.2
mEq/L. Which ECG finding should the nurse anticipate?
A. Flattened T waves
B. Peaked T waves
C. Prolonged QT interval
D. U waves
Answer: Peaked T waves
Rationale: Hyperkalemia commonly causes tall, peaked T waves and
can progress to widened QRS complexes and lethal dysrhythmias.
7. A nurse is caring for a client after thyroidectomy. Which finding
requires immediate action?
A. Mild incisional pain
B. Hoarse voice immediately after surgery
C. Stridor
D. Temperature of 37.2°C (99°F)
, Answer: Stridor
Rationale: Stridor can indicate airway obstruction from edema or
bleeding and requires immediate intervention.
8. A client with SIADH has a sodium level of 118 mEq/L. Which
intervention is appropriate?
A. Encourage free water intake
B. Restrict fluids
C. Administer hypotonic IV fluids
D. Encourage excessive oral fluids
Answer: Restrict fluids
Rationale: SIADH causes excessive water retention and dilutional
hyponatremia. Fluid restriction helps correct the water imbalance.
9. A client with Addison's disease is at risk for which electrolyte
imbalance?
A. Hypernatremia
B. Hypokalemia
C. Hyperkalemia
D. Hypercalcemia
Answer: Hyperkalemia
Rationale: Reduced aldosterone secretion causes sodium loss and
potassium retention, resulting in hyponatremia and hyperkalemia.
10. A nurse is assessing a client who has a pulmonary embolism. Which
finding is expected?
