ATI MED-SURG PROCTORED EXAM
(2024-2025 Edition)
100% Verified Exam-Style Questions
120 NCLEX-Style Practice Questions
Questions on Respiratory, Cardiac,
Neuro, Gastrointestinal & Endocrine
Detailed Rationales
, ATI Med-Surg Proctored Exam 2024- 2025| 120 Nclex-Style Practice Questions with Rationales
TABLE OF CONTENTS
1. Section 1: Respiratory
2. Section 2: Cardiac
3. Section 3: Neuro
4. Section 5: Gastrointestinal & Endocrine
5. Section 6: Fluids & Electrolytes
6. Section 7: STATA Priority
2
, ATI Med-Surg Proctored Exam 2024- 2025| 120 Nclex-Style Practice Questions with Rationales
RESPIRATORY
Focus Areas: COPD • ARDS • Pneumonia • TB • Pulmonary Embolism
1. COPD Exacerbation Priority
Scenario: 65yo with COPD (FEV1 45%) presents with increased sputum purulence and
wheezing.
Question: Which intervention is most urgent?
A. Administer oral corticosteroids (Correct)
B. Start IV antibiotics
C. Increase oxygen to 5L/min
Rationale: "Steroids (A) reduce inflammation fastest. Avoid high O2 (C) to prevent CO2
retention."
2. ARDS Ventilator Setting
Scenario: PaO2 55mmHg on 100% FiO2, bilateral infiltrates on CXR.
Question: Which ventilator adjustment is priority?
A. Increase PEEP (Correct)
B. Raise tidal volume
C. Switch to pressure control
Rationale: "PEEP (A) improves oxygenation in refractory hypoxemia. High tidal volumes worsen
lung injury."
3. Pneumonia Prevention
Question: Which patient needs pneumococcal vaccine today?
A. 68yo with emphysema (Correct)
B. 30yo with seasonal allergies
C. 45yo on low-dose aspirin
Rationale: "Chronic lung disease (A) warrants PCV20. (B) and (C) aren’t indications."
3
, ATI Med-Surg Proctored Exam 2024- 2025| 120 Nclex-Style Practice Questions with Rationales
4. TB Isolation
Scenario: Suspected pulmonary TB with positive sputum AFB smear.
Question: Which precaution is required?
A. Airborne isolation (Correct)
B. Contact precautions
C. Droplet mask
Rationale: "TB spreads via aerosolized droplets. N95 respirators are essential."
5. Pulmonary Embolism SATA
Scenario: Post-op patient with sudden dyspnea, HR 120, and SpO2 88%.
Question: Which findings support PE? (Select 3)
A. ☑Unilateral calf swelling
B. ☑Elevated D-dimer
C. ☑Right ventricular strain on EKG
D. ☐ Barrel chest
Rationale: "PE triad = dyspnea + tachycardia + hypoxia. Barrel chest (D) suggests COPD."
6. Asthma Action Plan
Question: Which metric indicates poor asthma control?
A. >2 rescue inhaler uses/week (Correct)
B. Morning peak flow 80% predicted
C. Occasional nighttime cough
Rationale: "Frequent rescue use (A) signals inadequate controller therapy."
7. Chest Tube Management
Scenario: Post-thoracotomy patient has 200mL/hr bloody drainage.
Question: What is the priority action?
A. Assess for tamponade (Correct)
B. Clamp the tube
C. Increase suction pressure
4
(2024-2025 Edition)
100% Verified Exam-Style Questions
120 NCLEX-Style Practice Questions
Questions on Respiratory, Cardiac,
Neuro, Gastrointestinal & Endocrine
Detailed Rationales
, ATI Med-Surg Proctored Exam 2024- 2025| 120 Nclex-Style Practice Questions with Rationales
TABLE OF CONTENTS
1. Section 1: Respiratory
2. Section 2: Cardiac
3. Section 3: Neuro
4. Section 5: Gastrointestinal & Endocrine
5. Section 6: Fluids & Electrolytes
6. Section 7: STATA Priority
2
, ATI Med-Surg Proctored Exam 2024- 2025| 120 Nclex-Style Practice Questions with Rationales
RESPIRATORY
Focus Areas: COPD • ARDS • Pneumonia • TB • Pulmonary Embolism
1. COPD Exacerbation Priority
Scenario: 65yo with COPD (FEV1 45%) presents with increased sputum purulence and
wheezing.
Question: Which intervention is most urgent?
A. Administer oral corticosteroids (Correct)
B. Start IV antibiotics
C. Increase oxygen to 5L/min
Rationale: "Steroids (A) reduce inflammation fastest. Avoid high O2 (C) to prevent CO2
retention."
2. ARDS Ventilator Setting
Scenario: PaO2 55mmHg on 100% FiO2, bilateral infiltrates on CXR.
Question: Which ventilator adjustment is priority?
A. Increase PEEP (Correct)
B. Raise tidal volume
C. Switch to pressure control
Rationale: "PEEP (A) improves oxygenation in refractory hypoxemia. High tidal volumes worsen
lung injury."
3. Pneumonia Prevention
Question: Which patient needs pneumococcal vaccine today?
A. 68yo with emphysema (Correct)
B. 30yo with seasonal allergies
C. 45yo on low-dose aspirin
Rationale: "Chronic lung disease (A) warrants PCV20. (B) and (C) aren’t indications."
3
, ATI Med-Surg Proctored Exam 2024- 2025| 120 Nclex-Style Practice Questions with Rationales
4. TB Isolation
Scenario: Suspected pulmonary TB with positive sputum AFB smear.
Question: Which precaution is required?
A. Airborne isolation (Correct)
B. Contact precautions
C. Droplet mask
Rationale: "TB spreads via aerosolized droplets. N95 respirators are essential."
5. Pulmonary Embolism SATA
Scenario: Post-op patient with sudden dyspnea, HR 120, and SpO2 88%.
Question: Which findings support PE? (Select 3)
A. ☑Unilateral calf swelling
B. ☑Elevated D-dimer
C. ☑Right ventricular strain on EKG
D. ☐ Barrel chest
Rationale: "PE triad = dyspnea + tachycardia + hypoxia. Barrel chest (D) suggests COPD."
6. Asthma Action Plan
Question: Which metric indicates poor asthma control?
A. >2 rescue inhaler uses/week (Correct)
B. Morning peak flow 80% predicted
C. Occasional nighttime cough
Rationale: "Frequent rescue use (A) signals inadequate controller therapy."
7. Chest Tube Management
Scenario: Post-thoracotomy patient has 200mL/hr bloody drainage.
Question: What is the priority action?
A. Assess for tamponade (Correct)
B. Clamp the tube
C. Increase suction pressure
4
