ATI Medical Surgical CMS Proctored Exam
2026 | Verified Questions & Accurate
Answers | Complete Med Surg CMS Study
Guide
• This study guide contains 200 verified ATI Medical Surgical CMS Proctored Exam
questions with accurate answers, correct answer highlights, and EXPERT
RATIONALE to reinforce your understanding.
• Use this material by reading each question carefully, selecting your answer before
checking the highlighted correct option, then studying the EXPERT RATIONALE to
solidify the concept.
QUESTION 1 A nurse is caring for a client who has heart failure and a
prescription for digoxin. Before administering the medication, the nurse
should assess which of the following?
A. Blood glucose level
B. Respiratory rate
C. Apical pulse
D. Blood pressure
E. Temperature
CORRECT ANSWER: C. Apical pulse
EXPERT RATIONALE: Digoxin slows the heart rate. The nurse must assess the apical
pulse for a full minute before administration. If the pulse is below 60 bpm in adults, the
medication should be withheld and the provider notified.
QUESTION 2 A nurse is assessing a client who has chronic obstructive
pulmonary disease (COPD). Which of the following findings should the nurse
expect?
A. Decreased anteroposterior chest diameter
B. Barrel chest appearance
,C. Productive cough with pink frothy sputum
D. Bradycardia
E. Decreased respiratory rate
CORRECT ANSWER: B. Barrel chest appearance
EXPERT RATIONALE: Chronic air trapping in COPD causes hyperinflation of the lungs,
resulting in a barrel chest where the anteroposterior diameter increases. This is a classic
hallmark of advanced COPD.
QUESTION 3 A nurse is caring for a client following a thyroidectomy. Which of
the following findings is the priority?
A. Mild hoarseness
B. Complaints of throat discomfort
C. Tingling around the mouth and fingertips
D. Slight neck swelling
E. Nausea and vomiting
CORRECT ANSWER: C. Tingling around the mouth and fingertips
EXPERT RATIONALE: Tingling around the mouth and fingertips indicates hypocalcemia
caused by inadvertent removal or damage to the parathyroid glands during
thyroidectomy. This can lead to tetany and laryngospasm, making it a priority finding.
QUESTION 4 A nurse is planning care for a client who has a deep vein
thrombosis (DVT). Which of the following interventions should the nurse
include?
A. Massage the affected extremity every 4 hours
B. Apply cold compresses to the affected area
C. Administer anticoagulant therapy as prescribed
,D. Encourage prolonged bed rest without ambulation
E. Elevate the head of bed to 90 degrees
CORRECT ANSWER: C. Administer anticoagulant therapy as prescribed
EXPERT RATIONALE: Anticoagulant therapy prevents further clot formation and
extension of the DVT. Massaging the affected extremity is contraindicated as it may
dislodge the clot, leading to pulmonary embolism.
QUESTION 5 A nurse is caring for a client who has been diagnosed with
pneumonia. Which of the following assessment findings requires immediate
intervention?
A. Oxygen saturation of 94%
B. Temperature of 38.2°C (100.8°F)
C. Oxygen saturation of 88%
D. Productive cough with yellow sputum
E. Respiratory rate of 20 breaths per minute
CORRECT ANSWER: C. Oxygen saturation of 88%
EXPERT RATIONALE: An oxygen saturation of 88% is critically low and indicates
hypoxemia requiring immediate intervention, including supplemental oxygen
administration and provider notification.
QUESTION 6 A nurse is reviewing laboratory results for a client receiving
warfarin therapy. Which value indicates the medication is at a therapeutic
level?
A. INR of 0.8
B. INR of 1.0
C. INR of 2.5
D. INR of 5.0
, E. INR of 6.2
CORRECT ANSWER: C. INR of 2.5
EXPERT RATIONALE: The therapeutic INR range for clients on warfarin therapy for DVT
or atrial fibrillation is 2.0 to 3.0. An INR of 2.5 falls within this range, indicating
therapeutic anticoagulation.
QUESTION 7 A nurse is caring for a client who has acute pancreatitis. Which
dietary instruction should the nurse provide during the recovery phase?
A. High-fat, high-protein diet
B. Low-carbohydrate, high-fat diet
C. Small frequent low-fat meals
D. High-calorie diet with three large meals
E. Unrestricted diet as tolerated
CORRECT ANSWER: C. Small frequent low-fat meals
EXPERT RATIONALE: During recovery from acute pancreatitis, the client should consume
small, frequent meals that are low in fat to reduce pancreatic stimulation and prevent
recurrence of symptoms.
QUESTION 8 A nurse is assessing a client who has had a myocardial infarction
(MI). Which of the following findings is most commonly associated with an MI?
A. Sharp pleuritic chest pain relieved by leaning forward
B. Crushing substernal chest pain radiating to the left arm
C. Burning epigastric pain relieved by antacids
D. Intermittent chest pain relieved by rest
E. Chest pain worsened by deep breathing
2026 | Verified Questions & Accurate
Answers | Complete Med Surg CMS Study
Guide
• This study guide contains 200 verified ATI Medical Surgical CMS Proctored Exam
questions with accurate answers, correct answer highlights, and EXPERT
RATIONALE to reinforce your understanding.
• Use this material by reading each question carefully, selecting your answer before
checking the highlighted correct option, then studying the EXPERT RATIONALE to
solidify the concept.
QUESTION 1 A nurse is caring for a client who has heart failure and a
prescription for digoxin. Before administering the medication, the nurse
should assess which of the following?
A. Blood glucose level
B. Respiratory rate
C. Apical pulse
D. Blood pressure
E. Temperature
CORRECT ANSWER: C. Apical pulse
EXPERT RATIONALE: Digoxin slows the heart rate. The nurse must assess the apical
pulse for a full minute before administration. If the pulse is below 60 bpm in adults, the
medication should be withheld and the provider notified.
QUESTION 2 A nurse is assessing a client who has chronic obstructive
pulmonary disease (COPD). Which of the following findings should the nurse
expect?
A. Decreased anteroposterior chest diameter
B. Barrel chest appearance
,C. Productive cough with pink frothy sputum
D. Bradycardia
E. Decreased respiratory rate
CORRECT ANSWER: B. Barrel chest appearance
EXPERT RATIONALE: Chronic air trapping in COPD causes hyperinflation of the lungs,
resulting in a barrel chest where the anteroposterior diameter increases. This is a classic
hallmark of advanced COPD.
QUESTION 3 A nurse is caring for a client following a thyroidectomy. Which of
the following findings is the priority?
A. Mild hoarseness
B. Complaints of throat discomfort
C. Tingling around the mouth and fingertips
D. Slight neck swelling
E. Nausea and vomiting
CORRECT ANSWER: C. Tingling around the mouth and fingertips
EXPERT RATIONALE: Tingling around the mouth and fingertips indicates hypocalcemia
caused by inadvertent removal or damage to the parathyroid glands during
thyroidectomy. This can lead to tetany and laryngospasm, making it a priority finding.
QUESTION 4 A nurse is planning care for a client who has a deep vein
thrombosis (DVT). Which of the following interventions should the nurse
include?
A. Massage the affected extremity every 4 hours
B. Apply cold compresses to the affected area
C. Administer anticoagulant therapy as prescribed
,D. Encourage prolonged bed rest without ambulation
E. Elevate the head of bed to 90 degrees
CORRECT ANSWER: C. Administer anticoagulant therapy as prescribed
EXPERT RATIONALE: Anticoagulant therapy prevents further clot formation and
extension of the DVT. Massaging the affected extremity is contraindicated as it may
dislodge the clot, leading to pulmonary embolism.
QUESTION 5 A nurse is caring for a client who has been diagnosed with
pneumonia. Which of the following assessment findings requires immediate
intervention?
A. Oxygen saturation of 94%
B. Temperature of 38.2°C (100.8°F)
C. Oxygen saturation of 88%
D. Productive cough with yellow sputum
E. Respiratory rate of 20 breaths per minute
CORRECT ANSWER: C. Oxygen saturation of 88%
EXPERT RATIONALE: An oxygen saturation of 88% is critically low and indicates
hypoxemia requiring immediate intervention, including supplemental oxygen
administration and provider notification.
QUESTION 6 A nurse is reviewing laboratory results for a client receiving
warfarin therapy. Which value indicates the medication is at a therapeutic
level?
A. INR of 0.8
B. INR of 1.0
C. INR of 2.5
D. INR of 5.0
, E. INR of 6.2
CORRECT ANSWER: C. INR of 2.5
EXPERT RATIONALE: The therapeutic INR range for clients on warfarin therapy for DVT
or atrial fibrillation is 2.0 to 3.0. An INR of 2.5 falls within this range, indicating
therapeutic anticoagulation.
QUESTION 7 A nurse is caring for a client who has acute pancreatitis. Which
dietary instruction should the nurse provide during the recovery phase?
A. High-fat, high-protein diet
B. Low-carbohydrate, high-fat diet
C. Small frequent low-fat meals
D. High-calorie diet with three large meals
E. Unrestricted diet as tolerated
CORRECT ANSWER: C. Small frequent low-fat meals
EXPERT RATIONALE: During recovery from acute pancreatitis, the client should consume
small, frequent meals that are low in fat to reduce pancreatic stimulation and prevent
recurrence of symptoms.
QUESTION 8 A nurse is assessing a client who has had a myocardial infarction
(MI). Which of the following findings is most commonly associated with an MI?
A. Sharp pleuritic chest pain relieved by leaning forward
B. Crushing substernal chest pain radiating to the left arm
C. Burning epigastric pain relieved by antacids
D. Intermittent chest pain relieved by rest
E. Chest pain worsened by deep breathing
