ATI RN MED SURG PROCTORED EXAM – QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Fluid and Electrolyte Imbalances
Perioperative Nursing Care
Cardiovascular Disorders and Management
Respiratory Function and Gas Exchange
Endocrine and Metabolic Disorders
Gastrointestinal Systems and Nutrition
Neurological Assessment and Intervention
Renal and Urinary Function
Integumentary Systems and Burn Care
Musculoskeletal Health and Mobility
Introduction
The purpose of this comprehensive assessment is to evaluate the clinical competence and readiness of nursing
students specializing in medical-surgical care. This exam assesses a broad range of essential skills, including
pharmacological interventions, pathophysiology, and holistic patient management. Through a combination of
multiple-choice and complex scenario-based items, the assessment challenges the learner’s ability to prioritize
,care, interpret diagnostic findings, and implement evidence-based practice. The exam places heavy emphasis on
real-world application and critical decision-making, ensuring that the nurse can safely and effectively navigate the
acute care environment while maintaining professional and ethical standards of practice.
Section One: Questions 1–100
1. A nurse is assessing a client who is 24 hours postoperative following an abdominal cholecystectomy.
Which of the following findings is the priority for the nurse to report to the provider?
A. Redness at the incision site
B. Client report of 5/10 pain on a numerical scale
🟢 C. Productive cough with yellow-green sputum
D. Absent bowel sounds in all four quadrants
🔴 RATIONALE: Using the airway, breathing, circulation (ABC) priority-setting framework, a productive cough with
colored sputum may indicate the development of postoperative pneumonia, which requires immediate
intervention.
2. A nurse is caring for a client who has a prescription for a magnesium sulfate infusion for the treatment of
hypomagnesemia. Which of the following findings should the nurse identify as a manifestation of
magnesium toxicity?
A. Hyperreflexia
B. Tachycardia
🟢 C. Decreased deep tendon reflexes
D. Increased respiratory rate
🔴 RATIONALE: Magnesium toxicity causes central nervous system depression, leading to clinical manifestations
such as bradycardia, hypotension, and the loss or decrease of deep tendon reflexes.
, 3. A nurse is teaching a client who has a new diagnosis of Type 1 diabetes mellitus about self-administration
of insulin. Which of the following instructions should the nurse include?
🟢 A. Rotate injection sites within the same anatomical area.
B. Shake the vial of NPH insulin vigorously before drawing it up.
C. Aspirate for blood return before injecting the medication.
D. Massage the site for 1 minute following the injection.
🔴 RATIONALE: Rotating sites within one anatomical area, such as the abdomen, helps maintain consistent
absorption rates while preventing lipodystrophy.
4. A nurse is reviewing the laboratory results of a client who has acute kidney injury (AKI). Which of the
following findings should the nurse expect?
A. Hypokalemia
B. Decreased serum creatinine
🟢 C. Increased serum phosphate
D. Metabolic alkalosis
🔴 RATIONALE: In AKI, the kidneys are unable to excrete phosphorus, leading to hyperphosphatemia;
additionally, clients typically exhibit hyperkalemia and metabolic acidosis.
5. A nurse is monitoring a client who is receiving a unit of packed red blood cells. Which of the following
findings indicates a hemolytic transfusion reaction?
🟢 A. Low back pain and apprehension
B. Hypertension and bounding pulse
, C. Generalized pruritus and hives
D. Distended neck veins and dyspnea
🔴 RATIONALE: Low back pain, hemoglobinuria, and chills are classic signs of an acute hemolytic reaction
caused by incompatibility, leading to red blood cell destruction.
6. A nurse is caring for a client who is in the compensatory stage of shock. Which of the following findings
should the nurse expect?
A. Hypoglycemia
🟢 B. Narrowed pulse pressure
C. Decreased heart rate
D. Increased urinary output
🔴 RATIONALE: During the compensatory stage, the body attempts to maintain cardiac output through
vasoconstriction, which results in a narrowed pulse pressure and increased heart rate.
7. A nurse is assessing a client with a history of heart failure who is taking digoxin. Which of the following
findings is an early sign of digoxin toxicity?
A. Blurred yellow vision
B. Weight gain of 1 kg in 24 hours
🟢 C. Anorexia and nausea
D. Pedal edema
🔴 RATIONALE: Gastrointestinal upset, including anorexia, nausea, and vomiting, are often the earliest signs of
digoxin toxicity, whereas visual disturbances are a later manifestation.
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Fluid and Electrolyte Imbalances
Perioperative Nursing Care
Cardiovascular Disorders and Management
Respiratory Function and Gas Exchange
Endocrine and Metabolic Disorders
Gastrointestinal Systems and Nutrition
Neurological Assessment and Intervention
Renal and Urinary Function
Integumentary Systems and Burn Care
Musculoskeletal Health and Mobility
Introduction
The purpose of this comprehensive assessment is to evaluate the clinical competence and readiness of nursing
students specializing in medical-surgical care. This exam assesses a broad range of essential skills, including
pharmacological interventions, pathophysiology, and holistic patient management. Through a combination of
multiple-choice and complex scenario-based items, the assessment challenges the learner’s ability to prioritize
,care, interpret diagnostic findings, and implement evidence-based practice. The exam places heavy emphasis on
real-world application and critical decision-making, ensuring that the nurse can safely and effectively navigate the
acute care environment while maintaining professional and ethical standards of practice.
Section One: Questions 1–100
1. A nurse is assessing a client who is 24 hours postoperative following an abdominal cholecystectomy.
Which of the following findings is the priority for the nurse to report to the provider?
A. Redness at the incision site
B. Client report of 5/10 pain on a numerical scale
🟢 C. Productive cough with yellow-green sputum
D. Absent bowel sounds in all four quadrants
🔴 RATIONALE: Using the airway, breathing, circulation (ABC) priority-setting framework, a productive cough with
colored sputum may indicate the development of postoperative pneumonia, which requires immediate
intervention.
2. A nurse is caring for a client who has a prescription for a magnesium sulfate infusion for the treatment of
hypomagnesemia. Which of the following findings should the nurse identify as a manifestation of
magnesium toxicity?
A. Hyperreflexia
B. Tachycardia
🟢 C. Decreased deep tendon reflexes
D. Increased respiratory rate
🔴 RATIONALE: Magnesium toxicity causes central nervous system depression, leading to clinical manifestations
such as bradycardia, hypotension, and the loss or decrease of deep tendon reflexes.
, 3. A nurse is teaching a client who has a new diagnosis of Type 1 diabetes mellitus about self-administration
of insulin. Which of the following instructions should the nurse include?
🟢 A. Rotate injection sites within the same anatomical area.
B. Shake the vial of NPH insulin vigorously before drawing it up.
C. Aspirate for blood return before injecting the medication.
D. Massage the site for 1 minute following the injection.
🔴 RATIONALE: Rotating sites within one anatomical area, such as the abdomen, helps maintain consistent
absorption rates while preventing lipodystrophy.
4. A nurse is reviewing the laboratory results of a client who has acute kidney injury (AKI). Which of the
following findings should the nurse expect?
A. Hypokalemia
B. Decreased serum creatinine
🟢 C. Increased serum phosphate
D. Metabolic alkalosis
🔴 RATIONALE: In AKI, the kidneys are unable to excrete phosphorus, leading to hyperphosphatemia;
additionally, clients typically exhibit hyperkalemia and metabolic acidosis.
5. A nurse is monitoring a client who is receiving a unit of packed red blood cells. Which of the following
findings indicates a hemolytic transfusion reaction?
🟢 A. Low back pain and apprehension
B. Hypertension and bounding pulse
, C. Generalized pruritus and hives
D. Distended neck veins and dyspnea
🔴 RATIONALE: Low back pain, hemoglobinuria, and chills are classic signs of an acute hemolytic reaction
caused by incompatibility, leading to red blood cell destruction.
6. A nurse is caring for a client who is in the compensatory stage of shock. Which of the following findings
should the nurse expect?
A. Hypoglycemia
🟢 B. Narrowed pulse pressure
C. Decreased heart rate
D. Increased urinary output
🔴 RATIONALE: During the compensatory stage, the body attempts to maintain cardiac output through
vasoconstriction, which results in a narrowed pulse pressure and increased heart rate.
7. A nurse is assessing a client with a history of heart failure who is taking digoxin. Which of the following
findings is an early sign of digoxin toxicity?
A. Blurred yellow vision
B. Weight gain of 1 kg in 24 hours
🟢 C. Anorexia and nausea
D. Pedal edema
🔴 RATIONALE: Gastrointestinal upset, including anorexia, nausea, and vomiting, are often the earliest signs of
digoxin toxicity, whereas visual disturbances are a later manifestation.
