Comprehensive ATI Medical-Surgical (Adult Health)
Proctored Exam: 200 Practice Questions with CORRECT
Answers & Rationales/pdf.
Introduction:
This comprehensive review guide is designed to help nursing students prepare for
the ATI Medical-Surgical (Adult Health) Proctored Examination. The exam is a
critical assessment of your ability to apply nursing knowledge to adult clients
across a wide range of common health conditions, including cardiovascular,
respiratory, gastrointestinal, endocrine, renal, neurological, and musculoskeletal
disorders.
ATI Medical-Surgical Proctored Exam Practice Questions
1. A nurse is assessing a client who is 12 hours post-operative following a colon
resection. Which of the following findings should the nurse report to the surgeon?
A. Heart rate 90/min
B. Absent bowel sounds
C. Hgb 8.2 g/dL
D. Gastric pH of 3.0
*Correct Answer: C. Hgb 8.2 g/dL*
Rationale: A hemoglobin of 8.2 g/dL is significantly below the normal range (13-18
g/dL for males, 12-16 g/dL for females). This finding may indicate postoperative
hemorrhage, which is a medical emergency and must be reported to the surgeon
immediately. Absent bowel sounds and gastric pH of 3.0 are expected findings after
abdominal surgery, and a heart rate of 90/min is within normal limits.
2. A nurse in the emergency department is assessing a client who reports chest
pain. The ECG reveals ST-segment elevation in the anterior leads. Which of the
following actions should the nurse take first?
A. Administer morphine sulfate
B. Obtain a 12-lead ECG
C. Start a heparin infusion
D. Administer oxygen via nasal cannula
, Correct Answer: D. Administer oxygen via nasal cannula
Rationale: The priority is to maintain the client's airway, breathing, and circulation
(ABCs). Administering oxygen helps increase myocardial oxygenation and minimize
damage. While obtaining a 12-lead ECG is important, oxygen administration takes
precedence. Morphine and heparin are important interventions but are not the first
action.
3. A client with heart failure reports increased shortness of breath and a 3-lb
weight gain in 24 hours. Which of the following findings indicates worsening heart
failure?
A. Bounding pulses
B. Crackles in lung bases
C. Blood pressure 130/90 mm Hg
D. Heart rate 88/min
Correct Answer: B. Crackles in lung bases
Rationale: Crackles (rales) in the lung bases are a classic sign of pulmonary congestion
due to fluid overload in left-sided heart failure. Weight gain combined with crackles
indicates worsening heart failure. Bounding pulses, blood pressure 130/90 mm Hg, and
heart rate 88/min are not specific indicators of worsening heart failure.
4. A client receiving IV furosemide develops muscle weakness. Which of the
following laboratory values should the nurse check?
A. Hemoglobin
B. Sodium
C. Potassium
D. Chloride
Correct Answer: C. Potassium
Rationale: Furosemide is a loop diuretic that causes potassium loss (hypokalemia).
Hypokalemia can lead to muscle weakness, fatigue, and cardiac arrhythmias. Monitoring
serum potassium levels is essential when administering loop diuretics. Hemoglobin,
sodium, and chloride are not primarily affected by furosemide.
5. A client with atrial fibrillation is starting warfarin. Which of the following
statements by the client indicates an understanding of the teaching?
, A. "I will increase green leafy vegetables in my diet."
B. "I need to avoid acetaminophen."
C. "I will keep my diet consistent each week."
D. "I do not need blood tests."
Correct Answer: C. "I will keep my diet consistent each week."
Rationale: Warfarin's effectiveness is influenced by vitamin K intake. Keeping the diet
consistent in vitamin K content (found in green leafy vegetables) helps maintain a stable
INR. Clients need regular blood tests to monitor INR, and acetaminophen is generally
safe but should be discussed with the healthcare provider.
6. A nurse notes ST depression on a client's ECG. This finding is most indicative of
which of the following conditions?
A. Ventricular fibrillation
B. Acute STEMI
C. Myocardial ischemia
D. Pericarditis
Correct Answer: C. Myocardial ischemia
Rationale: ST-segment depression is a characteristic ECG finding of myocardial ischemia
(insufficient oxygen supply to the heart muscle). ST-segment elevation (not depression)
indicates acute ST-elevation myocardial infarction (STEMI). Pericarditis typically shows
diffuse ST-segment elevation. Ventricular fibrillation has chaotic, disorganized waves
without discernible ST segments.
7. A client with pericarditis has pulsus paradoxus. This finding suggests which of
the following complications?
A. Cardiogenic shock
B. Cardiac tamponade
C. Right-sided heart failure
D. Myocardial infarction
Correct Answer: B. Cardiac tamponade
Rationale: Pulsus paradoxus (a drop in systolic blood pressure greater than 10 mm Hg
during inspiration) is a hallmark sign of cardiac tamponade. It occurs because increased
pericardial pressure restricts ventricular filling during inspiration. Pulsus paradoxus is not
, characteristic of cardiogenic shock, right-sided heart failure, or myocardial infarction
alone.
8. A nurse is preparing to administer sublingual nitroglycerin to a client. Which of
the following assessments is the priority?
A. Pain score
B. Heart rate
C. Blood pressure
D. Oxygen saturation
Correct Answer: C. Blood pressure
Rationale: Sublingual nitroglycerin is a potent vasodilator that can cause significant
hypotension, leading to dizziness, syncope, or reduced coronary perfusion. The priority
assessment before and after administration is blood pressure to ensure the client is not
hypotensive. Pain relief is the goal but not the priority assessment.
9. A client with left-sided heart failure is at increased risk for which of the
following findings?
A. Peripheral edema
B. Jugular vein distention
C. Pulmonary congestion
D. Weight loss
Correct Answer: C. Pulmonary congestion
Rationale: Left-sided heart failure leads to fluid backup into the pulmonary circulation,
resulting in pulmonary congestion. Symptoms include dyspnea, crackles, and cough.
Peripheral edema and jugular vein distention are signs of right-sided heart failure, which
can develop secondary to left-sided failure but are not the primary direct effects.
10. A client with infective endocarditis reports new onset of flank pain. The nurse
should suspect which of the following complications?
A. Kidney infection
B. Emboli to renal arteries
C. Hydronephrosis
D. Dehydration
Correct Answer: B. Emboli to renal arteries
Proctored Exam: 200 Practice Questions with CORRECT
Answers & Rationales/pdf.
Introduction:
This comprehensive review guide is designed to help nursing students prepare for
the ATI Medical-Surgical (Adult Health) Proctored Examination. The exam is a
critical assessment of your ability to apply nursing knowledge to adult clients
across a wide range of common health conditions, including cardiovascular,
respiratory, gastrointestinal, endocrine, renal, neurological, and musculoskeletal
disorders.
ATI Medical-Surgical Proctored Exam Practice Questions
1. A nurse is assessing a client who is 12 hours post-operative following a colon
resection. Which of the following findings should the nurse report to the surgeon?
A. Heart rate 90/min
B. Absent bowel sounds
C. Hgb 8.2 g/dL
D. Gastric pH of 3.0
*Correct Answer: C. Hgb 8.2 g/dL*
Rationale: A hemoglobin of 8.2 g/dL is significantly below the normal range (13-18
g/dL for males, 12-16 g/dL for females). This finding may indicate postoperative
hemorrhage, which is a medical emergency and must be reported to the surgeon
immediately. Absent bowel sounds and gastric pH of 3.0 are expected findings after
abdominal surgery, and a heart rate of 90/min is within normal limits.
2. A nurse in the emergency department is assessing a client who reports chest
pain. The ECG reveals ST-segment elevation in the anterior leads. Which of the
following actions should the nurse take first?
A. Administer morphine sulfate
B. Obtain a 12-lead ECG
C. Start a heparin infusion
D. Administer oxygen via nasal cannula
, Correct Answer: D. Administer oxygen via nasal cannula
Rationale: The priority is to maintain the client's airway, breathing, and circulation
(ABCs). Administering oxygen helps increase myocardial oxygenation and minimize
damage. While obtaining a 12-lead ECG is important, oxygen administration takes
precedence. Morphine and heparin are important interventions but are not the first
action.
3. A client with heart failure reports increased shortness of breath and a 3-lb
weight gain in 24 hours. Which of the following findings indicates worsening heart
failure?
A. Bounding pulses
B. Crackles in lung bases
C. Blood pressure 130/90 mm Hg
D. Heart rate 88/min
Correct Answer: B. Crackles in lung bases
Rationale: Crackles (rales) in the lung bases are a classic sign of pulmonary congestion
due to fluid overload in left-sided heart failure. Weight gain combined with crackles
indicates worsening heart failure. Bounding pulses, blood pressure 130/90 mm Hg, and
heart rate 88/min are not specific indicators of worsening heart failure.
4. A client receiving IV furosemide develops muscle weakness. Which of the
following laboratory values should the nurse check?
A. Hemoglobin
B. Sodium
C. Potassium
D. Chloride
Correct Answer: C. Potassium
Rationale: Furosemide is a loop diuretic that causes potassium loss (hypokalemia).
Hypokalemia can lead to muscle weakness, fatigue, and cardiac arrhythmias. Monitoring
serum potassium levels is essential when administering loop diuretics. Hemoglobin,
sodium, and chloride are not primarily affected by furosemide.
5. A client with atrial fibrillation is starting warfarin. Which of the following
statements by the client indicates an understanding of the teaching?
, A. "I will increase green leafy vegetables in my diet."
B. "I need to avoid acetaminophen."
C. "I will keep my diet consistent each week."
D. "I do not need blood tests."
Correct Answer: C. "I will keep my diet consistent each week."
Rationale: Warfarin's effectiveness is influenced by vitamin K intake. Keeping the diet
consistent in vitamin K content (found in green leafy vegetables) helps maintain a stable
INR. Clients need regular blood tests to monitor INR, and acetaminophen is generally
safe but should be discussed with the healthcare provider.
6. A nurse notes ST depression on a client's ECG. This finding is most indicative of
which of the following conditions?
A. Ventricular fibrillation
B. Acute STEMI
C. Myocardial ischemia
D. Pericarditis
Correct Answer: C. Myocardial ischemia
Rationale: ST-segment depression is a characteristic ECG finding of myocardial ischemia
(insufficient oxygen supply to the heart muscle). ST-segment elevation (not depression)
indicates acute ST-elevation myocardial infarction (STEMI). Pericarditis typically shows
diffuse ST-segment elevation. Ventricular fibrillation has chaotic, disorganized waves
without discernible ST segments.
7. A client with pericarditis has pulsus paradoxus. This finding suggests which of
the following complications?
A. Cardiogenic shock
B. Cardiac tamponade
C. Right-sided heart failure
D. Myocardial infarction
Correct Answer: B. Cardiac tamponade
Rationale: Pulsus paradoxus (a drop in systolic blood pressure greater than 10 mm Hg
during inspiration) is a hallmark sign of cardiac tamponade. It occurs because increased
pericardial pressure restricts ventricular filling during inspiration. Pulsus paradoxus is not
, characteristic of cardiogenic shock, right-sided heart failure, or myocardial infarction
alone.
8. A nurse is preparing to administer sublingual nitroglycerin to a client. Which of
the following assessments is the priority?
A. Pain score
B. Heart rate
C. Blood pressure
D. Oxygen saturation
Correct Answer: C. Blood pressure
Rationale: Sublingual nitroglycerin is a potent vasodilator that can cause significant
hypotension, leading to dizziness, syncope, or reduced coronary perfusion. The priority
assessment before and after administration is blood pressure to ensure the client is not
hypotensive. Pain relief is the goal but not the priority assessment.
9. A client with left-sided heart failure is at increased risk for which of the
following findings?
A. Peripheral edema
B. Jugular vein distention
C. Pulmonary congestion
D. Weight loss
Correct Answer: C. Pulmonary congestion
Rationale: Left-sided heart failure leads to fluid backup into the pulmonary circulation,
resulting in pulmonary congestion. Symptoms include dyspnea, crackles, and cough.
Peripheral edema and jugular vein distention are signs of right-sided heart failure, which
can develop secondary to left-sided failure but are not the primary direct effects.
10. A client with infective endocarditis reports new onset of flank pain. The nurse
should suspect which of the following complications?
A. Kidney infection
B. Emboli to renal arteries
C. Hydronephrosis
D. Dehydration
Correct Answer: B. Emboli to renal arteries
