ASSESSMENT TECHNOLOGIES INSTITUTE
ATI PN MEDICAL-SURGICAL
PROCTORED EXAM
Official Practice Exam - 2026/2027 Edition
QUESTIONS MINUTES PASSING SCORE RECERTIFICATION
100 120 80% Annual
TABLE OF CONTENTS
Section: Cardiovascular and Hematologic Disorders (Q1-Q18)
Section: Respiratory Disorders (Q19-Q35)
Section: Gastrointestinal Disorders (Q36-Q52)
Section: Endocrine and Metabolic Disorders (Q53-Q69)
Section: Neurological and Sensory Disorders (Q70-Q85)
Section: Musculoskeletal and Integumentary Disorders (Q86-Q100)
EXAM INSTRUCTIONS
1. Read each question carefully. Each question contains a realistic clinical scenario followed by four answer choices.
2. Select the ONE best answer for each question. All four choices are plausible; choose the most correct.
3. There is no penalty for guessing. Answer every question even if you are uncertain.
4. Manage your time wisely: approximately 72 seconds per question to complete all 100 questions in 120 minutes.
5. A passing score of 80% (80 correct out of 100) is required.
6. The correct answer and a rationale are provided immediately after each question for study purposes.
7. Mark the correct answer letter on the answer grid on the final page for self-scoring.
This practice exam is independently created for educational study purposes.
It is not affiliated with, endorsed by, or connected to Assessment Technologies Institute (ATI).
ATI PN Med Surg Proctored - 2026/2027 | Passing Score: 80% | Page 1 of 54
, SECTION: Cardiovascular and Hematologic Disorders - 2026/2027
Q1. Question 1 of 100
Q1. A 68-year-old male is admitted with complaints of crushing substernal chest pain that radiates to
his left arm, occurring at rest for the past 30 minutes. His vital signs are BP 148/92, HR 102, RR 22,
and SpO2 93% on room air. The nurse should recognize these findings as most consistent with which
condition?
A. Acute myocardial infarction
B. Stable angina pectoris
C. Pericarditis
D. Gastroesophageal reflux disease
Correct Answer: A
Rationale:
Crushing substernal chest pain at rest radiating to the left arm is the hallmark of an acute myocardial
infarction. Stable angina occurs with exertion and resolves with rest, making it the incorrect choice for pain
at rest.
Q2. Question 2 of 100
Q2. A 72-year-old female with a history of heart failure presents with increasing dyspnea, orthopnea,
and bilateral crackles throughout her lung fields. She has gained 4 pounds over the past two days.
Which assessment finding would the nurse expect with left-sided heart failure?
A. Peripheral edema in the ankles
B. Bilateral crackles in the lungs
C. Jugular vein distension
D. Hepatomegaly
Correct Answer: B
Rationale:
Bilateral crackles indicate pulmonary congestion, the hallmark of left-sided heart failure. Peripheral edema,
jugular vein distension, and hepatomegaly are signs of right-sided heart failure resulting from systemic
venous congestion.
ATI PN Med Surg Proctored - 2026/2027 | Passing Score: 80% | Page 2 of 54
,Q3. Question 3 of 100
Q3. A 65-year-old male with a newly implanted permanent pacemaker is being prepared for
discharge. The nurse is providing education regarding pacemaker precautions. Which statement by
the patient indicates a need for further teaching?
A. I will carry my pacemaker identification card at all times.
B. I should avoid standing near large electrical generators.
C. I can resume playing contact sports in two weeks.
D. I will check my pulse daily and record it in a log.
Correct Answer: C
Rationale:
Contact sports pose a risk of direct trauma to the pacemaker site and should be avoided permanently, not
resumed in two weeks. Carrying identification, avoiding large generators, and daily pulse checks are all
appropriate pacemaker precautions.
Q4. Question 4 of 100
Q4. A 58-year-old female is receiving IV heparin for a deep vein thrombosis in her left leg. Her most
recent aPTT result is 95 seconds, which is significantly above the therapeutic range. Which action
should the nurse take first?
A. Notify the healthcare provider.
B. Administer protamine sulfate.
C. Obtain a repeat aPTT in one hour.
D. Stop the heparin infusion immediately.
Correct Answer: D
Rationale:
When the aPTT is critically elevated above the therapeutic range, the nurse must stop the heparin infusion
first to prevent further anticoagulation and bleeding risk. Notifying the provider and administering the
antidote are important but come after stopping the infusion.
ATI PN Med Surg Proctored - 2026/2027 | Passing Score: 80% | Page 3 of 54
, Q5. Question 5 of 100
Q5. A 74-year-old male with chronic atrial fibrillation is being discharged on warfarin therapy. The
nurse should instruct the patient to maintain a consistent intake of foods high in which vitamin?
A. Vitamin K
B. Vitamin C
C. Vitamin D
D. Vitamin B12
Correct Answer: A
Rationale:
Warfarin works by inhibiting vitamin K-dependent clotting factors, so maintaining a consistent daily intake of
vitamin K-rich foods is essential to avoid fluctuations in the INR. Sudden increases or decreases in vitamin
K intake can cause the INR to become unstable.
Q6. Question 6 of 100
Q6. A 60-year-old male is admitted with a diagnosis of acute decompensated heart failure and is
started on IV furosemide. Which electrolyte imbalance should the nurse monitor for most closely
during aggressive diuretic therapy?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypophosphatemia
Correct Answer: B
Rationale:
Furosemide is a loop diuretic that causes significant potassium loss in the urine, putting the patient at high
risk for hypokalemia. Hypokalemia can lead to dangerous cardiac dysrhythmias, especially in a patient
already compromised by heart failure.
ATI PN Med Surg Proctored - 2026/2027 | Passing Score: 80% | Page 4 of 54
ATI PN MEDICAL-SURGICAL
PROCTORED EXAM
Official Practice Exam - 2026/2027 Edition
QUESTIONS MINUTES PASSING SCORE RECERTIFICATION
100 120 80% Annual
TABLE OF CONTENTS
Section: Cardiovascular and Hematologic Disorders (Q1-Q18)
Section: Respiratory Disorders (Q19-Q35)
Section: Gastrointestinal Disorders (Q36-Q52)
Section: Endocrine and Metabolic Disorders (Q53-Q69)
Section: Neurological and Sensory Disorders (Q70-Q85)
Section: Musculoskeletal and Integumentary Disorders (Q86-Q100)
EXAM INSTRUCTIONS
1. Read each question carefully. Each question contains a realistic clinical scenario followed by four answer choices.
2. Select the ONE best answer for each question. All four choices are plausible; choose the most correct.
3. There is no penalty for guessing. Answer every question even if you are uncertain.
4. Manage your time wisely: approximately 72 seconds per question to complete all 100 questions in 120 minutes.
5. A passing score of 80% (80 correct out of 100) is required.
6. The correct answer and a rationale are provided immediately after each question for study purposes.
7. Mark the correct answer letter on the answer grid on the final page for self-scoring.
This practice exam is independently created for educational study purposes.
It is not affiliated with, endorsed by, or connected to Assessment Technologies Institute (ATI).
ATI PN Med Surg Proctored - 2026/2027 | Passing Score: 80% | Page 1 of 54
, SECTION: Cardiovascular and Hematologic Disorders - 2026/2027
Q1. Question 1 of 100
Q1. A 68-year-old male is admitted with complaints of crushing substernal chest pain that radiates to
his left arm, occurring at rest for the past 30 minutes. His vital signs are BP 148/92, HR 102, RR 22,
and SpO2 93% on room air. The nurse should recognize these findings as most consistent with which
condition?
A. Acute myocardial infarction
B. Stable angina pectoris
C. Pericarditis
D. Gastroesophageal reflux disease
Correct Answer: A
Rationale:
Crushing substernal chest pain at rest radiating to the left arm is the hallmark of an acute myocardial
infarction. Stable angina occurs with exertion and resolves with rest, making it the incorrect choice for pain
at rest.
Q2. Question 2 of 100
Q2. A 72-year-old female with a history of heart failure presents with increasing dyspnea, orthopnea,
and bilateral crackles throughout her lung fields. She has gained 4 pounds over the past two days.
Which assessment finding would the nurse expect with left-sided heart failure?
A. Peripheral edema in the ankles
B. Bilateral crackles in the lungs
C. Jugular vein distension
D. Hepatomegaly
Correct Answer: B
Rationale:
Bilateral crackles indicate pulmonary congestion, the hallmark of left-sided heart failure. Peripheral edema,
jugular vein distension, and hepatomegaly are signs of right-sided heart failure resulting from systemic
venous congestion.
ATI PN Med Surg Proctored - 2026/2027 | Passing Score: 80% | Page 2 of 54
,Q3. Question 3 of 100
Q3. A 65-year-old male with a newly implanted permanent pacemaker is being prepared for
discharge. The nurse is providing education regarding pacemaker precautions. Which statement by
the patient indicates a need for further teaching?
A. I will carry my pacemaker identification card at all times.
B. I should avoid standing near large electrical generators.
C. I can resume playing contact sports in two weeks.
D. I will check my pulse daily and record it in a log.
Correct Answer: C
Rationale:
Contact sports pose a risk of direct trauma to the pacemaker site and should be avoided permanently, not
resumed in two weeks. Carrying identification, avoiding large generators, and daily pulse checks are all
appropriate pacemaker precautions.
Q4. Question 4 of 100
Q4. A 58-year-old female is receiving IV heparin for a deep vein thrombosis in her left leg. Her most
recent aPTT result is 95 seconds, which is significantly above the therapeutic range. Which action
should the nurse take first?
A. Notify the healthcare provider.
B. Administer protamine sulfate.
C. Obtain a repeat aPTT in one hour.
D. Stop the heparin infusion immediately.
Correct Answer: D
Rationale:
When the aPTT is critically elevated above the therapeutic range, the nurse must stop the heparin infusion
first to prevent further anticoagulation and bleeding risk. Notifying the provider and administering the
antidote are important but come after stopping the infusion.
ATI PN Med Surg Proctored - 2026/2027 | Passing Score: 80% | Page 3 of 54
, Q5. Question 5 of 100
Q5. A 74-year-old male with chronic atrial fibrillation is being discharged on warfarin therapy. The
nurse should instruct the patient to maintain a consistent intake of foods high in which vitamin?
A. Vitamin K
B. Vitamin C
C. Vitamin D
D. Vitamin B12
Correct Answer: A
Rationale:
Warfarin works by inhibiting vitamin K-dependent clotting factors, so maintaining a consistent daily intake of
vitamin K-rich foods is essential to avoid fluctuations in the INR. Sudden increases or decreases in vitamin
K intake can cause the INR to become unstable.
Q6. Question 6 of 100
Q6. A 60-year-old male is admitted with a diagnosis of acute decompensated heart failure and is
started on IV furosemide. Which electrolyte imbalance should the nurse monitor for most closely
during aggressive diuretic therapy?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypophosphatemia
Correct Answer: B
Rationale:
Furosemide is a loop diuretic that causes significant potassium loss in the urine, putting the patient at high
risk for hypokalemia. Hypokalemia can lead to dangerous cardiac dysrhythmias, especially in a patient
already compromised by heart failure.
ATI PN Med Surg Proctored - 2026/2027 | Passing Score: 80% | Page 4 of 54
