ATI-MED-SURG VERIFIED EXAM QUESTIONS AND
ANSWERS - LATEST VERSION 2026/2027
1. Priority action for a client in acute respiratory distress?
Position high-Fowler's, apply oxygen, assess airway and SpO2.
2. Maximum suction time per pass for tracheal suctioning? 10
seconds.
3. Before suctioning, what should the nurse do? Hyperoxygenate
with 100% oxygen and hyperventilate.
4. Suction pressure range for adults? 80–120 mmHg.
5. Continuous bubbling in the water seal chamber of a chest tube
indicates? An air leak — check connections.
6. Chest tube becomes disconnected from the drainage system —
action? Submerge the end in sterile water.
7. Chest tube is accidentally pulled from the chest — action? Cover
with an occlusive (petrolatum) sterile dressing and press to seal.
8. Fluctuation (tidaling) in the water seal stops — what does it
mean? Lung has re-expanded or tubing is occluded — assess the
client.
9. What type of precautions for active TB? Airborne — N95
respirator, negative-pressure room.
10. When is a PPD read? 48–72 hours; measure induration (not
erythema).
11. Client with positive PPD — next step? Chest x-ray and
sputum cultures.
12. Most important TB medication teaching? Complete the full
course even after symptoms resolve.
13. First-line TB medications? Isoniazid, rifampin,
pyrazinamide, ethambutol.
,14. Key isoniazid teaching? Take with vitamin B6 (pyridoxine)
to prevent peripheral neuropathy; monitor for hepatotoxicity.
15. Client should report which visual change on ethambutol?
Color vision changes (optic neuritis).
16. Rifampin — expected harmless side effect? Orange-red
discoloration of urine and other body fluids.
17. Oxygen delivery for a client with COPD? Low-flow, low-
concentration (1–2 L/min nasal cannula).
18. Breathing technique taught for COPD? Pursed-lip breathing;
tripod positioning.
19. "Pink puffer" vs "blue bloater"? Emphysema vs chronic
bronchitis.
20. Priority medication during an acute asthma attack? Short-
acting beta-agonist (albuterol).
21. Teaching for inhaled fluticasone (corticosteroid)? Rinse
mouth after use to prevent oral candidiasis.
22. Why is salmeterol never used for acute attacks? It is a
long-acting controller with slow onset.
23. Status asthmaticus? Severe asthma unrelieved by usual
treatment — medical emergency.
24. Manifestations of pneumothorax? Sudden sharp chest pain,
dyspnea, absent breath sounds on affected side.
25. Late sign of tension pneumothorax? Tracheal deviation
away from the affected side.
26. Classic manifestations of pulmonary embolism? Sudden
dyspnea, pleuritic chest pain, tachycardia, anxiety.
27. Expected treatment for PE? Oxygen and anticoagulation
(heparin); thrombolytics in massive PE.
28. Priority intervention for pneumonia? Incentive spirometry,
deep breathing, hydration, early ambulation.
29. Hallmark of ARDS? Refractory hypoxemia despite increasing
oxygen.
, 30. Priority goals in cystic fibrosis care? Airway clearance and
pancreatic enzymes with meals.
❤️ CARDIOVASCULAR (31–65)
31. Priority assessment after cardiac catheterization?
Insertion site for bleeding/hematoma and distal pulses.
32. Position teaching after femoral catheterization? Keep leg
straight; increase fluids to flush contrast.
33. Earliest and most specific cardiac marker in MI? Troponin
I (rises ~2–3 hours).
34. Priority when a client reports chest pain? ECG within 10
minutes, vital signs, oxygen if hypoxic, aspirin, nitroglycerin.
35. Nitroglycerin administration for angina? One sublingual
tablet every 5 minutes, up to 3 doses; call if pain persists.
36. Nitroglycerin teaching? Expect headache; keep in dark glass
container; sit down when taking; replace every 6 months.
37. Which drug class is contraindicated with nitroglycerin?
PDE5 inhibitors (sildenafil) — severe hypotension.
38. Left-sided heart failure manifestations? Crackles, dyspnea,
orthopnea, cough (pulmonary congestion).
39. Right-sided heart failure manifestations? JVD, peripheral
edema, hepatomegaly, weight gain.
40. Priority teaching for heart failure? Daily weights — report
gain of 3 lb in 1 day or 5 lb in 1 week.
41. Before giving digoxin, the nurse must? Check apical pulse
for 1 full minute; hold if < 60 bpm.
42. Signs of digoxin toxicity? N/V, anorexia, visual disturbances
(halos, yellow-green vision), bradycardia.
43. Therapeutic digoxin level? 0.5–2.0 ng/mL; > 2.0 = toxicity.
44. Hypokalemia + digoxin risk? Increased risk of digoxin
toxicity.
ANSWERS - LATEST VERSION 2026/2027
1. Priority action for a client in acute respiratory distress?
Position high-Fowler's, apply oxygen, assess airway and SpO2.
2. Maximum suction time per pass for tracheal suctioning? 10
seconds.
3. Before suctioning, what should the nurse do? Hyperoxygenate
with 100% oxygen and hyperventilate.
4. Suction pressure range for adults? 80–120 mmHg.
5. Continuous bubbling in the water seal chamber of a chest tube
indicates? An air leak — check connections.
6. Chest tube becomes disconnected from the drainage system —
action? Submerge the end in sterile water.
7. Chest tube is accidentally pulled from the chest — action? Cover
with an occlusive (petrolatum) sterile dressing and press to seal.
8. Fluctuation (tidaling) in the water seal stops — what does it
mean? Lung has re-expanded or tubing is occluded — assess the
client.
9. What type of precautions for active TB? Airborne — N95
respirator, negative-pressure room.
10. When is a PPD read? 48–72 hours; measure induration (not
erythema).
11. Client with positive PPD — next step? Chest x-ray and
sputum cultures.
12. Most important TB medication teaching? Complete the full
course even after symptoms resolve.
13. First-line TB medications? Isoniazid, rifampin,
pyrazinamide, ethambutol.
,14. Key isoniazid teaching? Take with vitamin B6 (pyridoxine)
to prevent peripheral neuropathy; monitor for hepatotoxicity.
15. Client should report which visual change on ethambutol?
Color vision changes (optic neuritis).
16. Rifampin — expected harmless side effect? Orange-red
discoloration of urine and other body fluids.
17. Oxygen delivery for a client with COPD? Low-flow, low-
concentration (1–2 L/min nasal cannula).
18. Breathing technique taught for COPD? Pursed-lip breathing;
tripod positioning.
19. "Pink puffer" vs "blue bloater"? Emphysema vs chronic
bronchitis.
20. Priority medication during an acute asthma attack? Short-
acting beta-agonist (albuterol).
21. Teaching for inhaled fluticasone (corticosteroid)? Rinse
mouth after use to prevent oral candidiasis.
22. Why is salmeterol never used for acute attacks? It is a
long-acting controller with slow onset.
23. Status asthmaticus? Severe asthma unrelieved by usual
treatment — medical emergency.
24. Manifestations of pneumothorax? Sudden sharp chest pain,
dyspnea, absent breath sounds on affected side.
25. Late sign of tension pneumothorax? Tracheal deviation
away from the affected side.
26. Classic manifestations of pulmonary embolism? Sudden
dyspnea, pleuritic chest pain, tachycardia, anxiety.
27. Expected treatment for PE? Oxygen and anticoagulation
(heparin); thrombolytics in massive PE.
28. Priority intervention for pneumonia? Incentive spirometry,
deep breathing, hydration, early ambulation.
29. Hallmark of ARDS? Refractory hypoxemia despite increasing
oxygen.
, 30. Priority goals in cystic fibrosis care? Airway clearance and
pancreatic enzymes with meals.
❤️ CARDIOVASCULAR (31–65)
31. Priority assessment after cardiac catheterization?
Insertion site for bleeding/hematoma and distal pulses.
32. Position teaching after femoral catheterization? Keep leg
straight; increase fluids to flush contrast.
33. Earliest and most specific cardiac marker in MI? Troponin
I (rises ~2–3 hours).
34. Priority when a client reports chest pain? ECG within 10
minutes, vital signs, oxygen if hypoxic, aspirin, nitroglycerin.
35. Nitroglycerin administration for angina? One sublingual
tablet every 5 minutes, up to 3 doses; call if pain persists.
36. Nitroglycerin teaching? Expect headache; keep in dark glass
container; sit down when taking; replace every 6 months.
37. Which drug class is contraindicated with nitroglycerin?
PDE5 inhibitors (sildenafil) — severe hypotension.
38. Left-sided heart failure manifestations? Crackles, dyspnea,
orthopnea, cough (pulmonary congestion).
39. Right-sided heart failure manifestations? JVD, peripheral
edema, hepatomegaly, weight gain.
40. Priority teaching for heart failure? Daily weights — report
gain of 3 lb in 1 day or 5 lb in 1 week.
41. Before giving digoxin, the nurse must? Check apical pulse
for 1 full minute; hold if < 60 bpm.
42. Signs of digoxin toxicity? N/V, anorexia, visual disturbances
(halos, yellow-green vision), bradycardia.
43. Therapeutic digoxin level? 0.5–2.0 ng/mL; > 2.0 = toxicity.
44. Hypokalemia + digoxin risk? Increased risk of digoxin
toxicity.
