NURS 211L ATI MEDSURGE PROCTORED FINAL EXAM 2026.REAL EXAM WITH
CORRECT DETAILED ANSWERS WITH RATIONALES A+ GRADE (HIGHLY
RECCOMMENDED.
SECTION 1: Cardiovascular Disorders (Qs 1–25)
1. A client with a history of heart failure is admitted with shortness of breath,
crackles in the lung bases, and 3+ pitting edema in the lower extremities. Which
prescribed medication should the nurse administer first?
A) Digoxin 0.25 mg PO
B) Furosemide 40 mg IV
C) Metoprolol 25 mg PO
D) Lisinopril 10 mg PO
Answer: B
Rationale: Furosemide is a loop diuretic that rapidly reduces preload and fluid
overload. IV administration ensures immediate action. Digoxin, beta-blockers, and
ACE inhibitors are chronic therapies.
2. A client receiving a blood transfusion reports chills, back pain, and dark urine.
What is the nurse’s priority action?
,A) Stop the transfusion immediately
B) Slow the transfusion rate
C) Administer diphenhydramine
D) Notify the provider
Answer: A
Rationale: These symptoms indicate an acute hemolytic transfusion reaction. The
nurse must stop the transfusion immediately, disconnect the tubing, keep the IV
line open with normal saline, and notify the provider. Slowing the infusion is not
safe.
3. A client with heart failure has an apical pulse of 52 bpm and is prescribed
digoxin 0.25 mg daily. What should the nurse do?
A) Administer the medication as ordered
B) Hold the dose and notify the provider
C) Administer half the dose
D) Recheck the pulse in 30 minutes
Answer: B
,Rationale: Digoxin is held if the apical pulse is <60 bpm in adults. Bradycardia
increases the risk of digoxin toxicity. The provider should be notified for further
orders.
4. A client diagnosed with deep vein thrombosis (DVT) is receiving heparin IV.
Which laboratory value should the nurse monitor to evaluate therapeutic
effectiveness?
A) PT/INR
B) aPTT
C) Platelet count
D) Fibrinogen
Answer: B
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor
unfractionated heparin therapy. The therapeutic goal is typically 1.5–2.5 times the
control value. PT/INR monitors warfarin.
5. A client with stable angina is prescribed nitroglycerin sublingual. Which
instruction should the nurse include?
A) “Take one tablet every 5 minutes for up to 3 doses; if pain is not relieved, call
911.”
, B) “Swallow the tablet with a full glass of water.”
C) “Store the tablets in the refrigerator.”
D) “You may take up to 10 tablets in an hour if pain is severe.”
Answer: A
Rationale: Standard nitroglycerin dosing: one tablet SL every 5 minutes for up to
three doses. If chest pain persists after three doses, emergency services should be
contacted.
6. 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) Venous insufficiency
D) Neuropathic pain
Answer: B
Rationale: Intermittent claudication is muscle pain/cramping induced by exercise
and relieved by rest, caused by insufficient arterial blood flow. Rest pain indicates
severe PAD.
CORRECT DETAILED ANSWERS WITH RATIONALES A+ GRADE (HIGHLY
RECCOMMENDED.
SECTION 1: Cardiovascular Disorders (Qs 1–25)
1. A client with a history of heart failure is admitted with shortness of breath,
crackles in the lung bases, and 3+ pitting edema in the lower extremities. Which
prescribed medication should the nurse administer first?
A) Digoxin 0.25 mg PO
B) Furosemide 40 mg IV
C) Metoprolol 25 mg PO
D) Lisinopril 10 mg PO
Answer: B
Rationale: Furosemide is a loop diuretic that rapidly reduces preload and fluid
overload. IV administration ensures immediate action. Digoxin, beta-blockers, and
ACE inhibitors are chronic therapies.
2. A client receiving a blood transfusion reports chills, back pain, and dark urine.
What is the nurse’s priority action?
,A) Stop the transfusion immediately
B) Slow the transfusion rate
C) Administer diphenhydramine
D) Notify the provider
Answer: A
Rationale: These symptoms indicate an acute hemolytic transfusion reaction. The
nurse must stop the transfusion immediately, disconnect the tubing, keep the IV
line open with normal saline, and notify the provider. Slowing the infusion is not
safe.
3. A client with heart failure has an apical pulse of 52 bpm and is prescribed
digoxin 0.25 mg daily. What should the nurse do?
A) Administer the medication as ordered
B) Hold the dose and notify the provider
C) Administer half the dose
D) Recheck the pulse in 30 minutes
Answer: B
,Rationale: Digoxin is held if the apical pulse is <60 bpm in adults. Bradycardia
increases the risk of digoxin toxicity. The provider should be notified for further
orders.
4. A client diagnosed with deep vein thrombosis (DVT) is receiving heparin IV.
Which laboratory value should the nurse monitor to evaluate therapeutic
effectiveness?
A) PT/INR
B) aPTT
C) Platelet count
D) Fibrinogen
Answer: B
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor
unfractionated heparin therapy. The therapeutic goal is typically 1.5–2.5 times the
control value. PT/INR monitors warfarin.
5. A client with stable angina is prescribed nitroglycerin sublingual. Which
instruction should the nurse include?
A) “Take one tablet every 5 minutes for up to 3 doses; if pain is not relieved, call
911.”
, B) “Swallow the tablet with a full glass of water.”
C) “Store the tablets in the refrigerator.”
D) “You may take up to 10 tablets in an hour if pain is severe.”
Answer: A
Rationale: Standard nitroglycerin dosing: one tablet SL every 5 minutes for up to
three doses. If chest pain persists after three doses, emergency services should be
contacted.
6. 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) Venous insufficiency
D) Neuropathic pain
Answer: B
Rationale: Intermittent claudication is muscle pain/cramping induced by exercise
and relieved by rest, caused by insufficient arterial blood flow. Rest pain indicates
severe PAD.
