ATI PN MED SURG PROCTORED EXAM
2026 , PN ATI MED SURG PROCTORED
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES/
EXAM WITH MULTIPLE MODALITIES
MIDTERM EXAM |AGRADE
CARDIOVASCULAR & HEMATOLOGY (Questions 1-15)
QUESTION 1
A nurse is caring for a client with heart failure who has gained 2 kg (4.4
lb) in 2 days. What is the priority action?
A) Restrict sodium intake
B) Notify the provider
C) Encourage ambulation
D) Increase fluid intake
Correct ,,,answer,,,: B) Notify the provider
,Rationale: Rapid weight gain of 2 kg (4.4 lb) in 2 days indicates
significant fluid retention and possible worsening heart failure requiring
immediate medical intervention. This is a priority because it may signal
pulmonary edema or acute decompensation requiring medication
adjustment.
QUESTION 2
A client is receiving heparin therapy. Which laboratory value should the
nurse report immediately?
A) Platelets 90,000/mm³
B) aPTT 60 seconds
C) Hemoglobin 13 g/dL
D) INR 1.2
Correct ,,,answer,,,: A) Platelets 90,000/mm³
Rationale: A platelet count of 90,000/mm³ is below normal (150,000-
400,000) and suggests heparin-induced thrombocytopenia (HIT), a
serious, potentially life-threatening complication of heparin therapy. The
nurse should notify the provider immediately and prepare to discontinue
heparin.
QUESTION 3
A client is on warfarin (Coumadin) therapy. Which laboratory value
indicates a therapeutic effect?
,A) Platelets
B) PT/INR
C) aPTT
D) Hemoglobin
Correct ,,,answer,,,: B) PT/INR
Rationale: Warfarin effectiveness is monitored by PT (prothrombin
time) and INR (international normalized ratio). Therapeutic INR for
most indications is 2.0-3.0. aPTT monitors heparin therapy, not
warfarin.
QUESTION 4
Which finding in a client receiving heparin indicates a therapeutic
response?
A) aPTT 1.5 to 2.5 times the normal control
B) INR 2.0 to 3.0
C) Platelets 250,000/mm³
D) Hemoglobin 12 g/dL
Correct ,,,answer,,,: A) aPTT 1.5 to 2.5 times the normal control
Rationale: Heparin therapy is monitored using the activated partial
thromboplastin time (aPTT). The therapeutic goal is typically 1.5 to 2.5
times the normal control value. INR is used to monitor warfarin
therapy.
, QUESTION 5
A nurse is assessing a client who has atrial fibrillation. When
documenting the quality of the client's pulse, which term should the
nurse use?
A) Bounding
B) Regular
C) Irregular
D) Thready
Correct ,,,answer,,,: C) Irregular
Rationale: Atrial fibrillation is characterized by an irregularly irregular
pulse rhythm due to chaotic electrical activity in the atria. The pulse has
no discernible pattern and varies in intensity.
QUESTION 6
A nurse is caring for a client following a cardiac catheterization using
the femoral approach. Which method should the nurse use to monitor for
complications?
A) Check blood pressure lying, sitting, and standing
B) Palpate brachial pulses and compare bilaterally
C) Assess the insertion site for hematoma formation
D) Monitor intake and output every 8 hours
Correct ,,,answer,,,: C) Assess the insertion site for hematoma
formation
2026 , PN ATI MED SURG PROCTORED
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES/
EXAM WITH MULTIPLE MODALITIES
MIDTERM EXAM |AGRADE
CARDIOVASCULAR & HEMATOLOGY (Questions 1-15)
QUESTION 1
A nurse is caring for a client with heart failure who has gained 2 kg (4.4
lb) in 2 days. What is the priority action?
A) Restrict sodium intake
B) Notify the provider
C) Encourage ambulation
D) Increase fluid intake
Correct ,,,answer,,,: B) Notify the provider
,Rationale: Rapid weight gain of 2 kg (4.4 lb) in 2 days indicates
significant fluid retention and possible worsening heart failure requiring
immediate medical intervention. This is a priority because it may signal
pulmonary edema or acute decompensation requiring medication
adjustment.
QUESTION 2
A client is receiving heparin therapy. Which laboratory value should the
nurse report immediately?
A) Platelets 90,000/mm³
B) aPTT 60 seconds
C) Hemoglobin 13 g/dL
D) INR 1.2
Correct ,,,answer,,,: A) Platelets 90,000/mm³
Rationale: A platelet count of 90,000/mm³ is below normal (150,000-
400,000) and suggests heparin-induced thrombocytopenia (HIT), a
serious, potentially life-threatening complication of heparin therapy. The
nurse should notify the provider immediately and prepare to discontinue
heparin.
QUESTION 3
A client is on warfarin (Coumadin) therapy. Which laboratory value
indicates a therapeutic effect?
,A) Platelets
B) PT/INR
C) aPTT
D) Hemoglobin
Correct ,,,answer,,,: B) PT/INR
Rationale: Warfarin effectiveness is monitored by PT (prothrombin
time) and INR (international normalized ratio). Therapeutic INR for
most indications is 2.0-3.0. aPTT monitors heparin therapy, not
warfarin.
QUESTION 4
Which finding in a client receiving heparin indicates a therapeutic
response?
A) aPTT 1.5 to 2.5 times the normal control
B) INR 2.0 to 3.0
C) Platelets 250,000/mm³
D) Hemoglobin 12 g/dL
Correct ,,,answer,,,: A) aPTT 1.5 to 2.5 times the normal control
Rationale: Heparin therapy is monitored using the activated partial
thromboplastin time (aPTT). The therapeutic goal is typically 1.5 to 2.5
times the normal control value. INR is used to monitor warfarin
therapy.
, QUESTION 5
A nurse is assessing a client who has atrial fibrillation. When
documenting the quality of the client's pulse, which term should the
nurse use?
A) Bounding
B) Regular
C) Irregular
D) Thready
Correct ,,,answer,,,: C) Irregular
Rationale: Atrial fibrillation is characterized by an irregularly irregular
pulse rhythm due to chaotic electrical activity in the atria. The pulse has
no discernible pattern and varies in intensity.
QUESTION 6
A nurse is caring for a client following a cardiac catheterization using
the femoral approach. Which method should the nurse use to monitor for
complications?
A) Check blood pressure lying, sitting, and standing
B) Palpate brachial pulses and compare bilaterally
C) Assess the insertion site for hematoma formation
D) Monitor intake and output every 8 hours
Correct ,,,answer,,,: C) Assess the insertion site for hematoma
formation
