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MED SURG ATI ADVANCED FINAL EXAM /ATI MED SURG ADVANCED FINAL
PROCTORED 2026-2027 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS
1. A client with COPD is receiving oxygen at 6 L/min via nasal cannula. The nurse should take
which action?
A. Increase oxygen to 10 L/min
B. Switch to a nonrebreather
C. Assess the client’s respiratory status
D. Discontinue oxygen
Rationale:
COPD patients require careful assessment to avoid CO₂ retention. Never increase oxygen
without assessment.
2. Which client should the nurse see FIRST?
A. Client with chronic back pain requesting medication
B. Client with asthma using accessory muscles
C. Client with controlled diabetes
D. Client awaiting discharge
Rationale:
Airway and breathing take priority.
3. A client with heart failure reports sudden weight gain of 4 lb in 2 days. This indicates:
A. Improved nutrition
B. Fluid retention
C. Medication effectiveness
D. Dehydration
Rationale:
Rapid weight gain = fluid overload.
4. Which finding requires IMMEDIATE intervention?
A. Blood glucose 180 mg/dL
B. Potassium 6.1 mEq/L
2026 2027 GRADED A+
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C. Sodium 135 mEq/L
D. Calcium 9.2 mg/dL
Rationale:
Hyperkalemia can cause fatal dysrhythmias.
5. A post-op client reports calf pain and swelling. The nurse should:
A. Massage the leg
B. Encourage ambulation
C. Notify the provider immediately
D. Apply heat
Rationale:
Signs of DVT → risk for pulmonary embolism.
6. Which client can the nurse delegate to an unlicensed assistive personnel (UAP)?
A. Assess pain level
B. Administer insulin
C. Measure intake and output
D. Teach incentive spirometry
Rationale:
UAP can perform routine, non-assessment tasks.
7. A client with diabetes is shaky, diaphoretic, and confused. What is the FIRST action?
A. Administer insulin
B. Check blood glucose
C. Call the provider
D. Start IV fluids
Rationale:
Always assess before intervening when safe.
2026 2027 GRADED A+
,3|Page
8. Which ABG indicates respiratory acidosis?
A. pH 7.48, CO₂ 30
B. pH 7.32, CO₂ 52
C. pH 7.45, CO₂ 40
D. pH 7.36, CO₂ 38
Rationale:
Low pH + high CO₂ = respiratory acidosis.
9. A client with increased ICP should be positioned:
A. Supine
B. Trendelenburg
C. Head of bed elevated 30°
D. Side-lying
Rationale:
Elevating HOB reduces intracranial pressure.
10. Which finding in a client with GI bleeding is MOST concerning?
A. Dark stools
B. Hemoglobin 8.1 g/dL
C. Heart rate 124 bpm
D. Fatigue
Rationale:
Tachycardia indicates active blood loss/shock.
1. A client with COPD has an O₂ saturation of 88% on room air. The nurse should:
A. Administer high-flow oxygen at 10 L/min
B. Assess the client’s respiratory status
C. Encourage deep breathing without oxygen
D. Notify provider after 1 hour
2026 2027 GRADED A+
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Rationale:
Assessment comes first. COPD patients are sensitive to high O₂; abrupt increases may worsen
CO₂ retention.
2. A post-op client has a heart rate of 128 bpm and BP 88/54 mmHg. The nurse should:
A. Encourage ambulation
B. Administer PRN pain medication
C. Assess for bleeding
D. Notify provider in 24 hours
Rationale:
Tachycardia and hypotension post-op may indicate hemorrhage; rapid assessment is priority.
3. Which task can be delegated to UAP?
A. Administer insulin
B. Measure and record vital signs
C. Assess lung sounds
D. Evaluate IV site for infection
Rationale:
UAPs can perform routine data collection, not assessment or medication administration.
4. A client with DKA is lethargic, tachypneic, and has K+ 3.1 mEq/L. The nurse should:
A. Begin insulin therapy immediately
B. Hold fluids and call provider
C. Administer potassium replacement
D. Give oral glucose
Rationale:
Hypokalemia must be corrected before insulin to prevent cardiac arrest.
5. Which lab indicates risk for infection in a post-op client?
A. WBC 12,500
B. Hemoglobin 13 g/dL
2026 2027 GRADED A+
MED SURG ATI ADVANCED FINAL EXAM /ATI MED SURG ADVANCED FINAL
PROCTORED 2026-2027 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS
1. A client with COPD is receiving oxygen at 6 L/min via nasal cannula. The nurse should take
which action?
A. Increase oxygen to 10 L/min
B. Switch to a nonrebreather
C. Assess the client’s respiratory status
D. Discontinue oxygen
Rationale:
COPD patients require careful assessment to avoid CO₂ retention. Never increase oxygen
without assessment.
2. Which client should the nurse see FIRST?
A. Client with chronic back pain requesting medication
B. Client with asthma using accessory muscles
C. Client with controlled diabetes
D. Client awaiting discharge
Rationale:
Airway and breathing take priority.
3. A client with heart failure reports sudden weight gain of 4 lb in 2 days. This indicates:
A. Improved nutrition
B. Fluid retention
C. Medication effectiveness
D. Dehydration
Rationale:
Rapid weight gain = fluid overload.
4. Which finding requires IMMEDIATE intervention?
A. Blood glucose 180 mg/dL
B. Potassium 6.1 mEq/L
2026 2027 GRADED A+
,2|Page
C. Sodium 135 mEq/L
D. Calcium 9.2 mg/dL
Rationale:
Hyperkalemia can cause fatal dysrhythmias.
5. A post-op client reports calf pain and swelling. The nurse should:
A. Massage the leg
B. Encourage ambulation
C. Notify the provider immediately
D. Apply heat
Rationale:
Signs of DVT → risk for pulmonary embolism.
6. Which client can the nurse delegate to an unlicensed assistive personnel (UAP)?
A. Assess pain level
B. Administer insulin
C. Measure intake and output
D. Teach incentive spirometry
Rationale:
UAP can perform routine, non-assessment tasks.
7. A client with diabetes is shaky, diaphoretic, and confused. What is the FIRST action?
A. Administer insulin
B. Check blood glucose
C. Call the provider
D. Start IV fluids
Rationale:
Always assess before intervening when safe.
2026 2027 GRADED A+
,3|Page
8. Which ABG indicates respiratory acidosis?
A. pH 7.48, CO₂ 30
B. pH 7.32, CO₂ 52
C. pH 7.45, CO₂ 40
D. pH 7.36, CO₂ 38
Rationale:
Low pH + high CO₂ = respiratory acidosis.
9. A client with increased ICP should be positioned:
A. Supine
B. Trendelenburg
C. Head of bed elevated 30°
D. Side-lying
Rationale:
Elevating HOB reduces intracranial pressure.
10. Which finding in a client with GI bleeding is MOST concerning?
A. Dark stools
B. Hemoglobin 8.1 g/dL
C. Heart rate 124 bpm
D. Fatigue
Rationale:
Tachycardia indicates active blood loss/shock.
1. A client with COPD has an O₂ saturation of 88% on room air. The nurse should:
A. Administer high-flow oxygen at 10 L/min
B. Assess the client’s respiratory status
C. Encourage deep breathing without oxygen
D. Notify provider after 1 hour
2026 2027 GRADED A+
, 4|Page
Rationale:
Assessment comes first. COPD patients are sensitive to high O₂; abrupt increases may worsen
CO₂ retention.
2. A post-op client has a heart rate of 128 bpm and BP 88/54 mmHg. The nurse should:
A. Encourage ambulation
B. Administer PRN pain medication
C. Assess for bleeding
D. Notify provider in 24 hours
Rationale:
Tachycardia and hypotension post-op may indicate hemorrhage; rapid assessment is priority.
3. Which task can be delegated to UAP?
A. Administer insulin
B. Measure and record vital signs
C. Assess lung sounds
D. Evaluate IV site for infection
Rationale:
UAPs can perform routine data collection, not assessment or medication administration.
4. A client with DKA is lethargic, tachypneic, and has K+ 3.1 mEq/L. The nurse should:
A. Begin insulin therapy immediately
B. Hold fluids and call provider
C. Administer potassium replacement
D. Give oral glucose
Rationale:
Hypokalemia must be corrected before insulin to prevent cardiac arrest.
5. Which lab indicates risk for infection in a post-op client?
A. WBC 12,500
B. Hemoglobin 13 g/dL
2026 2027 GRADED A+
