ATI PN ADULT MEDICAL SURGICAL (MED-SURG) PROCTORED
EXAM WITH NGN - (90 QUESTIONS) UP-TO-DATE ACTUAL EXAM
QUESTIONS AND 100% ACCURATE SOLUTIONS | VERIFIED
ANSWERS - INSTANT PDF DOWNLOAD
Examiner/Administrator: Assessment Technologies Institute (ATI)
CANDIDATE INFORMATION
Candidate Name: _______________________________________
Candidate ID Number: __________________________________
Testing Date: _________________________________________
Testing Center / Institution: ____________________________
Program Cohort: _______________________________________
Instructor/Proctor: ____________________________________
Signature: ____________________________________________
ATI PRACTICAL NURSING MEDICAL-SURG ASSESSMENT
BOOKLET
Time Allocation: 2 Hours 30 Minutes
Total Questions: Approximately 90 Questions
Question Types Included: Multiple Choice, Clinical Judgment, Prioritization,
Delegation, NGN-Style Scenario Analysis
Candidate Instructions
This assessment evaluates the candidate’s ability to apply practical nursing
knowledge and clinical judgment in adult medical-surgical nursing situations
commonly encountered in acute care, rehabilitation, perioperative, and long-
term care settings. Candidates are expected to demonstrate safe nursing
decision-making, prioritization, pharmacologic understanding, interpretation
of clinical findings, and appropriate interventions for clients experiencing
,alterations in cardiovascular, respiratory, neurological, endocrine, renal,
gastrointestinal, musculoskeletal, immune, and multisystem functioning.
Read each question carefully before selecting the best response. Some
questions require identification of priority interventions, recognition of life-
threatening complications, or interpretation of laboratory and diagnostic
findings. Use evidence-based nursing principles and patient safety standards
throughout the examination. The approximate examination length is 90
questions, and candidates should manage time efficiently to complete all items
within the allotted testing period.
Core Clinical Competency Areas
• Cardiovascular Disorders
• Respiratory System Management
• Neurological and Cognitive Disorders
• Endocrine and Metabolic Disorders
• Gastrointestinal and Hepatic Conditions
• Renal and Urinary Disorders
• Musculoskeletal and Mobility Care
• Oncology and Immune Disorders
• Fluid, Electrolyte, and Acid–Base Balance
• Infection Prevention and Control
• Pharmacological Therapies
• Perioperative and Emergency Nursing
• Clinical Judgment and NGN Case Analysis
• Delegation and Prioritization
This examination simulation is an original educational resource developed to
reflect the structure, tone, and competency focus commonly associated with
standardized PN medical-surgical nursing assessments. It is not an official
ATI examination product and does not contain reproduced secure
examination content.
Q1. A nurse is caring for a client admitted with acute exacerbation of chronic
obstructive pulmonary disease (COPD). The client suddenly becomes restless,
confused, and tachycardic while receiving oxygen at 2 L/min via nasal cannula.
Which action should the nurse take first?
,A. Increase oxygen flow to 6 L/min
B. Obtain an arterial blood gas sample
C. Assess the client’s oxygen saturation level
D. Place the client in a supine position
Correct Answer: C. Assess the client’s oxygen saturation level
Explanation: The nurse should first assess oxygen saturation to rapidly
determine the severity of hypoxemia and guide further interventions. COPD
clients are at risk for impaired gas exchange and CO₂ retention. Assessment
precedes intervention. Option A may worsen hypercapnia if oxygen is increased
excessively without assessment. Option B is appropriate but not the immediate
first action. Option D would worsen ventilation because COPD clients should
remain upright to maximize lung expansion.
Q2. A client with heart failure reports increasing dyspnea and weight gain of 2.3
kg (5 lb) over 3 days. Which finding requires immediate intervention?
A. Bilateral ankle edema
B. Crackles in both lung bases
C. Blood pressure of 138/84 mm Hg
D. Heart rate of 88/min
Correct Answer: B. Crackles in both lung bases
Explanation: Crackles indicate pulmonary fluid accumulation and
worsening left-sided heart failure, which can rapidly progress to pulmonary
edema. Immediate intervention is required to improve oxygenation and reduce
fluid overload. Option A is expected with fluid retention but is less emergent.
Option C is within acceptable range. Option D is mildly elevated but not
critical.
Q3. A nurse is reinforcing teaching with a client newly prescribed warfarin.
Which statement by the client indicates understanding?
A. “I should avoid foods high in potassium.”
B. “I will take aspirin if I develop a headache.”
C. “I should notify my provider about black stools.”
D. “I can stop the medication once I feel better.”
, Correct Answer: C. “I should notify my provider about black stools.”
Explanation: Black, tarry stools may indicate gastrointestinal bleeding, a
serious adverse effect of warfarin therapy. Clients must report bleeding
immediately. Option A is unrelated because warfarin affects vitamin K, not
potassium. Option B is incorrect because aspirin increases bleeding risk.
Option D is unsafe because anticoagulants should never be discontinued
without provider guidance.
Q4. A client with type 1 diabetes mellitus becomes diaphoretic and confused.
The client’s blood glucose level is 48 mg/dL. Which intervention should the
nurse implement first?
A. Administer regular insulin
B. Provide 15 g of rapid-acting carbohydrate
C. Encourage physical activity
D. Restrict oral intake
Correct Answer: B. Provide 15 g of rapid-acting carbohydrate
Explanation: The client is experiencing hypoglycemia. Immediate
administration of fast-acting carbohydrates is the priority to restore blood
glucose levels and prevent seizures or loss of consciousness. Option A would
worsen hypoglycemia. Option C could further decrease glucose levels. Option
D delays necessary treatment.
Q5. A nurse is caring for a client following a thyroidectomy. Which finding
should the nurse report immediately?
A. Hoarse voice
B. Temperature of 37.4°C (99.3°F)
C. Mild incisional pain
D. Heart rate of 78/min
Correct Answer: A. Hoarse voice
Explanation: Hoarseness after thyroidectomy may indicate laryngeal nerve
damage or airway edema, both of which can compromise the airway. Prompt
EXAM WITH NGN - (90 QUESTIONS) UP-TO-DATE ACTUAL EXAM
QUESTIONS AND 100% ACCURATE SOLUTIONS | VERIFIED
ANSWERS - INSTANT PDF DOWNLOAD
Examiner/Administrator: Assessment Technologies Institute (ATI)
CANDIDATE INFORMATION
Candidate Name: _______________________________________
Candidate ID Number: __________________________________
Testing Date: _________________________________________
Testing Center / Institution: ____________________________
Program Cohort: _______________________________________
Instructor/Proctor: ____________________________________
Signature: ____________________________________________
ATI PRACTICAL NURSING MEDICAL-SURG ASSESSMENT
BOOKLET
Time Allocation: 2 Hours 30 Minutes
Total Questions: Approximately 90 Questions
Question Types Included: Multiple Choice, Clinical Judgment, Prioritization,
Delegation, NGN-Style Scenario Analysis
Candidate Instructions
This assessment evaluates the candidate’s ability to apply practical nursing
knowledge and clinical judgment in adult medical-surgical nursing situations
commonly encountered in acute care, rehabilitation, perioperative, and long-
term care settings. Candidates are expected to demonstrate safe nursing
decision-making, prioritization, pharmacologic understanding, interpretation
of clinical findings, and appropriate interventions for clients experiencing
,alterations in cardiovascular, respiratory, neurological, endocrine, renal,
gastrointestinal, musculoskeletal, immune, and multisystem functioning.
Read each question carefully before selecting the best response. Some
questions require identification of priority interventions, recognition of life-
threatening complications, or interpretation of laboratory and diagnostic
findings. Use evidence-based nursing principles and patient safety standards
throughout the examination. The approximate examination length is 90
questions, and candidates should manage time efficiently to complete all items
within the allotted testing period.
Core Clinical Competency Areas
• Cardiovascular Disorders
• Respiratory System Management
• Neurological and Cognitive Disorders
• Endocrine and Metabolic Disorders
• Gastrointestinal and Hepatic Conditions
• Renal and Urinary Disorders
• Musculoskeletal and Mobility Care
• Oncology and Immune Disorders
• Fluid, Electrolyte, and Acid–Base Balance
• Infection Prevention and Control
• Pharmacological Therapies
• Perioperative and Emergency Nursing
• Clinical Judgment and NGN Case Analysis
• Delegation and Prioritization
This examination simulation is an original educational resource developed to
reflect the structure, tone, and competency focus commonly associated with
standardized PN medical-surgical nursing assessments. It is not an official
ATI examination product and does not contain reproduced secure
examination content.
Q1. A nurse is caring for a client admitted with acute exacerbation of chronic
obstructive pulmonary disease (COPD). The client suddenly becomes restless,
confused, and tachycardic while receiving oxygen at 2 L/min via nasal cannula.
Which action should the nurse take first?
,A. Increase oxygen flow to 6 L/min
B. Obtain an arterial blood gas sample
C. Assess the client’s oxygen saturation level
D. Place the client in a supine position
Correct Answer: C. Assess the client’s oxygen saturation level
Explanation: The nurse should first assess oxygen saturation to rapidly
determine the severity of hypoxemia and guide further interventions. COPD
clients are at risk for impaired gas exchange and CO₂ retention. Assessment
precedes intervention. Option A may worsen hypercapnia if oxygen is increased
excessively without assessment. Option B is appropriate but not the immediate
first action. Option D would worsen ventilation because COPD clients should
remain upright to maximize lung expansion.
Q2. A client with heart failure reports increasing dyspnea and weight gain of 2.3
kg (5 lb) over 3 days. Which finding requires immediate intervention?
A. Bilateral ankle edema
B. Crackles in both lung bases
C. Blood pressure of 138/84 mm Hg
D. Heart rate of 88/min
Correct Answer: B. Crackles in both lung bases
Explanation: Crackles indicate pulmonary fluid accumulation and
worsening left-sided heart failure, which can rapidly progress to pulmonary
edema. Immediate intervention is required to improve oxygenation and reduce
fluid overload. Option A is expected with fluid retention but is less emergent.
Option C is within acceptable range. Option D is mildly elevated but not
critical.
Q3. A nurse is reinforcing teaching with a client newly prescribed warfarin.
Which statement by the client indicates understanding?
A. “I should avoid foods high in potassium.”
B. “I will take aspirin if I develop a headache.”
C. “I should notify my provider about black stools.”
D. “I can stop the medication once I feel better.”
, Correct Answer: C. “I should notify my provider about black stools.”
Explanation: Black, tarry stools may indicate gastrointestinal bleeding, a
serious adverse effect of warfarin therapy. Clients must report bleeding
immediately. Option A is unrelated because warfarin affects vitamin K, not
potassium. Option B is incorrect because aspirin increases bleeding risk.
Option D is unsafe because anticoagulants should never be discontinued
without provider guidance.
Q4. A client with type 1 diabetes mellitus becomes diaphoretic and confused.
The client’s blood glucose level is 48 mg/dL. Which intervention should the
nurse implement first?
A. Administer regular insulin
B. Provide 15 g of rapid-acting carbohydrate
C. Encourage physical activity
D. Restrict oral intake
Correct Answer: B. Provide 15 g of rapid-acting carbohydrate
Explanation: The client is experiencing hypoglycemia. Immediate
administration of fast-acting carbohydrates is the priority to restore blood
glucose levels and prevent seizures or loss of consciousness. Option A would
worsen hypoglycemia. Option C could further decrease glucose levels. Option
D delays necessary treatment.
Q5. A nurse is caring for a client following a thyroidectomy. Which finding
should the nurse report immediately?
A. Hoarse voice
B. Temperature of 37.4°C (99.3°F)
C. Mild incisional pain
D. Heart rate of 78/min
Correct Answer: A. Hoarse voice
Explanation: Hoarseness after thyroidectomy may indicate laryngeal nerve
damage or airway edema, both of which can compromise the airway. Prompt
