ATI PN ADULT MEDICAL-SURGICAL EXAM 2023–
2024 – 60 REALISTIC NGN PRACTICE QUESTIONS
WITH DETAILED RATIONALES
Question 1 of 60:
A nurse is assisting with the plan of care for a client who has a new prescription for lisinopril
for hypertension. Which of the following instructions should be included in the teaching?
• A) Increase intake of potassium-rich foods.
• B) Change positions slowly when standing.
• C) Take the medication with grapefruit juice.
• D) Expect weight gain while taking this medication.
,Answer: (B) Change positions slowly when standing.
Rationale: Lisinopril is an ACE inhibitor that can cause orthostatic hypotension, especially with
the first dose. Clients should be instructed to rise slowly to prevent dizziness and falls.
Question 2 of 60:
A nurse is reinforcing teaching for a client who is prescribed insulin glargine. Which statement
by the client indicates correct understanding?
• A) “I will take this insulin before each meal.”
• B) “This insulin peaks in 1 hour.”
• C) “I will take this insulin at the same time every day.”
• D) “I will mix this insulin with regular insulin.”
Answer: (C) “I will take this insulin at the same time every day.”
Rationale: Insulin glargine is a long-acting insulin that should be administered once daily at the
same time. It does not peak and should never be mixed with other insulins.
Question 3 of 60:
A nurse is caring for a client with COPD who is receiving oxygen therapy. Which finding
indicates the therapy is effective?
• A) Respiratory rate decreases
• B) Oxygen saturation remains at 82%
• C) Increased drowsiness
• D) Cyanosis of the lips
Answer: (A) Respiratory rate decreases
Rationale: An improved respiratory rate indicates that oxygen therapy is reducing the client’s
work of breathing and improving oxygenation.
Question 4 of 60:
A nurse is caring for a client receiving heparin therapy. Which laboratory value should the
nurse monitor?
• A) INR
• B) aPTT
• C) Platelet count
• D) Hemoglobin A1c
Answer: (B) aPTT
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor the therapeutic
effect of heparin.
Question 5 of 60:
, A nurse is assisting in the care of a client with hypokalemia. Which ECG change should the
nurse expect?
• A) Tall peaked T waves
• B) ST elevation
• C) Flattened T waves
• D) Prolonged PR interval
Answer: (C) Flattened T waves
Rationale: Hypokalemia causes flattened T waves, the presence of U waves, and risk for
dysrhythmias.
Question 6 of 60:
A nurse is caring for a client with a new diagnosis of type 1 diabetes mellitus. Which statement
by the client indicates understanding of the disease?
• A) “I will need oral medication for control.”
• B) “My pancreas does not produce insulin.”
• C) “I developed this because of obesity.”
• D) “I will only need insulin when sick.”
Answer: (B) “My pancreas does not produce insulin.”
Rationale: Type 1 diabetes is caused by destruction of pancreatic beta cells, resulting in little to
no insulin production.
Question 7 of 60:
A client with heart failure is prescribed furosemide. Which finding indicates the medication is
effective?
• A) Decreased urine output
• B) Weight loss
• C) Increased edema
• D) Bradycardia
Answer: (B) Weight loss
Rationale: Furosemide reduces excess fluid volume. Weight loss indicates diuresis and reduced
fluid retention.
Question 8 of 60:
A nurse is caring for a client with a chest tube connected to suction. Which finding requires
immediate intervention?
• A) Continuous bubbling in the water-seal chamber
• B) Intermittent bubbling in the suction chamber
2024 – 60 REALISTIC NGN PRACTICE QUESTIONS
WITH DETAILED RATIONALES
Question 1 of 60:
A nurse is assisting with the plan of care for a client who has a new prescription for lisinopril
for hypertension. Which of the following instructions should be included in the teaching?
• A) Increase intake of potassium-rich foods.
• B) Change positions slowly when standing.
• C) Take the medication with grapefruit juice.
• D) Expect weight gain while taking this medication.
,Answer: (B) Change positions slowly when standing.
Rationale: Lisinopril is an ACE inhibitor that can cause orthostatic hypotension, especially with
the first dose. Clients should be instructed to rise slowly to prevent dizziness and falls.
Question 2 of 60:
A nurse is reinforcing teaching for a client who is prescribed insulin glargine. Which statement
by the client indicates correct understanding?
• A) “I will take this insulin before each meal.”
• B) “This insulin peaks in 1 hour.”
• C) “I will take this insulin at the same time every day.”
• D) “I will mix this insulin with regular insulin.”
Answer: (C) “I will take this insulin at the same time every day.”
Rationale: Insulin glargine is a long-acting insulin that should be administered once daily at the
same time. It does not peak and should never be mixed with other insulins.
Question 3 of 60:
A nurse is caring for a client with COPD who is receiving oxygen therapy. Which finding
indicates the therapy is effective?
• A) Respiratory rate decreases
• B) Oxygen saturation remains at 82%
• C) Increased drowsiness
• D) Cyanosis of the lips
Answer: (A) Respiratory rate decreases
Rationale: An improved respiratory rate indicates that oxygen therapy is reducing the client’s
work of breathing and improving oxygenation.
Question 4 of 60:
A nurse is caring for a client receiving heparin therapy. Which laboratory value should the
nurse monitor?
• A) INR
• B) aPTT
• C) Platelet count
• D) Hemoglobin A1c
Answer: (B) aPTT
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor the therapeutic
effect of heparin.
Question 5 of 60:
, A nurse is assisting in the care of a client with hypokalemia. Which ECG change should the
nurse expect?
• A) Tall peaked T waves
• B) ST elevation
• C) Flattened T waves
• D) Prolonged PR interval
Answer: (C) Flattened T waves
Rationale: Hypokalemia causes flattened T waves, the presence of U waves, and risk for
dysrhythmias.
Question 6 of 60:
A nurse is caring for a client with a new diagnosis of type 1 diabetes mellitus. Which statement
by the client indicates understanding of the disease?
• A) “I will need oral medication for control.”
• B) “My pancreas does not produce insulin.”
• C) “I developed this because of obesity.”
• D) “I will only need insulin when sick.”
Answer: (B) “My pancreas does not produce insulin.”
Rationale: Type 1 diabetes is caused by destruction of pancreatic beta cells, resulting in little to
no insulin production.
Question 7 of 60:
A client with heart failure is prescribed furosemide. Which finding indicates the medication is
effective?
• A) Decreased urine output
• B) Weight loss
• C) Increased edema
• D) Bradycardia
Answer: (B) Weight loss
Rationale: Furosemide reduces excess fluid volume. Weight loss indicates diuresis and reduced
fluid retention.
Question 8 of 60:
A nurse is caring for a client with a chest tube connected to suction. Which finding requires
immediate intervention?
• A) Continuous bubbling in the water-seal chamber
• B) Intermittent bubbling in the suction chamber
