1|Page
ATI MEDICAL SURGICAL 3 COMBINATION –
ALL 3 FORMS (A, B, C) + 225 PRACTICE
QUESTIONS WITH RATIONALES 2026/2027 |
RATED A+
## Table of Contents
| Section | Form/Content | Question Numbers | Count |
|---------|--------------|------------------|-------|
| 1 | Form A – Medical-Surgical Core Concepts | 1 – 45 | 45 |
| 2 | Form B – Critical Care & Emergency Nursing | 46 – 90 | 45 |
| 3 | Form C – Complex Systems & Management | 91 – 135 | 45 |
| 4 | GI & Digestive Disorders | 136 – 165 | 30 |
| 5 | Cardiovascular & Respiratory | 166 – 195 | 30 |
| 6 | Neurological & Renal | 196 – 225 | 30 |
| **Total** | | **1 – 225** | **225** |
---
## SECTION 1: FORM A – MEDICAL-SURGICAL CORE
CONCEPTS (Q1–45)
,2|Page
**1. A nurse is preparing to administer a unit of packed RBCs to a
client. Which of the following actions should the nurse take?**
A) Obtain the client's first set of vital signs 1 hour after the infusion
starts
B) Initiate venous access with a 21-gauge needle
C) Administer the unit of packed RBCs over 1 hour
D) Use Y tubing with 0.9% sodium chloride when administering the
blood
**Correct Answer:** D
**Rationale:** Y tubing with 0.9% sodium chloride (normal saline) is
the only solution compatible with blood products. Dextrose solutions or
lactated Ringer's can cause hemolysis. A 20-gauge or larger needle is
preferred for blood administration to prevent hemolysis .
**High-Yield Tip:** Always prime blood tubing with normal saline.
Never add medications to blood products.
**2. A nurse is caring for a client who has intractable vomiting. The
client's ABG findings are pH 7.8, HCO3 35 mEq/L, PaO2 90 mm Hg.
The nurse should identify these findings as indicating which acid-base
imbalance?**
A) Respiratory alkalosis
B) Metabolic acidosis
C) Respiratory acidosis
,3|Page
D) Metabolic alkalosis
**Correct Answer:** D
**Rationale:** Metabolic alkalosis is characterized by elevated pH
(>7.45) and elevated HCO3 (>26 mEq/L). Intractable vomiting causes
loss of gastric acid (hydrochloric acid), leading to metabolic alkalosis .
**High-Yield Tip:** "Vomiting = loss of acid = metabolic alkalosis."
Diarrhea = loss of base = metabolic acidosis.
**3. A nurse is caring for a client who has a chest tube. The client asks
why the fluid in the water-seal chamber rises and falls. Which statement
should the nurse make?**
A) "Your breathing pattern causes this"
B) "Suction pressure that is too high causes this"
C) "This means your lung is fully expanded"
D) "This indicates a possible leak"
**Correct Answer:** A
**Rationale:** Tidaling (the rise and fall of fluid in the water-seal
chamber with inspiration and expiration) is a normal finding that
indicates the chest tube is patent and functioning correctly. It reflects
intrapleural pressure changes during breathing .
**High-Yield Tip:** Absence of tidaling may indicate tube obstruction
or lung re-expansion. Continuous bubbling in water-seal chamber
indicates an air leak.
, 4|Page
**4. A nurse is reviewing laboratory results for a client with pancreatitis.
Which finding should the nurse expect?**
A) Decreased serum amylase
B) Elevated serum calcium
C) Decreased erythrocyte sedimentation rate (ESR)
D) Elevated blood glucose level
**Correct Answer:** D
**Rationale:** In acute pancreatitis, blood glucose is often elevated due
to decreased insulin production from inflamed pancreatic islet cells.
Serum amylase and lipase are elevated (not decreased). Hypocalcemia
(not hypercalcemia) may occur from fat saponification .
**High-Yield Tip:** Classic pancreatitis triad: elevated amylase,
elevated lipase, and elevated glucose.
**5. A nurse is caring for a client who has an IV in the left forearm and
whose infusion pump has alarmed several times. Which action should
the nurse take first?**
A) Flush the IV catheter
B) Reposition the client's left arm
C) Ensure the tubing connection is secure
D) Check the IV site for redness
ATI MEDICAL SURGICAL 3 COMBINATION –
ALL 3 FORMS (A, B, C) + 225 PRACTICE
QUESTIONS WITH RATIONALES 2026/2027 |
RATED A+
## Table of Contents
| Section | Form/Content | Question Numbers | Count |
|---------|--------------|------------------|-------|
| 1 | Form A – Medical-Surgical Core Concepts | 1 – 45 | 45 |
| 2 | Form B – Critical Care & Emergency Nursing | 46 – 90 | 45 |
| 3 | Form C – Complex Systems & Management | 91 – 135 | 45 |
| 4 | GI & Digestive Disorders | 136 – 165 | 30 |
| 5 | Cardiovascular & Respiratory | 166 – 195 | 30 |
| 6 | Neurological & Renal | 196 – 225 | 30 |
| **Total** | | **1 – 225** | **225** |
---
## SECTION 1: FORM A – MEDICAL-SURGICAL CORE
CONCEPTS (Q1–45)
,2|Page
**1. A nurse is preparing to administer a unit of packed RBCs to a
client. Which of the following actions should the nurse take?**
A) Obtain the client's first set of vital signs 1 hour after the infusion
starts
B) Initiate venous access with a 21-gauge needle
C) Administer the unit of packed RBCs over 1 hour
D) Use Y tubing with 0.9% sodium chloride when administering the
blood
**Correct Answer:** D
**Rationale:** Y tubing with 0.9% sodium chloride (normal saline) is
the only solution compatible with blood products. Dextrose solutions or
lactated Ringer's can cause hemolysis. A 20-gauge or larger needle is
preferred for blood administration to prevent hemolysis .
**High-Yield Tip:** Always prime blood tubing with normal saline.
Never add medications to blood products.
**2. A nurse is caring for a client who has intractable vomiting. The
client's ABG findings are pH 7.8, HCO3 35 mEq/L, PaO2 90 mm Hg.
The nurse should identify these findings as indicating which acid-base
imbalance?**
A) Respiratory alkalosis
B) Metabolic acidosis
C) Respiratory acidosis
,3|Page
D) Metabolic alkalosis
**Correct Answer:** D
**Rationale:** Metabolic alkalosis is characterized by elevated pH
(>7.45) and elevated HCO3 (>26 mEq/L). Intractable vomiting causes
loss of gastric acid (hydrochloric acid), leading to metabolic alkalosis .
**High-Yield Tip:** "Vomiting = loss of acid = metabolic alkalosis."
Diarrhea = loss of base = metabolic acidosis.
**3. A nurse is caring for a client who has a chest tube. The client asks
why the fluid in the water-seal chamber rises and falls. Which statement
should the nurse make?**
A) "Your breathing pattern causes this"
B) "Suction pressure that is too high causes this"
C) "This means your lung is fully expanded"
D) "This indicates a possible leak"
**Correct Answer:** A
**Rationale:** Tidaling (the rise and fall of fluid in the water-seal
chamber with inspiration and expiration) is a normal finding that
indicates the chest tube is patent and functioning correctly. It reflects
intrapleural pressure changes during breathing .
**High-Yield Tip:** Absence of tidaling may indicate tube obstruction
or lung re-expansion. Continuous bubbling in water-seal chamber
indicates an air leak.
, 4|Page
**4. A nurse is reviewing laboratory results for a client with pancreatitis.
Which finding should the nurse expect?**
A) Decreased serum amylase
B) Elevated serum calcium
C) Decreased erythrocyte sedimentation rate (ESR)
D) Elevated blood glucose level
**Correct Answer:** D
**Rationale:** In acute pancreatitis, blood glucose is often elevated due
to decreased insulin production from inflamed pancreatic islet cells.
Serum amylase and lipase are elevated (not decreased). Hypocalcemia
(not hypercalcemia) may occur from fat saponification .
**High-Yield Tip:** Classic pancreatitis triad: elevated amylase,
elevated lipase, and elevated glucose.
**5. A nurse is caring for a client who has an IV in the left forearm and
whose infusion pump has alarmed several times. Which action should
the nurse take first?**
A) Flush the IV catheter
B) Reposition the client's left arm
C) Ensure the tubing connection is secure
D) Check the IV site for redness
