ATI MED-SURG TEST BANKS GRADED A
LATREST VERSION 2026 NGN QUESTIONS
INCLUDED WITH RATIONALE/A+ GRADE
1|Page
,ATI MED-SURG TEST BANKS GRADED A LATEST VERSION 2026 NGN QUESTIONS INCLUDED WITH
RATIONALE/A+ GRADE
2026/2027 Examination
Total Questions: 200
Instructions:
• Answer all questions.
• Select the single best answer.
• Each question has four answer choices: A, B, C, and D.
• Select only ONE answer for each question.
PART 1 — Q1–Q50
SECTION 1: CARDIOVASCULAR SYSTEM
Questions 1–25
Q1. A nurse is assessing a client who was admitted with acute decompensated heart failure.
Which finding requires immediate intervention?
A. Bibasilar crackles that clear with coughing
B. Jugular venous distention at 45 degrees
C. Pink frothy sputum with severe dyspnea
D. 2+ pitting edema in the lower extremities
Correct Answer: C. Pink frothy sputum with severe dyspnea
Rationale: Pink frothy sputum combined with severe dyspnea indicates acute pulmonary edema,
a life-threatening emergency requiring immediate intervention. Crackles that clear with coughing
may indicate atelectasis. JVD and pitting edema are expected findings in heart failure exacerbation
but do not require the same urgency as airway compromise.
Q2. A client who had a myocardial infarction 48 hours ago develops a new onset of crackles,
jugular venous distention, and oliguria. Which complication should the nurse suspect?
A. Cardiac tamponade
B. Cardiogenic shock
C. Pulmonary embolism
D. Recurrent myocardial infarction
Correct Answer: B. Cardiogenic shock
Rationale: The combination of pulmonary congestion (crackles), elevated venous pressure (JVD),
and decreased renal perfusion (oliguria) indicates pump failure leading to cardiogenic shock. Cardiac
2|Page
,tamponade presents with muffled heart sounds and pulsus paradoxus. Pulmonary embolism causes
sudden dyspnea and hypoxia without pulmonary congestion.
Q3. A nurse is caring for a client receiving IV heparin for deep vein thrombosis. The aPTT result is
98 seconds (therapeutic range 60-80 seconds). Which action should the nurse take first?
A. Stop the heparin infusion immediately
B. Assess the client for signs of bleeding
C. Prepare to administer protamine sulfate
D. Document the result and continue monitoring
Correct Answer: B. Assess the client for signs of bleeding
Rationale: Before taking action on the infusion, the nurse must assess the client for clinical
manifestations of bleeding. Assessment precedes intervention. Stopping the infusion may be
indicated, but assessment data guides the decision. Protamine sulfate is the antidote but is only
given for severe bleeding, not an elevated aPTT alone.
Q4. A nurse is teaching a client who has a new prescription for sublingual nitroglycerin. Which
statement indicates the client understands the teaching?
A. "I should swallow the tablet with a full glass of water."
B. "I will lie down before taking the medication."
C. "I can take up to five tablets in 15 minutes."
D. "I should discard the medication after 12 months."
Correct Answer: B. "I will lie down before taking the medication."
Rationale: Sublingual nitroglycerin causes vasodilation and can lead to hypotension and syncope.
Clients should lie down before administration to prevent injury from falls. The tablet should dissolve
under the tongue, not be swallowed. The maximum is three tablets in 15 minutes. Nitroglycerin
should be replaced every 6 months, not yearly.
Q5. A client is admitted with an inferior wall myocardial infarction. Which assessment finding
should the nurse report to the provider immediately?
A. Heart rate of 52 beats per minute
B. Blood pressure of 88/52 mmHg
C. ST elevation in leads II, III, and aVF
D. Complaint of nausea and diaphoresis
Correct Answer: B. Blood pressure of 88/52 mmHg
Rationale: Hypotension in the setting of an acute MI suggests cardiogenic shock or right
ventricular involvement, which requires immediate intervention. While bradycardia and ST elevation
are expected with inferior MI, the hypotension represents hemodynamic instability that is
immediately life-threatening. Nausea and diaphoresis are common symptoms of MI.
3|Page
, Q6. A nurse is assessing a client who had a cardiac catheterization via the femoral approach 2
hours ago. Which finding requires immediate notification of the provider?
A. Small amount of serosanguineous drainage on the dressing
B. Pedal pulse +1 on the affected extremity
C. Hematoma formation at the insertion site with cool, pale foot
D. Complaint of mild discomfort at the insertion site
Correct Answer: C. Hematoma formation at the insertion site with cool, pale foot
Rationale: A hematoma with a cool, pale extremity indicates bleeding with compromised arterial
circulation to the limb, a vascular emergency requiring immediate intervention. Small
serosanguineous drainage and mild discomfort are expected. A +1 pedal pulse may be the client's
baseline but requires ongoing monitoring.
Q7. A client with atrial fibrillation is receiving warfarin. The INR is 5.2. Which action should the
nurse anticipate?
A. Administer vitamin K as prescribed
B. Increase the warfarin dose
C. Continue the current dose
D. Administer protamine sulfate
Correct Answer: A. Administer vitamin K as prescribed
Rationale: An INR of 5.2 is above the therapeutic range of 2.0-3.0 for atrial fibrillation, indicating
increased bleeding risk. Vitamin K is the antidote for warfarin. The dose should be held and the
provider notified. Protamine sulfate reverses heparin, not warfarin.
Q8. A nurse is caring for a client who develops ventricular tachycardia with a pulse and a blood
pressure of 78/42 mmHg. Which intervention should the nurse prepare for?
A. Administration of oral amiodarone
B. Synchronized cardioversion
C. Defibrillation
D. Vagal maneuvers
Correct Answer: B. Synchronized cardioversion
Rationale: Unstable ventricular tachycardia with a pulse requires synchronized cardioversion to
convert the rhythm. Defibrillation is used for pulseless ventricular tachycardia or ventricular
fibrillation. Oral medications are not appropriate for hemodynamically unstable clients. Vagal
maneuvers are used for stable supraventricular tachycardia.
Q9. A nurse is assessing a client with pericarditis. Which finding is most characteristic of this
condition?
4|Page
LATREST VERSION 2026 NGN QUESTIONS
INCLUDED WITH RATIONALE/A+ GRADE
1|Page
,ATI MED-SURG TEST BANKS GRADED A LATEST VERSION 2026 NGN QUESTIONS INCLUDED WITH
RATIONALE/A+ GRADE
2026/2027 Examination
Total Questions: 200
Instructions:
• Answer all questions.
• Select the single best answer.
• Each question has four answer choices: A, B, C, and D.
• Select only ONE answer for each question.
PART 1 — Q1–Q50
SECTION 1: CARDIOVASCULAR SYSTEM
Questions 1–25
Q1. A nurse is assessing a client who was admitted with acute decompensated heart failure.
Which finding requires immediate intervention?
A. Bibasilar crackles that clear with coughing
B. Jugular venous distention at 45 degrees
C. Pink frothy sputum with severe dyspnea
D. 2+ pitting edema in the lower extremities
Correct Answer: C. Pink frothy sputum with severe dyspnea
Rationale: Pink frothy sputum combined with severe dyspnea indicates acute pulmonary edema,
a life-threatening emergency requiring immediate intervention. Crackles that clear with coughing
may indicate atelectasis. JVD and pitting edema are expected findings in heart failure exacerbation
but do not require the same urgency as airway compromise.
Q2. A client who had a myocardial infarction 48 hours ago develops a new onset of crackles,
jugular venous distention, and oliguria. Which complication should the nurse suspect?
A. Cardiac tamponade
B. Cardiogenic shock
C. Pulmonary embolism
D. Recurrent myocardial infarction
Correct Answer: B. Cardiogenic shock
Rationale: The combination of pulmonary congestion (crackles), elevated venous pressure (JVD),
and decreased renal perfusion (oliguria) indicates pump failure leading to cardiogenic shock. Cardiac
2|Page
,tamponade presents with muffled heart sounds and pulsus paradoxus. Pulmonary embolism causes
sudden dyspnea and hypoxia without pulmonary congestion.
Q3. A nurse is caring for a client receiving IV heparin for deep vein thrombosis. The aPTT result is
98 seconds (therapeutic range 60-80 seconds). Which action should the nurse take first?
A. Stop the heparin infusion immediately
B. Assess the client for signs of bleeding
C. Prepare to administer protamine sulfate
D. Document the result and continue monitoring
Correct Answer: B. Assess the client for signs of bleeding
Rationale: Before taking action on the infusion, the nurse must assess the client for clinical
manifestations of bleeding. Assessment precedes intervention. Stopping the infusion may be
indicated, but assessment data guides the decision. Protamine sulfate is the antidote but is only
given for severe bleeding, not an elevated aPTT alone.
Q4. A nurse is teaching a client who has a new prescription for sublingual nitroglycerin. Which
statement indicates the client understands the teaching?
A. "I should swallow the tablet with a full glass of water."
B. "I will lie down before taking the medication."
C. "I can take up to five tablets in 15 minutes."
D. "I should discard the medication after 12 months."
Correct Answer: B. "I will lie down before taking the medication."
Rationale: Sublingual nitroglycerin causes vasodilation and can lead to hypotension and syncope.
Clients should lie down before administration to prevent injury from falls. The tablet should dissolve
under the tongue, not be swallowed. The maximum is three tablets in 15 minutes. Nitroglycerin
should be replaced every 6 months, not yearly.
Q5. A client is admitted with an inferior wall myocardial infarction. Which assessment finding
should the nurse report to the provider immediately?
A. Heart rate of 52 beats per minute
B. Blood pressure of 88/52 mmHg
C. ST elevation in leads II, III, and aVF
D. Complaint of nausea and diaphoresis
Correct Answer: B. Blood pressure of 88/52 mmHg
Rationale: Hypotension in the setting of an acute MI suggests cardiogenic shock or right
ventricular involvement, which requires immediate intervention. While bradycardia and ST elevation
are expected with inferior MI, the hypotension represents hemodynamic instability that is
immediately life-threatening. Nausea and diaphoresis are common symptoms of MI.
3|Page
, Q6. A nurse is assessing a client who had a cardiac catheterization via the femoral approach 2
hours ago. Which finding requires immediate notification of the provider?
A. Small amount of serosanguineous drainage on the dressing
B. Pedal pulse +1 on the affected extremity
C. Hematoma formation at the insertion site with cool, pale foot
D. Complaint of mild discomfort at the insertion site
Correct Answer: C. Hematoma formation at the insertion site with cool, pale foot
Rationale: A hematoma with a cool, pale extremity indicates bleeding with compromised arterial
circulation to the limb, a vascular emergency requiring immediate intervention. Small
serosanguineous drainage and mild discomfort are expected. A +1 pedal pulse may be the client's
baseline but requires ongoing monitoring.
Q7. A client with atrial fibrillation is receiving warfarin. The INR is 5.2. Which action should the
nurse anticipate?
A. Administer vitamin K as prescribed
B. Increase the warfarin dose
C. Continue the current dose
D. Administer protamine sulfate
Correct Answer: A. Administer vitamin K as prescribed
Rationale: An INR of 5.2 is above the therapeutic range of 2.0-3.0 for atrial fibrillation, indicating
increased bleeding risk. Vitamin K is the antidote for warfarin. The dose should be held and the
provider notified. Protamine sulfate reverses heparin, not warfarin.
Q8. A nurse is caring for a client who develops ventricular tachycardia with a pulse and a blood
pressure of 78/42 mmHg. Which intervention should the nurse prepare for?
A. Administration of oral amiodarone
B. Synchronized cardioversion
C. Defibrillation
D. Vagal maneuvers
Correct Answer: B. Synchronized cardioversion
Rationale: Unstable ventricular tachycardia with a pulse requires synchronized cardioversion to
convert the rhythm. Defibrillation is used for pulseless ventricular tachycardia or ventricular
fibrillation. Oral medications are not appropriate for hemodynamically unstable clients. Vagal
maneuvers are used for stable supraventricular tachycardia.
Q9. A nurse is assessing a client with pericarditis. Which finding is most characteristic of this
condition?
4|Page
