ATI PN Adult Medical-Surgical — 300 Exam
Prep MCQs questions with answers and
rationales
Systems covered include: Cardiovascular, Respiratory, Neurological,
Musculoskeletal, Gastrointestinal, Renal/Urinary, Endocrine, Hematologic,
Immune, Integumentary, Oncology, Perioperative, Fluid/Electrolytes, Acid-
Base, Pharmacology, Infection Control, Delegation, Critical Care, and more.
CARDIOVASCULAR SYSTEM
1. A nurse is caring for a client who has heart failure and a prescription for
furosemide 40 mg IV. Which of the following findings should the nurse
monitor for as an adverse effect?
A) Hyperkalemia B) Hypokalemia ✅ (Correct Answer) C) Hypernatremia D)
Hypercalcemia
Rationale: Furosemide is a loop diuretic that causes loss of potassium through
urine. Hypokalemia is a major adverse effect. The nurse should monitor
potassium levels and assess for muscle weakness, cardiac dysrhythmias, and
leg cramps.
,2. A nurse is assessing a client who has left-sided heart failure. Which of the
following findings should the nurse expect?
A) Peripheral edema B) Jugular vein distension C) Crackles in the lungs ✅
(Correct Answer) D) Hepatomegaly
Rationale: Left-sided heart failure causes pulmonary congestion because the
left ventricle fails to pump blood forward, causing fluid to back up into the
lungs, resulting in crackles. Peripheral edema, JVD, and hepatomegaly are
signs of right-sided heart failure.
3. A nurse is caring for a client who has angina. The client reports chest pain
rated 6/10. Which of the following actions should the nurse take first?
A) Administer morphine sulfate IV B) Obtain a 12-lead ECG C) Administer
sublingual nitroglycerin ✅ (Correct Answer) D) Notify the provider
Rationale: Per the MONA protocol (Morphine, Oxygen, Nitroglycerin,
Aspirin), nitroglycerin is the first-line treatment for anginal chest pain. It
causes vasodilation, reducing cardiac workload and relieving ischemic pain.
4. A client is prescribed metoprolol for hypertension. The nurse should
instruct the client to avoid which of the following actions?
A) Taking the medication with food B) Stopping the medication abruptly ✅
(Correct Answer) C) Monitoring blood pressure at home D) Taking the
medication in the morning
,Rationale: Beta-blockers such as metoprolol must never be stopped abruptly
as this can precipitate rebound hypertension, angina, or myocardial
infarction. The medication should be tapered gradually under provider
supervision.
5. A nurse is caring for a client who has a myocardial infarction (MI). Which
of the following laboratory values is the most specific indicator of myocardial
damage?
A) WBC B) CK-MB C) Troponin I ✅ (Correct Answer) D) LDH
Rationale: Troponin I is the most cardiac-specific biomarker. It rises within
3–6 hours of MI, peaks at 14–24 hours, and remains elevated for up to 10–14
days. It is more specific than CK-MB or LDH.
6. A nurse is reviewing the medical record of a client who has atrial
fibrillation. Which medication should the nurse anticipate being prescribed to
prevent stroke?
A) Metoprolol B) Digoxin C) Warfarin ✅ (Correct Answer) D) Furosemide
Rationale: Atrial fibrillation promotes formation of thrombi in the atria due
to stagnant blood flow. Warfarin (an anticoagulant) is prescribed to reduce
the risk of thrombus formation and subsequent embolic stroke.
, 7. A client with hypertension is prescribed hydrochlorothiazide. Which
instruction should the nurse include in the teaching?
A) "Avoid foods high in potassium." B) "Increase your intake of potassium-rich
foods." ✅ (Correct Answer) C) "Take the medication at bedtime." D) "Limit
your fluid intake to 1 liter per day."
Rationale: Thiazide diuretics like hydrochlorothiazide cause potassium
wasting. The nurse should instruct the client to eat potassium-rich foods such
as bananas, oranges, and potatoes to prevent hypokalemia.
8. A nurse is assessing a client who has been admitted with hypertensive crisis.
Which of the following findings is the priority?
A) Nausea and vomiting B) Altered level of consciousness ✅ (Correct Answer)
C) Facial flushing D) Blood pressure of 180/110 mmHg
Rationale: Although elevated BP is expected in hypertensive crisis, altered
level of consciousness indicates possible hypertensive encephalopathy or
stroke, which is life-threatening and requires immediate intervention — it is
the priority finding.
9. A nurse is caring for a client post-cardiac catheterization via the right
femoral artery. Which of the following is the priority nursing action?
Prep MCQs questions with answers and
rationales
Systems covered include: Cardiovascular, Respiratory, Neurological,
Musculoskeletal, Gastrointestinal, Renal/Urinary, Endocrine, Hematologic,
Immune, Integumentary, Oncology, Perioperative, Fluid/Electrolytes, Acid-
Base, Pharmacology, Infection Control, Delegation, Critical Care, and more.
CARDIOVASCULAR SYSTEM
1. A nurse is caring for a client who has heart failure and a prescription for
furosemide 40 mg IV. Which of the following findings should the nurse
monitor for as an adverse effect?
A) Hyperkalemia B) Hypokalemia ✅ (Correct Answer) C) Hypernatremia D)
Hypercalcemia
Rationale: Furosemide is a loop diuretic that causes loss of potassium through
urine. Hypokalemia is a major adverse effect. The nurse should monitor
potassium levels and assess for muscle weakness, cardiac dysrhythmias, and
leg cramps.
,2. A nurse is assessing a client who has left-sided heart failure. Which of the
following findings should the nurse expect?
A) Peripheral edema B) Jugular vein distension C) Crackles in the lungs ✅
(Correct Answer) D) Hepatomegaly
Rationale: Left-sided heart failure causes pulmonary congestion because the
left ventricle fails to pump blood forward, causing fluid to back up into the
lungs, resulting in crackles. Peripheral edema, JVD, and hepatomegaly are
signs of right-sided heart failure.
3. A nurse is caring for a client who has angina. The client reports chest pain
rated 6/10. Which of the following actions should the nurse take first?
A) Administer morphine sulfate IV B) Obtain a 12-lead ECG C) Administer
sublingual nitroglycerin ✅ (Correct Answer) D) Notify the provider
Rationale: Per the MONA protocol (Morphine, Oxygen, Nitroglycerin,
Aspirin), nitroglycerin is the first-line treatment for anginal chest pain. It
causes vasodilation, reducing cardiac workload and relieving ischemic pain.
4. A client is prescribed metoprolol for hypertension. The nurse should
instruct the client to avoid which of the following actions?
A) Taking the medication with food B) Stopping the medication abruptly ✅
(Correct Answer) C) Monitoring blood pressure at home D) Taking the
medication in the morning
,Rationale: Beta-blockers such as metoprolol must never be stopped abruptly
as this can precipitate rebound hypertension, angina, or myocardial
infarction. The medication should be tapered gradually under provider
supervision.
5. A nurse is caring for a client who has a myocardial infarction (MI). Which
of the following laboratory values is the most specific indicator of myocardial
damage?
A) WBC B) CK-MB C) Troponin I ✅ (Correct Answer) D) LDH
Rationale: Troponin I is the most cardiac-specific biomarker. It rises within
3–6 hours of MI, peaks at 14–24 hours, and remains elevated for up to 10–14
days. It is more specific than CK-MB or LDH.
6. A nurse is reviewing the medical record of a client who has atrial
fibrillation. Which medication should the nurse anticipate being prescribed to
prevent stroke?
A) Metoprolol B) Digoxin C) Warfarin ✅ (Correct Answer) D) Furosemide
Rationale: Atrial fibrillation promotes formation of thrombi in the atria due
to stagnant blood flow. Warfarin (an anticoagulant) is prescribed to reduce
the risk of thrombus formation and subsequent embolic stroke.
, 7. A client with hypertension is prescribed hydrochlorothiazide. Which
instruction should the nurse include in the teaching?
A) "Avoid foods high in potassium." B) "Increase your intake of potassium-rich
foods." ✅ (Correct Answer) C) "Take the medication at bedtime." D) "Limit
your fluid intake to 1 liter per day."
Rationale: Thiazide diuretics like hydrochlorothiazide cause potassium
wasting. The nurse should instruct the client to eat potassium-rich foods such
as bananas, oranges, and potatoes to prevent hypokalemia.
8. A nurse is assessing a client who has been admitted with hypertensive crisis.
Which of the following findings is the priority?
A) Nausea and vomiting B) Altered level of consciousness ✅ (Correct Answer)
C) Facial flushing D) Blood pressure of 180/110 mmHg
Rationale: Although elevated BP is expected in hypertensive crisis, altered
level of consciousness indicates possible hypertensive encephalopathy or
stroke, which is life-threatening and requires immediate intervention — it is
the priority finding.
9. A nurse is caring for a client post-cardiac catheterization via the right
femoral artery. Which of the following is the priority nursing action?
