ATI PN MED SURG PROCTORED EXAM (2025/2026)
Actual Exam with Complete Questions | Practical Nurse Medical-
Surgical | NCLEX-PN® Readiness
Overview
This 2025/2026 validated resource contains the complete ATI PN Med Surg
proctored exam with actual questions and verified answers, directly aligned with
current ATI testing standards. Essential for practical/vocational nursing students preparing
for proctored assessment and demonstrating competency in medical-surgical nursing care.
Key Features
✓ 75-Question Proctored Exam matching ATI testing format
✓ Medical-Surgical Nursing Scenarios with priority interventions
✓ Clinical Judgment Applications across body systems
✓ Updated 2025/2026 ATI content mastery series standards
✓ Pharmacology & Treatment Protocols with nursing considerations
Content Domains
• Cardiovascular & Hematological Disorders (16 Questions)
• Respiratory & Pulmonary Conditions (14 Questions)
• Gastrointestinal & Hepatic Disorders (12 Questions)
• Renal & Urinary Conditions (11 Questions)
• Endocrine & Metabolic Disorders (10 Questions)
• Neurological & Musculoskeletal Conditions (12 Questions)
Answer Format
Verified correct answers in bold green with:
• Nursing priority rationales
• Medication action justifications
• Complication prevention strategies
• Patient safety considerations
Critical Updates 2025/2026
NEW - Enhanced sepsis recognition protocols
UPDATED - Heart failure management guidelines
REVISED - Pain assessment standards
MODIFIED - Medication safety protocols
CARDIOVASCULAR & HEMATOLOGICAL DISORDERS (Questions 1–16)
1. A PN is caring for a client with HF who is receiving digoxin 0.25 mg PO daily. Which
finding should the PN report immediately?
a) HR 98 bpm
b) Serum potassium 3.0 mEq/L
c) Digoxin level 1.2 ng/mL
, d) Crackles bilaterally
b) Serum potassium 3.0 mEq/L
Rationale: Hypokalemia increases risk of digoxin toxicity; level <3.5 warrants prompt
replacement.
2. The PN notes a new murmur in a client with a mechanical aortic valve. Priority action?
a) Document and reassess in 1 hour
b) Notify RN/Provider immediately (possible valve thrombosis or infection)
c) Offer oral fluids
d) Increase activity
b) Notify RN/Provider immediately (possible valve thrombosis or infection)
Rationale: New murmur can indicate clot, vegetation, or paravalvular leak—life-threatening.
3. Post-MI client receives alteplase. Which is a contraindication?
a) BP 150/90 mmHg
b) Major surgery 3 weeks ago
c) Age 75
d) Chest pain 30 min
b) Major surgery 3 weeks ago
Rationale: Recent surgery ↑ bleeding risk; absolute contraindication to fibrinolytics.
4. A client with chronic venous insufficiency is prescribed thigh-high compression stockings.
The PN should apply them:
a) While client is sitting in chair
b) After legs have been elevated 10 min and before getting out of bed
c) After ambulation
d) Only at night
b) After legs have been elevated 10 min and before getting out of bed
Rationale: Minimizes edema; ensures accurate gradient pressure when legs are least
congested.
5. Lab value most indicative of heparin-induced thrombocytopenia (HIT)?
a) Platelet count 180 k
b) Platelet drop >50 % from baseline 5 days after start
c) aPTT 60 s
d) INR 1.5
b) Platelet drop >50 % from baseline 5 days after start
Rationale: HIT immune-mediated drop typically 5–10 days after initiation; immediate
heparin cessation required.
6. PN teaches energy conservation to HF client. Which statement indicates understanding?
a) “I will climb stairs quickly to finish faster.”
b) “I will alternate heavy and light activities with rest periods.”
c) “I will skip meals to avoid fatigue.”
d) “I will exercise immediately after eating.”
b) “I will alternate heavy and light activities with rest periods.”
Rationale: Pacing reduces cardiac workload and hypoxia episodes.
7. A client receiving packed RBCs develops chills and fever 15 min after initiation. Priority
PN action?
a) Stop transfusion immediately, maintain IV access with normal saline, notify provider
b) Slow rate and give acetaminophen
c) Continue and document
d) Remove IV
Actual Exam with Complete Questions | Practical Nurse Medical-
Surgical | NCLEX-PN® Readiness
Overview
This 2025/2026 validated resource contains the complete ATI PN Med Surg
proctored exam with actual questions and verified answers, directly aligned with
current ATI testing standards. Essential for practical/vocational nursing students preparing
for proctored assessment and demonstrating competency in medical-surgical nursing care.
Key Features
✓ 75-Question Proctored Exam matching ATI testing format
✓ Medical-Surgical Nursing Scenarios with priority interventions
✓ Clinical Judgment Applications across body systems
✓ Updated 2025/2026 ATI content mastery series standards
✓ Pharmacology & Treatment Protocols with nursing considerations
Content Domains
• Cardiovascular & Hematological Disorders (16 Questions)
• Respiratory & Pulmonary Conditions (14 Questions)
• Gastrointestinal & Hepatic Disorders (12 Questions)
• Renal & Urinary Conditions (11 Questions)
• Endocrine & Metabolic Disorders (10 Questions)
• Neurological & Musculoskeletal Conditions (12 Questions)
Answer Format
Verified correct answers in bold green with:
• Nursing priority rationales
• Medication action justifications
• Complication prevention strategies
• Patient safety considerations
Critical Updates 2025/2026
NEW - Enhanced sepsis recognition protocols
UPDATED - Heart failure management guidelines
REVISED - Pain assessment standards
MODIFIED - Medication safety protocols
CARDIOVASCULAR & HEMATOLOGICAL DISORDERS (Questions 1–16)
1. A PN is caring for a client with HF who is receiving digoxin 0.25 mg PO daily. Which
finding should the PN report immediately?
a) HR 98 bpm
b) Serum potassium 3.0 mEq/L
c) Digoxin level 1.2 ng/mL
, d) Crackles bilaterally
b) Serum potassium 3.0 mEq/L
Rationale: Hypokalemia increases risk of digoxin toxicity; level <3.5 warrants prompt
replacement.
2. The PN notes a new murmur in a client with a mechanical aortic valve. Priority action?
a) Document and reassess in 1 hour
b) Notify RN/Provider immediately (possible valve thrombosis or infection)
c) Offer oral fluids
d) Increase activity
b) Notify RN/Provider immediately (possible valve thrombosis or infection)
Rationale: New murmur can indicate clot, vegetation, or paravalvular leak—life-threatening.
3. Post-MI client receives alteplase. Which is a contraindication?
a) BP 150/90 mmHg
b) Major surgery 3 weeks ago
c) Age 75
d) Chest pain 30 min
b) Major surgery 3 weeks ago
Rationale: Recent surgery ↑ bleeding risk; absolute contraindication to fibrinolytics.
4. A client with chronic venous insufficiency is prescribed thigh-high compression stockings.
The PN should apply them:
a) While client is sitting in chair
b) After legs have been elevated 10 min and before getting out of bed
c) After ambulation
d) Only at night
b) After legs have been elevated 10 min and before getting out of bed
Rationale: Minimizes edema; ensures accurate gradient pressure when legs are least
congested.
5. Lab value most indicative of heparin-induced thrombocytopenia (HIT)?
a) Platelet count 180 k
b) Platelet drop >50 % from baseline 5 days after start
c) aPTT 60 s
d) INR 1.5
b) Platelet drop >50 % from baseline 5 days after start
Rationale: HIT immune-mediated drop typically 5–10 days after initiation; immediate
heparin cessation required.
6. PN teaches energy conservation to HF client. Which statement indicates understanding?
a) “I will climb stairs quickly to finish faster.”
b) “I will alternate heavy and light activities with rest periods.”
c) “I will skip meals to avoid fatigue.”
d) “I will exercise immediately after eating.”
b) “I will alternate heavy and light activities with rest periods.”
Rationale: Pacing reduces cardiac workload and hypoxia episodes.
7. A client receiving packed RBCs develops chills and fever 15 min after initiation. Priority
PN action?
a) Stop transfusion immediately, maintain IV access with normal saline, notify provider
b) Slow rate and give acetaminophen
c) Continue and document
d) Remove IV
