ATI Med-Surg Proctored Exam Test Bank 2026
| Medical-Surgical Nursing, NCLEX
Preparation | 600 Multiple Choice Questions
and Answers with Detailed Rationales | 100%
Guaranteed A+
Question 1: A client with heart failure is receiving digoxin. Which finding indicates potential toxicity?
A) Heart rate of 68 bpm
B) Serum potassium of 3.8 mEq/L
C) Visual disturbances with yellow halos
D) Blood pressure of 130/80 mmHg
Answer: C
Digoxin toxicity manifests with gastrointestinal symptoms, cardiac arrhythmias, and visual disturbances
including yellow-green halos. The therapeutic range is narrow, and toxicity risk increases with hypokalemia,
renal impairment, and advanced age.
Question 2: A postoperative client develops sudden chest pain, dyspnea, and hemoptysis. What is the priority
nursing action?
A) Administer oxygen and notify healthcare provider
B) Position client in high Fowler's position
C) Prepare for emergency thoracentesis
D) Administer prescribed anticoagulants
Answer: A
1|P a g e SUCCESS!!!
,These symptoms suggest pulmonary embolism, a life-threatening complication requiring immediate oxygen
therapy and rapid provider notification. High Fowler's position assists breathing but doesn't address the
underlying emergency. Anticoagulation requires confirmation before administration.
Question 3: A client with diabetes mellitus type 2 presents with blood glucose of 650 mg/dL, confusion, and dry
mucous membranes. Which intervention is most important initially?
A) Administer regular insulin IV
B) Initiate IV fluid resuscitation
C) Check serum electrolytes
D) Insert indwelling urinary catheter
Answer: B
Hyperglycemic hyperosmolar syndrome requires aggressive fluid replacement as the priority to correct
severe dehydration and restore tissue perfusion. While insulin and electrolytes are important, volume
resuscitation prevents cardiovascular collapse and reduces serum osmolality.
Question 4: A client receiving mechanical ventilation has a sudden drop in oxygen saturation to 82%. What is the
nurse's first action?
A) Increase FiO2 immediately
B) Assess for tube dislodgement
C) Suction the endotracheal tube
D) Call respiratory therapy
Answer: B
Sudden desaturation in ventilated patients must first prompt assessment of tube position and patency. Tube
dislodgement or obstruction is immediately life-threatening and requires rapid intervention before adjusting
settings or suctioning.
2|P a g e SUCCESS!!!
,Question 5: Which assessment finding indicates compromised arterial circulation in a client's lower extremity?
A) Bilateral foot edema
B) Warm, pink skin with hair growth
C) Pallor on elevation and dependent rubor
D) Diminished but present pedal pulses
Answer: C
Pallor with elevation and dependent rubor are classic signs of arterial insufficiency caused by inadequate
blood flow. Diminished pulses are significant but pallor with positional changes specifically indicates severe
arterial compromise requiring intervention.
Question 6: A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min via nasal cannula.
The nurse notes the client is lethargic and breathing shallowly. What should the nurse do?
A) Increase oxygen to 4 L/min
B) Decrease oxygen to 1 L/min
C) Place client in prone position
D) Prepare for immediate intubation
Answer: B
COPD clients with chronic hypercapnia rely on hypoxic drive. Excessive oxygen can suppress this stimulus
leading to respiratory depression and carbon dioxide narcosis. Decreasing oxygen may reverse respiratory
depression while maintaining adequate saturation.
Question 7: A client with cirrhosis develops asterixis and confusion. Which medication should the nurse anticipate?
A) Furosemide
B) Spironolactone
C) Lactulose
3|P a g e SUCCESS!!!
, D) Omeprazole
Answer: C
Asterixis and confusion indicate hepatic encephalopathy from ammonia accumulation. Lactulose promotes
ammonia excretion through the gastrointestinal tract by acidifying the colon and converting ammonia to
ammonium, which is excreted in feces.
Question 8: A client is recovering from a total hip arthroplasty. Which position is contraindicated?
A) Supine with pillow between legs
B) Side-lying on the unaffected side
C) Crossed legs while sitting
D) Elevated foot of bed slightly
Answer: C
Crossing legs is contraindicated after hip arthroplasty as it creates hip flexion and adduction exceeding 90
degrees, increasing dislocation risk. Maintain hip abduction with pillows between legs and avoid positions
that compromise the new joint.
Question 9: A client with acute pancreatitis reports severe abdominal pain radiating to the back. What is the most
appropriate nursing intervention?
A) Position in side-lying with knees flexed
B) Apply heat to the abdomen
C) Encourage oral fluids
D) Ambulate to relieve gas pain
Answer: A
4|P a g e SUCCESS!!!
| Medical-Surgical Nursing, NCLEX
Preparation | 600 Multiple Choice Questions
and Answers with Detailed Rationales | 100%
Guaranteed A+
Question 1: A client with heart failure is receiving digoxin. Which finding indicates potential toxicity?
A) Heart rate of 68 bpm
B) Serum potassium of 3.8 mEq/L
C) Visual disturbances with yellow halos
D) Blood pressure of 130/80 mmHg
Answer: C
Digoxin toxicity manifests with gastrointestinal symptoms, cardiac arrhythmias, and visual disturbances
including yellow-green halos. The therapeutic range is narrow, and toxicity risk increases with hypokalemia,
renal impairment, and advanced age.
Question 2: A postoperative client develops sudden chest pain, dyspnea, and hemoptysis. What is the priority
nursing action?
A) Administer oxygen and notify healthcare provider
B) Position client in high Fowler's position
C) Prepare for emergency thoracentesis
D) Administer prescribed anticoagulants
Answer: A
1|P a g e SUCCESS!!!
,These symptoms suggest pulmonary embolism, a life-threatening complication requiring immediate oxygen
therapy and rapid provider notification. High Fowler's position assists breathing but doesn't address the
underlying emergency. Anticoagulation requires confirmation before administration.
Question 3: A client with diabetes mellitus type 2 presents with blood glucose of 650 mg/dL, confusion, and dry
mucous membranes. Which intervention is most important initially?
A) Administer regular insulin IV
B) Initiate IV fluid resuscitation
C) Check serum electrolytes
D) Insert indwelling urinary catheter
Answer: B
Hyperglycemic hyperosmolar syndrome requires aggressive fluid replacement as the priority to correct
severe dehydration and restore tissue perfusion. While insulin and electrolytes are important, volume
resuscitation prevents cardiovascular collapse and reduces serum osmolality.
Question 4: A client receiving mechanical ventilation has a sudden drop in oxygen saturation to 82%. What is the
nurse's first action?
A) Increase FiO2 immediately
B) Assess for tube dislodgement
C) Suction the endotracheal tube
D) Call respiratory therapy
Answer: B
Sudden desaturation in ventilated patients must first prompt assessment of tube position and patency. Tube
dislodgement or obstruction is immediately life-threatening and requires rapid intervention before adjusting
settings or suctioning.
2|P a g e SUCCESS!!!
,Question 5: Which assessment finding indicates compromised arterial circulation in a client's lower extremity?
A) Bilateral foot edema
B) Warm, pink skin with hair growth
C) Pallor on elevation and dependent rubor
D) Diminished but present pedal pulses
Answer: C
Pallor with elevation and dependent rubor are classic signs of arterial insufficiency caused by inadequate
blood flow. Diminished pulses are significant but pallor with positional changes specifically indicates severe
arterial compromise requiring intervention.
Question 6: A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min via nasal cannula.
The nurse notes the client is lethargic and breathing shallowly. What should the nurse do?
A) Increase oxygen to 4 L/min
B) Decrease oxygen to 1 L/min
C) Place client in prone position
D) Prepare for immediate intubation
Answer: B
COPD clients with chronic hypercapnia rely on hypoxic drive. Excessive oxygen can suppress this stimulus
leading to respiratory depression and carbon dioxide narcosis. Decreasing oxygen may reverse respiratory
depression while maintaining adequate saturation.
Question 7: A client with cirrhosis develops asterixis and confusion. Which medication should the nurse anticipate?
A) Furosemide
B) Spironolactone
C) Lactulose
3|P a g e SUCCESS!!!
, D) Omeprazole
Answer: C
Asterixis and confusion indicate hepatic encephalopathy from ammonia accumulation. Lactulose promotes
ammonia excretion through the gastrointestinal tract by acidifying the colon and converting ammonia to
ammonium, which is excreted in feces.
Question 8: A client is recovering from a total hip arthroplasty. Which position is contraindicated?
A) Supine with pillow between legs
B) Side-lying on the unaffected side
C) Crossed legs while sitting
D) Elevated foot of bed slightly
Answer: C
Crossing legs is contraindicated after hip arthroplasty as it creates hip flexion and adduction exceeding 90
degrees, increasing dislocation risk. Maintain hip abduction with pillows between legs and avoid positions
that compromise the new joint.
Question 9: A client with acute pancreatitis reports severe abdominal pain radiating to the back. What is the most
appropriate nursing intervention?
A) Position in side-lying with knees flexed
B) Apply heat to the abdomen
C) Encourage oral fluids
D) Ambulate to relieve gas pain
Answer: A
4|P a g e SUCCESS!!!
