ATI PN Med-Surg Proctored Exam 2026 |
Verified Questions & Correct Answers with
Detailed Rationales | Complete A+ Graded
Medical-Surgical Nursing Study Guide &
Practice Test
• This guide features 200 ATI PN Med-Surg verified questions with 5 options
each, bold correct answers, and detailed EXPERT RATIONALE — covering every
high-yield topic tested on the proctored exam.
• Study tip: Attempt each question independently before reading the correct
answer and EXPERT RATIONALE; focus extra time on any topic where you miss 2 or
more consecutive questions.
1. A nurse is caring for a client with left-sided heart failure. Which assessment
finding should the nurse expect?
A. Jugular vein distension
B. Peripheral pitting edema
C. Hepatomegaly
D. Crackles in the lung bases
E. Ascites
✓ Correct Answer: D. Crackles in the lung bases
EXPERT RATIONALE: Left-sided heart failure causes fluid to back up into the
pulmonary circulation, resulting in pulmonary congestion and crackles (rales) in the
lung bases. Options A, B, C, and E are manifestations of right-sided heart failure due
to systemic venous congestion.
2. A nurse is assessing a client who is experiencing a myocardial infarction.
Which symptom is most commonly reported?
,A. Sharp pleuritic chest pain
B. Pain that worsens with inspiration
C. Crushing substernal chest pain radiating to the left arm
D. Burning epigastric pain relieved by antacids
E. Intermittent chest tightness relieved by rest
✓ Correct Answer: C. Crushing substernal chest pain radiating to the left arm
EXPERT RATIONALE: MI presents classically with crushing, pressure-like substernal
pain that may radiate to the left arm, jaw, or shoulder. This pain is not relieved by
rest or nitroglycerin and is caused by myocardial ischemia and necrosis.
3. A nurse is reviewing the laboratory results of a client suspected of having a
myocardial infarction. Which laboratory value is the most specific indicator of
myocardial damage?
A. Lactate dehydrogenase (LDH)
B. White blood cell count (WBC)
C. C-reactive protein (CRP)
D. Troponin I
E. Creatine kinase (CK-MM)
✓ Correct Answer: D. Troponin I
EXPERT RATIONALE: Troponin I is the most cardiac-specific biomarker available. It
rises within 3–6 hours of myocardial injury, peaks at 14–18 hours, and remains
elevated for up to 14 days. It is more specific to cardiac muscle than CK-MB or LDH.
4. A nurse is caring for a client with stable angina. The client asks why
nitroglycerin relieves chest pain. What is the nurse's best response?
A. It increases the heart rate to improve cardiac output
,B. It dilates coronary and peripheral blood vessels, reducing cardiac workload
C. It dissolves clots that are blocking the coronary arteries
D. It strengthens myocardial contractions
E. It reduces inflammation in the coronary arteries
✓ Correct Answer: B. It dilates coronary and peripheral blood vessels,
reducing cardiac workload
EXPERT RATIONALE: Nitroglycerin is a vasodilator that relaxes vascular smooth
muscle. It dilates veins (reducing preload) and arteries (reducing afterload),
decreasing myocardial oxygen demand. It also dilates coronary arteries, improving
blood supply to the myocardium.
5. A client is prescribed sublingual nitroglycerin for chest pain. The nurse
should instruct the client to take the medication and then:
A. Lie flat and elevate both legs
B. Repeat the dose every 15 minutes for up to three doses if pain persists
C. Repeat the dose every 5 minutes for up to three doses if pain persists, then call
911
D. Drink a full glass of water with each dose
E. Avoid taking more than one tablet per episode
✓ Correct Answer: C. Repeat the dose every 5 minutes for up to three doses if
pain persists, then call 911
EXPERT RATIONALE: The standard protocol for sublingual nitroglycerin is one
tablet every 5 minutes, up to three doses. If pain is not relieved after three doses,
the client should call emergency services immediately as this may indicate an MI.
6. A nurse is caring for a client with hypertension. Which dietary teaching is
most important?
, A. Increase calcium-rich foods
B. Reduce sodium intake to less than 2,400 mg/day
C. Increase potassium intake by eating citrus fruits
D. Follow the DASH diet and limit sodium to less than 2,300 mg/day
E. Avoid all forms of fat in the diet
✓ Correct Answer: D. Follow the DASH diet and limit sodium to less than 2,300
mg/day
EXPERT RATIONALE: The DASH (Dietary Approaches to Stop Hypertension) diet
emphasizes fruits, vegetables, whole grains, low-fat dairy, and reduced sodium. It
has strong evidence for reducing blood pressure. Sodium restriction to less than
2,300 mg/day is a key component.
7. A nurse is assessing a client with atrial fibrillation. Which complication is
the nurse most concerned about?
A. Heart block
B. Ventricular fibrillation
C. Stroke due to thromboembolism
D. Cardiac tamponade
E. Pulmonary hypertension
✓ Correct Answer: C. Stroke due to thromboembolism
EXPERT RATIONALE: Atrial fibrillation causes the atria to quiver rather than
contract effectively, leading to blood pooling and clot formation (particularly in the
left atrial appendage). These clots can embolize to the brain, causing a stroke.
Anticoagulation therapy is a primary concern in A-fib management.
8. A nurse is caring for a client taking digoxin. Which assessment finding
indicates digoxin toxicity?
Verified Questions & Correct Answers with
Detailed Rationales | Complete A+ Graded
Medical-Surgical Nursing Study Guide &
Practice Test
• This guide features 200 ATI PN Med-Surg verified questions with 5 options
each, bold correct answers, and detailed EXPERT RATIONALE — covering every
high-yield topic tested on the proctored exam.
• Study tip: Attempt each question independently before reading the correct
answer and EXPERT RATIONALE; focus extra time on any topic where you miss 2 or
more consecutive questions.
1. A nurse is caring for a client with left-sided heart failure. Which assessment
finding should the nurse expect?
A. Jugular vein distension
B. Peripheral pitting edema
C. Hepatomegaly
D. Crackles in the lung bases
E. Ascites
✓ Correct Answer: D. Crackles in the lung bases
EXPERT RATIONALE: Left-sided heart failure causes fluid to back up into the
pulmonary circulation, resulting in pulmonary congestion and crackles (rales) in the
lung bases. Options A, B, C, and E are manifestations of right-sided heart failure due
to systemic venous congestion.
2. A nurse is assessing a client who is experiencing a myocardial infarction.
Which symptom is most commonly reported?
,A. Sharp pleuritic chest pain
B. Pain that worsens with inspiration
C. Crushing substernal chest pain radiating to the left arm
D. Burning epigastric pain relieved by antacids
E. Intermittent chest tightness relieved by rest
✓ Correct Answer: C. Crushing substernal chest pain radiating to the left arm
EXPERT RATIONALE: MI presents classically with crushing, pressure-like substernal
pain that may radiate to the left arm, jaw, or shoulder. This pain is not relieved by
rest or nitroglycerin and is caused by myocardial ischemia and necrosis.
3. A nurse is reviewing the laboratory results of a client suspected of having a
myocardial infarction. Which laboratory value is the most specific indicator of
myocardial damage?
A. Lactate dehydrogenase (LDH)
B. White blood cell count (WBC)
C. C-reactive protein (CRP)
D. Troponin I
E. Creatine kinase (CK-MM)
✓ Correct Answer: D. Troponin I
EXPERT RATIONALE: Troponin I is the most cardiac-specific biomarker available. It
rises within 3–6 hours of myocardial injury, peaks at 14–18 hours, and remains
elevated for up to 14 days. It is more specific to cardiac muscle than CK-MB or LDH.
4. A nurse is caring for a client with stable angina. The client asks why
nitroglycerin relieves chest pain. What is the nurse's best response?
A. It increases the heart rate to improve cardiac output
,B. It dilates coronary and peripheral blood vessels, reducing cardiac workload
C. It dissolves clots that are blocking the coronary arteries
D. It strengthens myocardial contractions
E. It reduces inflammation in the coronary arteries
✓ Correct Answer: B. It dilates coronary and peripheral blood vessels,
reducing cardiac workload
EXPERT RATIONALE: Nitroglycerin is a vasodilator that relaxes vascular smooth
muscle. It dilates veins (reducing preload) and arteries (reducing afterload),
decreasing myocardial oxygen demand. It also dilates coronary arteries, improving
blood supply to the myocardium.
5. A client is prescribed sublingual nitroglycerin for chest pain. The nurse
should instruct the client to take the medication and then:
A. Lie flat and elevate both legs
B. Repeat the dose every 15 minutes for up to three doses if pain persists
C. Repeat the dose every 5 minutes for up to three doses if pain persists, then call
911
D. Drink a full glass of water with each dose
E. Avoid taking more than one tablet per episode
✓ Correct Answer: C. Repeat the dose every 5 minutes for up to three doses if
pain persists, then call 911
EXPERT RATIONALE: The standard protocol for sublingual nitroglycerin is one
tablet every 5 minutes, up to three doses. If pain is not relieved after three doses,
the client should call emergency services immediately as this may indicate an MI.
6. A nurse is caring for a client with hypertension. Which dietary teaching is
most important?
, A. Increase calcium-rich foods
B. Reduce sodium intake to less than 2,400 mg/day
C. Increase potassium intake by eating citrus fruits
D. Follow the DASH diet and limit sodium to less than 2,300 mg/day
E. Avoid all forms of fat in the diet
✓ Correct Answer: D. Follow the DASH diet and limit sodium to less than 2,300
mg/day
EXPERT RATIONALE: The DASH (Dietary Approaches to Stop Hypertension) diet
emphasizes fruits, vegetables, whole grains, low-fat dairy, and reduced sodium. It
has strong evidence for reducing blood pressure. Sodium restriction to less than
2,300 mg/day is a key component.
7. A nurse is assessing a client with atrial fibrillation. Which complication is
the nurse most concerned about?
A. Heart block
B. Ventricular fibrillation
C. Stroke due to thromboembolism
D. Cardiac tamponade
E. Pulmonary hypertension
✓ Correct Answer: C. Stroke due to thromboembolism
EXPERT RATIONALE: Atrial fibrillation causes the atria to quiver rather than
contract effectively, leading to blood pooling and clot formation (particularly in the
left atrial appendage). These clots can embolize to the brain, causing a stroke.
Anticoagulation therapy is a primary concern in A-fib management.
8. A nurse is caring for a client taking digoxin. Which assessment finding
indicates digoxin toxicity?
