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ATI RN Adult Health 2025 – 180 High-Yield Med-Surg
Questions with Answers & Detailed Rationales
Question 1
A patient with chronic heart failure reports increasing dyspnea and orthopnea. Nursing priority:
a. Assess oxygen saturation and lung sounds
b. Encourage ambulation
c. Provide a high-sodium diet
d. Administer a diuretic without assessment
ANS: a
Rationale: Assessing oxygenation and lung sounds is crucial to identify fluid overload or
respiratory compromise. Diuretics are given after assessment. Encouraging ambulation or
providing high-sodium foods could worsen symptoms.
DIF: Hard | OBJ: Heart Failure Assessment | TOP: Cardiovascular | MSC: Physiological Integrity
Question 2
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A patient is admitted with acute myocardial infarction (MI). The nurse should prioritize:
a. Monitoring for dysrhythmias
b. Teaching discharge instructions
c. Encouraging early ambulation
d. Performing passive range-of-motion exercises
ANS: a
Rationale: Dysrhythmias are the most immediate life-threatening complication post-MI. Early
ambulation, teaching, and exercises follow stabilization.
DIF: Hard | OBJ: Cardiac Care | TOP: MI Management | MSC: Safe and Effective Care
Question 3
A patient with COPD has an SpO₂ of 88% on room air. Appropriate nursing intervention:
a. Administer supplemental oxygen as prescribed
b. Encourage deep breathing only
c. Restrict fluids
d. Place in supine position
ANS: a
Rationale: Oxygen therapy maintains adequate oxygenation. Deep breathing is helpful but not
sufficient alone. Supine positioning may worsen dyspnea.
DIF: Moderate | OBJ: Respiratory Management | TOP: COPD | MSC: Physiological Integrity
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Question 4
A patient is receiving heparin therapy for DVT. Which lab test should the nurse monitor?
a. aPTT
b. INR
c. Platelet count only
d. Hemoglobin only
ANS: a
Rationale: aPTT monitors heparin efficacy and prevents bleeding. INR is used for warfarin
therapy. Platelets and hemoglobin are also monitored but not primary for heparin dosing.
DIF: Moderate | OBJ: Medication Safety | TOP: Anticoagulation | MSC: Physiological Integrity
Question 5
A patient with pneumonia has a temp of 102.4°F and productive cough. Nursing action:
a. Obtain sputum culture before starting antibiotics
b. Administer antipyretics only
c. Encourage bedrest without treatment
d. Begin antibiotics immediately without cultures
ANS: a
Rationale: Obtaining a culture before antibiotic therapy ensures accurate identification of
causative organisms. Antipyretics and antibiotics follow culture collection.
DIF: Moderate | OBJ: Infection Control | TOP: Pneumonia | MSC: Physiological Integrity
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Question 6
A patient with CKD shows serum potassium of 6.2 mEq/L. Priority intervention:
a. Assess for ECG changes and notify provider
b. Restrict fluids only
c. Administer potassium supplements
d. Encourage high-potassium foods
ANS: a
Rationale: Hyperkalemia is life-threatening; ECG monitoring and provider notification are
urgent. Potassium supplements or high-potassium foods are contraindicated.
DIF: Hard | OBJ: Electrolyte Management | TOP: CKD | MSC: Physiological Integrity
Question 7
A patient with peptic ulcer disease reports black, tarry stools. Nursing action:
a. Notify the provider immediately
b. Encourage a high-fiber diet
c. Assess pain only
d. Reassure patient without intervention
ANS: a
Rationale: Melena indicates GI bleeding. Prompt provider notification and assessment are
ATI RN Adult Health 2025 – 180 High-Yield Med-Surg
Questions with Answers & Detailed Rationales
Question 1
A patient with chronic heart failure reports increasing dyspnea and orthopnea. Nursing priority:
a. Assess oxygen saturation and lung sounds
b. Encourage ambulation
c. Provide a high-sodium diet
d. Administer a diuretic without assessment
ANS: a
Rationale: Assessing oxygenation and lung sounds is crucial to identify fluid overload or
respiratory compromise. Diuretics are given after assessment. Encouraging ambulation or
providing high-sodium foods could worsen symptoms.
DIF: Hard | OBJ: Heart Failure Assessment | TOP: Cardiovascular | MSC: Physiological Integrity
Question 2
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A patient is admitted with acute myocardial infarction (MI). The nurse should prioritize:
a. Monitoring for dysrhythmias
b. Teaching discharge instructions
c. Encouraging early ambulation
d. Performing passive range-of-motion exercises
ANS: a
Rationale: Dysrhythmias are the most immediate life-threatening complication post-MI. Early
ambulation, teaching, and exercises follow stabilization.
DIF: Hard | OBJ: Cardiac Care | TOP: MI Management | MSC: Safe and Effective Care
Question 3
A patient with COPD has an SpO₂ of 88% on room air. Appropriate nursing intervention:
a. Administer supplemental oxygen as prescribed
b. Encourage deep breathing only
c. Restrict fluids
d. Place in supine position
ANS: a
Rationale: Oxygen therapy maintains adequate oxygenation. Deep breathing is helpful but not
sufficient alone. Supine positioning may worsen dyspnea.
DIF: Moderate | OBJ: Respiratory Management | TOP: COPD | MSC: Physiological Integrity
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Question 4
A patient is receiving heparin therapy for DVT. Which lab test should the nurse monitor?
a. aPTT
b. INR
c. Platelet count only
d. Hemoglobin only
ANS: a
Rationale: aPTT monitors heparin efficacy and prevents bleeding. INR is used for warfarin
therapy. Platelets and hemoglobin are also monitored but not primary for heparin dosing.
DIF: Moderate | OBJ: Medication Safety | TOP: Anticoagulation | MSC: Physiological Integrity
Question 5
A patient with pneumonia has a temp of 102.4°F and productive cough. Nursing action:
a. Obtain sputum culture before starting antibiotics
b. Administer antipyretics only
c. Encourage bedrest without treatment
d. Begin antibiotics immediately without cultures
ANS: a
Rationale: Obtaining a culture before antibiotic therapy ensures accurate identification of
causative organisms. Antipyretics and antibiotics follow culture collection.
DIF: Moderate | OBJ: Infection Control | TOP: Pneumonia | MSC: Physiological Integrity
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Question 6
A patient with CKD shows serum potassium of 6.2 mEq/L. Priority intervention:
a. Assess for ECG changes and notify provider
b. Restrict fluids only
c. Administer potassium supplements
d. Encourage high-potassium foods
ANS: a
Rationale: Hyperkalemia is life-threatening; ECG monitoring and provider notification are
urgent. Potassium supplements or high-potassium foods are contraindicated.
DIF: Hard | OBJ: Electrolyte Management | TOP: CKD | MSC: Physiological Integrity
Question 7
A patient with peptic ulcer disease reports black, tarry stools. Nursing action:
a. Notify the provider immediately
b. Encourage a high-fiber diet
c. Assess pain only
d. Reassure patient without intervention
ANS: a
Rationale: Melena indicates GI bleeding. Prompt provider notification and assessment are
