ATI Adult Medical-Surgical Nursing (Content Mastery Series) Exam | 2026/2027
ATI Adult Medical-Surgical Nursing (Content Mastery Series) Exam |
2026/2027
70 Questions and Correct Answers | Graded A+ | 100% Verified
This assessment contains 70 multiple-choice questions aligned with the NCSBN Clinical Judgment Measurement
Model (CJMM) and Elsevier ATI Content Mastery Series blueprints.
Time Limit: 2 hours | Format: Computer-based
Correct answers are indicated in bold cyan text.
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SECTION I: CARDIOVASCULAR DISORDERS
Questions 1–12 | ~17%
1. A nurse is caring for a client who was admitted with acute coronary syndrome (ACS) and reports
substernal chest pain rated 8/10. The client's troponin I level is elevated. Which of the following actions
should the nurse take first?
A. Administer sublingual nitroglycerin as prescribed
B. Obtain a 12-lead electrocardiogram (ECG)
C. Initiate continuous cardiac monitoring
D. Assess the client's oxygen saturation level
Correct Answer: A - Administer sublingual nitroglycerin as prescribed
Rationale: Using the ABC priority framework, the nurse should first address the client's pain and myocardial oxygen
demand by administering sublingual nitroglycerin to promote coronary vasodilation. While a 12-lead ECG, continuous
monitoring, and oxygen assessment are all essential, the immediate priority is relieving chest pain and reducing
cardiac workload (CJMM: Take Action; Nursing Process: Implementation). Current AHA/ACC guidelines for ACS
emphasize early nitroglycerin for ongoing ischemic chest pain.
2. A nurse is providing discharge teaching to a client who has heart failure with reduced ejection fraction
(HFrEF). Which of the following client statements indicates an understanding of the teaching?
A. "I will drink at least 3 liters of fluid every day."
B. "I will weigh myself every morning before eating breakfast."
C. "I will take my metoprolol only when I feel short of breath."
D. "I will increase my dietary sodium intake to 4 grams per day."
Correct Answer: B - I will weigh myself every morning before eating breakfast.
Rationale: Daily morning weight measurement before breakfast is the gold standard for monitoring fluid retention in
heart failure clients. A weight gain of 1-2 kg (2-4 lbs) in 24 hours or 2.3 kg (5 lbs) in a week warrants clinical
intervention. Fluid restriction (not liberal intake), consistent beta-blocker use (not PRN), and sodium restriction to less
than 2-3 g/day are also critical (CJMM: Evaluate Outcomes; ACC/AHA Heart Failure Guidelines).
1
, ATI Adult Medical-Surgical Nursing (Content Mastery Series) Exam | 2026/2027
3. A nurse is reviewing the laboratory results of a client who has hypertension and is taking lisinopril. Which
of the following findings should the nurse report to the provider immediately?
A. Potassium 5.8 mEq/L
B. Sodium 138 mEq/L
C. BUN 15 mg/dL
D. Creatinine 1.0 mg/dL
Correct Answer: A - Potassium 5.8 mEq/L
Rationale: Lisinopril, an ACE inhibitor, inhibits aldosterone secretion and can cause hyperkalemia. A potassium level
of 5.8 mEq/L exceeds the normal range of 3.5-5.0 mEq/L and places the client at risk for life-threatening cardiac
dysrhythmias. This requires immediate provider notification (CJMM: Recognize Cues; Critical Thinking: Safety
Priority). Sodium, BUN, and creatinine values listed are within normal limits.
4. A nurse is assessing a client who has atrial fibrillation with a ventricular rate of 150/min. Which of the
following findings should the nurse anticipate as a priority complication?
A. Pulmonary embolism
B. Acute stroke
C. Myocardial infarction
D. Deep vein thrombosis
Correct Answer: B - Acute stroke
Rationale: Atrial fibrillation causes stasis of blood in the atria due to ineffective atrial contraction, leading to thrombus
formation in the left atrial appendage. These thrombi can embolize to the cerebral circulation, causing ischemic stroke.
The rapid ventricular rate further increases cardiovascular risk. Stroke prevention with anticoagulation therapy (e.g.,
warfarin, DOACs) based on CHA2DS2-VASc score is the priority intervention (CJMM: Prioritize Hypotheses;
AHA/ACC/ESC AF Guidelines).
5. A nurse is caring for a client who is receiving heparin by continuous IV infusion for treatment of deep
vein thrombosis (DVT). The client's aPTT is 95 seconds. Which of the following actions should the nurse
take?
A. Increase the heparin infusion rate
B. Stop the heparin infusion immediately
C. Administer protamine sulfate
D. Continue the current infusion rate
Correct Answer: B - Stop the heparin infusion immediately
Rationale: The therapeutic aPTT range for heparin therapy is typically 1.5-2.5 times the control value (approximately
60-80 seconds). An aPTT of 95 seconds exceeds the therapeutic range, indicating the client is at increased risk for
serious bleeding. The nurse should stop the heparin infusion and notify the provider (CJMM: Take Action; ATI CMS:
Pharmacological and Parenteral Therapies). Protamine sulfate would be indicated only for active hemorrhage.
6. A nurse is providing health teaching to a client who has peripheral arterial disease (PAD). Which of the
following statements by the client indicates a need for further teaching?
A. "I will avoid crossing my legs when sitting."
B. "I will apply a heating pad to my feet to improve circulation."
C. "I will walk daily to promote collateral circulation."
2
, ATI Adult Medical-Surgical Nursing (Content Mastery Series) Exam | 2026/2027
D. "I will stop smoking cigarettes immediately."
Correct Answer: B - I will apply a heating pad to my feet to improve circulation.
Rationale: Clients with PAD have reduced sensation due to arterial insufficiency and are at high risk for thermal
injury. Applying a heating pad can cause severe burns without the client realizing it. The correct teaching is to keep feet
warm with socks and avoid direct heat application. Walking promotes collateral circulation, leg crossing restricts
blood flow, and smoking cessation is the single most important intervention (CJMM: Evaluate Outcomes; ATI CMS:
Health Promotion and Maintenance).
7. A nurse is caring for a client who has pulmonary embolism (PE) and is receiving anticoagulant therapy
with enoxaparin. Which of the following laboratory results requires the nurse to notify the provider?
A. Hemoglobin 12 g/dL
B. Platelet count 50,000/mm³
C. WBC 8,500/mm³
D. Serum creatinine 0.9 mg/dL
Correct Answer: B - Platelet count 50,000/mm³
Rationale: A platelet count of 50,000/mm³ is critically low and may indicate heparin-induced thrombocytopenia (HIT),
a potentially life-threatening complication of heparin and LMWH therapy. HIT paradoxically increases thrombotic risk.
The nurse must immediately stop the enoxaparin and notify the provider. Normal platelet count is 150,000-400,000/mm³
(CJMM: Recognize Cues; Critical Thinking: Safety Priority).
8. A nurse is performing an admission assessment on a client who has a history of hypertension. The client's
blood pressure is 188/110 mmHg. Which of the following findings should alert the nurse to a hypertensive
crisis?
A. Headache and blurred vision
B. Fatigue and muscle weakness
C. Tinnitus and intermittent claudication
D. Nausea and joint pain
Correct Answer: A - Headache and blurred vision
Rationale: Headache and visual changes (blurred vision) are hallmark signs of hypertensive encephalopathy, a
hypertensive emergency requiring immediate treatment to prevent permanent end-organ damage. A BP of 188/110
mmHg without end-organ symptoms is hypertensive urgency, but with neurological symptoms it becomes a hypertensive
emergency requiring IV antihypertensive therapy and continuous monitoring (CJMM: Analyze Cues; AHA
Hypertension Guidelines).
9. A nurse is caring for a client who has undergone cardiac catheterization via the femoral artery. Which of
the following nursing interventions is the priority in the immediate post-procedure period?
A. Assess the distal pulses in the affected extremity
B. Encourage the client to ambulate within 2 hours
C. Offer the client clear fluids to prevent dehydration
D. Instruct the client to take a warm shower
Correct Answer: A - Assess the distal pulses in the affected extremity
Rationale: The priority post-cardiac catheterization intervention is assessing distal pulses (dorsalis pedis and posterior
tibial), skin temperature, color, and sensation in the affected extremity. This monitors for arterial occlusion, hematoma,
3
ATI Adult Medical-Surgical Nursing (Content Mastery Series) Exam |
2026/2027
70 Questions and Correct Answers | Graded A+ | 100% Verified
This assessment contains 70 multiple-choice questions aligned with the NCSBN Clinical Judgment Measurement
Model (CJMM) and Elsevier ATI Content Mastery Series blueprints.
Time Limit: 2 hours | Format: Computer-based
Correct answers are indicated in bold cyan text.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━
SECTION I: CARDIOVASCULAR DISORDERS
Questions 1–12 | ~17%
1. A nurse is caring for a client who was admitted with acute coronary syndrome (ACS) and reports
substernal chest pain rated 8/10. The client's troponin I level is elevated. Which of the following actions
should the nurse take first?
A. Administer sublingual nitroglycerin as prescribed
B. Obtain a 12-lead electrocardiogram (ECG)
C. Initiate continuous cardiac monitoring
D. Assess the client's oxygen saturation level
Correct Answer: A - Administer sublingual nitroglycerin as prescribed
Rationale: Using the ABC priority framework, the nurse should first address the client's pain and myocardial oxygen
demand by administering sublingual nitroglycerin to promote coronary vasodilation. While a 12-lead ECG, continuous
monitoring, and oxygen assessment are all essential, the immediate priority is relieving chest pain and reducing
cardiac workload (CJMM: Take Action; Nursing Process: Implementation). Current AHA/ACC guidelines for ACS
emphasize early nitroglycerin for ongoing ischemic chest pain.
2. A nurse is providing discharge teaching to a client who has heart failure with reduced ejection fraction
(HFrEF). Which of the following client statements indicates an understanding of the teaching?
A. "I will drink at least 3 liters of fluid every day."
B. "I will weigh myself every morning before eating breakfast."
C. "I will take my metoprolol only when I feel short of breath."
D. "I will increase my dietary sodium intake to 4 grams per day."
Correct Answer: B - I will weigh myself every morning before eating breakfast.
Rationale: Daily morning weight measurement before breakfast is the gold standard for monitoring fluid retention in
heart failure clients. A weight gain of 1-2 kg (2-4 lbs) in 24 hours or 2.3 kg (5 lbs) in a week warrants clinical
intervention. Fluid restriction (not liberal intake), consistent beta-blocker use (not PRN), and sodium restriction to less
than 2-3 g/day are also critical (CJMM: Evaluate Outcomes; ACC/AHA Heart Failure Guidelines).
1
, ATI Adult Medical-Surgical Nursing (Content Mastery Series) Exam | 2026/2027
3. A nurse is reviewing the laboratory results of a client who has hypertension and is taking lisinopril. Which
of the following findings should the nurse report to the provider immediately?
A. Potassium 5.8 mEq/L
B. Sodium 138 mEq/L
C. BUN 15 mg/dL
D. Creatinine 1.0 mg/dL
Correct Answer: A - Potassium 5.8 mEq/L
Rationale: Lisinopril, an ACE inhibitor, inhibits aldosterone secretion and can cause hyperkalemia. A potassium level
of 5.8 mEq/L exceeds the normal range of 3.5-5.0 mEq/L and places the client at risk for life-threatening cardiac
dysrhythmias. This requires immediate provider notification (CJMM: Recognize Cues; Critical Thinking: Safety
Priority). Sodium, BUN, and creatinine values listed are within normal limits.
4. A nurse is assessing a client who has atrial fibrillation with a ventricular rate of 150/min. Which of the
following findings should the nurse anticipate as a priority complication?
A. Pulmonary embolism
B. Acute stroke
C. Myocardial infarction
D. Deep vein thrombosis
Correct Answer: B - Acute stroke
Rationale: Atrial fibrillation causes stasis of blood in the atria due to ineffective atrial contraction, leading to thrombus
formation in the left atrial appendage. These thrombi can embolize to the cerebral circulation, causing ischemic stroke.
The rapid ventricular rate further increases cardiovascular risk. Stroke prevention with anticoagulation therapy (e.g.,
warfarin, DOACs) based on CHA2DS2-VASc score is the priority intervention (CJMM: Prioritize Hypotheses;
AHA/ACC/ESC AF Guidelines).
5. A nurse is caring for a client who is receiving heparin by continuous IV infusion for treatment of deep
vein thrombosis (DVT). The client's aPTT is 95 seconds. Which of the following actions should the nurse
take?
A. Increase the heparin infusion rate
B. Stop the heparin infusion immediately
C. Administer protamine sulfate
D. Continue the current infusion rate
Correct Answer: B - Stop the heparin infusion immediately
Rationale: The therapeutic aPTT range for heparin therapy is typically 1.5-2.5 times the control value (approximately
60-80 seconds). An aPTT of 95 seconds exceeds the therapeutic range, indicating the client is at increased risk for
serious bleeding. The nurse should stop the heparin infusion and notify the provider (CJMM: Take Action; ATI CMS:
Pharmacological and Parenteral Therapies). Protamine sulfate would be indicated only for active hemorrhage.
6. A nurse is providing health teaching to a client who has peripheral arterial disease (PAD). Which of the
following statements by the client indicates a need for further teaching?
A. "I will avoid crossing my legs when sitting."
B. "I will apply a heating pad to my feet to improve circulation."
C. "I will walk daily to promote collateral circulation."
2
, ATI Adult Medical-Surgical Nursing (Content Mastery Series) Exam | 2026/2027
D. "I will stop smoking cigarettes immediately."
Correct Answer: B - I will apply a heating pad to my feet to improve circulation.
Rationale: Clients with PAD have reduced sensation due to arterial insufficiency and are at high risk for thermal
injury. Applying a heating pad can cause severe burns without the client realizing it. The correct teaching is to keep feet
warm with socks and avoid direct heat application. Walking promotes collateral circulation, leg crossing restricts
blood flow, and smoking cessation is the single most important intervention (CJMM: Evaluate Outcomes; ATI CMS:
Health Promotion and Maintenance).
7. A nurse is caring for a client who has pulmonary embolism (PE) and is receiving anticoagulant therapy
with enoxaparin. Which of the following laboratory results requires the nurse to notify the provider?
A. Hemoglobin 12 g/dL
B. Platelet count 50,000/mm³
C. WBC 8,500/mm³
D. Serum creatinine 0.9 mg/dL
Correct Answer: B - Platelet count 50,000/mm³
Rationale: A platelet count of 50,000/mm³ is critically low and may indicate heparin-induced thrombocytopenia (HIT),
a potentially life-threatening complication of heparin and LMWH therapy. HIT paradoxically increases thrombotic risk.
The nurse must immediately stop the enoxaparin and notify the provider. Normal platelet count is 150,000-400,000/mm³
(CJMM: Recognize Cues; Critical Thinking: Safety Priority).
8. A nurse is performing an admission assessment on a client who has a history of hypertension. The client's
blood pressure is 188/110 mmHg. Which of the following findings should alert the nurse to a hypertensive
crisis?
A. Headache and blurred vision
B. Fatigue and muscle weakness
C. Tinnitus and intermittent claudication
D. Nausea and joint pain
Correct Answer: A - Headache and blurred vision
Rationale: Headache and visual changes (blurred vision) are hallmark signs of hypertensive encephalopathy, a
hypertensive emergency requiring immediate treatment to prevent permanent end-organ damage. A BP of 188/110
mmHg without end-organ symptoms is hypertensive urgency, but with neurological symptoms it becomes a hypertensive
emergency requiring IV antihypertensive therapy and continuous monitoring (CJMM: Analyze Cues; AHA
Hypertension Guidelines).
9. A nurse is caring for a client who has undergone cardiac catheterization via the femoral artery. Which of
the following nursing interventions is the priority in the immediate post-procedure period?
A. Assess the distal pulses in the affected extremity
B. Encourage the client to ambulate within 2 hours
C. Offer the client clear fluids to prevent dehydration
D. Instruct the client to take a warm shower
Correct Answer: A - Assess the distal pulses in the affected extremity
Rationale: The priority post-cardiac catheterization intervention is assessing distal pulses (dorsalis pedis and posterior
tibial), skin temperature, color, and sensation in the affected extremity. This monitors for arterial occlusion, hematoma,
3
