VERIFIED ATI RN ADULT MEDICAL SURGICAL
PROCTORED EXAM 2026 WITH NGN | 100 REAL
EXAM QUESTIONS & ANSWERS | COMPLETE
ACTUAL + RETAKE TEST | ATI RN MED-SURG
LEVEL 3 PASS GUIDE
• This is a comprehensive 100-question ATI RN Adult Medical-Surgical Proctored
Exam 2026 prep guide with NGN-style questions covering Level 3 critical thinking —
study by attempting each question first before checking the correct answer and
EXPERT RATIONALE.
• Features real exam-style questions with five options (A–E), highlighted correct
answers, and detailed EXPERT RATIONALE
to reinforce clinical reasoning across all major med-surg systems.
VERIFIED ATI RN ADULT MEDICAL SURGICAL PROCTORED EXAM 2026 WITH NGN
100 REAL EXAM QUESTIONS & ANSWERS | COMPLETE ACTUAL + RETAKE TEST |
ATI RN MED-SURG LEVEL 3 PASS GUIDE
QUESTION 1: A nurse is caring for a client who has chronic kidney disease and
a potassium level of 6.2 mEq/L. Which of the following findings should the
nurse report to the provider immediately?
A. Urine output of 40 mL/hr
B. Blood pressure of 148/90 mmHg
C. Serum sodium of 138 mEq/L
D. Peaked T waves on ECG
E. Mild lower extremity edema
Correct Answer: D. Peaked T waves on ECG
EXPERT RATIONALE: Hyperkalemia causes cardiac conduction changes. Peaked
T waves are an early and critical ECG finding indicating the heart is at risk for life-
,threatening dysrhythmias such as ventricular fibrillation. This requires immediate
provider notification.
QUESTION 2: A nurse is assessing a client who has been diagnosed with deep
vein thrombosis (DVT). Which of the following clinical findings should the
nurse expect?
A. Pallor and coolness of the affected extremity
B. Bilateral leg swelling with pitting edema
C. Unilateral calf pain, warmth, and redness
D. Absent peripheral pulses in the affected leg
E. Intermittent claudication relieved by rest
Correct Answer: C. Unilateral calf pain, warmth, and redness
EXPERT RATIONALE: DVT presents with unilateral findings including calf pain,
erythema, and warmth due to venous inflammation and clot formation. Bilateral
edema and absent pulses suggest other conditions such as heart failure or arterial
occlusion.
QUESTION 3: A nurse is caring for a client postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take to prevent
dislocation?
A. Position the client with hip flexion greater than 90 degrees
B. Place a pillow between the client's knees when side-lying on the operative side
C. Maintain hip abduction using an abduction pillow
D. Encourage the client to cross legs when sitting
E. Allow internal rotation of the hip during transfers
Correct Answer: C. Maintain hip abduction using an abduction pillow
, EXPERT RATIONALE: After total hip arthroplasty, the hip must be kept abducted
to prevent dislocation. The nurse should avoid adduction, internal rotation, and
flexion beyond 90 degrees. An abduction pillow maintains the correct positioning.
QUESTION 4: A nurse is reviewing the laboratory results of a client who has
liver cirrhosis. Which of the following findings is consistent with this
condition?
A. Elevated albumin
B. Decreased PT/INR
C. Decreased platelet count
D. Elevated hemoglobin
E. Decreased bilirubin
Correct Answer: C. Decreased platelet count
EXPERT RATIONALE: Liver cirrhosis causes portal hypertension and
splenomegaly, leading to platelet sequestration and thrombocytopenia. The liver
also fails to produce clotting factors, causing elevated PT/INR. Albumin is
decreased, not elevated.
QUESTION 5: A nurse is caring for a client who has pneumonia and is receiving
oxygen via nasal cannula at 4 L/min. The client's SpO₂ is 88%. Which of the
following actions should the nurse take first?
A. Notify the provider
B. Obtain an arterial blood gas
C. Increase the oxygen flow rate
D. Reposition the client to the lateral position
E. Administer a bronchodilator via nebulizer
Correct Answer: C. Increase the oxygen flow rate
, EXPERT RATIONALE: Using the ABC priority framework, the nurse must address
oxygenation first. An SpO₂ of 88% is below the acceptable range of 95–100%. The
immediate action is to increase the oxygen flow rate. After stabilizing the client, the
provider should be notified.
QUESTION 6: A nurse is caring for a client who has type 1 diabetes mellitus
and reports feeling shaky and sweaty. The client's blood glucose is 54 mg/dL.
Which of the following actions should the nurse take?
A. Administer 1 mg of glucagon intramuscularly
B. Hold the next scheduled insulin dose
C. Give 15 grams of fast-acting carbohydrate orally
D. Administer 50% dextrose intravenously
E. Encourage the client to drink a full glass of milk
Correct Answer: C. Give 15 grams of fast-acting carbohydrate orally
EXPERT RATIONALE: The Rule of 15 applies here — give 15 g of fast-acting
carbohydrate (e.g., 4 oz of juice), recheck glucose in 15 minutes, and repeat if still
below 70 mg/dL. The client is conscious and able to swallow, so oral treatment is
appropriate before escalating to IV dextrose or glucagon.
QUESTION 7: A nurse is assessing a client who has heart failure. Which of the
following findings indicates fluid volume overload?
A. Dry mucous membranes
B. Decreased jugular venous distension
C. Crackles in the lung bases
D. Sunken fontanelle
E. Poor skin turgor
Correct Answer: C. Crackles in the lung bases
PROCTORED EXAM 2026 WITH NGN | 100 REAL
EXAM QUESTIONS & ANSWERS | COMPLETE
ACTUAL + RETAKE TEST | ATI RN MED-SURG
LEVEL 3 PASS GUIDE
• This is a comprehensive 100-question ATI RN Adult Medical-Surgical Proctored
Exam 2026 prep guide with NGN-style questions covering Level 3 critical thinking —
study by attempting each question first before checking the correct answer and
EXPERT RATIONALE.
• Features real exam-style questions with five options (A–E), highlighted correct
answers, and detailed EXPERT RATIONALE
to reinforce clinical reasoning across all major med-surg systems.
VERIFIED ATI RN ADULT MEDICAL SURGICAL PROCTORED EXAM 2026 WITH NGN
100 REAL EXAM QUESTIONS & ANSWERS | COMPLETE ACTUAL + RETAKE TEST |
ATI RN MED-SURG LEVEL 3 PASS GUIDE
QUESTION 1: A nurse is caring for a client who has chronic kidney disease and
a potassium level of 6.2 mEq/L. Which of the following findings should the
nurse report to the provider immediately?
A. Urine output of 40 mL/hr
B. Blood pressure of 148/90 mmHg
C. Serum sodium of 138 mEq/L
D. Peaked T waves on ECG
E. Mild lower extremity edema
Correct Answer: D. Peaked T waves on ECG
EXPERT RATIONALE: Hyperkalemia causes cardiac conduction changes. Peaked
T waves are an early and critical ECG finding indicating the heart is at risk for life-
,threatening dysrhythmias such as ventricular fibrillation. This requires immediate
provider notification.
QUESTION 2: A nurse is assessing a client who has been diagnosed with deep
vein thrombosis (DVT). Which of the following clinical findings should the
nurse expect?
A. Pallor and coolness of the affected extremity
B. Bilateral leg swelling with pitting edema
C. Unilateral calf pain, warmth, and redness
D. Absent peripheral pulses in the affected leg
E. Intermittent claudication relieved by rest
Correct Answer: C. Unilateral calf pain, warmth, and redness
EXPERT RATIONALE: DVT presents with unilateral findings including calf pain,
erythema, and warmth due to venous inflammation and clot formation. Bilateral
edema and absent pulses suggest other conditions such as heart failure or arterial
occlusion.
QUESTION 3: A nurse is caring for a client postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take to prevent
dislocation?
A. Position the client with hip flexion greater than 90 degrees
B. Place a pillow between the client's knees when side-lying on the operative side
C. Maintain hip abduction using an abduction pillow
D. Encourage the client to cross legs when sitting
E. Allow internal rotation of the hip during transfers
Correct Answer: C. Maintain hip abduction using an abduction pillow
, EXPERT RATIONALE: After total hip arthroplasty, the hip must be kept abducted
to prevent dislocation. The nurse should avoid adduction, internal rotation, and
flexion beyond 90 degrees. An abduction pillow maintains the correct positioning.
QUESTION 4: A nurse is reviewing the laboratory results of a client who has
liver cirrhosis. Which of the following findings is consistent with this
condition?
A. Elevated albumin
B. Decreased PT/INR
C. Decreased platelet count
D. Elevated hemoglobin
E. Decreased bilirubin
Correct Answer: C. Decreased platelet count
EXPERT RATIONALE: Liver cirrhosis causes portal hypertension and
splenomegaly, leading to platelet sequestration and thrombocytopenia. The liver
also fails to produce clotting factors, causing elevated PT/INR. Albumin is
decreased, not elevated.
QUESTION 5: A nurse is caring for a client who has pneumonia and is receiving
oxygen via nasal cannula at 4 L/min. The client's SpO₂ is 88%. Which of the
following actions should the nurse take first?
A. Notify the provider
B. Obtain an arterial blood gas
C. Increase the oxygen flow rate
D. Reposition the client to the lateral position
E. Administer a bronchodilator via nebulizer
Correct Answer: C. Increase the oxygen flow rate
, EXPERT RATIONALE: Using the ABC priority framework, the nurse must address
oxygenation first. An SpO₂ of 88% is below the acceptable range of 95–100%. The
immediate action is to increase the oxygen flow rate. After stabilizing the client, the
provider should be notified.
QUESTION 6: A nurse is caring for a client who has type 1 diabetes mellitus
and reports feeling shaky and sweaty. The client's blood glucose is 54 mg/dL.
Which of the following actions should the nurse take?
A. Administer 1 mg of glucagon intramuscularly
B. Hold the next scheduled insulin dose
C. Give 15 grams of fast-acting carbohydrate orally
D. Administer 50% dextrose intravenously
E. Encourage the client to drink a full glass of milk
Correct Answer: C. Give 15 grams of fast-acting carbohydrate orally
EXPERT RATIONALE: The Rule of 15 applies here — give 15 g of fast-acting
carbohydrate (e.g., 4 oz of juice), recheck glucose in 15 minutes, and repeat if still
below 70 mg/dL. The client is conscious and able to swallow, so oral treatment is
appropriate before escalating to IV dextrose or glucagon.
QUESTION 7: A nurse is assessing a client who has heart failure. Which of the
following findings indicates fluid volume overload?
A. Dry mucous membranes
B. Decreased jugular venous distension
C. Crackles in the lung bases
D. Sunken fontanelle
E. Poor skin turgor
Correct Answer: C. Crackles in the lung bases
