ATI PN Adult Medical Surgical (Med-
Surg) 2023 Proctored Exam with NGN
120 Questions and Answers
Cardiovascular System (Questions 1–20)
Q1. A nurse is caring for a client with heart failure who
reports sudden shortness of breath and coughing up pink,
frothy sputum. Which action should the nurse take first?
A) Administer furosemide IV push
B) Place the client in High-Fowler's position
C) Apply a non-rebreather mask at 15 L/min
D) Notify the provider immediately
Answer: B
Rationale: High-Fowler's position reduces venous return and
decreases pulmonary congestion. Airway and breathing come
before medications or notification.
Q2. A nurse is caring for a client who has heart failure and is
receiving furosemide. Which laboratory value should the
nurse report to the provider?
, A) Potassium 3.2 mEq/L
B) Sodium 138 mEq/L
C) Chloride 100 mEq/L
D) Calcium 9.5 mg/dL
Answer: A
Rationale: Furosemide is a loop diuretic that causes potassium
loss. Hypokalemia (normal 3.5–5.0) increases the risk of cardiac
arrhythmias, especially in clients taking digoxin.
Q3. A nurse is reinforcing discharge teaching with a client
who has a new prescription for warfarin. Which statement
indicates a need for further teaching?
A) "I'll use a soft toothbrush to brush my teeth."
B) "I'll eat more green leafy vegetables for extra vitamin K."
C) "I'll avoid drinking alcohol while taking this medication."
D) "I'll report any unusual bruising to my provider."
Answer: B
Rationale: Green leafy vegetables are high in vitamin K, which
antagonizes the anticoagulant effect of warfarin. The client should
maintain a consistent intake of vitamin K, not increase it.
,Q4. A nurse is reinforcing teaching with a client who has a
new prescription for nitroglycerin sublingual tablets. Which
instruction should the nurse include?
A) "Take a tablet every 5 minutes until chest pain stops, up to
three doses."
B) "Swallow the tablet with a full glass of water."
C) "Store the tablets in the refrigerator."
D) "Take the medication with food to prevent stomach
upset."
Answer: A
Rationale: Standard dosing: one tablet every 5 minutes for up to
three doses. If pain persists after the first tablet, call 911.
Nitroglycerin should not be swallowed; it is placed under the
tongue.
Q5. A nurse is caring for a client following a cardiac
catheterization via the right femoral artery. Which finding
requires immediate intervention?
A) Heart rate 90 bpm
B) Blood pressure 110/70 mmHg
C) Right foot is cool and pulseless
D) Pain at the insertion site
Answer: C
, Rationale: A cool, pulseless foot indicates arterial occlusion—a
medical emergency requiring immediate intervention to prevent
tissue necrosis.
Q6. A client with angina is prescribed nitroglycerin sublingual.
The nurse should instruct the client to:
A) Swallow the tablet with water
B) Take one tablet every 5 minutes for up to three doses for
chest pain
C) Store the tablets in the refrigerator
D) Take the medication with food to prevent nausea
Answer: B
Rationale: Nitroglycerin sublingual should be taken at the onset
of chest pain—one tablet every 5 minutes for up to three doses.
Call 911 if pain persists after the first tablet.
Q7. A nurse is preparing to administer digoxin. The apical
pulse is 52 bpm in an adult. What should the nurse do?
A) Administer the medication
B) Hold the dose and reassess in 1 hour
C) Hold and notify the provider
D) Give half the dose
Surg) 2023 Proctored Exam with NGN
120 Questions and Answers
Cardiovascular System (Questions 1–20)
Q1. A nurse is caring for a client with heart failure who
reports sudden shortness of breath and coughing up pink,
frothy sputum. Which action should the nurse take first?
A) Administer furosemide IV push
B) Place the client in High-Fowler's position
C) Apply a non-rebreather mask at 15 L/min
D) Notify the provider immediately
Answer: B
Rationale: High-Fowler's position reduces venous return and
decreases pulmonary congestion. Airway and breathing come
before medications or notification.
Q2. A nurse is caring for a client who has heart failure and is
receiving furosemide. Which laboratory value should the
nurse report to the provider?
, A) Potassium 3.2 mEq/L
B) Sodium 138 mEq/L
C) Chloride 100 mEq/L
D) Calcium 9.5 mg/dL
Answer: A
Rationale: Furosemide is a loop diuretic that causes potassium
loss. Hypokalemia (normal 3.5–5.0) increases the risk of cardiac
arrhythmias, especially in clients taking digoxin.
Q3. A nurse is reinforcing discharge teaching with a client
who has a new prescription for warfarin. Which statement
indicates a need for further teaching?
A) "I'll use a soft toothbrush to brush my teeth."
B) "I'll eat more green leafy vegetables for extra vitamin K."
C) "I'll avoid drinking alcohol while taking this medication."
D) "I'll report any unusual bruising to my provider."
Answer: B
Rationale: Green leafy vegetables are high in vitamin K, which
antagonizes the anticoagulant effect of warfarin. The client should
maintain a consistent intake of vitamin K, not increase it.
,Q4. A nurse is reinforcing teaching with a client who has a
new prescription for nitroglycerin sublingual tablets. Which
instruction should the nurse include?
A) "Take a tablet every 5 minutes until chest pain stops, up to
three doses."
B) "Swallow the tablet with a full glass of water."
C) "Store the tablets in the refrigerator."
D) "Take the medication with food to prevent stomach
upset."
Answer: A
Rationale: Standard dosing: one tablet every 5 minutes for up to
three doses. If pain persists after the first tablet, call 911.
Nitroglycerin should not be swallowed; it is placed under the
tongue.
Q5. A nurse is caring for a client following a cardiac
catheterization via the right femoral artery. Which finding
requires immediate intervention?
A) Heart rate 90 bpm
B) Blood pressure 110/70 mmHg
C) Right foot is cool and pulseless
D) Pain at the insertion site
Answer: C
, Rationale: A cool, pulseless foot indicates arterial occlusion—a
medical emergency requiring immediate intervention to prevent
tissue necrosis.
Q6. A client with angina is prescribed nitroglycerin sublingual.
The nurse should instruct the client to:
A) Swallow the tablet with water
B) Take one tablet every 5 minutes for up to three doses for
chest pain
C) Store the tablets in the refrigerator
D) Take the medication with food to prevent nausea
Answer: B
Rationale: Nitroglycerin sublingual should be taken at the onset
of chest pain—one tablet every 5 minutes for up to three doses.
Call 911 if pain persists after the first tablet.
Q7. A nurse is preparing to administer digoxin. The apical
pulse is 52 bpm in an adult. What should the nurse do?
A) Administer the medication
B) Hold the dose and reassess in 1 hour
C) Hold and notify the provider
D) Give half the dose
