ATI MED SURG NGN
COMPREHENSIVE ASSESSMENT
2026 QUESTIONS AND ANSWERS
WITH RATIONALES/GRADED
A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
Section 1: Cardiovascular Disorders (Questions 1–12)
1. A nurse is caring for a client with acute decompensated heart failure (ADHF) who
has jugular venous distention, crackles in lung bases, and 3+ pitting edema. Which
medication is priority to administer first?
A. Digoxin 0.125 mg PO
B. Metoprolol succinate 25 mg PO
C. Furosemide 40 mg IV
D. Spironolactone 25 mg PO
Rationale: IV loop diuretics (furosemide) rapidly reduce preload and relieve
pulmonary congestion in ADHF. Beta-blockers are not given in acute
decompensation.
2. A client with unstable angina undergoes percutaneous coronary intervention (PCI)
with drug-eluting stent placement. Which post-procedure medication regimen is
essential to prevent stent thrombosis? (SATA)
A. Aspirin 81 mg daily
B. Clopidogrel 75 mg daily
C. Warfarin 5 mg daily
D. Ticagrelor 90 mg BID
E. Heparin drip for 48 hours
, Rationale: Dual antiplatelet therapy (DAPT: aspirin + P2Y12 inhibitor like clopidogrel
or ticagrelor) is mandatory post-stent. Warfarin used in atrial fibrillation, not routinely
post-stent alone.
3. Bowtie Question – A client is admitted with acute pericarditis. Complete the
bowtie by dragging and dropping the one priority condition to monitor
for, two expected assessment findings, and two priority interventions.
Category Options
Condition to monitor for Cardiac tamponade / Heart failure / Myocardial infarction
Assessment findings Friction rub / Muffled heart sounds / Lower extremity edema / Pulsus par
(choose 2) / Hepatomegaly
Prepare for pericardiocentesis / Administer IV heparin / Give NSAIDs / Be
Interventions (choose 2)
thrombolytics / Apply oxygen
Correct Answer:
• Condition: Cardiac tamponade
• Findings: Friction rub, Pulsus paradoxus (or muffled heart sounds – both
valid; but rub is classic for pericarditis)
• Interventions: Prepare for pericardiocentesis, Give NSAIDs
Rationale: Pericarditis risks tamponade (muffled sounds, paradoxical pulse). NSAIDs
treat inflammation; pericardiocentesis for tamponade.
4. A client with infective endocarditis has a fever, Janeway lesions, and a new
regurgitant murmur. Which complication is the nurse most concerned about?
A. Embolic stroke
B. Heart failure
C. Septic shock
D. Myocarditis
Rationale: Valvular destruction leads to acute regurgitation and heart failure—the
most common cause of death in endocarditis.
Section 2: Respiratory Disorders (Questions 5–16)
COMPREHENSIVE ASSESSMENT
2026 QUESTIONS AND ANSWERS
WITH RATIONALES/GRADED
A+/2026 UPDATE/100% CORRECT
/INSTANT DOWNLOAD
Section 1: Cardiovascular Disorders (Questions 1–12)
1. A nurse is caring for a client with acute decompensated heart failure (ADHF) who
has jugular venous distention, crackles in lung bases, and 3+ pitting edema. Which
medication is priority to administer first?
A. Digoxin 0.125 mg PO
B. Metoprolol succinate 25 mg PO
C. Furosemide 40 mg IV
D. Spironolactone 25 mg PO
Rationale: IV loop diuretics (furosemide) rapidly reduce preload and relieve
pulmonary congestion in ADHF. Beta-blockers are not given in acute
decompensation.
2. A client with unstable angina undergoes percutaneous coronary intervention (PCI)
with drug-eluting stent placement. Which post-procedure medication regimen is
essential to prevent stent thrombosis? (SATA)
A. Aspirin 81 mg daily
B. Clopidogrel 75 mg daily
C. Warfarin 5 mg daily
D. Ticagrelor 90 mg BID
E. Heparin drip for 48 hours
, Rationale: Dual antiplatelet therapy (DAPT: aspirin + P2Y12 inhibitor like clopidogrel
or ticagrelor) is mandatory post-stent. Warfarin used in atrial fibrillation, not routinely
post-stent alone.
3. Bowtie Question – A client is admitted with acute pericarditis. Complete the
bowtie by dragging and dropping the one priority condition to monitor
for, two expected assessment findings, and two priority interventions.
Category Options
Condition to monitor for Cardiac tamponade / Heart failure / Myocardial infarction
Assessment findings Friction rub / Muffled heart sounds / Lower extremity edema / Pulsus par
(choose 2) / Hepatomegaly
Prepare for pericardiocentesis / Administer IV heparin / Give NSAIDs / Be
Interventions (choose 2)
thrombolytics / Apply oxygen
Correct Answer:
• Condition: Cardiac tamponade
• Findings: Friction rub, Pulsus paradoxus (or muffled heart sounds – both
valid; but rub is classic for pericarditis)
• Interventions: Prepare for pericardiocentesis, Give NSAIDs
Rationale: Pericarditis risks tamponade (muffled sounds, paradoxical pulse). NSAIDs
treat inflammation; pericardiocentesis for tamponade.
4. A client with infective endocarditis has a fever, Janeway lesions, and a new
regurgitant murmur. Which complication is the nurse most concerned about?
A. Embolic stroke
B. Heart failure
C. Septic shock
D. Myocarditis
Rationale: Valvular destruction leads to acute regurgitation and heart failure—the
most common cause of death in endocarditis.
Section 2: Respiratory Disorders (Questions 5–16)
