ATI Med-Surg Proctored Exam 2026 (NGN-
Style Questions & Case Scenarios) –
LATEST EXAM WITH VERRIFIED ANSWERS
FOR 100% PASS
1. A nurse is assessing a client who is 6 hours post-angiogram via the right
femoral artery. Which finding requires immediate action?
A. A blood pressure of 128/74 mm Hg
B. A heart rate of 86 bpm
C. A small amount of bloody drainage on the pressure dressing
D. A palpable, hard lump at the catheter insertion site
Correct Answer💜💜: D. A palpable, hard lump at the catheter insertion site
Rationale: A palpable, hard lump (hematoma) at the insertion site indicates active
bleeding into the tissue. This can lead to compromised circulation to the limb and
significant blood loss. The nurse should immediately apply firm pressure proximal
to the site, assess distal pulses, and notify the provider. The other findings are
within normal limits.
,2. A client with heart failure reports a sudden weight gain of 2 kg (4.4 lb) in 2
days. What is the nurse’s priority action?
A. Encourage ambulation
B. Restrict fluids
C. Notify the provider
D. Administer potassium
Correct Answer💜💜: C. Notify the provider
Rationale: Rapid weight gain indicates fluid overload and a possible exacerbation
of heart failure, requiring immediate provider intervention for diuretic
adjustment or other medical management.
3. A client is receiving a heparin infusion. Which lab value should the nurse
monitor to evaluate therapeutic effect?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
,Correct Answer💜💜: B. aPTT
Rationale: Activated partial thromboplastin time (aPTT) is the lab value used to
monitor the therapeutic effect of unfractionated heparin. INR is used for warfarin.
4. A 65-year-old patient with chest pain has an ECG showing ST-elevation in
leads II, III, and aVF. What is the priority nursing action?
A. Administer nitroglycerin
B. Prepare for percutaneous coronary intervention (PCI)
C. Start oxygen at 2 L/min
D. Obtain a troponin level
Correct Answer💜💜: B. Prepare for percutaneous coronary intervention (PCI)
Rationale: ST-elevation in the inferior leads (II, III, aVF) suggests an acute ST-
elevation myocardial infarction (STEMI). The priority is to prepare for PCI to
restore coronary blood flow as quickly as possible.
5. A nurse in an emergency department is reviewing a client's ECG. Which
finding indicates first-degree heart block?
A. More P waves than QRS complexes
B. Non-discernible P waves
, C. Prolonged PR interval
D. No correlation between P and QRS waves
Correct Answer💜💜: C. Prolonged PR interval
Rationale: First-degree AV block is characterized by a consistent but prolonged PR
interval (greater than 0.20 seconds). All other impulses are conducted normally.
6. NGN Case Study: A 50-year-old client with a history of hypertension is post-
operative day 1 following a cholecystectomy. The client reports sudden onset of
sharp chest pain and dyspnea. Vital signs: HR 118 bpm, RR 28/min, BP 100/58
mm Hg, SpO2 88% on room air.
Part 1: What is the nurse's priority action?
A. Notify the healthcare provider.
B. Administer prescribed morphine for pain.
C. Apply supplemental oxygen.
D. Obtain a stat ECG.
Correct Answer💜💜: C. Apply supplemental oxygen.
Rationale: Airway and breathing are always the priority. The client's symptoms
are highly suggestive of a pulmonary embolism. The first action is to administer
oxygen to correct or prevent hypoxemia.
Style Questions & Case Scenarios) –
LATEST EXAM WITH VERRIFIED ANSWERS
FOR 100% PASS
1. A nurse is assessing a client who is 6 hours post-angiogram via the right
femoral artery. Which finding requires immediate action?
A. A blood pressure of 128/74 mm Hg
B. A heart rate of 86 bpm
C. A small amount of bloody drainage on the pressure dressing
D. A palpable, hard lump at the catheter insertion site
Correct Answer💜💜: D. A palpable, hard lump at the catheter insertion site
Rationale: A palpable, hard lump (hematoma) at the insertion site indicates active
bleeding into the tissue. This can lead to compromised circulation to the limb and
significant blood loss. The nurse should immediately apply firm pressure proximal
to the site, assess distal pulses, and notify the provider. The other findings are
within normal limits.
,2. A client with heart failure reports a sudden weight gain of 2 kg (4.4 lb) in 2
days. What is the nurse’s priority action?
A. Encourage ambulation
B. Restrict fluids
C. Notify the provider
D. Administer potassium
Correct Answer💜💜: C. Notify the provider
Rationale: Rapid weight gain indicates fluid overload and a possible exacerbation
of heart failure, requiring immediate provider intervention for diuretic
adjustment or other medical management.
3. A client is receiving a heparin infusion. Which lab value should the nurse
monitor to evaluate therapeutic effect?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
,Correct Answer💜💜: B. aPTT
Rationale: Activated partial thromboplastin time (aPTT) is the lab value used to
monitor the therapeutic effect of unfractionated heparin. INR is used for warfarin.
4. A 65-year-old patient with chest pain has an ECG showing ST-elevation in
leads II, III, and aVF. What is the priority nursing action?
A. Administer nitroglycerin
B. Prepare for percutaneous coronary intervention (PCI)
C. Start oxygen at 2 L/min
D. Obtain a troponin level
Correct Answer💜💜: B. Prepare for percutaneous coronary intervention (PCI)
Rationale: ST-elevation in the inferior leads (II, III, aVF) suggests an acute ST-
elevation myocardial infarction (STEMI). The priority is to prepare for PCI to
restore coronary blood flow as quickly as possible.
5. A nurse in an emergency department is reviewing a client's ECG. Which
finding indicates first-degree heart block?
A. More P waves than QRS complexes
B. Non-discernible P waves
, C. Prolonged PR interval
D. No correlation between P and QRS waves
Correct Answer💜💜: C. Prolonged PR interval
Rationale: First-degree AV block is characterized by a consistent but prolonged PR
interval (greater than 0.20 seconds). All other impulses are conducted normally.
6. NGN Case Study: A 50-year-old client with a history of hypertension is post-
operative day 1 following a cholecystectomy. The client reports sudden onset of
sharp chest pain and dyspnea. Vital signs: HR 118 bpm, RR 28/min, BP 100/58
mm Hg, SpO2 88% on room air.
Part 1: What is the nurse's priority action?
A. Notify the healthcare provider.
B. Administer prescribed morphine for pain.
C. Apply supplemental oxygen.
D. Obtain a stat ECG.
Correct Answer💜💜: C. Apply supplemental oxygen.
Rationale: Airway and breathing are always the priority. The client's symptoms
are highly suggestive of a pulmonary embolism. The first action is to administer
oxygen to correct or prevent hypoxemia.
