ATI RN ADULT MEDICAL SURGICAL PROCTORED EXAM 2025/2026 - 330
VERIFIED QUESTIONS & RATIONALES | NGN | LEVEL 3
Course: ATI RN Adult Medical Surgical CMS Proctored 2025/2026 | Total: 200 Verified Questions
Description: Actual ATI Med-Surg proctored retake exam with NGN format. Covers cardiovascular, respiratory, GI, endocrine,
renal, neuro, musculoskeletal.
Original study material based on ATI testing standards, Lewis Med-Surg, Saunders NCLEX, and NCSBN Clinical Judgment Measurement Model. All
questions author-created, not copied from ATI.
[1] Post-op thyroidectomy, client has laryngeal stridor. Action?
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[2] Client with DKA: pH 7.20, K+ 5.5. First IV fluid?
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[3] Chest tube tidaling absent. What does it mean?
Tube is obstructed or lung re-expanded
Normal always
Infection
Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
[4] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 4)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[5] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 5)
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[6] Chest tube tidaling absent. What does it mean? (Case Variant 6)
Tube is obstructed or lung re-expanded
Normal always
Infection
, Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
[7] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 7)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[8] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 8)
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[9] Chest tube tidaling absent. What does it mean? (Case Variant 9)
Tube is obstructed or lung re-expanded
Normal always
Infection
Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
[10] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 10)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[11] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 11)
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[12] Chest tube tidaling absent. What does it mean? (Case Variant 12)
Tube is obstructed or lung re-expanded
Normal always
Infection
Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
,[13] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 13)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[14] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 14)
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[15] Chest tube tidaling absent. What does it mean? (Case Variant 15)
Tube is obstructed or lung re-expanded
Normal always
Infection
Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
[16] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 16)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[17] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 17)
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[18] Chest tube tidaling absent. What does it mean? (Case Variant 18)
Tube is obstructed or lung re-expanded
Normal always
Infection
Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
[19] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 19)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
, Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[20] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 20)
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[21] Chest tube tidaling absent. What does it mean? (Case Variant 21)
Tube is obstructed or lung re-expanded
Normal always
Infection
Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
[22] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 22)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[23] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 23)
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[24] Chest tube tidaling absent. What does it mean? (Case Variant 24)
Tube is obstructed or lung re-expanded
Normal always
Infection
Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
[25] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 25)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[26] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 26)
0.9% Normal Saline
VERIFIED QUESTIONS & RATIONALES | NGN | LEVEL 3
Course: ATI RN Adult Medical Surgical CMS Proctored 2025/2026 | Total: 200 Verified Questions
Description: Actual ATI Med-Surg proctored retake exam with NGN format. Covers cardiovascular, respiratory, GI, endocrine,
renal, neuro, musculoskeletal.
Original study material based on ATI testing standards, Lewis Med-Surg, Saunders NCLEX, and NCSBN Clinical Judgment Measurement Model. All
questions author-created, not copied from ATI.
[1] Post-op thyroidectomy, client has laryngeal stridor. Action?
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[2] Client with DKA: pH 7.20, K+ 5.5. First IV fluid?
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[3] Chest tube tidaling absent. What does it mean?
Tube is obstructed or lung re-expanded
Normal always
Infection
Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
[4] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 4)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[5] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 5)
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[6] Chest tube tidaling absent. What does it mean? (Case Variant 6)
Tube is obstructed or lung re-expanded
Normal always
Infection
, Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
[7] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 7)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[8] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 8)
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[9] Chest tube tidaling absent. What does it mean? (Case Variant 9)
Tube is obstructed or lung re-expanded
Normal always
Infection
Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
[10] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 10)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[11] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 11)
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[12] Chest tube tidaling absent. What does it mean? (Case Variant 12)
Tube is obstructed or lung re-expanded
Normal always
Infection
Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
,[13] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 13)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[14] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 14)
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[15] Chest tube tidaling absent. What does it mean? (Case Variant 15)
Tube is obstructed or lung re-expanded
Normal always
Infection
Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
[16] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 16)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[17] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 17)
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[18] Chest tube tidaling absent. What does it mean? (Case Variant 18)
Tube is obstructed or lung re-expanded
Normal always
Infection
Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
[19] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 19)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
, Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[20] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 20)
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[21] Chest tube tidaling absent. What does it mean? (Case Variant 21)
Tube is obstructed or lung re-expanded
Normal always
Infection
Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
[22] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 22)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[23] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 23)
0.9% Normal Saline
D5W
0.45% NS
LR
Correct Answer: A
Rationale: DKA first fluid NS to restore volume, then 0.45% NS, then add dextrose when glucose <250 to prevent cerebral edema.
[24] Chest tube tidaling absent. What does it mean? (Case Variant 24)
Tube is obstructed or lung re-expanded
Normal always
Infection
Pneumothorax resolved always
Correct Answer: A
Rationale: Tidaling reflects pressure changes. Absent may mean obstruction/clot or lung re-expanded - assess breath sounds,
X-ray.
[25] Post-op thyroidectomy, client has laryngeal stridor. Action? (Case Variant 25)
Prepare for tracheostomy set at bedside, call provider, keep calm
Give water
Encourage coughing
Discharge
Correct Answer: A
Rationale: Stridor after thyroidectomy = laryngeal edema or tetany/bleeding compressing trachea - emergency airway.
[26] Client with DKA: pH 7.20, K+ 5.5. First IV fluid? (Case Variant 26)
0.9% Normal Saline
