ATI PN Adult Medical-Surgical 2025-2026 Style Practice
Exam (190 Questions)
1. A nurse is caring for a client with heart failure who reports sudden shortness
of breath and coughing up pink, frothy sputum. Which action should the nurse
take first?
A. Administer furosemide IV push
B. Place the client in high-Fowler’s position
C. Apply a non-rebreather mask at 15 L/min
D. Notify the provider immediately
Correct Answer: B
Rationale: High-Fowler’s position reduces venous return and decreases
pulmonary congestion. Airway and breathing come before medications or
notification.
Concept: Gas Exchange
2. A client post–left hip arthroplasty has a new order for enoxaparin 40 mg
subcut daily. Which finding requires immediate notification of the provider?
A. Platelet count 140,000/mm³
B. Hematocrit 33%
C. Bloody drainage on the surgical dressing
D. Pain rated 4/10 at incision site
Correct Answer: C
Rationale: Enoxaparin is an anticoagulant. Active bleeding (bloody drainage)
,requires immediate provider notification to possibly hold the next dose.
Concept: Clotting
3. A nurse is teaching a client with COPD about pursed-lip breathing. Which
statement by the client indicates understanding?
A. “I should breathe in quickly and breathe out slowly.”
B. “I will inhale through my nose and exhale through pursed lips.”
C. “Pursed-lip breathing helps me inhale more oxygen.”
D. “I should hold my breath for 5 seconds after inhaling.”
Correct Answer: B
Rationale: Pursed-lip breathing prolongs exhalation, preventing airway collapse.
Inhale through nose, exhale slowly through pursed lips.
Concept: Oxygenation
4. A client with diabetes mellitus type 2 has a blood glucose of 58 mg/dL and is
awake but drowsy. What should the nurse administer first?
A. ½ cup orange juice
B. Glucagon 1 mg IM
C. 50 mL dextrose 50% IV push
D. 4 oz skim milk
Correct Answer: A
Rationale: The client is conscious and can swallow. 15 g of fast-acting
carbohydrate (OJ) is first-line for mild hypoglycemia.
Concept: Glucose Regulation
,5. (NGN) Case Study – Client with pneumonia.
Vitals: HR 110, RR 28, O2 sat 88% on room air, temp 39.2°C (102.6°F), crackles in
right lower lobe.
Which three actions should the nurse take first? (Select all that apply)
A. Apply oxygen at 2 L/min via nasal cannula
B. Collect sputum culture
C. Administer acetaminophen 650 mg PO
D. Place client in semi-Fowler’s position
E. Initiate IV antibiotics
F. Obtain chest x-ray
Correct Answers: A, D, E
Rationale: Oxygen for hypoxemia (A), semi-Fowler’s for lung expansion (D),
antibiotics for bacterial pneumonia (E). Sputum culture can wait; fever is
secondary.
Concept: Infection, Gas Exchange
6. A client with chronic kidney disease has a potassium level of 6.8 mEq/L.
Which ECG change does the nurse expect?
A. Flat T waves
B. Prominent U waves
C. Tall peaked T waves
D. Prolonged PR interval
Correct Answer: C
Rationale: Hyperkalemia causes tall, peaked T waves. Flat T waves and U waves
, are seen in hypokalemia.
Concept: Electrolytes
7. A nurse is caring for a client with cirrhosis and ascites. Which measure is most
important to prevent skin breakdown?
A. Turn client every 4 hours
B. Apply barrier cream to sacrum
C. Elevate feet of bed
D. Use a soft mattress
Correct Answer: B
Rationale: Barrier cream protects skin from moisture due to ascites-related
edema and possible leakage. Turning q2h is better, but barrier cream is priority
for moisture-associated damage.
Concept: Skin Integrity
8. A client is 1 day post-op after a bowel resection. The nurse notes absent
bowel sounds, abdominal distention, and nausea. What is the priority action?
A. Insert a nasogastric tube
B. Ambulate the client
C. Administer metoclopramide
D. Auscultate for 5 minutes in all quadrants
Correct Answer: B
Rationale: Ambulation stimulates peristalsis. Paralytic ileus is common post-
abdominal surgery; early mobility is first-line non-pharmacologic treatment.
Concept: Elimination
Exam (190 Questions)
1. A nurse is caring for a client with heart failure who reports sudden shortness
of breath and coughing up pink, frothy sputum. Which action should the nurse
take first?
A. Administer furosemide IV push
B. Place the client in high-Fowler’s position
C. Apply a non-rebreather mask at 15 L/min
D. Notify the provider immediately
Correct Answer: B
Rationale: High-Fowler’s position reduces venous return and decreases
pulmonary congestion. Airway and breathing come before medications or
notification.
Concept: Gas Exchange
2. A client post–left hip arthroplasty has a new order for enoxaparin 40 mg
subcut daily. Which finding requires immediate notification of the provider?
A. Platelet count 140,000/mm³
B. Hematocrit 33%
C. Bloody drainage on the surgical dressing
D. Pain rated 4/10 at incision site
Correct Answer: C
Rationale: Enoxaparin is an anticoagulant. Active bleeding (bloody drainage)
,requires immediate provider notification to possibly hold the next dose.
Concept: Clotting
3. A nurse is teaching a client with COPD about pursed-lip breathing. Which
statement by the client indicates understanding?
A. “I should breathe in quickly and breathe out slowly.”
B. “I will inhale through my nose and exhale through pursed lips.”
C. “Pursed-lip breathing helps me inhale more oxygen.”
D. “I should hold my breath for 5 seconds after inhaling.”
Correct Answer: B
Rationale: Pursed-lip breathing prolongs exhalation, preventing airway collapse.
Inhale through nose, exhale slowly through pursed lips.
Concept: Oxygenation
4. A client with diabetes mellitus type 2 has a blood glucose of 58 mg/dL and is
awake but drowsy. What should the nurse administer first?
A. ½ cup orange juice
B. Glucagon 1 mg IM
C. 50 mL dextrose 50% IV push
D. 4 oz skim milk
Correct Answer: A
Rationale: The client is conscious and can swallow. 15 g of fast-acting
carbohydrate (OJ) is first-line for mild hypoglycemia.
Concept: Glucose Regulation
,5. (NGN) Case Study – Client with pneumonia.
Vitals: HR 110, RR 28, O2 sat 88% on room air, temp 39.2°C (102.6°F), crackles in
right lower lobe.
Which three actions should the nurse take first? (Select all that apply)
A. Apply oxygen at 2 L/min via nasal cannula
B. Collect sputum culture
C. Administer acetaminophen 650 mg PO
D. Place client in semi-Fowler’s position
E. Initiate IV antibiotics
F. Obtain chest x-ray
Correct Answers: A, D, E
Rationale: Oxygen for hypoxemia (A), semi-Fowler’s for lung expansion (D),
antibiotics for bacterial pneumonia (E). Sputum culture can wait; fever is
secondary.
Concept: Infection, Gas Exchange
6. A client with chronic kidney disease has a potassium level of 6.8 mEq/L.
Which ECG change does the nurse expect?
A. Flat T waves
B. Prominent U waves
C. Tall peaked T waves
D. Prolonged PR interval
Correct Answer: C
Rationale: Hyperkalemia causes tall, peaked T waves. Flat T waves and U waves
, are seen in hypokalemia.
Concept: Electrolytes
7. A nurse is caring for a client with cirrhosis and ascites. Which measure is most
important to prevent skin breakdown?
A. Turn client every 4 hours
B. Apply barrier cream to sacrum
C. Elevate feet of bed
D. Use a soft mattress
Correct Answer: B
Rationale: Barrier cream protects skin from moisture due to ascites-related
edema and possible leakage. Turning q2h is better, but barrier cream is priority
for moisture-associated damage.
Concept: Skin Integrity
8. A client is 1 day post-op after a bowel resection. The nurse notes absent
bowel sounds, abdominal distention, and nausea. What is the priority action?
A. Insert a nasogastric tube
B. Ambulate the client
C. Administer metoclopramide
D. Auscultate for 5 minutes in all quadrants
Correct Answer: B
Rationale: Ambulation stimulates peristalsis. Paralytic ileus is common post-
abdominal surgery; early mobility is first-line non-pharmacologic treatment.
Concept: Elimination
