ATI RN MEDICAL-SURGICAL PROCTORED RETAKE EXAM 2023-2024:
100 QUESTIONS WITH ANSWERS & RATIONALES
Cardiovascular Disorders (Questions 1-15)
Q1. A nurse is preparing a client who has supraventricular tachycardia
for elective cardioversion. Which medication should the client
withhold for 48 hours prior?
• a. Enoxaparin
• b. Metformin
• c. Diazepam
• d. Digoxin
Rationale: 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 after synchronized
countershock .
Q2. A nurse is caring for a client 1 hour following a cardiac
catheterization. A hematoma forms at the insertion site with
decreased pulse in the affected extremity. Which intervention is the
priority?
• a. Initiate oxygen at 2 L/min via nasal cannula
• b. Apply firm pressure to the insertion site
• c. Take the client's vital signs
• d. Obtain a stat order for an aPTT
Rationale: The greatest risk to the client is bleeding. The priority
intervention is applying firm pressure to the hematoma to stop the
bleeding .
,Q3. A nurse is assessing a client following a cardiac catheterization via
the right femoral artery. Which finding requires immediate
intervention?
• a. 3 cm area of ecchymosis at the insertion site
• b. Client reports pain at the site rated 3/10
• c. Dorsalis pedis pulse is +2 bilaterally
• d. Right foot is cool to touch with capillary refill of 6 seconds
Rationale: Coolness and delayed capillary refill (normal is <3 seconds)
indicate arterial insufficiency, which may be caused by thrombus
formation or arterial occlusion. This is a vascular emergency .
Q4. A client with heart failure has 3+ pitting edema, crackles halfway
up lung fields, and weight gain of 5 lbs in 24 hours. Which
intervention should the nurse implement first?
• a. Restrict oral fluids to 1,500 mL/day
• b. Administer furosemide 40 mg IV push
• c. Elevate the lower extremities
• d. Apply sequential compression devices
Rationale: The client has fluid volume overload. Furosemide (Lasix)
rapidly reduces preload, decreasing pulmonary congestion and
improving oxygenation. This addresses the immediate threat of
pulmonary edema .
Q5. A nurse is providing discharge teaching to a client with heart
failure and a new prescription for furosemide. Which statement
indicates understanding?
• a. "I will take my medication in the evening before bed"
, • b. "I will eat foods high in potassium like bananas and oranges"
• c. "I will weigh myself once a week"
• d. "I will stop the medication if I feel dizzy"
Rationale: Furosemide is a loop diuretic that causes potassium loss.
Clients should increase potassium-rich foods to prevent hypokalemia.
Furosemide should be taken in the morning to avoid nocturia .
Q6. A nurse is assessing a client with infective endocarditis. Which
finding is the nurse most likely to observe?
• a. Splinter hemorrhages under the fingernails
• b. Bounding peripheral pulses
• c. Decreased jugular venous pressure
• d. Warm, dry skin
Rationale: Infective endocarditis causes systemic embolization and
vasculitis. Splinter hemorrhages (linear red-brown streaks under nails),
Osler nodes, Janeway lesions, and petechiae are classic peripheral
manifestations .
Q7. A client with peripheral artery disease (PAD) reports leg pain that
occurs when walking and is relieved by rest. The nurse documents this
as:
• a. Rest pain
• b. Intermittent claudication
• c. Neuropathic pain
• d. Venous stasis pain
, Rationale: Intermittent claudication is muscle pain that occurs with
exercise and is relieved by rest, which is characteristic of PAD due to
inadequate blood flow during activity .
Q8. A client has a mechanical heart valve and takes warfarin. Which
instruction should the nurse include?
• a. "Take ibuprofen for minor pain"
• b. "Increase intake of green leafy vegetables"
• c. "Take antibiotics before any dental procedures"
• d. "Resume heavy lifting in 2 weeks"
Rationale: Clients with mechanical heart valves are at high risk for
infective endocarditis. The American Heart Association recommends
prophylactic antibiotics before dental procedures involving
manipulation of gingival tissue .
Q9. A nurse is caring for a client with hypertension and a new
prescription for hydrochlorothiazide. Which adverse effect should the
nurse monitor?
• a. Hyperkalemia
• b. Hypoglycemia
• c. Hypokalemia
• d. Hypercalcemia
Rationale: Hydrochlorothiazide is a thiazide diuretic that causes
potassium wasting. The nurse should monitor for hypokalemia, which
can manifest as muscle weakness, fatigue, and dysrhythmias .
Q10. A nurse is assessing a client receiving digoxin. Which finding
indicates digoxin toxicity?
100 QUESTIONS WITH ANSWERS & RATIONALES
Cardiovascular Disorders (Questions 1-15)
Q1. A nurse is preparing a client who has supraventricular tachycardia
for elective cardioversion. Which medication should the client
withhold for 48 hours prior?
• a. Enoxaparin
• b. Metformin
• c. Diazepam
• d. Digoxin
Rationale: 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 after synchronized
countershock .
Q2. A nurse is caring for a client 1 hour following a cardiac
catheterization. A hematoma forms at the insertion site with
decreased pulse in the affected extremity. Which intervention is the
priority?
• a. Initiate oxygen at 2 L/min via nasal cannula
• b. Apply firm pressure to the insertion site
• c. Take the client's vital signs
• d. Obtain a stat order for an aPTT
Rationale: The greatest risk to the client is bleeding. The priority
intervention is applying firm pressure to the hematoma to stop the
bleeding .
,Q3. A nurse is assessing a client following a cardiac catheterization via
the right femoral artery. Which finding requires immediate
intervention?
• a. 3 cm area of ecchymosis at the insertion site
• b. Client reports pain at the site rated 3/10
• c. Dorsalis pedis pulse is +2 bilaterally
• d. Right foot is cool to touch with capillary refill of 6 seconds
Rationale: Coolness and delayed capillary refill (normal is <3 seconds)
indicate arterial insufficiency, which may be caused by thrombus
formation or arterial occlusion. This is a vascular emergency .
Q4. A client with heart failure has 3+ pitting edema, crackles halfway
up lung fields, and weight gain of 5 lbs in 24 hours. Which
intervention should the nurse implement first?
• a. Restrict oral fluids to 1,500 mL/day
• b. Administer furosemide 40 mg IV push
• c. Elevate the lower extremities
• d. Apply sequential compression devices
Rationale: The client has fluid volume overload. Furosemide (Lasix)
rapidly reduces preload, decreasing pulmonary congestion and
improving oxygenation. This addresses the immediate threat of
pulmonary edema .
Q5. A nurse is providing discharge teaching to a client with heart
failure and a new prescription for furosemide. Which statement
indicates understanding?
• a. "I will take my medication in the evening before bed"
, • b. "I will eat foods high in potassium like bananas and oranges"
• c. "I will weigh myself once a week"
• d. "I will stop the medication if I feel dizzy"
Rationale: Furosemide is a loop diuretic that causes potassium loss.
Clients should increase potassium-rich foods to prevent hypokalemia.
Furosemide should be taken in the morning to avoid nocturia .
Q6. A nurse is assessing a client with infective endocarditis. Which
finding is the nurse most likely to observe?
• a. Splinter hemorrhages under the fingernails
• b. Bounding peripheral pulses
• c. Decreased jugular venous pressure
• d. Warm, dry skin
Rationale: Infective endocarditis causes systemic embolization and
vasculitis. Splinter hemorrhages (linear red-brown streaks under nails),
Osler nodes, Janeway lesions, and petechiae are classic peripheral
manifestations .
Q7. A client with peripheral artery disease (PAD) reports leg pain that
occurs when walking and is relieved by rest. The nurse documents this
as:
• a. Rest pain
• b. Intermittent claudication
• c. Neuropathic pain
• d. Venous stasis pain
, Rationale: Intermittent claudication is muscle pain that occurs with
exercise and is relieved by rest, which is characteristic of PAD due to
inadequate blood flow during activity .
Q8. A client has a mechanical heart valve and takes warfarin. Which
instruction should the nurse include?
• a. "Take ibuprofen for minor pain"
• b. "Increase intake of green leafy vegetables"
• c. "Take antibiotics before any dental procedures"
• d. "Resume heavy lifting in 2 weeks"
Rationale: Clients with mechanical heart valves are at high risk for
infective endocarditis. The American Heart Association recommends
prophylactic antibiotics before dental procedures involving
manipulation of gingival tissue .
Q9. A nurse is caring for a client with hypertension and a new
prescription for hydrochlorothiazide. Which adverse effect should the
nurse monitor?
• a. Hyperkalemia
• b. Hypoglycemia
• c. Hypokalemia
• d. Hypercalcemia
Rationale: Hydrochlorothiazide is a thiazide diuretic that causes
potassium wasting. The nurse should monitor for hypokalemia, which
can manifest as muscle weakness, fatigue, and dysrhythmias .
Q10. A nurse is assessing a client receiving digoxin. Which finding
indicates digoxin toxicity?
