ATI PN ADULT MEDICAL SURGICAL EXAM FORM A, B AND C
ACTUAL EXAM EACH FORM CONTAINS 70 QUESTIONS AND
CORRECT DETAILED ANSWERS
Question 1
A nurse is caring for a client who is prescribed warfarin. Which of the
following laboratory values should the nurse monitor to evaluate the
effectiveness of this medication?
A) Activated partial thromboplastin time (aPTT)
B) Platelet count
C) Prothrombin time (PT) and International Normalized Ratio (INR)
D) Fibrinogen levels
E) D-dimer
Correct Answer: C) Prothrombin time (PT) and International
Normalized Ratio (INR)
Rationale: Warfarin is an oral anticoagulant that inhibits vitamin K-
dependent clotting factors. Its effectiveness is monitored by PT,
which is standardized to the INR, ensuring consistent therapeutic
ranges.
Question 2
A nurse is caring for a client who has a new prescription for digoxin. The
nurse should withhold the medication and notify the provider if the client's
apical pulse is less than:
A) 80/min
B) 70/min
C) 60/min
D) 50/min
E) 40/min
Correct Answer: C) 60/min
Rationale: Digoxin slows the heart rate. The nurse should always
check the apical pulse for a full minute before administering digoxin
and withhold the medication if the pulse is below 60 beats per
minute (or as per specific provider orders/parameters).
,Question 3
A client with chronic obstructive pulmonary disease (COPD) is experiencing
dyspnea. Which of the following positions should the nurse encourage the
client to assume?
A) Supine with legs elevated.
B) Trendelenburg position.
C) High-Fowler's position or orthopneic position.
D) Left lateral recumbent.
E) Prone position.
Correct Answer: C) High-Fowler's position or orthopneic position.
Rationale: Elevating the head of the bed (High-Fowler's) or having the
client lean forward on an overbed table (orthopneic position) helps
reduce dyspnea by allowing for better lung expansion and
diaphragm excursion.
Question 4
A nurse is administering a subcutaneous injection of insulin. Which of the
following actions should the nurse take?
A) Aspirate for blood return before injecting.
B) Massage the injection site after administering.
C) Inject the insulin at a 15-degree angle.
D) Pinch the skin and inject at a 45- or 90-degree angle.
E) Administer the insulin into the deltoid muscle.
Correct Answer: D) Pinch the skin and inject at a 45- or 90-degree
angle.
Rationale: Subcutaneous injections involve injecting into the adipose
tissue. Pinching the skin helps to ensure the medication is delivered
into the subcutaneous layer. A 45-degree angle is common, and a
90-degree angle can be used with sufficient adipose tissue or a
shorter needle. Aspiration and massaging are generally not
recommended for insulin.
,Question 5
A nurse is caring for a client who has a new colostomy. Which of the following
statements indicates the client understands how to care for the colostomy?
A) "I will change my pouch every morning after breakfast."
B) "I should expect some bleeding around the stoma when I clean it."
C) "I will empty the pouch when it is one-third to one-half full."
D) "I will only eat soft foods to prevent irritation to the stoma."
E) "I will apply a hot pack to the stoma if it becomes red."
Correct Answer: C) "I will empty the pouch when it is one-third to one-
half full."
Rationale: Emptying the colostomy pouch when it is 1/3 to 1/2 full
prevents it from becoming too heavy, which could cause it to pull
away from the skin, and helps maintain a proper seal.
Question 6
A nurse is assessing a client who has hyperkalemia. Which of the following
ECG changes should the nurse anticipate?
A) Flattened T waves
B) Prominent U waves
C) Peaked T waves
D) Shortened PR interval
E) ST segment depression
Correct Answer: C) Peaked T waves
Rationale: Peaked, narrow T waves are a classic and early ECG
manifestation of hyperkalemia (elevated potassium levels).
Question 7
A nurse is caring for a client who has a new prescription for furosemide. The
nurse should plan to monitor which of the following electrolyte levels closely?
A) Sodium
B) Calcium
C) Magnesium
, D) Potassium
E) Phosphate
Correct Answer: D) Potassium
Rationale: Furosemide is a loop diuretic, which primarily acts on the
loop of Henle to inhibit sodium and chloride reabsorption, leading to
increased excretion of potassium and a risk of hypokalemia.
Question 8
A nurse is preparing to administer medication through a nasogastric (NG)
tube. After checking placement, what is the next step?
A) Administer all medications simultaneously.
B) Flush the tube with 15-30 mL of water.
C) Clamp the tube for 30 minutes.
D) Aspirate gastric residual volume.
E) Administer the medication directly without flushing.
Correct Answer: B) Flush the tube with 15-30 mL of water.
Rationale: Flushing the NG tube with water before administering
medication ensures patency and prevents clogging. Gastric residual
volume is typically checked before administering feed, not
necessarily before medications unless specified by policy.
Question 9
A nurse is teaching a client about a low-sodium diet. Which of the following
food choices should the nurse advise the client to avoid?
A) Fresh fruits
B) Canned soup
C) Unsalted nuts
D) Steamed vegetables
E) Whole grains
Correct Answer: B) Canned soup
Rationale: Processed foods, including most canned soups, are
typically very high in sodium as a preservative and flavor enhancer.
ACTUAL EXAM EACH FORM CONTAINS 70 QUESTIONS AND
CORRECT DETAILED ANSWERS
Question 1
A nurse is caring for a client who is prescribed warfarin. Which of the
following laboratory values should the nurse monitor to evaluate the
effectiveness of this medication?
A) Activated partial thromboplastin time (aPTT)
B) Platelet count
C) Prothrombin time (PT) and International Normalized Ratio (INR)
D) Fibrinogen levels
E) D-dimer
Correct Answer: C) Prothrombin time (PT) and International
Normalized Ratio (INR)
Rationale: Warfarin is an oral anticoagulant that inhibits vitamin K-
dependent clotting factors. Its effectiveness is monitored by PT,
which is standardized to the INR, ensuring consistent therapeutic
ranges.
Question 2
A nurse is caring for a client who has a new prescription for digoxin. The
nurse should withhold the medication and notify the provider if the client's
apical pulse is less than:
A) 80/min
B) 70/min
C) 60/min
D) 50/min
E) 40/min
Correct Answer: C) 60/min
Rationale: Digoxin slows the heart rate. The nurse should always
check the apical pulse for a full minute before administering digoxin
and withhold the medication if the pulse is below 60 beats per
minute (or as per specific provider orders/parameters).
,Question 3
A client with chronic obstructive pulmonary disease (COPD) is experiencing
dyspnea. Which of the following positions should the nurse encourage the
client to assume?
A) Supine with legs elevated.
B) Trendelenburg position.
C) High-Fowler's position or orthopneic position.
D) Left lateral recumbent.
E) Prone position.
Correct Answer: C) High-Fowler's position or orthopneic position.
Rationale: Elevating the head of the bed (High-Fowler's) or having the
client lean forward on an overbed table (orthopneic position) helps
reduce dyspnea by allowing for better lung expansion and
diaphragm excursion.
Question 4
A nurse is administering a subcutaneous injection of insulin. Which of the
following actions should the nurse take?
A) Aspirate for blood return before injecting.
B) Massage the injection site after administering.
C) Inject the insulin at a 15-degree angle.
D) Pinch the skin and inject at a 45- or 90-degree angle.
E) Administer the insulin into the deltoid muscle.
Correct Answer: D) Pinch the skin and inject at a 45- or 90-degree
angle.
Rationale: Subcutaneous injections involve injecting into the adipose
tissue. Pinching the skin helps to ensure the medication is delivered
into the subcutaneous layer. A 45-degree angle is common, and a
90-degree angle can be used with sufficient adipose tissue or a
shorter needle. Aspiration and massaging are generally not
recommended for insulin.
,Question 5
A nurse is caring for a client who has a new colostomy. Which of the following
statements indicates the client understands how to care for the colostomy?
A) "I will change my pouch every morning after breakfast."
B) "I should expect some bleeding around the stoma when I clean it."
C) "I will empty the pouch when it is one-third to one-half full."
D) "I will only eat soft foods to prevent irritation to the stoma."
E) "I will apply a hot pack to the stoma if it becomes red."
Correct Answer: C) "I will empty the pouch when it is one-third to one-
half full."
Rationale: Emptying the colostomy pouch when it is 1/3 to 1/2 full
prevents it from becoming too heavy, which could cause it to pull
away from the skin, and helps maintain a proper seal.
Question 6
A nurse is assessing a client who has hyperkalemia. Which of the following
ECG changes should the nurse anticipate?
A) Flattened T waves
B) Prominent U waves
C) Peaked T waves
D) Shortened PR interval
E) ST segment depression
Correct Answer: C) Peaked T waves
Rationale: Peaked, narrow T waves are a classic and early ECG
manifestation of hyperkalemia (elevated potassium levels).
Question 7
A nurse is caring for a client who has a new prescription for furosemide. The
nurse should plan to monitor which of the following electrolyte levels closely?
A) Sodium
B) Calcium
C) Magnesium
, D) Potassium
E) Phosphate
Correct Answer: D) Potassium
Rationale: Furosemide is a loop diuretic, which primarily acts on the
loop of Henle to inhibit sodium and chloride reabsorption, leading to
increased excretion of potassium and a risk of hypokalemia.
Question 8
A nurse is preparing to administer medication through a nasogastric (NG)
tube. After checking placement, what is the next step?
A) Administer all medications simultaneously.
B) Flush the tube with 15-30 mL of water.
C) Clamp the tube for 30 minutes.
D) Aspirate gastric residual volume.
E) Administer the medication directly without flushing.
Correct Answer: B) Flush the tube with 15-30 mL of water.
Rationale: Flushing the NG tube with water before administering
medication ensures patency and prevents clogging. Gastric residual
volume is typically checked before administering feed, not
necessarily before medications unless specified by policy.
Question 9
A nurse is teaching a client about a low-sodium diet. Which of the following
food choices should the nurse advise the client to avoid?
A) Fresh fruits
B) Canned soup
C) Unsalted nuts
D) Steamed vegetables
E) Whole grains
Correct Answer: B) Canned soup
Rationale: Processed foods, including most canned soups, are
typically very high in sodium as a preservative and flavor enhancer.
