ATI PN ADULT MED SURG PROCTORED EXAM LATEST
2026| PN ADULT MED SURG PROCTORED EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) GRADED A+
Q1. A nurse is caring for a client who has a chest tube connected to a closed
water-seal drainage system. Which of the following findings should the nurse
report to the provider?
• A) Fluctuation of the water level in the chamber as the client breathes
• B) Constant bubbling in the water seal chamber
• C) Numerous small blood clots in the drainage tubing
• D) Water seal chamber contains 1 cm of water
Correct ,,,answer,,,: B) Constant bubbling in the water seal chamber
Rationale: Constant bubbling in the water seal chamber indicates an air leak, which
should be reported to the provider. Fluctuation (tidaling) in the water seal chamber
with the client's respirations is an expected finding and indicates a patent drainage
system .
Q2. A nurse is caring for a client who is receiving mechanical ventilation. Which of
the following actions should the nurse implement to decrease the client's risk for
ventilator-associated pneumonia (VAP)? (Select all that apply.)
• A) Wear a protective gown when suctioning the client's airway
• B) Monitor for oral secretions every 2 hr
, • C) Provide oral care every 2 hr
• D) Maintain the client in a supine position
• E) Assess the client daily for readiness of extubation
Correct ,,,answer,,,: B, C, E
*Rationale: Monitor for oral secretions every 2 hr to decrease micro-organisms
moving from mouth to respiratory tract. Provide oral care every 2 hr using
chlorhexidine rinse. Assess daily for neurological readiness for extubation to lower
VAP risk. The supine position increases aspiration risk, so HOB should be elevated
30-45 degrees .*
Q3. A nurse is providing discharge teaching to a client who has COPD. Which of
the following instructions should the nurse include?
• A) "Schedule controlled coughing exercises after meals."
• B) "Consume a diet that is high in calories."
• C) "Practice breath-holding."
• D) "Perform arm-reaching exercises."
Correct ,,,answer,,,: B) "Consume a diet that is high in calories."
Rationale: Dyspnea decreases energy available for eating. The nurse should
encourage the client to eat soft, high-calorie and high-protein foods to prevent weight
loss. Controlled coughing should be done before meals to clear airways. Pursed-lip
breathing (not breath-holding) is recommended .
,Q4. A nurse is caring for a client who has a prescription for enalapril. Which of the
following findings should the nurse identify as an adverse effect of the
medication?
• A) Orthostatic hypotension
• B) Hyperkalemia
• C) Dry cough
• D) All of the above
Correct ,,,answer,,,: D) All of the above
Rationale: Enalapril (an ACE inhibitor) commonly causes orthostatic hypotension
(due to vasodilation), hyperkalemia (due to decreased aldosterone), and a
characteristic dry, persistent cough (due to bradykinin accumulation). The nurse
should monitor BP, potassium levels, and assess for cough .
Q5. A nurse is caring for a client who is 1 hr following a cardiac catheterization.
The nurse notes the formation of a hematoma at the insertion site and a
decreased pulse rate in the affected extremity. Which of the following actions
should the nurse take first?
• A) Notify the provider
• B) Apply firm pressure to the site
• C) Apply a warm compress to the site
• D) Measure the size of the hematoma
Correct ,,,answer,,,: B) Apply firm pressure to the site
Rationale: The priority action is to apply firm pressure to the site to prevent further
bleeding and hematoma expansion. After bleeding is controlled, the nurse should
notify the provider and monitor the extremity for pulses, color, and temperature .
, Q6. A nurse is caring for a client who is experiencing supraventricular
tachycardia. The nurse observes the following findings: heart rate 200/min, blood
pressure 90/50 mmHg, and the client reports dizziness. Which of the following
actions should the nurse take?
• A) Administer adenosine 6 mg IV push
• B) Prepare for synchronized cardioversion
• C) Administer oxygen via nasal cannula
• D) Place the client in Trendelenburg position
Correct ,,,answer,,,: B) Prepare for synchronized cardioversion
*Rationale: The client has symptomatic SVT with hypotension (BP 90/50).
Synchronized cardioversion is indicated for unstable tachycardia. Adenosine is for
stable SVT. Oxygen is appropriate but not the priority. Trendelenburg position is not
indicated .*
Q7. A nurse is caring for a client who has pneumonia. Which of the following
findings indicates that the client is experiencing a complication?
• A) Temperature 38.5°C (101.3°F)
• B) Respiratory rate 24/min
• C) Oxygen saturation 85% on room air
• D) Coarse crackles in lung bases
Correct ,,,answer,,,: C) Oxygen saturation 85% on room air
2026| PN ADULT MED SURG PROCTORED EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) GRADED A+
Q1. A nurse is caring for a client who has a chest tube connected to a closed
water-seal drainage system. Which of the following findings should the nurse
report to the provider?
• A) Fluctuation of the water level in the chamber as the client breathes
• B) Constant bubbling in the water seal chamber
• C) Numerous small blood clots in the drainage tubing
• D) Water seal chamber contains 1 cm of water
Correct ,,,answer,,,: B) Constant bubbling in the water seal chamber
Rationale: Constant bubbling in the water seal chamber indicates an air leak, which
should be reported to the provider. Fluctuation (tidaling) in the water seal chamber
with the client's respirations is an expected finding and indicates a patent drainage
system .
Q2. A nurse is caring for a client who is receiving mechanical ventilation. Which of
the following actions should the nurse implement to decrease the client's risk for
ventilator-associated pneumonia (VAP)? (Select all that apply.)
• A) Wear a protective gown when suctioning the client's airway
• B) Monitor for oral secretions every 2 hr
, • C) Provide oral care every 2 hr
• D) Maintain the client in a supine position
• E) Assess the client daily for readiness of extubation
Correct ,,,answer,,,: B, C, E
*Rationale: Monitor for oral secretions every 2 hr to decrease micro-organisms
moving from mouth to respiratory tract. Provide oral care every 2 hr using
chlorhexidine rinse. Assess daily for neurological readiness for extubation to lower
VAP risk. The supine position increases aspiration risk, so HOB should be elevated
30-45 degrees .*
Q3. A nurse is providing discharge teaching to a client who has COPD. Which of
the following instructions should the nurse include?
• A) "Schedule controlled coughing exercises after meals."
• B) "Consume a diet that is high in calories."
• C) "Practice breath-holding."
• D) "Perform arm-reaching exercises."
Correct ,,,answer,,,: B) "Consume a diet that is high in calories."
Rationale: Dyspnea decreases energy available for eating. The nurse should
encourage the client to eat soft, high-calorie and high-protein foods to prevent weight
loss. Controlled coughing should be done before meals to clear airways. Pursed-lip
breathing (not breath-holding) is recommended .
,Q4. A nurse is caring for a client who has a prescription for enalapril. Which of the
following findings should the nurse identify as an adverse effect of the
medication?
• A) Orthostatic hypotension
• B) Hyperkalemia
• C) Dry cough
• D) All of the above
Correct ,,,answer,,,: D) All of the above
Rationale: Enalapril (an ACE inhibitor) commonly causes orthostatic hypotension
(due to vasodilation), hyperkalemia (due to decreased aldosterone), and a
characteristic dry, persistent cough (due to bradykinin accumulation). The nurse
should monitor BP, potassium levels, and assess for cough .
Q5. A nurse is caring for a client who is 1 hr following a cardiac catheterization.
The nurse notes the formation of a hematoma at the insertion site and a
decreased pulse rate in the affected extremity. Which of the following actions
should the nurse take first?
• A) Notify the provider
• B) Apply firm pressure to the site
• C) Apply a warm compress to the site
• D) Measure the size of the hematoma
Correct ,,,answer,,,: B) Apply firm pressure to the site
Rationale: The priority action is to apply firm pressure to the site to prevent further
bleeding and hematoma expansion. After bleeding is controlled, the nurse should
notify the provider and monitor the extremity for pulses, color, and temperature .
, Q6. A nurse is caring for a client who is experiencing supraventricular
tachycardia. The nurse observes the following findings: heart rate 200/min, blood
pressure 90/50 mmHg, and the client reports dizziness. Which of the following
actions should the nurse take?
• A) Administer adenosine 6 mg IV push
• B) Prepare for synchronized cardioversion
• C) Administer oxygen via nasal cannula
• D) Place the client in Trendelenburg position
Correct ,,,answer,,,: B) Prepare for synchronized cardioversion
*Rationale: The client has symptomatic SVT with hypotension (BP 90/50).
Synchronized cardioversion is indicated for unstable tachycardia. Adenosine is for
stable SVT. Oxygen is appropriate but not the priority. Trendelenburg position is not
indicated .*
Q7. A nurse is caring for a client who has pneumonia. Which of the following
findings indicates that the client is experiencing a complication?
• A) Temperature 38.5°C (101.3°F)
• B) Respiratory rate 24/min
• C) Oxygen saturation 85% on room air
• D) Coarse crackles in lung bases
Correct ,,,answer,,,: C) Oxygen saturation 85% on room air
