ATI RN Adult Medical-Surgical Nursing
2025/2026 – Verified Correct Answers &
Rationales | Real Exam Format
1. A nurse is caring for a client who has stable angina and is prescribed sublingual
nitroglycerin. Which of the following instructions should the nurse provide?
o A. "Take one tablet every 4 hours prophylactically."
o B. "Repeat dose every 5 minutes up to three times if pain persists."
o C. "Swallow the tablet with water for faster absorption."
o D. "Store tablets in a plastic container for convenience." Rationale: Sublingual
nitroglycerin provides rapid vasodilation to relieve angina by increasing coronary
perfusion; limiting to three doses prioritizes myocardial oxygen supply stability
while preventing overdose hypotension per AHA 2024 guidelines.
2. A nurse is assessing a client who has a new prescription for digoxin. Which of the
following laboratory values should the nurse review prior to administration?
o A. Serum creatinine
o B. Potassium level
o C. Hemoglobin
o D. Blood glucose Rationale: Hypokalemia potentiates digoxin toxicity, risking
arrhythmias; monitoring electrolytes ensures safe glycoside therapy and cardiac
rhythm stability in heart failure management.
3. A nurse is teaching a client who has venous insufficiency about compression therapy.
Which of the following should the nurse recommend?
o A. Apply stockings in the evening
o B. Wear 20-30 mm Hg gradient stockings daily
o C. Remove stockings during the day
o D. Use knee-high stockings for thigh involvement Rationale: Graduated
compression enhances venous return, reducing edema and ulceration risk;
consistent use prioritizes lower extremity circulation stability per SVS 2025
venous disease guidelines.
4. A nurse is caring for a client who has an abdominal aortic aneurysm (AAA) and is
scheduled for endovascular repair. Which of the following should the nurse monitor
postoperatively?
o A. Bowel sounds
o B. Renal artery perfusion
o C. Respiratory rate
o D. Skin turgor Rationale: Endograft placement risks renal ischemia from
embolization; monitoring urine output and creatinine ensures glomerular filtration
stability, prioritizing acute kidney injury prevention per SVS AAA repair
protocols.
5. A nurse is assessing a client who has rheumatic heart disease with mitral stenosis. Which
of the following findings should the nurse expect?
o A. Bounding pulses
o B. Opening snap on auscultation
, o C. S3 heart sound
o D. Holosystolic murmur Rationale: The opening snap indicates stiff mitral valve
mobility, guiding beta-blocker therapy to control atrial fibrillation and maintain
hemodynamic stability in valvular heart disease.
6. A nurse is preparing a client for a dobutamine stress echocardiogram. Which of the
following should the nurse explain?
o A. "The test will measure your lung capacity."
o B. "Dobutamine simulates exercise to assess heart function."
o C. "You will receive a radioactive tracer."
o D. "It involves inserting a catheter in your groin." Rationale: Dobutamine
increases myocardial oxygen demand, revealing ischemia; patient education
ensures cooperation, prioritizing coronary artery disease diagnostic accuracy and
procedural safety.
7. A nurse is caring for a client who has a prosthetic aortic valve and is on warfarin. Which
of the following should the nurse instruct regarding INR monitoring?
o A. "Check monthly if stable."
o B. "Target INR 2.0-3.0 for mechanical valves."
o C. "Stop monitoring after 6 months."
o D. "INR below 1.5 is therapeutic." Rationale: Therapeutic INR prevents
thromboembolism while minimizing bleeding; regular monitoring ensures
anticoagulation stability, essential for prosthetic valve longevity per AHA 2025
valvular guidelines.
8. A nurse is evaluating a client who has a pacemaker insertion. Which of the following
should indicate successful function?
o A. Heart rate 120/min
o B. Capture on ECG telemetry
o C. Blood pressure 90/60 mm Hg
o D. Presence of pulse deficit Rationale: P-wave and QRS capture confirms atrial
and ventricular depolarization, ensuring pacemaker efficacy and cardiac output
stability post-implantation.
9. A nurse is caring for a client who has pericarditis. Which of the following positions
should the nurse recommend to alleviate pain?
o A. Supine with knees flexed
o B. Leaning forward while sitting
o C. Side-lying with pillow under knees
o D. Prone with head turned Rationale: Forward leaning reduces pericardial
friction rub and pain by decreasing myocardial compression, prioritizing comfort
and respiratory stability in inflammatory pericardial conditions.
10. A nurse is assessing a client who has cor pulmonale. Which of the following should the
nurse anticipate?
o A. Right ventricular hypertrophy
o B. Jugular vein distention
o C. S4 heart sound absent
o D. Peripheral edema absent Rationale: JVD reflects right heart failure from
pulmonary hypertension; early recognition guides diuretic therapy to maintain
preload and prevent hepatic congestion stability.
, 11. A nurse is caring for a client who has community-acquired pneumonia (CAP) and a
CURB-65 score of 2. Which of the following should the nurse anticipate?
o A. Outpatient oral antibiotics
o B. Hospitalization with IV ceftriaxone
o C. No oxygen therapy needed
o D. Discharge within 24 hours Rationale: CURB-65 score ≥2 predicts mortality
risk, necessitating inpatient IV antibiotics to stabilize oxygenation and resolve
infection per IDSA 2025 CAP guidelines.
12. A nurse is teaching a client who has cystic fibrosis about airway clearance. Which of the
following should the nurse include?
o A. "Perform postural drainage twice weekly."
o B. "Use high-frequency chest wall oscillation daily."
o C. "Avoid mucolytics like dornase alfa."
o D. "Cough suppressants improve clearance." Rationale: Vest therapy mobilizes
secretions, enhancing ventilation-perfusion matching and preventing
exacerbations for chronic respiratory stability in CF management.
13. A nurse is caring for a client who has a pulmonary contusion following trauma. Which of
the following should the nurse monitor?
o A. Increased tidal volume
o B. Hypoxemia refractory to oxygen
o C. Bradypnea
o D. Clear lung sounds bilaterally Rationale: Contusions cause shunting and V/Q
mismatch, leading to hypoxemia; continuous pulse oximetry ensures early
mechanical ventilation to maintain gas exchange stability.
14. A nurse is assessing a client who has interstitial lung disease. Which of the following
findings should the nurse expect?
o A. Wheezing on expiration
o B. Fine inspiratory crackles
o C. Hyperresonance to percussion
o D. Increased vocal fremitus Rationale: Velcro-like crackles indicate fibrosis,
guiding antifibrotic therapy like nintedanib to slow progression and preserve
pulmonary function stability per ATS 2025 ILD guidelines.
15. A nurse is caring for a client who has a tension pneumothorax. Which of the following
should the nurse prepare for?
o A. Needle decompression
o B. Immediate chest tube insertion
o C. Supplemental oxygen only
o D. Trendelenburg positioning Rationale: Chest tube relieves mediastinal shift and
restores negative pressure, prioritizing cardiovascular and respiratory stability in
this life-threatening emergency per ATLS protocols.
16. A nurse is teaching a client who has sleep apnea about CPAP therapy. Which of the
following should the nurse include?
o A. "Use a full-face mask for nasal congestion."
o B. "Maintain consistent nightly use for 4+ hours."
o C. "Increase pressure during the day."
2025/2026 – Verified Correct Answers &
Rationales | Real Exam Format
1. A nurse is caring for a client who has stable angina and is prescribed sublingual
nitroglycerin. Which of the following instructions should the nurse provide?
o A. "Take one tablet every 4 hours prophylactically."
o B. "Repeat dose every 5 minutes up to three times if pain persists."
o C. "Swallow the tablet with water for faster absorption."
o D. "Store tablets in a plastic container for convenience." Rationale: Sublingual
nitroglycerin provides rapid vasodilation to relieve angina by increasing coronary
perfusion; limiting to three doses prioritizes myocardial oxygen supply stability
while preventing overdose hypotension per AHA 2024 guidelines.
2. A nurse is assessing a client who has a new prescription for digoxin. Which of the
following laboratory values should the nurse review prior to administration?
o A. Serum creatinine
o B. Potassium level
o C. Hemoglobin
o D. Blood glucose Rationale: Hypokalemia potentiates digoxin toxicity, risking
arrhythmias; monitoring electrolytes ensures safe glycoside therapy and cardiac
rhythm stability in heart failure management.
3. A nurse is teaching a client who has venous insufficiency about compression therapy.
Which of the following should the nurse recommend?
o A. Apply stockings in the evening
o B. Wear 20-30 mm Hg gradient stockings daily
o C. Remove stockings during the day
o D. Use knee-high stockings for thigh involvement Rationale: Graduated
compression enhances venous return, reducing edema and ulceration risk;
consistent use prioritizes lower extremity circulation stability per SVS 2025
venous disease guidelines.
4. A nurse is caring for a client who has an abdominal aortic aneurysm (AAA) and is
scheduled for endovascular repair. Which of the following should the nurse monitor
postoperatively?
o A. Bowel sounds
o B. Renal artery perfusion
o C. Respiratory rate
o D. Skin turgor Rationale: Endograft placement risks renal ischemia from
embolization; monitoring urine output and creatinine ensures glomerular filtration
stability, prioritizing acute kidney injury prevention per SVS AAA repair
protocols.
5. A nurse is assessing a client who has rheumatic heart disease with mitral stenosis. Which
of the following findings should the nurse expect?
o A. Bounding pulses
o B. Opening snap on auscultation
, o C. S3 heart sound
o D. Holosystolic murmur Rationale: The opening snap indicates stiff mitral valve
mobility, guiding beta-blocker therapy to control atrial fibrillation and maintain
hemodynamic stability in valvular heart disease.
6. A nurse is preparing a client for a dobutamine stress echocardiogram. Which of the
following should the nurse explain?
o A. "The test will measure your lung capacity."
o B. "Dobutamine simulates exercise to assess heart function."
o C. "You will receive a radioactive tracer."
o D. "It involves inserting a catheter in your groin." Rationale: Dobutamine
increases myocardial oxygen demand, revealing ischemia; patient education
ensures cooperation, prioritizing coronary artery disease diagnostic accuracy and
procedural safety.
7. A nurse is caring for a client who has a prosthetic aortic valve and is on warfarin. Which
of the following should the nurse instruct regarding INR monitoring?
o A. "Check monthly if stable."
o B. "Target INR 2.0-3.0 for mechanical valves."
o C. "Stop monitoring after 6 months."
o D. "INR below 1.5 is therapeutic." Rationale: Therapeutic INR prevents
thromboembolism while minimizing bleeding; regular monitoring ensures
anticoagulation stability, essential for prosthetic valve longevity per AHA 2025
valvular guidelines.
8. A nurse is evaluating a client who has a pacemaker insertion. Which of the following
should indicate successful function?
o A. Heart rate 120/min
o B. Capture on ECG telemetry
o C. Blood pressure 90/60 mm Hg
o D. Presence of pulse deficit Rationale: P-wave and QRS capture confirms atrial
and ventricular depolarization, ensuring pacemaker efficacy and cardiac output
stability post-implantation.
9. A nurse is caring for a client who has pericarditis. Which of the following positions
should the nurse recommend to alleviate pain?
o A. Supine with knees flexed
o B. Leaning forward while sitting
o C. Side-lying with pillow under knees
o D. Prone with head turned Rationale: Forward leaning reduces pericardial
friction rub and pain by decreasing myocardial compression, prioritizing comfort
and respiratory stability in inflammatory pericardial conditions.
10. A nurse is assessing a client who has cor pulmonale. Which of the following should the
nurse anticipate?
o A. Right ventricular hypertrophy
o B. Jugular vein distention
o C. S4 heart sound absent
o D. Peripheral edema absent Rationale: JVD reflects right heart failure from
pulmonary hypertension; early recognition guides diuretic therapy to maintain
preload and prevent hepatic congestion stability.
, 11. A nurse is caring for a client who has community-acquired pneumonia (CAP) and a
CURB-65 score of 2. Which of the following should the nurse anticipate?
o A. Outpatient oral antibiotics
o B. Hospitalization with IV ceftriaxone
o C. No oxygen therapy needed
o D. Discharge within 24 hours Rationale: CURB-65 score ≥2 predicts mortality
risk, necessitating inpatient IV antibiotics to stabilize oxygenation and resolve
infection per IDSA 2025 CAP guidelines.
12. A nurse is teaching a client who has cystic fibrosis about airway clearance. Which of the
following should the nurse include?
o A. "Perform postural drainage twice weekly."
o B. "Use high-frequency chest wall oscillation daily."
o C. "Avoid mucolytics like dornase alfa."
o D. "Cough suppressants improve clearance." Rationale: Vest therapy mobilizes
secretions, enhancing ventilation-perfusion matching and preventing
exacerbations for chronic respiratory stability in CF management.
13. A nurse is caring for a client who has a pulmonary contusion following trauma. Which of
the following should the nurse monitor?
o A. Increased tidal volume
o B. Hypoxemia refractory to oxygen
o C. Bradypnea
o D. Clear lung sounds bilaterally Rationale: Contusions cause shunting and V/Q
mismatch, leading to hypoxemia; continuous pulse oximetry ensures early
mechanical ventilation to maintain gas exchange stability.
14. A nurse is assessing a client who has interstitial lung disease. Which of the following
findings should the nurse expect?
o A. Wheezing on expiration
o B. Fine inspiratory crackles
o C. Hyperresonance to percussion
o D. Increased vocal fremitus Rationale: Velcro-like crackles indicate fibrosis,
guiding antifibrotic therapy like nintedanib to slow progression and preserve
pulmonary function stability per ATS 2025 ILD guidelines.
15. A nurse is caring for a client who has a tension pneumothorax. Which of the following
should the nurse prepare for?
o A. Needle decompression
o B. Immediate chest tube insertion
o C. Supplemental oxygen only
o D. Trendelenburg positioning Rationale: Chest tube relieves mediastinal shift and
restores negative pressure, prioritizing cardiovascular and respiratory stability in
this life-threatening emergency per ATLS protocols.
16. A nurse is teaching a client who has sleep apnea about CPAP therapy. Which of the
following should the nurse include?
o A. "Use a full-face mask for nasal congestion."
o B. "Maintain consistent nightly use for 4+ hours."
o C. "Increase pressure during the day."
