Med Surg CMS Proctored Exam | 100% Correct Questions and Verified Answers (2026/2027 Update) 2026/2027 | Page 1 | Passing Score: Pass/Fail
ATI NURSING EDUCATION
Med Surg CMS Proctored Exam| 100% Correct
Questions and Verified Answers
(2026/2027 Update)
2026/2027 Edition - Official Exam 2026/2027
85 P/F N/A
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Cardiovascular Disorders Q1-Q11
Section 2 Respiratory Disorders Q12-Q22
Section 3 Gastrointestinal Disorders Q23-Q33
Section 4 Renal and Urinary Disorders Q34-Q43
Section 5 Endocrine Disorders Q44-Q53
Section 6 Neurologic Disorders Q54-Q63
Section 7 Musculoskeletal and Integumentary Q64-Q74
Section 8 Hematologic and Immunologic Q75-Q85
Instructions: Select the single best answer for each question. This exam is designed for Med Surg CMS Proctored Exam
certification preparation. Passing score determined by ATI standard.
MED SURG CMS PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 1 of 47
,MED SURG CMS PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 2 of 47
, SECTION 1 | Cardiovascular Disorders | Q1-Q11 | MED SURG CMS PROCTORED EXAM 2026/2027
Q1 Question 1 of 85
Q1. A 67-year-old male presents to the emergency department with crushing substernal chest pain
radiating to his left arm that began 45 minutes ago while shoveling snow. His blood pressure is
148/92 mm Hg, heart rate 102/min, and his ECG shows ST-segment elevation in leads V1 through
V4. Troponin I is elevated at 2.8 ng/mL. The nurse should anticipate which immediate intervention?
A. Thrombolytic therapy or percutaneous coronary intervention
B. Beta-blocker therapy alone
C. Serial cardiac enzyme monitoring without intervention
D. Administration of digoxin for rate control
Correct Answer: A
Rationale:
ST-elevation myocardial infarction requires immediate reperfusion via thrombolytics or PCI to salvage
myocardium. Delaying reperfusion increases infarct size and mortality, while beta-blockers alone do not
restore coronary flow.
Q2 Question 2 of 85
Q2. A 54-year-old female is admitted with acute decompensated heart failure and has crackles
bilaterally in the lower lung fields, jugular venous distension, and 3+ pitting edema in both ankles. Her
BNP level is 1,840 pg/mL and her oxygen saturation is 89% on room air. Which assessment finding
most strongly indicates worsening right-sided heart failure?
A. Increasing jugular venous distension and peripheral edema
B. Bilateral crackles in the lung bases
C. Decreased urinary output alone
D. Presence of an S3 heart sound
Correct Answer: A
Rationale:
Jugular venous distension and peripheral edema are hallmark signs of right-sided heart failure due to
systemic venous congestion. Bilateral crackles and S3 gallop are more indicative of left-sided failure from
pulmonary congestion.
MED SURG CMS PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 3 of 47
, Q3 Question 3 of 85
Q3. A 72-year-old male with a history of atrial fibrillation on warfarin therapy presents with an INR of
6.2 and active bleeding from a minor laceration on his arm that has not stopped after 20 minutes of
direct pressure. His most recent INR two weeks ago was 2.8. The nurse should prepare to administer
which antidote?
A. Vitamin K - phytonadione
B. Protamine sulfate
C. Idarucizumab
D. Flumazenil
Correct Answer: A
Rationale:
Vitamin K is the specific antidote for warfarin toxicity and reverses its anticoagulant effect by supporting
hepatic synthesis of factors II, VII, IX, and X. Protamine reverses heparin, not warfarin.
Q4 Question 4 of 85
Q4. A 58-year-old male with hypertension and type 2 diabetes presents for a routine follow-up. His
blood pressure is 162/98 mm Hg despite being on lisinopril 20 mg daily. His creatinine is 1.4 mg/dL
and potassium is 4.8 mEq/L. The nurse recognizes that adding which medication class would be
most appropriate given his comorbidities?
A. Calcium channel blocker
B. Thiazide diuretic
C. Alpha-1 blocker
D. Direct vasodilator
Correct Answer: A
Rationale:
A calcium channel blocker is appropriate add-on therapy for uncontrolled hypertension in a diabetic patient
already on an ACE inhibitor. Thiazide diuretics may worsen glucose control, and alpha-blockers are not
first-line for hypertension with diabetes.
MED SURG CMS PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 4 of 47
ATI NURSING EDUCATION
Med Surg CMS Proctored Exam| 100% Correct
Questions and Verified Answers
(2026/2027 Update)
2026/2027 Edition - Official Exam 2026/2027
85 P/F N/A
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Cardiovascular Disorders Q1-Q11
Section 2 Respiratory Disorders Q12-Q22
Section 3 Gastrointestinal Disorders Q23-Q33
Section 4 Renal and Urinary Disorders Q34-Q43
Section 5 Endocrine Disorders Q44-Q53
Section 6 Neurologic Disorders Q54-Q63
Section 7 Musculoskeletal and Integumentary Q64-Q74
Section 8 Hematologic and Immunologic Q75-Q85
Instructions: Select the single best answer for each question. This exam is designed for Med Surg CMS Proctored Exam
certification preparation. Passing score determined by ATI standard.
MED SURG CMS PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 1 of 47
,MED SURG CMS PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 2 of 47
, SECTION 1 | Cardiovascular Disorders | Q1-Q11 | MED SURG CMS PROCTORED EXAM 2026/2027
Q1 Question 1 of 85
Q1. A 67-year-old male presents to the emergency department with crushing substernal chest pain
radiating to his left arm that began 45 minutes ago while shoveling snow. His blood pressure is
148/92 mm Hg, heart rate 102/min, and his ECG shows ST-segment elevation in leads V1 through
V4. Troponin I is elevated at 2.8 ng/mL. The nurse should anticipate which immediate intervention?
A. Thrombolytic therapy or percutaneous coronary intervention
B. Beta-blocker therapy alone
C. Serial cardiac enzyme monitoring without intervention
D. Administration of digoxin for rate control
Correct Answer: A
Rationale:
ST-elevation myocardial infarction requires immediate reperfusion via thrombolytics or PCI to salvage
myocardium. Delaying reperfusion increases infarct size and mortality, while beta-blockers alone do not
restore coronary flow.
Q2 Question 2 of 85
Q2. A 54-year-old female is admitted with acute decompensated heart failure and has crackles
bilaterally in the lower lung fields, jugular venous distension, and 3+ pitting edema in both ankles. Her
BNP level is 1,840 pg/mL and her oxygen saturation is 89% on room air. Which assessment finding
most strongly indicates worsening right-sided heart failure?
A. Increasing jugular venous distension and peripheral edema
B. Bilateral crackles in the lung bases
C. Decreased urinary output alone
D. Presence of an S3 heart sound
Correct Answer: A
Rationale:
Jugular venous distension and peripheral edema are hallmark signs of right-sided heart failure due to
systemic venous congestion. Bilateral crackles and S3 gallop are more indicative of left-sided failure from
pulmonary congestion.
MED SURG CMS PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 3 of 47
, Q3 Question 3 of 85
Q3. A 72-year-old male with a history of atrial fibrillation on warfarin therapy presents with an INR of
6.2 and active bleeding from a minor laceration on his arm that has not stopped after 20 minutes of
direct pressure. His most recent INR two weeks ago was 2.8. The nurse should prepare to administer
which antidote?
A. Vitamin K - phytonadione
B. Protamine sulfate
C. Idarucizumab
D. Flumazenil
Correct Answer: A
Rationale:
Vitamin K is the specific antidote for warfarin toxicity and reverses its anticoagulant effect by supporting
hepatic synthesis of factors II, VII, IX, and X. Protamine reverses heparin, not warfarin.
Q4 Question 4 of 85
Q4. A 58-year-old male with hypertension and type 2 diabetes presents for a routine follow-up. His
blood pressure is 162/98 mm Hg despite being on lisinopril 20 mg daily. His creatinine is 1.4 mg/dL
and potassium is 4.8 mEq/L. The nurse recognizes that adding which medication class would be
most appropriate given his comorbidities?
A. Calcium channel blocker
B. Thiazide diuretic
C. Alpha-1 blocker
D. Direct vasodilator
Correct Answer: A
Rationale:
A calcium channel blocker is appropriate add-on therapy for uncontrolled hypertension in a diabetic patient
already on an ACE inhibitor. Thiazide diuretics may worsen glucose control, and alpha-blockers are not
first-line for hypertension with diabetes.
MED SURG CMS PROCTORED EXAM -- 2026/2027 | Passing Score: Pass/Fail | Page 4 of 47
