ATI Med-Surg Proctored Exam Test Bank 2026 | Medical-Surgical Nursing, NCLEX Preparation | Multiple Choice Questions and Answers with Verified Rationales | Get HighScore | Instant Download

GET HIGHSCORE on the ATI Med-Surg Proctored Exam 2026 with this comprehensive test bank covering Medical-Surgical Nursing and NCLEX preparation—featuring multiple-choice questions with verified answers and detailed rationales. The ATI Medical-Surgical proctored exam is a comprehensive assessment used by nursing programs to evaluate students' understanding of medical-surgical nursing concepts, including patient assessment, disease management, pharmacologic interventions, and evidence-based practice . This resource includes 300+ exam-style questions covering all essential topics , fully aligned with the ATI Med-Surg content blueprint. MASTER PAIN MANAGEMENT & PHARMACOLOGY Open-Ended Pain Assessment: The question "How would you describe your pain?" gives the most information about the patient's pain experience because it is broad and allows the patient to provide detailed information. This approach focuses on the patient's perception of pain, which is the most reliable indicator . Breakthrough Pain Definition: Breakthrough pain is a transient, moderate to severe pain that occurs in patients already taking around-the-clock opioids for persistent pain. It has a rapid onset and is often severe . Breakthrough Pain Management: For a patient already on long-acting opioids (e.g., MS Contin), breakthrough pain should be treated with a short-acting/immediate-release opioid. The dose is typically 10-20% of the total daily opioid dose . Opioid Administration Post-Thoracic Surgery: When administering an opioid analgesic for pain following thoracic surgery, the nurse should explain that the medication should have a reducing anxiety effect, as anxiety often accompanies postoperative pain . Pain Management Goal: The goal of pain management is to improve function and quality of life. The patient's ability to accomplish desired activities indicates that pain control is adequate, regardless of the specific pain score . Cognitive-Behavioral Pain Techniques (Imagery/Hypnosis) : These strategies work by affecting the perception of pain. They do not block nerve transmission but help the patient reinterpret or refocus attention away from pain signals . Ibuprofen Mechanism of Action: Ibuprofen (NSAID) works by inhibiting prostaglandin synthesis, reducing inflammation and pain . MASTER CARDIOVASCULAR & RESPIRATORY CONDITIONS Peripheral Arterial Disease (PAD) Comfort Measure: For a client with vascular occlusion reporting cold feet, the nurse should obtain a pair of slipper socks for the client. Rubbing the feet could dislodge a thrombus, and heating pads should be avoided because sensory perception may be diminished, increasing burn risk . Emphysema Expected Findings (Select-All-That-Apply) : Clients with emphysema typically present with dyspnea, barrel chest, clubbing of the fingers, and shallow respirations . Mechanical Ventilation High-Pressure Alarm: When a client on mechanical ventilation appears anxious and restless and the high-pressure alarm is sounding, the nurse should first instruct the client to allow the machine to breathe for them (least restrictive intervention). Clients can exhibit anxiety when trying to "fight the ventilator" . Chest Tube Suction Control Chamber: If there is no bubbling in the suction control chamber, the nurse should verify that the suction regulator is on . Synchronized Cardioversion vs Defibrillation: For a client experiencing supraventricular tachycardia with heart rate 200/min, BP 78/40 mmHg, and RR 30/min, the nurse should perform synchronized cardioversion. Cardiac glycosides such as digoxin are withheld prior to cardioversion because they can increase ventricular irritability and put the client at risk for ventricular fibrillation . Cardiac Murmur Assessment: When performing a cardiac assessment and hearing a murmur, the nurse should listen with the client on their left side so it can be heard more clearly . MASTER ENDOCRINE & METABOLIC DISORDERS Levothyroxine (Hypothyroidism) Teaching: The client should take levothyroxine on an empty stomach, preferably in the morning before breakfast. Improvement in energy level is an expected outcome. Calcium supplements can interfere with absorption—avoid taking calcium within 4 hours of levothyroxine administration. Weight loss is expected as the medication increases metabolism. Regular follow-up is required for dose adjustments . Hyperthyroidism Expected Findings: Clients with hyperthyroidism often report frequent mood changes . Exophthalmos (bulging eyes) is a classic manifestation . Cushing's Syndrome Clinical Manifestations (Select-All-That-Apply) : Expected findings include buffalo hump, purple striations (stretch marks), and moon face . Type 1 Diabetes & Exercise Teaching: The client should understand: "I will carry a complex carbohydrate snack with me when I exercise." Exercise is contraindicated in the presence of ketones because it can worsen hyperglycemia and increase the risk of diabetic ketoacidosis (DKA) . Hypoglycemia Manifestations (Select-All-That-Apply) : Blurry vision, tachycardia, and sweating are manifestations of hypoglycemia . Type 2 Diabetes Teaching - Metformin: Metformin is a biguanide that decreases glucose production by the liver. It should be held before procedures involving contrast dye (e.g., cardiac catheterization) to prevent kidney damage. Renal impairment is a contraindication to metformin therapy (eGFR 30 mL/min) due to increased risk of lactic acidosis . Metformin & B12 Deficiency: Metformin use can lead to Vitamin B12 deficiency over time, requiring monitoring . Desmopressin (DDAVP) for Diabetes Insipidus: Diabetes insipidus is characterized by a deficiency of antidiuretic hormone (ADH), leading to excessive urination and thirst. Desmopressin is a synthetic form of ADH used to replace the deficient hormone. The nurse should monitor serum sodium levels because water retention can cause dilutional hyponatremia . MASTER NEUROLOGICAL DISORDERS Post-Seizure Phase Documentation: After a generalized tonic-clonic seizure, the client who is difficult to arouse and very sleepy for several hours is in the postictal phase . Myasthenia Gravis (MG) Complication: The nurse should monitor for respiratory difficulty, which is a serious complication of MG due to respiratory muscle weakness . Spinal Cord Injury (T-4) - Autonomic Dysreflexia Prevention: To prevent autonomic dysreflexia, the nurse should prevent bladder distention, which is the most common trigger. Autonomic dysreflexia is a medical emergency characterized by sudden severe hypertension, bradycardia, and pounding headache . Stroke: Left vs Right Hemisphere Symptoms: Left hemisphere stroke presents with aphasia (language deficits), right hemianopsia (vision loss on right side), and cautious behavior. Right hemisphere stroke presents with visual spatial deficits/loss of depth perception, one-sided neglect/unawareness of affected side, left hemianopsia, and impulsive behavior . MASTER GASTROINTESTINAL & RENAL DISORDERS Intestinal Obstruction with NG Decompression: For a client receiving continuous gastrointestinal decompression using a nasogastric tube, the nurse should maintain the client in Fowler's position . Laparoscopic Cholecystectomy - Referred Shoulder Pain: Following laparoscopic cholecystectomy, clients may report right shoulder pain due to CO2 inflation of the abdomen during surgery. The nurse should explain: "The pain will dissipate if you ambulate frequently" . Ulcerative Colitis Acute Exacerbation Priority: The priority action is to evaluate fluid and electrolyte levels, as diarrhea can lead to significant fluid and electrolyte losses . Acute Kidney Injury - Oliguric Phase: For a client in the oliguric phase of acute kidney injury, the nurse should monitor intake and output hourly . MASTER POSTOPERATIVE & TRAUMA CARE Total Hip Arthroplasty Post-Op Care (Select-All-That-Apply) : The nurse should maintain ABduction of the legs (not adduction), encourage range of motion of the hip up to 90 degrees (do not flex past 90 degrees), and place a pillow between the client's legs. Avoid internally rotating the hips . Open Reduction Internal Fixation (Hip Fracture) with Wound Drain: The nurse should empty the suction device every 4 hours . Skeletal Traction Care: The nurse should ensure the client's weights are hanging freely from the bed . Post-Mastectomy Invasive Device: Following a modified radical mastectomy, the nurse should expect the client to have a Jackson-Pratt (JP) drain . Lobectomy (Lung Cancer) Plan of Care Factor: Lung cancer usually has metastasized before the client presents with symptoms, which will have a significant impact on the plan of care . Postoperative Priority Finding (TURP) : Following transurethral resection of the prostate (TURP), the priority finding to report is thick, red-colored urine, which indicates significant bleeding and potential clot retention . Priority Finding Post-ORIF of Femur: Following open reduction and internal fixation of a fractured femur, the priority finding is altered level of consciousness, which may indicate fat embolism syndrome, pulmonary embolism, or other complications . MASTER INFECTIOUS DISEASE & IMMUNOLOGY Cellulitis of the Leg Intervention: The nurse should recommend washing daily with an antibacterial soap . Rifampin (TB Treatment) Teaching: For a female client taking rifampin, the nurse should instruct: "You should wear glasses instead of contacts while taking this medication" because rifampin can stain soft contact lenses orange-red . Feverfew & Naproxen Interaction: Feverfew (herbal supplement for migraine prevention) combined with naproxen (NSAID) increases the risk of bleeding, as both impair platelet aggregation . St. John's Wort & Atorvastatin Interaction: St. John's Wort decreases the effectiveness of atorvastatin (statin) by increasing its metabolism . MASTER LABORATORY VALUES & DIAGNOSTICS CT Scan with IV Contrast - History Requiring Further Assessment: A history of asthma requires further assessment because clients with asthma have a greater risk of reacting to contrast dye. Other conditions include allergies to shellfish, eggs, milk, and chocolate . Medications Requiring Further Screening Before IV Contrast: Aminoglycosides, NSAIDs, and metformin warrant further screening for increased risk of renal damage . Hypokalemia Expected Findings: With a potassium level of 3.0 mEq/L (hypokalemia), the nurse should expect hypoactive bowel sounds due to decreased smooth muscle contraction leading to decreased peristalsis . Deep Tendon Reflexes & Electrolytes: Deep tendon reflexes are used to monitor magnesium levels. Hypomagnesemia causes increased reflexes (e.g., 4+); hypermagnesemia causes decreased reflexes (e.g., absent or 1+) . Trousseau's Sign: Evaluates for hypocalcemia and hypomagnesemia . Hypokalemia Effect on Respirations: Hypokalemia causes shallow respirations due to respiratory muscle weakness . MASTER MEDICATION ADMINISTRATION & TEACHING Ciprofloxacin (Fluoroquinolone) Teaching: Avoid calcium-containing foods (decrease absorption). Do not take with antacids (administer ciprofloxacin 2 hours before antacid or 6 hours after taking antacid). Can cause tendon rupture (black box warning) . Enoxaparin (Lovenox) Administration: Given subcutaneously (blood thinner). Should administer at the same time every day. Do not massage after giving . Oral Iron Supplementation Teaching: Do not take with dairy (inhibits absorption). Do not take with antacids. Can cause gastrointestinal issues. Client should eat high fiber foods to prevent constipation. Take between meals for optimal absorption . Ferrous Gluconate Teaching: "Take this medication between meals" . TPN (Total Parenteral Nutrition) Management: TPN solutions contain a high concentration of dextrose. If a TPN solution is temporarily unavailable, the nurse should administer dextrose 10% in water to avoid a drop in blood glucose levels. Never abruptly stop TPN. Speeding up/slowing down the rate is contraindicated. An abrupt rate change can alter blood glucose levels significantly. Check vitals q4-8 hours . Erythropoietin Goal: The goal is to decrease fatigue and improve activity tolerance. It increases the level of hematocrit and RBCs. Can result in hypertension . Cyclosporine (Post-Renal Transplant) Teaching: "I will need to take this medication for the rest of my life" indicates understanding, as cyclosporine is an immunosuppressant required long-term to prevent organ rejection . MASTER ADDITIONAL HIGH-YIELD TOPICS Esophagogastroduodenoscopy (EGD) Teaching: "You will remain NPO for 8 hours before the procedure" . Lumbar Puncture Post-Procedure Care (Select-All-That-Apply) : Encourage fluid intake to prevent post-dural puncture headache. Monitor the puncture site for hematoma . Mandible Fracture with Jaw Wiring - Priority Action: Prevent aspiration, as the client cannot open their mouth to clear secretions or vomitus . Scleroderma Expected Finding: Hardened skin (tight, thickened skin due to collagen deposition) . Wound Drainage Type - Purulent: Yellow and thick drainage should be documented as purulent, indicating infection . Basal Skull Fracture - CSF Leak: For a client with a basal skull fracture with thin stream of clear drainage from the nostril, the nurse should first test the drainage for glucose (CSF contains glucose; mucus does not) . Escharotomy Explanation: For severe burns to lower extremities requiring escharotomy, the nurse should explain: "Large incisions will be made in the burned tissue to improve circulation" . Cataract Expected Manifestation: Decreased color perception . Gout Exacerbation Findings (Select-All-That-Apply) : Edema, erythema (redness), tophi (urate crystal deposits), and tight skin . AIDS - Oral Candidiasis: White, creamy covering on the tongue and buccal membranes indicates candidiasis (thrush) . Pernicious Anemia Treatment: Vitamin B12 (cobalamin) supplementation . Systemic Lupus Erythematosus (SLE) Renal Function: Review serum creatinine to determine renal function . Laryngeal Cancer Early Manifestation: Hoarseness (persistent voice change) . Each question includes detailed rationales explaining the "why" behind every correct answer, reinforcing clinical judgment for ATI Med-Surg Proctored Exam success and NCLEX readiness. DOCUMENT ACCESS: This resource is available as an instant digital download (PDF) immediately upon purchase. Fully text-searchable, printable, and accessible anytime through your user account. Trusted by thousands of nursing students for ATI Med-Surg Proctored Exam success and NCLEX preparation. 4. VERTICAL KEYWORDS / TAGS ATI Med-Surg Proctored Exam Test Bank 2026 Medical-Surgical Nursing NCLEX Preparation Multiple Choice Questions and Answers with Verified Rationales ATI Med-Surg Proctored Review Get HighScore ATI Medical-Surgical Pain Assessment Open-Ended Question How Would You Describe Breakthrough Pain Management Immediate-Release Opioid Opioid Analgesic Post-Thoracic Surgery Reducing Anxiety Peripheral Arterial Disease Cold Feet Slipper Socks No Heating Pad Emphysema Expected Findings Dyspnea Barrel Chest Clubbing Mechanical Ventilation High-Pressure Alarm Instruct Client to Relax Synchronized Cardioversion Supraventricular Tachycardia Cardiac Murmur Left Side Auscultation Levothyroxine Teaching Empty Stomach No Calcium Within 4 Hours Hyperthyroidism Frequent Mood Changes Exophthalmos Cushing's Syndrome Buffalo Hump Purple Striae Moon Face Diabetes Education No Exercise with Ketones Hypoglycemia Manifestations Blurry Vision Tachycardia Sweating Metformin Contraindication Renal Impairment Lactic Acidosis Desmopressin Diabetes Insipidus Monitor Serum Sodium Postictal Phase Seizure Recovery Autonomic Dysreflexia Prevention Prevent Bladder Distention Stroke Left Hemisphere Aphasia Right Hemisphere Neglect NG Decompression Fowler's Position Laparoscopic Cholecystectomy Shoulder Pain Ambulation Ulcerative Colitis Priority Fluid and Electrolytes Acute Kidney Injury Oliguric Phase Monitor I&O q1h Total Hip Arthroplasty Abduction Pillow Between Legs No Flexion 90° Skeletal Traction Weights Hanging Freely Jackson-Pratt Drain Post-Mastectomy Lung Cancer Metastasis Before Symptoms TURP Priority Finding Thick Red Urine Cellulitis Wash Daily with Antibacterial Soap Rifampin Teaching Wear Glasses Not Contacts Feverfew Naproxen Bleeding Risk St. John's Wort Decreases Atorvastatin Effect CT Contrast Risk Factors Asthma Shellfish Allergy Hypokalemia Hypoactive Bowel Sounds Shallow Respirations Deep Tendon Reflexes Magnesium Monitoring Ciprofloxacin Avoid Calcium No Antacids Enoxaparin Subcutaneous No Massage Iron Supplementation Between Meals No Dairy High Fiber TPN Management Dextrose 10% if Unavailable No Abrupt Stop Erythropoietin Goal Decrease Fatigue Monitor BP Cyclosporine Lifelong Immunosuppression Esophagogastroduodenoscopy NPO 8 Hours Lumbar Puncture Post-Care Fluids Monitor Hematoma Mandible Fracture Jaw Wiring Priority Prevent Aspiration Scleroderma Hardened Skin Purulent Drainage Infection Indicator CSF Leak Test Drainage for Glucose Escharotomy Incisions to Improve Circulation Cataract Decreased Color Perception Gout Exacerbation Edema Erythema Tophi AIDS Oral Candidiasis Thrush Pernicious Anemia Vitamin B12 SLE Renal Function Serum Creatinine Laryngeal Cancer Early Sign Hoarseness Downloadable PDF ATI Med-Surg Study Guide