ATI RN Adult Medical Surgical 2023–2026
Proctored Exam with NGN | 100 Practice
Questions & Verified Answers Study Guide
for Level 3 Success
ATI RN ADULT MEDICAL SURGICAL 2023–2026 PROCTORED EXAM PRACTICE
QUESTIONS & VERIFIED ANSWERS STUDY GUIDE
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DOCUMENT OVERVIEW
• This comprehensive study guide contains 100 evidence-based practice questions
designed to prepare you for the ATI RN Adult Medical Surgical proctored exam with
detailed EXPERT RATIONALE for every answer to reinforce critical thinking and
clinical decision-making.
• Study systematically by reviewing each question, attempting to answer before
reading options, then carefully reviewing the EXPERT RATIONALE to understand
the "why" behind correct answers—this method builds both knowledge retention
and test-taking confidence.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
QUESTION 1: A client with myocardial infarction is prescribed nitroglycerin
sublingual tablets. The nurse should instruct the client to report which of the
following adverse effects immediately?
A) Headache and flushing
B) Dizziness and lightheadedness
C) Severe chest pain that is unrelieved by three doses
D) Mild tingling in the fingers
E) Increased urination
CORRECT ANSWER: C) Severe chest pain that is unrelieved by three doses ✓
EXPERT RATIONALE:
,Nitroglycerin is a vasodilator used to relieve anginal chest pain. While headache,
flushing, dizziness, and lightheadedness are expected and common side effects
that typically resolve with continued use, severe chest pain unrelieved by three
doses of nitroglycerin taken 5 minutes apart indicates possible acute myocardial
infarction or unstable angina and constitutes a medical emergency requiring
immediate intervention. The client should seek emergency care immediately. Mild
tingling and increased urination are not typical adverse effects of nitroglycerin
requiring immediate reporting.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━
QUESTION 2: A client with chronic obstructive pulmonary disease is receiving
oxygen at 2 L/min via nasal cannula. Which assessment finding indicates the
client is experiencing hypoxemia despite oxygen therapy?
A) Respiratory rate of 18 breaths per minute
B) Oxygen saturation of 88%
C) Pink coloring of the oral mucosa
D) Clear breath sounds bilaterally
E) Heart rate of 72 beats per minute
CORRECT ANSWER: B) Oxygen saturation of 88% ✓
EXPERT RATIONALE:
Hypoxemia is defined as inadequate oxygenation of the blood. Normal oxygen
saturation (SpO2) is 95-100%. An oxygen saturation of 88% indicates hypoxemia,
which means the blood oxygen level is insufficient despite oxygen therapy
administration. For clients with COPD, target SpO2 is often 88-92%, but 88% at the
lower limit still indicates some degree of hypoxemia that may require intervention
adjustment. A respiratory rate of 18 breaths/min is within normal range (12-20
breaths/min), pink mucosa indicates adequate perfusion, clear bilateral breath
sounds are normal, and a heart rate of 72 beats/min is within normal range (60-100
beats/min).
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━
QUESTION 3: A client is diagnosed with acute appendicitis and is scheduled for
an appendectomy in 4 hours. The nurse provides preoperative education.
Which statement by the client indicates understanding of postoperative
expectations?
A) "I will not need pain medication after surgery because the anesthesia will last a
long time."
B) "I will be able to eat solid foods within 2-3 hours after surgery."
C) "I will need to change my surgical dressing daily and watch for signs of infection."
D) "I can resume my normal exercise routine immediately after discharge."
E) "I will not have any drainage from my surgical incision."
CORRECT ANSWER: C) I will need to change my surgical dressing daily and
watch for signs of infection. ✓
EXPERT RATIONALE:
Postoperative client education should include proper incision care, including
dressing changes and monitoring for signs of infection (increased redness, warmth,
swelling, purulent drainage, increased pain). This is an accurate expectation for
post-surgical care. Anesthesia does not provide prolonged pain relief—pain
medication will be needed postoperatively. Solid foods are typically introduced
gradually after bowel sounds return and as tolerated, not within 2-3 hours. Normal
exercise routines are not resumed immediately; gradual activity progression based
on physician orders and client tolerance is necessary. Some drainage from the
incision is normal initially; absence of any drainage is not a typical expectation.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━
QUESTION 4: A 68-year-old client with atrial fibrillation is prescribed warfarin.
The nurse understands that this anticoagulant is given to prevent which
serious complication?
, A) Hemorrhagic stroke
B) Ischemic stroke from thromboembolism
C) Hypertensive crisis
D) Myocardial infarction
E) Pulmonary edema
CORRECT ANSWER: B) Ischemic stroke from thromboembolism ✓
EXPERT RATIONALE:
Atrial fibrillation causes irregular heart rhythm, which prevents complete emptying
of the atria. This blood stasis increases the risk of thrombus formation. Warfarin is
an anticoagulant that prevents clot formation and subsequent thromboembolic
complications, particularly ischemic stroke. This is the primary indication for
anticoagulation in atrial fibrillation. Hemorrhagic stroke is a risk of over-
anticoagulation, not a complication warfarin prevents. While warfarin may reduce
the risk of MI, it is not the primary indication for its use in atrial fibrillation.
Hypertensive crisis and pulmonary edema are not direct complications prevented
by warfarin therapy.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━
QUESTION 5: A client with type 2 diabetes mellitus is newly prescribed
metformin. Which instruction should the nurse include when teaching about
this medication?
A) "Take the medication on an empty stomach for maximum absorption."
B) "You may discontinue the medication once your blood glucose levels normalize."
C) "Take the medication with food to minimize gastrointestinal distress."
D) "This medication will cause weight gain, so restrict your caloric intake."
E) "You should expect your urine to turn dark yellow or orange."
CORRECT ANSWER: C) Take the medication with food to minimize
gastrointestinal distress. ✓
Proctored Exam with NGN | 100 Practice
Questions & Verified Answers Study Guide
for Level 3 Success
ATI RN ADULT MEDICAL SURGICAL 2023–2026 PROCTORED EXAM PRACTICE
QUESTIONS & VERIFIED ANSWERS STUDY GUIDE
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━
DOCUMENT OVERVIEW
• This comprehensive study guide contains 100 evidence-based practice questions
designed to prepare you for the ATI RN Adult Medical Surgical proctored exam with
detailed EXPERT RATIONALE for every answer to reinforce critical thinking and
clinical decision-making.
• Study systematically by reviewing each question, attempting to answer before
reading options, then carefully reviewing the EXPERT RATIONALE to understand
the "why" behind correct answers—this method builds both knowledge retention
and test-taking confidence.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
QUESTION 1: A client with myocardial infarction is prescribed nitroglycerin
sublingual tablets. The nurse should instruct the client to report which of the
following adverse effects immediately?
A) Headache and flushing
B) Dizziness and lightheadedness
C) Severe chest pain that is unrelieved by three doses
D) Mild tingling in the fingers
E) Increased urination
CORRECT ANSWER: C) Severe chest pain that is unrelieved by three doses ✓
EXPERT RATIONALE:
,Nitroglycerin is a vasodilator used to relieve anginal chest pain. While headache,
flushing, dizziness, and lightheadedness are expected and common side effects
that typically resolve with continued use, severe chest pain unrelieved by three
doses of nitroglycerin taken 5 minutes apart indicates possible acute myocardial
infarction or unstable angina and constitutes a medical emergency requiring
immediate intervention. The client should seek emergency care immediately. Mild
tingling and increased urination are not typical adverse effects of nitroglycerin
requiring immediate reporting.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━
QUESTION 2: A client with chronic obstructive pulmonary disease is receiving
oxygen at 2 L/min via nasal cannula. Which assessment finding indicates the
client is experiencing hypoxemia despite oxygen therapy?
A) Respiratory rate of 18 breaths per minute
B) Oxygen saturation of 88%
C) Pink coloring of the oral mucosa
D) Clear breath sounds bilaterally
E) Heart rate of 72 beats per minute
CORRECT ANSWER: B) Oxygen saturation of 88% ✓
EXPERT RATIONALE:
Hypoxemia is defined as inadequate oxygenation of the blood. Normal oxygen
saturation (SpO2) is 95-100%. An oxygen saturation of 88% indicates hypoxemia,
which means the blood oxygen level is insufficient despite oxygen therapy
administration. For clients with COPD, target SpO2 is often 88-92%, but 88% at the
lower limit still indicates some degree of hypoxemia that may require intervention
adjustment. A respiratory rate of 18 breaths/min is within normal range (12-20
breaths/min), pink mucosa indicates adequate perfusion, clear bilateral breath
sounds are normal, and a heart rate of 72 beats/min is within normal range (60-100
beats/min).
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━
QUESTION 3: A client is diagnosed with acute appendicitis and is scheduled for
an appendectomy in 4 hours. The nurse provides preoperative education.
Which statement by the client indicates understanding of postoperative
expectations?
A) "I will not need pain medication after surgery because the anesthesia will last a
long time."
B) "I will be able to eat solid foods within 2-3 hours after surgery."
C) "I will need to change my surgical dressing daily and watch for signs of infection."
D) "I can resume my normal exercise routine immediately after discharge."
E) "I will not have any drainage from my surgical incision."
CORRECT ANSWER: C) I will need to change my surgical dressing daily and
watch for signs of infection. ✓
EXPERT RATIONALE:
Postoperative client education should include proper incision care, including
dressing changes and monitoring for signs of infection (increased redness, warmth,
swelling, purulent drainage, increased pain). This is an accurate expectation for
post-surgical care. Anesthesia does not provide prolonged pain relief—pain
medication will be needed postoperatively. Solid foods are typically introduced
gradually after bowel sounds return and as tolerated, not within 2-3 hours. Normal
exercise routines are not resumed immediately; gradual activity progression based
on physician orders and client tolerance is necessary. Some drainage from the
incision is normal initially; absence of any drainage is not a typical expectation.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━
QUESTION 4: A 68-year-old client with atrial fibrillation is prescribed warfarin.
The nurse understands that this anticoagulant is given to prevent which
serious complication?
, A) Hemorrhagic stroke
B) Ischemic stroke from thromboembolism
C) Hypertensive crisis
D) Myocardial infarction
E) Pulmonary edema
CORRECT ANSWER: B) Ischemic stroke from thromboembolism ✓
EXPERT RATIONALE:
Atrial fibrillation causes irregular heart rhythm, which prevents complete emptying
of the atria. This blood stasis increases the risk of thrombus formation. Warfarin is
an anticoagulant that prevents clot formation and subsequent thromboembolic
complications, particularly ischemic stroke. This is the primary indication for
anticoagulation in atrial fibrillation. Hemorrhagic stroke is a risk of over-
anticoagulation, not a complication warfarin prevents. While warfarin may reduce
the risk of MI, it is not the primary indication for its use in atrial fibrillation.
Hypertensive crisis and pulmonary edema are not direct complications prevented
by warfarin therapy.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━
QUESTION 5: A client with type 2 diabetes mellitus is newly prescribed
metformin. Which instruction should the nurse include when teaching about
this medication?
A) "Take the medication on an empty stomach for maximum absorption."
B) "You may discontinue the medication once your blood glucose levels normalize."
C) "Take the medication with food to minimize gastrointestinal distress."
D) "This medication will cause weight gain, so restrict your caloric intake."
E) "You should expect your urine to turn dark yellow or orange."
CORRECT ANSWER: C) Take the medication with food to minimize
gastrointestinal distress. ✓
