ATI RN Adult Medical Surgical Proctored
Exam 2026 NGN Questions and Answers |
Medical Surgical Nursing Study Guide with
Detailed Rationales, NCLEX RN Review,
Clinical Judgment & High Score Preparation
• This study guide features 300 NGN-style ATI RN Adult Medical-Surgical practice
questions with detailed EXPERT RATIONALE designed to sharpen your clinical
judgment and boost your proctored exam score.
• Each question mirrors the critical thinking demands of the actual ATI exam — use
it by reading every EXPERT RATIONALE carefully, not just checking answers, to
build true understanding.
1. A nurse is caring for a client who has chronic obstructive pulmonary
disease (COPD) and is receiving oxygen therapy. Which oxygen delivery device
should the nurse select to provide the most precise oxygen concentration?
A. Simple face mask
B. Nasal cannula
C. Non-rebreather mask
D. Partial rebreather mask
E. Venturi mask
The Venturi mask delivers a precise, controlled concentration of oxygen regardless of the
client's breathing pattern, making it the preferred device for clients with COPD who
depend on a hypoxic drive.
2. A nurse is assessing a client who has left-sided heart failure. Which finding
should the nurse expect?
A. Jugular vein distension
B. Peripheral edema
,C. Hepatomegaly
D. Crackles in the lung bases
E. Ascites
Left-sided heart failure causes fluid to back up into the pulmonary circulation, resulting
in pulmonary congestion and crackles heard at the lung bases.
3. A nurse is caring for a client following a thyroidectomy. Which finding
requires the nurse's immediate intervention?
A. Hoarse voice
B. Mild sore throat
C. Positive Chvostek's sign
D. Serosanguineous wound drainage
E. Blood pressure 138/86 mmHg
A positive Chvostek's sign indicates hypocalcemia, a life-threatening complication of
thyroidectomy caused by inadvertent removal of the parathyroid glands. Immediate
intervention is required.
4. A nurse is reviewing the laboratory results of a client who has chronic
kidney disease. Which finding is consistent with this condition?
A. Serum sodium 138 mEq/L
B. Serum potassium 3.5 mEq/L
C. BUN 65 mg/dL
D. Serum creatinine 0.9 mg/dL
E. Hemoglobin 14 g/dL
Elevated BUN reflects impaired renal excretion of nitrogenous waste products, which is a
hallmark finding in chronic kidney disease.
,5. A nurse is teaching a client who has a new prescription for warfarin. Which
statement by the client indicates understanding?
A. "I will take aspirin if I have a headache."
B. "I can eat as much spinach as I want."
C. "I will report any unusual bruising or bleeding to my provider."
D. "I should double my dose if I miss one."
E. "I do not need blood tests while on this medication."
Unusual bruising or bleeding may indicate supratherapeutic anticoagulation. Clients on
warfarin must monitor for bleeding and report it promptly.
6. A nurse is caring for a client who has a nasogastric (NG) tube. Before
administering a tube feeding, which action should the nurse take first?
A. Warm the formula to body temperature
B. Position the client supine
C. Verify tube placement by checking gastric pH
D. Flush the tube with 60 mL of water
E. Aspirate and discard residual volume
Verifying tube placement is the priority before initiating any feeding to prevent
aspiration. Checking gastric pH is a reliable bedside method.
7. A nurse is caring for a client who has a serum potassium level of 6.2 mEq/L.
Which ECG change should the nurse anticipate?
A. Prolonged QT interval
B. U waves
, C. Flattened T waves
D. Peaked T waves
E. Widened QRS complex only
Peaked T waves are the earliest ECG manifestation of hyperkalemia, reflecting altered
ventricular repolarization.
8. A nurse is assessing a client who is postoperative following a hip
arthroplasty. Which finding is the priority concern?
A. Pain rated 5/10
B. Urinary output 40 mL/hr
C. Calf tenderness and warmth
D. Temperature 37.8°C
E. Capillary refill 2 seconds
Calf tenderness and warmth are classic signs of deep vein thrombosis, a life-threatening
complication following hip surgery that requires immediate intervention.
9. A nurse is caring for a client who has Cushing's syndrome. Which
assessment finding should the nurse expect?
A. Hypotension
B. Hypoglycemia
C. Weight loss
D. Moon face and truncal obesity
E. Bronzed skin pigmentation
Cushing's syndrome results from excess cortisol, causing characteristic redistribution of
fat to the face (moon face) and trunk.
Exam 2026 NGN Questions and Answers |
Medical Surgical Nursing Study Guide with
Detailed Rationales, NCLEX RN Review,
Clinical Judgment & High Score Preparation
• This study guide features 300 NGN-style ATI RN Adult Medical-Surgical practice
questions with detailed EXPERT RATIONALE designed to sharpen your clinical
judgment and boost your proctored exam score.
• Each question mirrors the critical thinking demands of the actual ATI exam — use
it by reading every EXPERT RATIONALE carefully, not just checking answers, to
build true understanding.
1. A nurse is caring for a client who has chronic obstructive pulmonary
disease (COPD) and is receiving oxygen therapy. Which oxygen delivery device
should the nurse select to provide the most precise oxygen concentration?
A. Simple face mask
B. Nasal cannula
C. Non-rebreather mask
D. Partial rebreather mask
E. Venturi mask
The Venturi mask delivers a precise, controlled concentration of oxygen regardless of the
client's breathing pattern, making it the preferred device for clients with COPD who
depend on a hypoxic drive.
2. A nurse is assessing a client who has left-sided heart failure. Which finding
should the nurse expect?
A. Jugular vein distension
B. Peripheral edema
,C. Hepatomegaly
D. Crackles in the lung bases
E. Ascites
Left-sided heart failure causes fluid to back up into the pulmonary circulation, resulting
in pulmonary congestion and crackles heard at the lung bases.
3. A nurse is caring for a client following a thyroidectomy. Which finding
requires the nurse's immediate intervention?
A. Hoarse voice
B. Mild sore throat
C. Positive Chvostek's sign
D. Serosanguineous wound drainage
E. Blood pressure 138/86 mmHg
A positive Chvostek's sign indicates hypocalcemia, a life-threatening complication of
thyroidectomy caused by inadvertent removal of the parathyroid glands. Immediate
intervention is required.
4. A nurse is reviewing the laboratory results of a client who has chronic
kidney disease. Which finding is consistent with this condition?
A. Serum sodium 138 mEq/L
B. Serum potassium 3.5 mEq/L
C. BUN 65 mg/dL
D. Serum creatinine 0.9 mg/dL
E. Hemoglobin 14 g/dL
Elevated BUN reflects impaired renal excretion of nitrogenous waste products, which is a
hallmark finding in chronic kidney disease.
,5. A nurse is teaching a client who has a new prescription for warfarin. Which
statement by the client indicates understanding?
A. "I will take aspirin if I have a headache."
B. "I can eat as much spinach as I want."
C. "I will report any unusual bruising or bleeding to my provider."
D. "I should double my dose if I miss one."
E. "I do not need blood tests while on this medication."
Unusual bruising or bleeding may indicate supratherapeutic anticoagulation. Clients on
warfarin must monitor for bleeding and report it promptly.
6. A nurse is caring for a client who has a nasogastric (NG) tube. Before
administering a tube feeding, which action should the nurse take first?
A. Warm the formula to body temperature
B. Position the client supine
C. Verify tube placement by checking gastric pH
D. Flush the tube with 60 mL of water
E. Aspirate and discard residual volume
Verifying tube placement is the priority before initiating any feeding to prevent
aspiration. Checking gastric pH is a reliable bedside method.
7. A nurse is caring for a client who has a serum potassium level of 6.2 mEq/L.
Which ECG change should the nurse anticipate?
A. Prolonged QT interval
B. U waves
, C. Flattened T waves
D. Peaked T waves
E. Widened QRS complex only
Peaked T waves are the earliest ECG manifestation of hyperkalemia, reflecting altered
ventricular repolarization.
8. A nurse is assessing a client who is postoperative following a hip
arthroplasty. Which finding is the priority concern?
A. Pain rated 5/10
B. Urinary output 40 mL/hr
C. Calf tenderness and warmth
D. Temperature 37.8°C
E. Capillary refill 2 seconds
Calf tenderness and warmth are classic signs of deep vein thrombosis, a life-threatening
complication following hip surgery that requires immediate intervention.
9. A nurse is caring for a client who has Cushing's syndrome. Which
assessment finding should the nurse expect?
A. Hypotension
B. Hypoglycemia
C. Weight loss
D. Moon face and truncal obesity
E. Bronzed skin pigmentation
Cushing's syndrome results from excess cortisol, causing characteristic redistribution of
fat to the face (moon face) and trunk.
