ATI RN ADULT MEDICAL SURGICAL 2026 ACTUAL PROCTORED
EXAM TEST REAL QUESTIONS & ACCURATE ANSWERS WELL
ELABORATED RATIONALES \PASS GRADE A+\ NEWEST
UPDATED VERSION!! CURRENTLY UP NEW BRAND! 2026
ACTUAL ATI RN ADULT MEDUCAL SURGICAL\
ATI RN Adult Medical-Surgical 2026 Proctored Exam Practice
Test
1. A nurse is caring for a client who has heart failure and is receiving furosemide.
Which of the following findings indicates the medication is effective?
A. Decreased peripheral edema
B. Increased blood pressure
C. Decreased heart rate
D. Increased urine specific gravity
A. Decreased peripheral edema
Rationale: Furosemide is a loop diuretic that promotes excretion of water and
sodium, reducing fluid volume overload. Decreased peripheral edema indicates
effective reduction of extracellular fluid. Increased blood pressure would not be
expected as the primary goal in heart failure is reduction of preload. Heart rate
changes are not a direct indicator of furosemide effectiveness. Urine specific
gravity would decrease, not increase, with effective diuresis.
2. A nurse is assessing a client who has chronic obstructive pulmonary disease
(COPD). Which of the following findings should the nurse expect?
,A. Barrel chest
B. Clubbing of the fingers
C. Pursed-lip breathing
D. All of the above
D. All of the above
Rationale: All three findings are classic manifestations of COPD. Barrel chest
results from hyperinflation of the lungs due to air trapping. Clubbing of the
fingers occurs from chronic hypoxemia. Pursed-lip breathing is a compensatory
mechanism that prolongs expiration and keeps airways open.
3. A nurse is preparing to administer insulin to a client who has type 1 diabetes
mellitus. Which of the following actions should the nurse take?
A. Draw up regular insulin before NPH insulin
B. Draw up NPH insulin before regular insulin
C. Mix the insulins in the same syringe without regard to order
D. Administer the insulins in separate syringes
A. Draw up regular insulin before NPH insulin
Rationale: When mixing regular insulin and NPH insulin in the same syringe, the
nurse should draw up the regular (clear) insulin first, followed by the NPH
(cloudy) insulin. This prevents contamination of the regular insulin vial with NPH
insulin. Drawing up NPH first could cause the regular insulin to become cloudy
and alter its onset of action.
4. A nurse is caring for a client who is 2 hours postoperative following a
gastrectomy. Which of the following findings should the nurse report to the
provider?
A. Heart rate 88/min
B. Blood pressure 110/70 mm Hg
,C. Drainage of 50 mL of bright red blood from the nasogastric tube
D. Pain rating of 4 on a scale of 0 to 10
C. Drainage of 50 mL of bright red blood from the nasogastric tube
Rationale: Bright red blood from the nasogastric tube in the immediate
postoperative period may indicate hemorrhage and should be reported to the
provider immediately. A heart rate of 88/min and blood pressure of 110/70 mm
Hg are within normal limits. A pain rating of 4 is expected and should be
managed with analgesics.
5. A nurse is assessing a client who has acute pancreatitis. Which of the
following laboratory findings should the nurse expect?
A. Decreased serum amylase
B. Increased serum lipase
C. Decreased serum glucose
D. Increased serum calcium
B. Increased serum lipase
Rationale: Serum lipase is more specific to the pancreas and remains elevated
longer than amylase in acute pancreatitis. Serum amylase is typically increased,
not decreased. Serum glucose is often increased due to impaired insulin
production. Serum calcium may decrease due to fat necrosis and saponification.
6. A nurse is providing teaching to a client who has hypertension. Which of the
following dietary recommendations should the nurse include?
A. Increase intake of processed foods
B. Limit sodium intake to less than 2,300 mg per day
C. Increase intake of red meat
D. Limit potassium-rich foods
B. Limit sodium intake to less than 2,300 mg per day
Rationale: The DASH diet and hypertension management guidelines recommend
, limiting sodium intake to less than 2,300 mg per day, with an ideal limit of 1,500
mg per day for most adults. Processed foods are high in sodium and should be
avoided. Red meat is high in saturated fat and should be limited. Potassium-rich
foods are encouraged, not limited, as potassium helps lower blood pressure.
7. A nurse is caring for a client who has pneumonia. Which of the following
interventions should the nurse implement to promote airway clearance?
A. Encourage the client to cough forcefully
B. Administer oxygen at 2 L/min via nasal cannula
C. Encourage deep breathing and coughing exercises
D. Restrict fluid intake
C. Encourage deep breathing and coughing exercises
Rationale: Deep breathing and coughing exercises help mobilize secretions and
promote airway clearance in clients with pneumonia. Forceful coughing can
cause airway collapse and should be avoided; instead, the client should be
taught to take a deep breath and cough from the diaphragm. Oxygen therapy
treats hypoxemia but does not promote airway clearance. Fluid intake should be
increased, not restricted, to help liquefy secretions.
8. A nurse is assessing a client who has chronic kidney disease. Which of the
following findings should the nurse expect?
A. Polyuria
B. Hypotension
C. Anemia
D. Hypercalcemia
C. Anemia
Rationale: Anemia is a common finding in chronic kidney disease due to
decreased production of erythropoietin by the kidneys. Polyuria is seen in early
stages but not typically in advanced disease. Hypertension, not hypotension, is
EXAM TEST REAL QUESTIONS & ACCURATE ANSWERS WELL
ELABORATED RATIONALES \PASS GRADE A+\ NEWEST
UPDATED VERSION!! CURRENTLY UP NEW BRAND! 2026
ACTUAL ATI RN ADULT MEDUCAL SURGICAL\
ATI RN Adult Medical-Surgical 2026 Proctored Exam Practice
Test
1. A nurse is caring for a client who has heart failure and is receiving furosemide.
Which of the following findings indicates the medication is effective?
A. Decreased peripheral edema
B. Increased blood pressure
C. Decreased heart rate
D. Increased urine specific gravity
A. Decreased peripheral edema
Rationale: Furosemide is a loop diuretic that promotes excretion of water and
sodium, reducing fluid volume overload. Decreased peripheral edema indicates
effective reduction of extracellular fluid. Increased blood pressure would not be
expected as the primary goal in heart failure is reduction of preload. Heart rate
changes are not a direct indicator of furosemide effectiveness. Urine specific
gravity would decrease, not increase, with effective diuresis.
2. A nurse is assessing a client who has chronic obstructive pulmonary disease
(COPD). Which of the following findings should the nurse expect?
,A. Barrel chest
B. Clubbing of the fingers
C. Pursed-lip breathing
D. All of the above
D. All of the above
Rationale: All three findings are classic manifestations of COPD. Barrel chest
results from hyperinflation of the lungs due to air trapping. Clubbing of the
fingers occurs from chronic hypoxemia. Pursed-lip breathing is a compensatory
mechanism that prolongs expiration and keeps airways open.
3. A nurse is preparing to administer insulin to a client who has type 1 diabetes
mellitus. Which of the following actions should the nurse take?
A. Draw up regular insulin before NPH insulin
B. Draw up NPH insulin before regular insulin
C. Mix the insulins in the same syringe without regard to order
D. Administer the insulins in separate syringes
A. Draw up regular insulin before NPH insulin
Rationale: When mixing regular insulin and NPH insulin in the same syringe, the
nurse should draw up the regular (clear) insulin first, followed by the NPH
(cloudy) insulin. This prevents contamination of the regular insulin vial with NPH
insulin. Drawing up NPH first could cause the regular insulin to become cloudy
and alter its onset of action.
4. A nurse is caring for a client who is 2 hours postoperative following a
gastrectomy. Which of the following findings should the nurse report to the
provider?
A. Heart rate 88/min
B. Blood pressure 110/70 mm Hg
,C. Drainage of 50 mL of bright red blood from the nasogastric tube
D. Pain rating of 4 on a scale of 0 to 10
C. Drainage of 50 mL of bright red blood from the nasogastric tube
Rationale: Bright red blood from the nasogastric tube in the immediate
postoperative period may indicate hemorrhage and should be reported to the
provider immediately. A heart rate of 88/min and blood pressure of 110/70 mm
Hg are within normal limits. A pain rating of 4 is expected and should be
managed with analgesics.
5. A nurse is assessing a client who has acute pancreatitis. Which of the
following laboratory findings should the nurse expect?
A. Decreased serum amylase
B. Increased serum lipase
C. Decreased serum glucose
D. Increased serum calcium
B. Increased serum lipase
Rationale: Serum lipase is more specific to the pancreas and remains elevated
longer than amylase in acute pancreatitis. Serum amylase is typically increased,
not decreased. Serum glucose is often increased due to impaired insulin
production. Serum calcium may decrease due to fat necrosis and saponification.
6. A nurse is providing teaching to a client who has hypertension. Which of the
following dietary recommendations should the nurse include?
A. Increase intake of processed foods
B. Limit sodium intake to less than 2,300 mg per day
C. Increase intake of red meat
D. Limit potassium-rich foods
B. Limit sodium intake to less than 2,300 mg per day
Rationale: The DASH diet and hypertension management guidelines recommend
, limiting sodium intake to less than 2,300 mg per day, with an ideal limit of 1,500
mg per day for most adults. Processed foods are high in sodium and should be
avoided. Red meat is high in saturated fat and should be limited. Potassium-rich
foods are encouraged, not limited, as potassium helps lower blood pressure.
7. A nurse is caring for a client who has pneumonia. Which of the following
interventions should the nurse implement to promote airway clearance?
A. Encourage the client to cough forcefully
B. Administer oxygen at 2 L/min via nasal cannula
C. Encourage deep breathing and coughing exercises
D. Restrict fluid intake
C. Encourage deep breathing and coughing exercises
Rationale: Deep breathing and coughing exercises help mobilize secretions and
promote airway clearance in clients with pneumonia. Forceful coughing can
cause airway collapse and should be avoided; instead, the client should be
taught to take a deep breath and cough from the diaphragm. Oxygen therapy
treats hypoxemia but does not promote airway clearance. Fluid intake should be
increased, not restricted, to help liquefy secretions.
8. A nurse is assessing a client who has chronic kidney disease. Which of the
following findings should the nurse expect?
A. Polyuria
B. Hypotension
C. Anemia
D. Hypercalcemia
C. Anemia
Rationale: Anemia is a common finding in chronic kidney disease due to
decreased production of erythropoietin by the kidneys. Polyuria is seen in early
stages but not typically in advanced disease. Hypertension, not hypotension, is
