ATI Medical Surgical Nursing 2026 Exam Prep
Practice Test Questions Detailed Explanations
Disease Processes Patient Safety Nursing
Interventions Clinical Scenarios
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-20)
1. A nurse is caring for a patient with heart failure who is prescribed digoxin
and furosemide. The patient reports nausea, vomiting, and visual
disturbances. Which action should the nurse take first?
A) Administer the next dose of digoxin
B) Hold the digoxin and check the serum potassium level
C) Encourage the patient to eat a high-potassium diet
D) Notify the provider to increase the furosemide dose
Answer: B) Hold the digoxin and check the serum potassium level
Rationale: Nausea, vomiting, and visual disturbances (yellow-green halos) are
classic signs of digoxin toxicity. Hypokalemia, often caused by furosemide (a loop
diuretic), predisposes patients to digoxin toxicity. The nurse should hold the
digoxin, check the serum potassium level, and notify the provider. Administering
more digoxin would worsen toxicity. Encouraging a high-potassium diet is
appropriate but does not address the immediate concern of toxicity.
2. A nurse is assessing a patient with left-sided heart failure. Which finding
should the nurse expect?
,A) Peripheral edema
B) Jugular venous distension
C) Crackles in the lung bases
D) Hepatomegaly
Answer: C) Crackles in the lung bases
Rationale: Left-sided heart failure causes blood to back up into the pulmonary
circulation, leading to pulmonary congestion, crackles, dyspnea, orthopnea, and
paroxysmal nocturnal dyspnea. Right-sided heart failure causes systemic
congestion manifested by peripheral edema, jugular venous distension, and
hepatomegaly.
3. A nurse is teaching a patient about a low-sodium diet for hypertension.
Which food should the patient avoid?
A) Fresh fruits
B) Canned soups
C) Fresh vegetables
D) Lean poultry
Answer: B) Canned soups
Rationale: Canned soups are high in sodium due to added salt as a preservative.
Patients with hypertension should avoid processed and canned foods and choose
fresh fruits, vegetables, and lean meats. The recommended sodium intake for
hypertension is less than 1500-2300 mg/day.
4. A nurse is caring for a patient who is receiving heparin for deep vein
thrombosis. Which laboratory value should the nurse monitor?
A) INR
B) aPTT
C) Platelet count
D) Hemoglobin
,Answer: B) aPTT
Rationale: aPTT (activated partial thromboplastin time) is used to monitor heparin
therapy. The therapeutic aPTT is typically 1.5-2.5 times the control value. INR is
used to monitor warfarin. Platelet count should be monitored for HIT, and
hemoglobin for bleeding, but aPTT is the primary indicator of heparin
effectiveness.
5. A nurse is assessing a patient with an abdominal aortic aneurysm. Which
finding is most concerning?
A) Pulsatile mass in the abdomen
B) Blood pressure of 140/90 mmHg
C) Sudden onset of severe abdominal pain
D) Mild back discomfort
Answer: C) Sudden onset of severe abdominal pain
Rationale: Sudden onset of severe abdominal pain in a patient with an abdominal
aortic aneurysm may indicate rupture, a life-threatening emergency. This requires
immediate surgical intervention. A pulsatile mass is a common finding in AAA but
is not immediately life-threatening.
6. A nurse is caring for a patient after coronary artery bypass graft (CABG)
surgery. Which finding requires immediate intervention?
A) Temperature of 99.2°F (37.3°C)
B) Chest tube drainage of 150 mL/hour
C) Heart rate of 88 beats per minute
D) Blood pressure of 130/80 mmHg
Answer: B) Chest tube drainage of 150 mL/hour
Rationale: Chest tube drainage greater than 100-150 mL/hour after CABG may
indicate hemorrhage and requires immediate intervention. The nurse should notify
, the provider and prepare for possible re-exploration. Temperature of 99.2°F, heart
rate of 88, and blood pressure of 130/80 are expected findings after CABG.
7. A nurse is teaching a patient about warfarin therapy. Which instruction
should the nurse include?
A) "Increase your intake of green leafy vegetables"
B) "Avoid all foods containing vitamin K"
C) "Maintain consistent intake of vitamin K-rich foods"
D) "Take aspirin for headaches"
Answer: C) "Maintain consistent intake of vitamin K-rich foods"
Rationale: Warfarin is a vitamin K antagonist. Patients should maintain a
consistent intake of vitamin K-rich foods (green leafy vegetables) to keep their
INR stable. They do not need to avoid these foods entirely. Aspirin should be
avoided due to increased bleeding risk.
8. A nurse is assessing a patient with infective endocarditis. Which finding is
most characteristic?
A) Peripheral edema
B) New onset of a heart murmur
C) Jugular venous distension
D) Crackles in the lung bases
Answer: B) New onset of a heart murmur
Rationale: Infective endocarditis involves infection of the heart valves, leading to
vegetation formation. This can cause valve dysfunction and a new or changed heart
murmur. Other findings include fever, fatigue, Janeway lesions, Osler's nodes, and
splinter hemorrhages.
Practice Test Questions Detailed Explanations
Disease Processes Patient Safety Nursing
Interventions Clinical Scenarios
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-20)
1. A nurse is caring for a patient with heart failure who is prescribed digoxin
and furosemide. The patient reports nausea, vomiting, and visual
disturbances. Which action should the nurse take first?
A) Administer the next dose of digoxin
B) Hold the digoxin and check the serum potassium level
C) Encourage the patient to eat a high-potassium diet
D) Notify the provider to increase the furosemide dose
Answer: B) Hold the digoxin and check the serum potassium level
Rationale: Nausea, vomiting, and visual disturbances (yellow-green halos) are
classic signs of digoxin toxicity. Hypokalemia, often caused by furosemide (a loop
diuretic), predisposes patients to digoxin toxicity. The nurse should hold the
digoxin, check the serum potassium level, and notify the provider. Administering
more digoxin would worsen toxicity. Encouraging a high-potassium diet is
appropriate but does not address the immediate concern of toxicity.
2. A nurse is assessing a patient with left-sided heart failure. Which finding
should the nurse expect?
,A) Peripheral edema
B) Jugular venous distension
C) Crackles in the lung bases
D) Hepatomegaly
Answer: C) Crackles in the lung bases
Rationale: Left-sided heart failure causes blood to back up into the pulmonary
circulation, leading to pulmonary congestion, crackles, dyspnea, orthopnea, and
paroxysmal nocturnal dyspnea. Right-sided heart failure causes systemic
congestion manifested by peripheral edema, jugular venous distension, and
hepatomegaly.
3. A nurse is teaching a patient about a low-sodium diet for hypertension.
Which food should the patient avoid?
A) Fresh fruits
B) Canned soups
C) Fresh vegetables
D) Lean poultry
Answer: B) Canned soups
Rationale: Canned soups are high in sodium due to added salt as a preservative.
Patients with hypertension should avoid processed and canned foods and choose
fresh fruits, vegetables, and lean meats. The recommended sodium intake for
hypertension is less than 1500-2300 mg/day.
4. A nurse is caring for a patient who is receiving heparin for deep vein
thrombosis. Which laboratory value should the nurse monitor?
A) INR
B) aPTT
C) Platelet count
D) Hemoglobin
,Answer: B) aPTT
Rationale: aPTT (activated partial thromboplastin time) is used to monitor heparin
therapy. The therapeutic aPTT is typically 1.5-2.5 times the control value. INR is
used to monitor warfarin. Platelet count should be monitored for HIT, and
hemoglobin for bleeding, but aPTT is the primary indicator of heparin
effectiveness.
5. A nurse is assessing a patient with an abdominal aortic aneurysm. Which
finding is most concerning?
A) Pulsatile mass in the abdomen
B) Blood pressure of 140/90 mmHg
C) Sudden onset of severe abdominal pain
D) Mild back discomfort
Answer: C) Sudden onset of severe abdominal pain
Rationale: Sudden onset of severe abdominal pain in a patient with an abdominal
aortic aneurysm may indicate rupture, a life-threatening emergency. This requires
immediate surgical intervention. A pulsatile mass is a common finding in AAA but
is not immediately life-threatening.
6. A nurse is caring for a patient after coronary artery bypass graft (CABG)
surgery. Which finding requires immediate intervention?
A) Temperature of 99.2°F (37.3°C)
B) Chest tube drainage of 150 mL/hour
C) Heart rate of 88 beats per minute
D) Blood pressure of 130/80 mmHg
Answer: B) Chest tube drainage of 150 mL/hour
Rationale: Chest tube drainage greater than 100-150 mL/hour after CABG may
indicate hemorrhage and requires immediate intervention. The nurse should notify
, the provider and prepare for possible re-exploration. Temperature of 99.2°F, heart
rate of 88, and blood pressure of 130/80 are expected findings after CABG.
7. A nurse is teaching a patient about warfarin therapy. Which instruction
should the nurse include?
A) "Increase your intake of green leafy vegetables"
B) "Avoid all foods containing vitamin K"
C) "Maintain consistent intake of vitamin K-rich foods"
D) "Take aspirin for headaches"
Answer: C) "Maintain consistent intake of vitamin K-rich foods"
Rationale: Warfarin is a vitamin K antagonist. Patients should maintain a
consistent intake of vitamin K-rich foods (green leafy vegetables) to keep their
INR stable. They do not need to avoid these foods entirely. Aspirin should be
avoided due to increased bleeding risk.
8. A nurse is assessing a patient with infective endocarditis. Which finding is
most characteristic?
A) Peripheral edema
B) New onset of a heart murmur
C) Jugular venous distension
D) Crackles in the lung bases
Answer: B) New onset of a heart murmur
Rationale: Infective endocarditis involves infection of the heart valves, leading to
vegetation formation. This can cause valve dysfunction and a new or changed heart
murmur. Other findings include fever, fatigue, Janeway lesions, Osler's nodes, and
splinter hemorrhages.
