ATI MEDICAL-SURGICAL NURSING RETAKE PRACTICE EXAM — 2026/2027
50 Questions | Questions and Answers | Comprehensive Adult Health Assessment
Total: 50 questions | Time: 90–120 minutes | Passing: 75–78% (38–39/50) | Format: Multiple-choice
and NGN-style
Cardiovascular Disorders (Q1-Q6)
1. A nurse is caring for a client who is 2 hours postoperative following a total hip arthroplasty.
Which of the following findings should the nurse report to the provider immediately?
A. Pain level of 6 on a scale of 0 to 10
B. Shortness of breath and sudden chest pain
C. Temperature of 37.8° C (100° F)
D. Small amount of serosanguineous drainage on the dressing
Rationale: Shortness of breath and sudden chest pain are indicative of a pulmonary embolism (PE), a life-
threatening complication common after orthopedic surgeries due to immobility and vascular trauma. This
requires immediate provider notification and intervention. Pain, low-grade fever, and minimal
serosanguineous drainage are expected postoperative findings.
2. A nurse is assessing a client with chronic kidney disease (CKD). Which of the following
laboratory values should the nurse anticipate being elevated?
A. Hemoglobin
B. Calcium
C. Creatinine
D. Sodium
Rationale: In CKD, declining kidney function leads to elevated serum creatinine and BUN due to impaired
filtration. Hemoglobin is decreased (erythropoietin deficiency), calcium is decreased (impaired vitamin D
activation), and sodium is variable.
3. A nurse is caring for a client who has a new prescription for warfarin. Which of the
following instructions should the nurse include in the teaching?
A. Increase intake of leafy green vegetables
B. Avoid taking aspirin or NSAIDs unless prescribed
C. Use a hard-bristle toothbrush to prevent gum disease
1
,D. Expect dark red urine as a normal side effect
Rationale: Aspirin and NSAIDs increase bleeding risk with warfarin. Maintain consistent (not increased)
vitamin K intake. Use soft-bristle toothbrush. Dark red urine indicates hematuria and should be reported.
4. A nurse is providing discharge teaching to a client with heart failure. Which of the
following statements by the client indicates an understanding of the teaching?
A. “I will drink at least 3 liters of fluid daily.”
B. “I will weigh myself once a week.”
C. “I will report a weight gain of 2 pounds in one day to my provider.”
D. “I will take my prescribed diuretic only when I feel short of breath.”
Rationale: Weight gain of 2 lbs or more in 1 day (or 5 lbs in 1 week) indicates fluid retention and worsening
heart failure requiring provider notification. Fluid should be restricted per provider order. Daily weights
are necessary. Diuretics must be taken as prescribed, not PRN.
5. A nurse is assessing a client who has a deep vein thrombosis (DVT). Which of the following
findings should the nurse expect?
A. Unilateral leg swelling and warmth
B. Bilateral pedal edema
C. Throbbing pain relieved by elevation
D. Cool, pale extremity with diminished pulses
Rationale: DVT presents with unilateral swelling, warmth, tenderness, and erythema (Homan’s sign may
be present). Bilateral edema suggests systemic causes. Cool, pale extremity with diminished pulses suggests
arterial occlusion.
6. A nurse is caring for a client receiving heparin therapy. Which of the following laboratory
results should the nurse monitor to evaluate the therapeutic effect?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Platelet count
Rationale: aPTT monitors heparin therapy; therapeutic range is typically 1.5–2.5 times the control.
PT/INR monitors warfarin therapy. Platelet count monitors for heparin-induced thrombocytopenia (HIT).
2
, Respiratory Conditions (Q7-Q12)
7. A nurse is caring for a client with chronic obstructive pulmonary disease (COPD). Which of
the following interventions should the nurse include in the plan of care?
A. Administer oxygen at 6 L/min via nasal cannula
B. Encourage pursed-lip breathing during exhalation
C. Place the client in high Fowler’s position with the head of bed at 45 degrees
D. Restrict fluid intake to 500 mL per day
Rationale: Pursed-lip breathing prolongs exhalation, prevents airway collapse, and helps release trapped
air in COPD. Oxygen should be titrated to maintain SpO2 88–92% (low-flow, typically 1–3 L/min) to
prevent suppressing the hypoxic drive. Position should be upright/high Fowler’s. Fluids should be
encouraged (unless contraindicated) to thin secretions.
8. A nurse is assessing a client who is experiencing an acute asthma exacerbation. Which of
the following findings should the nurse expect?
A. Wheezing on expiration
B. Crackles on inspiration
C. Stridor on inspiration
D. Rhonchi on both inspiration and expiration
Rationale: Asthma causes bronchoconstriction leading to expiratory wheezing. Crackles suggest fluid
(pneumonia, heart failure). Stridor indicates upper airway obstruction. Rhonchi suggest secretions in
larger airways.
9. A nurse is caring for a client who has a chest tube connected to a closed drainage system.
Which of the following findings indicates that the client’s lung has re-expanded?
A. Continuous bubbling in the water seal chamber
B. No fluctuation (tidaling) in the water seal chamber
C. Drainage of 100 mL per hour
D. Subcutaneous emphysema around the insertion site
Rationale: When the lung re-expands, tidaling (fluctuation) in the water seal stops because the pleural
space is sealed. Continuous bubbling indicates an air leak. Drainage should decrease over time.
Subcutaneous emphysema indicates air leaking into tissues.
10. A nurse is providing discharge teaching to a client with pneumonia. Which of the
following statements by the client indicates understanding?
3
50 Questions | Questions and Answers | Comprehensive Adult Health Assessment
Total: 50 questions | Time: 90–120 minutes | Passing: 75–78% (38–39/50) | Format: Multiple-choice
and NGN-style
Cardiovascular Disorders (Q1-Q6)
1. A nurse is caring for a client who is 2 hours postoperative following a total hip arthroplasty.
Which of the following findings should the nurse report to the provider immediately?
A. Pain level of 6 on a scale of 0 to 10
B. Shortness of breath and sudden chest pain
C. Temperature of 37.8° C (100° F)
D. Small amount of serosanguineous drainage on the dressing
Rationale: Shortness of breath and sudden chest pain are indicative of a pulmonary embolism (PE), a life-
threatening complication common after orthopedic surgeries due to immobility and vascular trauma. This
requires immediate provider notification and intervention. Pain, low-grade fever, and minimal
serosanguineous drainage are expected postoperative findings.
2. A nurse is assessing a client with chronic kidney disease (CKD). Which of the following
laboratory values should the nurse anticipate being elevated?
A. Hemoglobin
B. Calcium
C. Creatinine
D. Sodium
Rationale: In CKD, declining kidney function leads to elevated serum creatinine and BUN due to impaired
filtration. Hemoglobin is decreased (erythropoietin deficiency), calcium is decreased (impaired vitamin D
activation), and sodium is variable.
3. A nurse is caring for a client who has a new prescription for warfarin. Which of the
following instructions should the nurse include in the teaching?
A. Increase intake of leafy green vegetables
B. Avoid taking aspirin or NSAIDs unless prescribed
C. Use a hard-bristle toothbrush to prevent gum disease
1
,D. Expect dark red urine as a normal side effect
Rationale: Aspirin and NSAIDs increase bleeding risk with warfarin. Maintain consistent (not increased)
vitamin K intake. Use soft-bristle toothbrush. Dark red urine indicates hematuria and should be reported.
4. A nurse is providing discharge teaching to a client with heart failure. Which of the
following statements by the client indicates an understanding of the teaching?
A. “I will drink at least 3 liters of fluid daily.”
B. “I will weigh myself once a week.”
C. “I will report a weight gain of 2 pounds in one day to my provider.”
D. “I will take my prescribed diuretic only when I feel short of breath.”
Rationale: Weight gain of 2 lbs or more in 1 day (or 5 lbs in 1 week) indicates fluid retention and worsening
heart failure requiring provider notification. Fluid should be restricted per provider order. Daily weights
are necessary. Diuretics must be taken as prescribed, not PRN.
5. A nurse is assessing a client who has a deep vein thrombosis (DVT). Which of the following
findings should the nurse expect?
A. Unilateral leg swelling and warmth
B. Bilateral pedal edema
C. Throbbing pain relieved by elevation
D. Cool, pale extremity with diminished pulses
Rationale: DVT presents with unilateral swelling, warmth, tenderness, and erythema (Homan’s sign may
be present). Bilateral edema suggests systemic causes. Cool, pale extremity with diminished pulses suggests
arterial occlusion.
6. A nurse is caring for a client receiving heparin therapy. Which of the following laboratory
results should the nurse monitor to evaluate the therapeutic effect?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Platelet count
Rationale: aPTT monitors heparin therapy; therapeutic range is typically 1.5–2.5 times the control.
PT/INR monitors warfarin therapy. Platelet count monitors for heparin-induced thrombocytopenia (HIT).
2
, Respiratory Conditions (Q7-Q12)
7. A nurse is caring for a client with chronic obstructive pulmonary disease (COPD). Which of
the following interventions should the nurse include in the plan of care?
A. Administer oxygen at 6 L/min via nasal cannula
B. Encourage pursed-lip breathing during exhalation
C. Place the client in high Fowler’s position with the head of bed at 45 degrees
D. Restrict fluid intake to 500 mL per day
Rationale: Pursed-lip breathing prolongs exhalation, prevents airway collapse, and helps release trapped
air in COPD. Oxygen should be titrated to maintain SpO2 88–92% (low-flow, typically 1–3 L/min) to
prevent suppressing the hypoxic drive. Position should be upright/high Fowler’s. Fluids should be
encouraged (unless contraindicated) to thin secretions.
8. A nurse is assessing a client who is experiencing an acute asthma exacerbation. Which of
the following findings should the nurse expect?
A. Wheezing on expiration
B. Crackles on inspiration
C. Stridor on inspiration
D. Rhonchi on both inspiration and expiration
Rationale: Asthma causes bronchoconstriction leading to expiratory wheezing. Crackles suggest fluid
(pneumonia, heart failure). Stridor indicates upper airway obstruction. Rhonchi suggest secretions in
larger airways.
9. A nurse is caring for a client who has a chest tube connected to a closed drainage system.
Which of the following findings indicates that the client’s lung has re-expanded?
A. Continuous bubbling in the water seal chamber
B. No fluctuation (tidaling) in the water seal chamber
C. Drainage of 100 mL per hour
D. Subcutaneous emphysema around the insertion site
Rationale: When the lung re-expands, tidaling (fluctuation) in the water seal stops because the pleural
space is sealed. Continuous bubbling indicates an air leak. Drainage should decrease over time.
Subcutaneous emphysema indicates air leaking into tissues.
10. A nurse is providing discharge teaching to a client with pneumonia. Which of the
following statements by the client indicates understanding?
3
