ATI PN Adult Medical Surgical 2026 Proctored
Exam Featuring 100 NGN Questions and
Answers for Level
Section 1: Cardiovascular Disorders (Questions 1-20)
1. A nurse is caring for a client who is 1 day postoperative following an open
cholecystectomy. The client reports pain at the incision site. Which of the
following actions should the nurse take first?
• A. Administer the prescribed analgesic.
• B. Assess the client's pain using a 0-10 scale.
• C. Reposition the client for comfort.
• D. Splint the incision with a pillow.
Rationale: The nursing process begins with assessment. Before intervening,
the nurse must first assess the client's pain to determine its severity, character,
and location. This data will guide the appropriate intervention. Administering an
analgesic (A) or repositioning (C) without a full assessment is premature. Splinting
(D) is an appropriate non-pharmacological intervention but is not the first step.
2. A nurse is assessing a client who is receiving furosemide for heart failure.
Which of the following findings should the nurse report to the provider
immediately?
• A. Urine output of 50 mL/hr.
• B. Blood pressure of 110/70 mm Hg.
• C. Serum potassium of 3.2 mEq/L.
• D. Muscle weakness and a heart rate of 118/min.
Rationale: Furosemide is a loop diuretic that can cause significant potassium
loss (hypokalemia). Muscle weakness and tachycardia are classic signs of
,hypokalemia, which can lead to fatal cardiac dysrhythmias. This is a critical finding
that requires immediate notification of the provider. While a potassium level of
3.2 (C) is low, the client's symptomatic presentation (D) makes it a more urgent
priority. Options A and B are expected or acceptable findings.
3. A client with heart disease is on a continuous telemetry monitor and has
developed sinus bradycardia. In determining the possible cause of the
bradycardia, the nurse assesses the client's medication record. Which
medication is most likely the cause of the bradycardia?
• A. Propranolol (Inderal).
• B. Captopril (Capoten).
• C. Furosemide (Lasix).
• D. Dobutamine (Dobutrex).
Rationale: Propranolol is a beta-blocker, which works by blocking the effects
of adrenaline on the heart. This slows the heart rate and can cause bradycardia.
Captopril is an ACE inhibitor, furosemide is a loop diuretic, and dobutamine is an
inotropic agent that increases heart rate.
4. A client with a history of hypertension presents with severe chest pain
radiating to the left arm, shortness of breath, and diaphoresis. Which nursing
intervention should be the priority?
• A. Obtain a 12-lead electrocardiogram (ECG).
• B. Administer aspirin 325 mg orally.
• C. Establish IV access and apply oxygen.
• D. Notify the healthcare provider immediately.
Rationale: Establishing IV access and applying oxygen addresses the
immediate physiological needs of a client experiencing acute coronary syndrome.
Oxygen therapy improves tissue oxygenation and reduces myocardial workload,
while IV access ensures immediate medication administration capability. An ECG
,and aspirin are important but should follow after basic stabilization measures.
Notifying the provider occurs concurrently with these interventions.
5. A 72-year-old client recovering from hip replacement surgery reports
increasing pain in the operative leg despite receiving prescribed pain
medication. The client's leg is swollen and warm to the touch. Which
complication should the nurse suspect?
• A. Phantom limb pain.
• B. Deep vein thrombosis (DVT).
• C. Compartment syndrome.
• D. Infection at the surgical site.
Rationale: The clinical presentation of swelling, warmth, and pain in the
postoperative extremity are classic signs of DVT. These symptoms suggest venous
obstruction and inflammation. Phantom limb pain occurs after amputation.
Compartment syndrome typically presents with severe pain out of proportion to
examination findings. Infection would be evidenced by drainage, erythema, and
fever.
6. A nurse is providing discharge teaching to a client who has a new prescription
for warfarin. Which of the following instructions should the nurse include?
• A. "Increase your intake of green, leafy vegetables."
• B. "Use an electric razor for shaving."
• C. "Take aspirin for headaches."
• D. "Expect to have your INR checked every 6 months."
Rationale: Warfarin is an anticoagulant, which increases the risk of bleeding.
Using an electric razor reduces the risk of cuts and bleeding. Clients should
maintain a consistent intake of Vitamin K (found in green, leafy vegetables), not
increase it (A). Aspirin (C) also increases bleeding risk and should be avoided. INR
is typically checked monthly or more frequently, not every 6 months (D).
, 7. A nurse is caring for a client who is receiving a blood transfusion. Which of the
following findings should the nurse identify as an acute hemolytic reaction?
• A. Urticaria and itching.
• B. Fever and chills.
• C. Low back pain and dark urine.
• D. Crackles in the lung bases.
Rationale: Low back pain and dark, reddish-brown urine (hemoglobinuria) are
classic signs of an acute hemolytic transfusion reaction, where the client's
immune system is destroying the donor red blood cells. Urticaria and itching (A)
indicate a mild allergic reaction. Fever and chills (B) can indicate a febrile non-
hemolytic reaction. Crackles (D) indicate circulatory overload.
8. A nurse is assessing a client with suspected left-sided heart failure. Which of
the following findings is the nurse most likely to encounter?
• A. Jugular venous distention.
• B. Peripheral edema.
• C. Bibasilar crackles.
• D. Hepatomegaly.
Rationale: Left-sided heart failure leads to pulmonary congestion, which is
manifested by crackles (rales) in the lung bases. Jugular venous distention (A),
peripheral edema (B), and hepatomegaly (D) are signs of right-sided heart failure.
9. A client is admitted with an acute exacerbation of chronic obstructive
pulmonary disease (COPD). Which of the following oxygen delivery systems
should the nurse anticipate using?
• A. Nasal cannula at 6 L/min.
• B. Simple face mask at 8 L/min.
• C. Venturi mask at 2 L/min.
Exam Featuring 100 NGN Questions and
Answers for Level
Section 1: Cardiovascular Disorders (Questions 1-20)
1. A nurse is caring for a client who is 1 day postoperative following an open
cholecystectomy. The client reports pain at the incision site. Which of the
following actions should the nurse take first?
• A. Administer the prescribed analgesic.
• B. Assess the client's pain using a 0-10 scale.
• C. Reposition the client for comfort.
• D. Splint the incision with a pillow.
Rationale: The nursing process begins with assessment. Before intervening,
the nurse must first assess the client's pain to determine its severity, character,
and location. This data will guide the appropriate intervention. Administering an
analgesic (A) or repositioning (C) without a full assessment is premature. Splinting
(D) is an appropriate non-pharmacological intervention but is not the first step.
2. A nurse is assessing a client who is receiving furosemide for heart failure.
Which of the following findings should the nurse report to the provider
immediately?
• A. Urine output of 50 mL/hr.
• B. Blood pressure of 110/70 mm Hg.
• C. Serum potassium of 3.2 mEq/L.
• D. Muscle weakness and a heart rate of 118/min.
Rationale: Furosemide is a loop diuretic that can cause significant potassium
loss (hypokalemia). Muscle weakness and tachycardia are classic signs of
,hypokalemia, which can lead to fatal cardiac dysrhythmias. This is a critical finding
that requires immediate notification of the provider. While a potassium level of
3.2 (C) is low, the client's symptomatic presentation (D) makes it a more urgent
priority. Options A and B are expected or acceptable findings.
3. A client with heart disease is on a continuous telemetry monitor and has
developed sinus bradycardia. In determining the possible cause of the
bradycardia, the nurse assesses the client's medication record. Which
medication is most likely the cause of the bradycardia?
• A. Propranolol (Inderal).
• B. Captopril (Capoten).
• C. Furosemide (Lasix).
• D. Dobutamine (Dobutrex).
Rationale: Propranolol is a beta-blocker, which works by blocking the effects
of adrenaline on the heart. This slows the heart rate and can cause bradycardia.
Captopril is an ACE inhibitor, furosemide is a loop diuretic, and dobutamine is an
inotropic agent that increases heart rate.
4. A client with a history of hypertension presents with severe chest pain
radiating to the left arm, shortness of breath, and diaphoresis. Which nursing
intervention should be the priority?
• A. Obtain a 12-lead electrocardiogram (ECG).
• B. Administer aspirin 325 mg orally.
• C. Establish IV access and apply oxygen.
• D. Notify the healthcare provider immediately.
Rationale: Establishing IV access and applying oxygen addresses the
immediate physiological needs of a client experiencing acute coronary syndrome.
Oxygen therapy improves tissue oxygenation and reduces myocardial workload,
while IV access ensures immediate medication administration capability. An ECG
,and aspirin are important but should follow after basic stabilization measures.
Notifying the provider occurs concurrently with these interventions.
5. A 72-year-old client recovering from hip replacement surgery reports
increasing pain in the operative leg despite receiving prescribed pain
medication. The client's leg is swollen and warm to the touch. Which
complication should the nurse suspect?
• A. Phantom limb pain.
• B. Deep vein thrombosis (DVT).
• C. Compartment syndrome.
• D. Infection at the surgical site.
Rationale: The clinical presentation of swelling, warmth, and pain in the
postoperative extremity are classic signs of DVT. These symptoms suggest venous
obstruction and inflammation. Phantom limb pain occurs after amputation.
Compartment syndrome typically presents with severe pain out of proportion to
examination findings. Infection would be evidenced by drainage, erythema, and
fever.
6. A nurse is providing discharge teaching to a client who has a new prescription
for warfarin. Which of the following instructions should the nurse include?
• A. "Increase your intake of green, leafy vegetables."
• B. "Use an electric razor for shaving."
• C. "Take aspirin for headaches."
• D. "Expect to have your INR checked every 6 months."
Rationale: Warfarin is an anticoagulant, which increases the risk of bleeding.
Using an electric razor reduces the risk of cuts and bleeding. Clients should
maintain a consistent intake of Vitamin K (found in green, leafy vegetables), not
increase it (A). Aspirin (C) also increases bleeding risk and should be avoided. INR
is typically checked monthly or more frequently, not every 6 months (D).
, 7. A nurse is caring for a client who is receiving a blood transfusion. Which of the
following findings should the nurse identify as an acute hemolytic reaction?
• A. Urticaria and itching.
• B. Fever and chills.
• C. Low back pain and dark urine.
• D. Crackles in the lung bases.
Rationale: Low back pain and dark, reddish-brown urine (hemoglobinuria) are
classic signs of an acute hemolytic transfusion reaction, where the client's
immune system is destroying the donor red blood cells. Urticaria and itching (A)
indicate a mild allergic reaction. Fever and chills (B) can indicate a febrile non-
hemolytic reaction. Crackles (D) indicate circulatory overload.
8. A nurse is assessing a client with suspected left-sided heart failure. Which of
the following findings is the nurse most likely to encounter?
• A. Jugular venous distention.
• B. Peripheral edema.
• C. Bibasilar crackles.
• D. Hepatomegaly.
Rationale: Left-sided heart failure leads to pulmonary congestion, which is
manifested by crackles (rales) in the lung bases. Jugular venous distention (A),
peripheral edema (B), and hepatomegaly (D) are signs of right-sided heart failure.
9. A client is admitted with an acute exacerbation of chronic obstructive
pulmonary disease (COPD). Which of the following oxygen delivery systems
should the nurse anticipate using?
• A. Nasal cannula at 6 L/min.
• B. Simple face mask at 8 L/min.
• C. Venturi mask at 2 L/min.
