1|Page
ATI MED-SURG PROCTORED EXAM – 255
QUESTIONS WITH RATIONALES |
CARDIOVASCULAR, RESPIRATORY,
ENDOCRINE, NEURO, RENAL, GI | A+
GUARANTEED
# Table of Contents
| Section | Topic Area | Question Numbers |
|---------|------------|------------------|
| 1 | Cardiovascular System | 1–30 |
| 2 | Respiratory System | 31–55 |
| 3 | Gastrointestinal System | 56–75 |
| 4 | Renal & Urinary System | 76–90 |
| 5 | Endocrine System | 91–110 |
| 6 | Neurological System | 111–130 |
| 7 | Musculoskeletal System | 131–145 |
| 8 | Integumentary System | 146–155 |
| 9 | Hematological & Immune Systems | 156–170 |
| 10 | Infectious Diseases & Immunology | 171–185 |
| 11 | Oncology | 186–195 |
| 12 | Perioperative & Pain Management | 196–210 |
| 13 | Fluid & Electrolyte Balance | 211–225 |
| 14 | High-Yield Exam Review & NGN Cases | 226–255 |
,2|Page
# Section 1: Cardiovascular System (1–30)
**1.** A nurse is assessing a client who has heart failure. Which finding
is the EARLIEST indicator of fluid volume overload?
A) Peripheral edema
B) Jugular venous distention (JVD)
C) Crackles in the lung bases
D) Daily weight gain of 1 kg (2.2 lbs)
**Answer:** D
**Rationale:** Daily weight gain is the earliest indicator of fluid
retention, as 1 liter of fluid weighs approximately 1 kg (2.2 lbs). Weight
gain occurs before other signs such as edema, JVD, or crackles.
**2.** A nurse is caring for a client with hypertension who is prescribed
hydrochlorothiazide. Which of the following laboratory values should
the nurse monitor?
A) Serum sodium
B) Serum potassium
C) Serum calcium
,3|Page
D) Serum magnesium
**Answer:** B
**Rationale:** Hydrochlorothiazide is a thiazide diuretic that can cause
hypokalemia (low potassium) due to increased potassium excretion.
Other potential imbalances include hyponatremia and hypercalcemia,
but hypokalemia is the most common and clinically significant.
**3.** A nurse is caring for a client following a myocardial infarction
(MI). Which complication should the nurse prioritize monitoring for in
the first 24 hours?
A) Pericarditis
B) Ventricular dysrhythmias
C) Heart failure
D) Cardiogenic shock
**Answer:** B
**Rationale:** Ventricular dysrhythmias (e.g., ventricular tachycardia,
ventricular fibrillation) are the most common cause of death in the first
24 hours after an MI due to myocardial irritability. Continuous ECG
monitoring is essential.
, 4|Page
**4.** A client with heart failure has a prescription for furosemide 40
mg IV push. Before administering, which laboratory value is most
important to review?
A) Serum creatinine
B) Hemoglobin
C) Serum potassium
D) B-type natriuretic peptide (BNP)
**Answer:** C
**Rationale:** Furosemide is a loop diuretic that causes potassium
wasting. Hypokalemia can lead to dysrhythmias, especially in clients
taking digoxin. Potassium level should be checked before
administration.
**5.** A nurse is assessing a client with peripheral arterial disease
(PAD). Which finding is expected?
A) Pallor of the affected extremity with elevation
B) Brownish discoloration around the ankles
C) Thickened, leathery skin
D) Dependent rubor
**Answer:** A
ATI MED-SURG PROCTORED EXAM – 255
QUESTIONS WITH RATIONALES |
CARDIOVASCULAR, RESPIRATORY,
ENDOCRINE, NEURO, RENAL, GI | A+
GUARANTEED
# Table of Contents
| Section | Topic Area | Question Numbers |
|---------|------------|------------------|
| 1 | Cardiovascular System | 1–30 |
| 2 | Respiratory System | 31–55 |
| 3 | Gastrointestinal System | 56–75 |
| 4 | Renal & Urinary System | 76–90 |
| 5 | Endocrine System | 91–110 |
| 6 | Neurological System | 111–130 |
| 7 | Musculoskeletal System | 131–145 |
| 8 | Integumentary System | 146–155 |
| 9 | Hematological & Immune Systems | 156–170 |
| 10 | Infectious Diseases & Immunology | 171–185 |
| 11 | Oncology | 186–195 |
| 12 | Perioperative & Pain Management | 196–210 |
| 13 | Fluid & Electrolyte Balance | 211–225 |
| 14 | High-Yield Exam Review & NGN Cases | 226–255 |
,2|Page
# Section 1: Cardiovascular System (1–30)
**1.** A nurse is assessing a client who has heart failure. Which finding
is the EARLIEST indicator of fluid volume overload?
A) Peripheral edema
B) Jugular venous distention (JVD)
C) Crackles in the lung bases
D) Daily weight gain of 1 kg (2.2 lbs)
**Answer:** D
**Rationale:** Daily weight gain is the earliest indicator of fluid
retention, as 1 liter of fluid weighs approximately 1 kg (2.2 lbs). Weight
gain occurs before other signs such as edema, JVD, or crackles.
**2.** A nurse is caring for a client with hypertension who is prescribed
hydrochlorothiazide. Which of the following laboratory values should
the nurse monitor?
A) Serum sodium
B) Serum potassium
C) Serum calcium
,3|Page
D) Serum magnesium
**Answer:** B
**Rationale:** Hydrochlorothiazide is a thiazide diuretic that can cause
hypokalemia (low potassium) due to increased potassium excretion.
Other potential imbalances include hyponatremia and hypercalcemia,
but hypokalemia is the most common and clinically significant.
**3.** A nurse is caring for a client following a myocardial infarction
(MI). Which complication should the nurse prioritize monitoring for in
the first 24 hours?
A) Pericarditis
B) Ventricular dysrhythmias
C) Heart failure
D) Cardiogenic shock
**Answer:** B
**Rationale:** Ventricular dysrhythmias (e.g., ventricular tachycardia,
ventricular fibrillation) are the most common cause of death in the first
24 hours after an MI due to myocardial irritability. Continuous ECG
monitoring is essential.
, 4|Page
**4.** A client with heart failure has a prescription for furosemide 40
mg IV push. Before administering, which laboratory value is most
important to review?
A) Serum creatinine
B) Hemoglobin
C) Serum potassium
D) B-type natriuretic peptide (BNP)
**Answer:** C
**Rationale:** Furosemide is a loop diuretic that causes potassium
wasting. Hypokalemia can lead to dysrhythmias, especially in clients
taking digoxin. Potassium level should be checked before
administration.
**5.** A nurse is assessing a client with peripheral arterial disease
(PAD). Which finding is expected?
A) Pallor of the affected extremity with elevation
B) Brownish discoloration around the ankles
C) Thickened, leathery skin
D) Dependent rubor
**Answer:** A
