ATI PN ADULT MEDICAL-SURGICAL CMS
2026 PROCTORED EXAM QUESTIONS
AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF
Core Domains
Cardiovascular and Hematologic Disorders
Respiratory and Infectious Disease Management
Endocrine, Renal, and Fluid/Electrolyte Balance
Gastrointestinal and Perioperative Nursing Care
Neurological and Musculoskeletal Disorders
Oncology and Immunologic Nursing
Pharmacological and Parenteral Therapies
Safety, Prioritization, and Clinical Judgment
NGN Case Studies and Dosage Calculation
Introduction
This comprehensive examination assesses the practical nursing student's
mastery of adult medical-surgical nursing concepts essential for entry-
level practice. The assessment evaluates clinical judgment, safe
medication administration, prioritization, and comprehensive nursing
knowledge across adult health populations. Questions are formatted to
mirror the actual ATI PN Adult Medical-Surgical CMS Proctored
Assessment, including multiple-choice, select-all-that-apply, and Next
Generation NCLEX-style case scenarios. Emphasis is placed on real-world
application, critical thinking, and decision-making in diverse clinical
settings.
Question 1
,A nurse is assessing a client who has been diagnosed with heart failure.
Which of the following findings is an early manifestation of fluid volume
overload?
A. Jugular vein distention
B. Crackles auscultated in the lung bases
C. Weight gain of 2 pounds in 24 hours
D. Peripheral edema (2+ pitting)
C. Weight gain of 2 pounds in 24 hours
RATIONALE: Weight gain is the earliest indicator of fluid volume
overload because 1 kg (2.2 pounds) of weight gain equals
approximately 1 liter of retained fluid. Daily weights are the most
sensitive indicator of fluid status changes.
Question 2
A nurse is reinforcing teaching with a client who has angina pectoris and
a new prescription for sublingual nitroglycerin. Which of the following
statements by the client indicates an understanding of the teaching?
A. "I will take one tablet and if the pain is not relieved in 10 minutes, I
will call 911."
B. "I will place the tablet under my tongue and allow it to dissolve
completely."
C. "I will swallow the tablet with a full glass of water."
D. "I will take the medication with food to prevent stomach upset."
B. "I will place the tablet under my tongue and allow it to dissolve
completely."
RATIONALE: Sublingual nitroglycerin should be placed under the
tongue and allowed to dissolve completely for rapid absorption through
,the oral mucosa. Swallowing the tablet renders it ineffective because it is
destroyed by first-pass metabolism in the liver.
Question 3
A nurse is caring for a client who is receiving IV heparin for treatment of
a deep vein thrombosis (DVT). The client's activated partial
thromboplastin time (aPTT) is 110 seconds (normal 25-35 seconds).
Which of the following actions should the nurse take?
A. Continue the infusion at the current rate
B. Increase the infusion rate as prescribed
C. Stop the infusion and notify the healthcare provider
D. Decrease the infusion rate by 50%
C. Stop the infusion and notify the healthcare provider
RATIONALE: The therapeutic range for aPTT during heparin therapy
is 1.5 to 2.5 times the normal control value, which is approximately 60-80
seconds. An aPTT of 110 seconds is significantly elevated and indicates
the client is at high risk for bleeding. The infusion should be stopped
immediately and the provider notified.
Question 4
A client who had a myocardial infarction (MI) 2 days ago is prescribed
aspirin 81 mg daily. The nurse should explain that the purpose of this
medication is to:
A. Relieve chest pain
B. Prevent platelet aggregation
C. Lower blood pressure
D. Dissolve existing clots
B. Prevent platelet aggregation
, RATIONALE: Low-dose aspirin is prescribed post-MI for its
antiplatelet effects, preventing platelet aggregation and reducing the
risk of recurrent thrombus formation.
Question 5
A nurse is caring for a client who has a new prescription for warfarin.
Which statement by the client indicates understanding of discharge
teaching?
A. I will eat more leafy green vegetables to increase vitamin K
B. I will use a straight razor when shaving
C. I will report any unexplained bruising or bleeding to my provider
D. I will take ibuprofen for headaches instead of acetaminophen
C. I will report any unexplained bruising or bleeding to my provider
RATIONALE: Unexplained bruising or bleeding may indicate
excessive anticoagulation and must be reported. Leafy greens decrease
warfarin effectiveness and should be eaten consistently.
Question 6
A nurse is reviewing the laboratory results of four clients. Which client
requires immediate intervention?
A. Client with potassium 5.2 mEq/L
B. Client with platelets 18,000/mm³
C. Client with hemoglobin 10.5 g/dL
D. Client with BUN 25 mg/dL
B. Client with platelets 18,000/mm³
RATIONALE: Platelets of 18,000/mm³ indicate severe
thrombocytopenia, placing the client at high risk for spontaneous
bleeding, including intracranial hemorrhage.
2026 PROCTORED EXAM QUESTIONS
AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF
Core Domains
Cardiovascular and Hematologic Disorders
Respiratory and Infectious Disease Management
Endocrine, Renal, and Fluid/Electrolyte Balance
Gastrointestinal and Perioperative Nursing Care
Neurological and Musculoskeletal Disorders
Oncology and Immunologic Nursing
Pharmacological and Parenteral Therapies
Safety, Prioritization, and Clinical Judgment
NGN Case Studies and Dosage Calculation
Introduction
This comprehensive examination assesses the practical nursing student's
mastery of adult medical-surgical nursing concepts essential for entry-
level practice. The assessment evaluates clinical judgment, safe
medication administration, prioritization, and comprehensive nursing
knowledge across adult health populations. Questions are formatted to
mirror the actual ATI PN Adult Medical-Surgical CMS Proctored
Assessment, including multiple-choice, select-all-that-apply, and Next
Generation NCLEX-style case scenarios. Emphasis is placed on real-world
application, critical thinking, and decision-making in diverse clinical
settings.
Question 1
,A nurse is assessing a client who has been diagnosed with heart failure.
Which of the following findings is an early manifestation of fluid volume
overload?
A. Jugular vein distention
B. Crackles auscultated in the lung bases
C. Weight gain of 2 pounds in 24 hours
D. Peripheral edema (2+ pitting)
C. Weight gain of 2 pounds in 24 hours
RATIONALE: Weight gain is the earliest indicator of fluid volume
overload because 1 kg (2.2 pounds) of weight gain equals
approximately 1 liter of retained fluid. Daily weights are the most
sensitive indicator of fluid status changes.
Question 2
A nurse is reinforcing teaching with a client who has angina pectoris and
a new prescription for sublingual nitroglycerin. Which of the following
statements by the client indicates an understanding of the teaching?
A. "I will take one tablet and if the pain is not relieved in 10 minutes, I
will call 911."
B. "I will place the tablet under my tongue and allow it to dissolve
completely."
C. "I will swallow the tablet with a full glass of water."
D. "I will take the medication with food to prevent stomach upset."
B. "I will place the tablet under my tongue and allow it to dissolve
completely."
RATIONALE: Sublingual nitroglycerin should be placed under the
tongue and allowed to dissolve completely for rapid absorption through
,the oral mucosa. Swallowing the tablet renders it ineffective because it is
destroyed by first-pass metabolism in the liver.
Question 3
A nurse is caring for a client who is receiving IV heparin for treatment of
a deep vein thrombosis (DVT). The client's activated partial
thromboplastin time (aPTT) is 110 seconds (normal 25-35 seconds).
Which of the following actions should the nurse take?
A. Continue the infusion at the current rate
B. Increase the infusion rate as prescribed
C. Stop the infusion and notify the healthcare provider
D. Decrease the infusion rate by 50%
C. Stop the infusion and notify the healthcare provider
RATIONALE: The therapeutic range for aPTT during heparin therapy
is 1.5 to 2.5 times the normal control value, which is approximately 60-80
seconds. An aPTT of 110 seconds is significantly elevated and indicates
the client is at high risk for bleeding. The infusion should be stopped
immediately and the provider notified.
Question 4
A client who had a myocardial infarction (MI) 2 days ago is prescribed
aspirin 81 mg daily. The nurse should explain that the purpose of this
medication is to:
A. Relieve chest pain
B. Prevent platelet aggregation
C. Lower blood pressure
D. Dissolve existing clots
B. Prevent platelet aggregation
, RATIONALE: Low-dose aspirin is prescribed post-MI for its
antiplatelet effects, preventing platelet aggregation and reducing the
risk of recurrent thrombus formation.
Question 5
A nurse is caring for a client who has a new prescription for warfarin.
Which statement by the client indicates understanding of discharge
teaching?
A. I will eat more leafy green vegetables to increase vitamin K
B. I will use a straight razor when shaving
C. I will report any unexplained bruising or bleeding to my provider
D. I will take ibuprofen for headaches instead of acetaminophen
C. I will report any unexplained bruising or bleeding to my provider
RATIONALE: Unexplained bruising or bleeding may indicate
excessive anticoagulation and must be reported. Leafy greens decrease
warfarin effectiveness and should be eaten consistently.
Question 6
A nurse is reviewing the laboratory results of four clients. Which client
requires immediate intervention?
A. Client with potassium 5.2 mEq/L
B. Client with platelets 18,000/mm³
C. Client with hemoglobin 10.5 g/dL
D. Client with BUN 25 mg/dL
B. Client with platelets 18,000/mm³
RATIONALE: Platelets of 18,000/mm³ indicate severe
thrombocytopenia, placing the client at high risk for spontaneous
bleeding, including intracranial hemorrhage.
