ATI RN ADULT MEDICAL
SURGICAL PROCTORED WITH
NGN 2023 -2024
Section 1: Cardiovascular Disorders
1. A nurse is caring for a client who has heart failure and is receiving furosemide. Which of the
following findings should the nurse identify as an adverse effect of this medication?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Correct Answer: B. Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia.
Clients should be monitored for low potassium levels (normal range 3.5–5.0 mEq/L). Signs
include muscle weakness, fatigue, and dysrhythmias. Hyperkalemia (A) is associated with
potassium-sparing diuretics such as spironolactone. Hypernatremia (C) and hypercalcemia (D)
are not typical adverse effects of furosemide; in fact, loop diuretics can cause hyponatremia and
hypocalcemia.
2. A nurse is assessing a client who has deep vein thrombosis (DVT) in the left calf. Which of
the following findings should the nurse expect?
A. Unilateral calf swelling and warmth
B. Bilateral dependent edema
C. Cool, pale extremity
D. Decreased pedal pulses
Correct Answer: A. Unilateral calf swelling and warmth
, Rationale: DVT typically presents with unilateral swelling, warmth, erythema, and pain in
the affected extremity. Bilateral edema (B) is more consistent with heart failure or venous
insufficiency. A cool, pale extremity (C) and decreased pedal pulses (D) are signs of arterial
insufficiency, not venous thrombosis.
3. A nurse is teaching a client who has atrial fibrillation and is prescribed warfarin. Which of
the following statements by the client indicates understanding of the teaching?
A. "I should increase my intake of green leafy vegetables."
B. "I will use a soft-bristled toothbrush."
C. "I can take aspirin for headaches."
D. "I should expect my INR to be between 3.5 and 4.5."
Correct Answer: B. "I will use a soft-bristled toothbrush."
Rationale: Warfarin increases bleeding risk, so clients should use a soft-bristled toothbrush
to prevent gum bleeding. Green leafy vegetables (A) are high in vitamin K and should be kept
consistent, not increased. Aspirin (C) increases bleeding risk and should be avoided unless
prescribed. The therapeutic INR for atrial fibrillation (D) is typically 2.0–3.0, not 3.5–4.5.
4. A nurse is caring for a client who is experiencing an acute myocardial infarction (MI). Which
of the following medications should the nurse anticipate administering first?
A. Morphine sulfate
B. Aspirin
C. Nitroglycerin
D. Metoprolol
Correct Answer: B. Aspirin
Rationale: Aspirin is given first in suspected MI because it inhibits platelet aggregation and
reduces mortality. Morphine (A) is given for pain unrelieved by nitroglycerin. Nitroglycerin (C) is
given for chest pain but is contraindicated in right ventricular MI or hypotension. Metoprolol (D)
is given to reduce myocardial oxygen demand but is not the first priority.
5. A nurse is assessing a client who has pericarditis. Which of the following findings should the
nurse expect?
,A. Pleuritic chest pain that worsens with deep inspiration
B. Chest pain that radiates to the left arm
C. Pain relieved by lying supine
D. Bilateral crackles in the lung bases
Correct Answer: A. Pleuritic chest pain that worsens with deep inspiration
Rationale: Pericarditis causes sharp, pleuritic chest pain that worsens with inspiration and is
relieved by sitting forward. Pain radiating to the left arm (B) is characteristic of MI. Pain relieved
by lying supine (C) is not typical; pericarditis pain worsens when supine. Bilateral crackles (D)
suggest heart failure, not pericarditis.
6. A nurse is caring for a client who has a new prescription for digoxin. Which of the following
findings indicates digoxin toxicity?
A. Heart rate of 88/min
B. Serum potassium of 4.0 mEq/L
C. Visual disturbances such as yellow halos
D. Blood pressure of 128/76 mm Hg
Correct Answer: C. Visual disturbances such as yellow halos
Rationale: Digoxin toxicity manifests with visual disturbances (yellow or green halos),
nausea, vomiting, and dysrhythmias. A heart rate of 88/min (A) is normal. Serum potassium of
4.0 mEq/L (B) is normal. Blood pressure of 128/76 mm Hg (D) is normal. Hypokalemia increases
the risk of digoxin toxicity.
7. A nurse is teaching a client who has hypertension about lifestyle modifications. Which of
the following instructions should the nurse include? (Select all that apply.)
A. Limit sodium intake to less than 2,300 mg/day
B. Increase physical activity to 150 minutes per week
C. Limit alcohol consumption to 2 drinks per day for men
D. Maintain a BMI of less than 30
E. Increase potassium-rich foods in the diet
Correct Answers: A, B, E
Rationale: Sodium restriction to <2,300 mg/day (A), physical activity of 150 minutes/week
(B), and increased potassium intake (E) are recommended for hypertension management.
, Alcohol should be limited to ≤2 drinks/day for men and ≤1 for women (C is partially correct but
the question asks for instructions to include; however, the strict recommendation is often ≤2 for
men, so this is acceptable, but the best answers are A, B, E). BMI should be <25, not <30 (D is
incorrect).
8. A nurse is caring for a client who has been prescribed lisinopril. Which of the following
findings should the nurse report to the provider immediately?
A. Dry cough
B. Swelling of the tongue and lips
C. Serum potassium of 4.2 mEq/L
D. Blood pressure of 118/72 mm Hg
Correct Answer: B. Swelling of the tongue and lips
Rationale: Angioedema (swelling of the tongue, lips, and face) is a serious adverse effect of
ACE inhibitors like lisinopril and requires immediate intervention. A dry cough (A) is a common
but not emergency side effect. Potassium of 4.2 mEq/L (C) is normal. Blood pressure of 118/72
mm Hg (D) is within normal limits.
9. A nurse is assessing a client who has left-sided heart failure. Which of the following findings
should the nurse expect?
A. Jugular venous distention
B. Peripheral edema
C. Crackles in the lungs
D. Hepatomegaly
Correct Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure leads to pulmonary congestion, causing crackles,
dyspnea, and orthopnea. Jugular venous distention (A), peripheral edema (B), and
hepatomegaly (D) are signs of right-sided heart failure.
10. A nurse is caring for a client who is receiving heparin therapy. Which of the following
laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?
SURGICAL PROCTORED WITH
NGN 2023 -2024
Section 1: Cardiovascular Disorders
1. A nurse is caring for a client who has heart failure and is receiving furosemide. Which of the
following findings should the nurse identify as an adverse effect of this medication?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Correct Answer: B. Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia.
Clients should be monitored for low potassium levels (normal range 3.5–5.0 mEq/L). Signs
include muscle weakness, fatigue, and dysrhythmias. Hyperkalemia (A) is associated with
potassium-sparing diuretics such as spironolactone. Hypernatremia (C) and hypercalcemia (D)
are not typical adverse effects of furosemide; in fact, loop diuretics can cause hyponatremia and
hypocalcemia.
2. A nurse is assessing a client who has deep vein thrombosis (DVT) in the left calf. Which of
the following findings should the nurse expect?
A. Unilateral calf swelling and warmth
B. Bilateral dependent edema
C. Cool, pale extremity
D. Decreased pedal pulses
Correct Answer: A. Unilateral calf swelling and warmth
, Rationale: DVT typically presents with unilateral swelling, warmth, erythema, and pain in
the affected extremity. Bilateral edema (B) is more consistent with heart failure or venous
insufficiency. A cool, pale extremity (C) and decreased pedal pulses (D) are signs of arterial
insufficiency, not venous thrombosis.
3. A nurse is teaching a client who has atrial fibrillation and is prescribed warfarin. Which of
the following statements by the client indicates understanding of the teaching?
A. "I should increase my intake of green leafy vegetables."
B. "I will use a soft-bristled toothbrush."
C. "I can take aspirin for headaches."
D. "I should expect my INR to be between 3.5 and 4.5."
Correct Answer: B. "I will use a soft-bristled toothbrush."
Rationale: Warfarin increases bleeding risk, so clients should use a soft-bristled toothbrush
to prevent gum bleeding. Green leafy vegetables (A) are high in vitamin K and should be kept
consistent, not increased. Aspirin (C) increases bleeding risk and should be avoided unless
prescribed. The therapeutic INR for atrial fibrillation (D) is typically 2.0–3.0, not 3.5–4.5.
4. A nurse is caring for a client who is experiencing an acute myocardial infarction (MI). Which
of the following medications should the nurse anticipate administering first?
A. Morphine sulfate
B. Aspirin
C. Nitroglycerin
D. Metoprolol
Correct Answer: B. Aspirin
Rationale: Aspirin is given first in suspected MI because it inhibits platelet aggregation and
reduces mortality. Morphine (A) is given for pain unrelieved by nitroglycerin. Nitroglycerin (C) is
given for chest pain but is contraindicated in right ventricular MI or hypotension. Metoprolol (D)
is given to reduce myocardial oxygen demand but is not the first priority.
5. A nurse is assessing a client who has pericarditis. Which of the following findings should the
nurse expect?
,A. Pleuritic chest pain that worsens with deep inspiration
B. Chest pain that radiates to the left arm
C. Pain relieved by lying supine
D. Bilateral crackles in the lung bases
Correct Answer: A. Pleuritic chest pain that worsens with deep inspiration
Rationale: Pericarditis causes sharp, pleuritic chest pain that worsens with inspiration and is
relieved by sitting forward. Pain radiating to the left arm (B) is characteristic of MI. Pain relieved
by lying supine (C) is not typical; pericarditis pain worsens when supine. Bilateral crackles (D)
suggest heart failure, not pericarditis.
6. A nurse is caring for a client who has a new prescription for digoxin. Which of the following
findings indicates digoxin toxicity?
A. Heart rate of 88/min
B. Serum potassium of 4.0 mEq/L
C. Visual disturbances such as yellow halos
D. Blood pressure of 128/76 mm Hg
Correct Answer: C. Visual disturbances such as yellow halos
Rationale: Digoxin toxicity manifests with visual disturbances (yellow or green halos),
nausea, vomiting, and dysrhythmias. A heart rate of 88/min (A) is normal. Serum potassium of
4.0 mEq/L (B) is normal. Blood pressure of 128/76 mm Hg (D) is normal. Hypokalemia increases
the risk of digoxin toxicity.
7. A nurse is teaching a client who has hypertension about lifestyle modifications. Which of
the following instructions should the nurse include? (Select all that apply.)
A. Limit sodium intake to less than 2,300 mg/day
B. Increase physical activity to 150 minutes per week
C. Limit alcohol consumption to 2 drinks per day for men
D. Maintain a BMI of less than 30
E. Increase potassium-rich foods in the diet
Correct Answers: A, B, E
Rationale: Sodium restriction to <2,300 mg/day (A), physical activity of 150 minutes/week
(B), and increased potassium intake (E) are recommended for hypertension management.
, Alcohol should be limited to ≤2 drinks/day for men and ≤1 for women (C is partially correct but
the question asks for instructions to include; however, the strict recommendation is often ≤2 for
men, so this is acceptable, but the best answers are A, B, E). BMI should be <25, not <30 (D is
incorrect).
8. A nurse is caring for a client who has been prescribed lisinopril. Which of the following
findings should the nurse report to the provider immediately?
A. Dry cough
B. Swelling of the tongue and lips
C. Serum potassium of 4.2 mEq/L
D. Blood pressure of 118/72 mm Hg
Correct Answer: B. Swelling of the tongue and lips
Rationale: Angioedema (swelling of the tongue, lips, and face) is a serious adverse effect of
ACE inhibitors like lisinopril and requires immediate intervention. A dry cough (A) is a common
but not emergency side effect. Potassium of 4.2 mEq/L (C) is normal. Blood pressure of 118/72
mm Hg (D) is within normal limits.
9. A nurse is assessing a client who has left-sided heart failure. Which of the following findings
should the nurse expect?
A. Jugular venous distention
B. Peripheral edema
C. Crackles in the lungs
D. Hepatomegaly
Correct Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure leads to pulmonary congestion, causing crackles,
dyspnea, and orthopnea. Jugular venous distention (A), peripheral edema (B), and
hepatomegaly (D) are signs of right-sided heart failure.
10. A nurse is caring for a client who is receiving heparin therapy. Which of the following
laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?
