A+ Multiple-Choice Questions & Study Guide for Proc-
tored Exam Success
Below are 80 original, non-repeating, scenario-based, NCLEX-style multiple-choice
questions for the ATI Medical-Surgical Nursing proctored exam, covering acute
and chronic conditions by body system (cardiovascular, gastrointestinal, neuro-
logical, respiratory, renal, endocrine, musculoskeletal), pre-op and post-op pa-
tient care, and clinical reasoning and prioritization. Each question includes four
answer choices (A–D) with one correct answer.
Question 1: A 62-year-old patient presents with chest pain and diaphoresis. The ECG
shows ST elevation. Which action should the nurse prioritize?
A. Administer sublingual nitroglycerin.
B. Obtain a 12-lead ECG and notify the provider.
C. Prepare for immediate thrombolytic therapy.
D. Encourage deep breathing exercises.
Question 2: A patient with heart failure reports weight gain of 3 kg in 2 days. Which
intervention should the nurse implement first?
A. Increase dietary sodium intake.
B. Assess for peripheral edema.
C. Administer a beta-blocker.
D. Restrict physical activity.
Question 3: A 58-year-old patient with atrial fibrillation is prescribed dabigatran. Which
teaching should the nurse provide?
A. Monitor for signs of bleeding.
B. Take the medication with a high-fat meal.
C. Expect an increased heart rate.
D. Avoid taking with other medications.
Question 4: A patient post-myocardial infarction reports shortness of breath. The nurse
auscultates crackles in both lungs. Which medication should the nurse an-
ticipate?
A. Metoprolol
B. Furosemide
C. Warfarin
D. Atropine
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, Question 5: A 70-year-old patient with hypertension is prescribed losartan. Which lab-
oratory value should the nurse monitor?
A. Serum potassium
B. Serum glucose
C. Platelet count
D. Hemoglobin
Question 6: A patient with a pacemaker reports dizziness and a pulse of 50 bpm. What
should the nurse do first?
A. Administer atropine IV.
B. Assess the pacemaker site.
C. Notify the healthcare provider.
D. Prepare for cardioversion.
Question 7: A 55-year-old patient post-coronary artery bypass graft (CABG) has a tem-
perature of 100.8°F. Which action should the nurse take?
A. Administer an antipyretic.
B. Assess the surgical site for infection.
C. Encourage incentive spirometry.
D. Restrict fluid intake.
Question 8: A patient with endocarditis reports fever and fatigue. Which diagnostic test
should the nurse prepare for?
A. Blood cultures
B. Chest X-ray
C. Serum creatinine
D. Complete blood count
Question 9: A 65-year-old patient with peripheral artery disease reports leg pain during
walking. Which intervention should the nurse suggest?
A. Elevate the legs above heart level.
B. Encourage a supervised walking program.
C. Apply cold packs to the legs.
D. Restrict all physical activity.
Question 10: A patient with cardiogenic shock is on dobutamine. Which finding indi-
cates the medication is effective?
A. Blood pressure of 100/60 mmHg
B. Heart rate of 120 bpm
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, C. Urine output of 40 mL/hr
D. Respiratory rate of 28 breaths/min
Question 11: A 60-year-old patient with angina is prescribed isosorbide mononitrate.
Which side effect should the nurse teach the patient to report?
A. Headache
B. Weight gain
C. Constipation
D. Insomnia
Question 12: A patient with a history of heart failure presents with jugular vein disten-
sion. Which dietary instruction should the nurse reinforce?
A. High-potassium diet
B. Low-sodium diet
C. High-protein diet
D. Low-carbohydrate diet
Question 13: A 50-year-old patient with peptic ulcer disease reports black, tarry stools.
Which action should the nurse take first?
A. Administer an antacid.
B. Notify the healthcare provider.
C. Encourage a high-fiber diet.
D. Restrict oral intake.
Question 14: A patient with Crohn’s disease reports abdominal cramping and diarrhea.
Which dietary modification should the nurse recommend?
A. High-fiber diet
B. Low-residue diet
C. High-fat diet
D. Low-protein diet
Question 15: A 62-year-old patient with cirrhosis presents with ascites. Which position
should the nurse encourage?
A. Supine
B. Semi-Fowler’s
C. Prone
D. Left lateral
Question 16: A patient post-cholecystectomy reports nausea and right shoulder pain.
Which complication should the nurse suspect?
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