ATI RN ADULT MEDICAL SURGICAL RETAKE EXAM
2026/2027 | Latest Combined Exam | Verified Answers |
Updated | Pass Guaranteed - A+ Graded
SECTION 1: CARDIOVASCULAR DISORDERS (Q1-20)
Q1. A client with heart failure is prescribed lisinopril 10 mg daily. The nurse notes
the client's serum potassium increased from 4.2 to 5.4 mEq/L after 2 weeks.
Which action should the nurse take FIRST?
A. Discontinue the lisinopril immediately
B. Assess for signs of hyperkalemia and notify the provider
C. Encourage increased potassium-rich foods
D. Administer sodium polystyrene sulfonate (Kayexalate)
Correct Answer: B
Rationale: ACE inhibitors cause potassium retention; the nurse must assess for
cardiac manifestations of hyperkalemia (peaked T waves, muscle weakness) and
notify the provider for possible dose adjustment. Discontinuing (A) is a provider
decision; increasing potassium (C) worsens hyperkalemia; Kayexalate (D) requires
provider orders. ATI Adult Med-Surg Chapter 42.
Q2. A client with atrial fibrillation is receiving warfarin 5 mg daily. The INR is 4.2
(therapeutic 2.0-3.0). The client has no active bleeding. Which action is most
appropriate?
A. Administer vitamin K 10 mg subcutaneously
B. Hold the next warfarin dose and recheck INR in 2-3 days
,C. Administer fresh frozen plasma immediately
D. Continue the current dose and increase monitoring
Correct Answer: B
Rationale: INR 4.2 without bleeding is managed by holding 1-2 doses and
rechecking; vitamin K (A) is for INR >10 or serious bleeding; FFP (C) is for life-
threatening hemorrhage; continuing (D) risks progression to bleeding. ATI Adult
Med-Surg Chapter 42.
Q3. A client with acute myocardial infarction develops cardiogenic shock. Blood
pressure is 78/50 mmHg, HR 118 bpm, urine output 18 mL/hr. Which medication
should the nurse anticipate FIRST?
A. Dopamine infusion
B. Norepinephrine infusion
C. Dobutamine infusion
D. Nitroprusside infusion
Correct Answer: B
Rationale: Norepinephrine is the first-line vasopressor for cardiogenic shock to
increase MAP >65 mmHg and restore coronary perfusion. Dopamine (A) is no longer
first-line; dobutamine (C) increases contractility but worsens hypotension without
vasopressor support; nitroprusside (D) causes vasodilation and worsens shock. ATI
Adult Med-Surg Chapter 42.
Q4. A client with heart failure has the following daily weights: Day 1: 72.4 kg, Day
2: 73.8 kg, Day 3: 75.1 kg. The client reports increased dyspnea. Which action is
the priority?
A. Increase oral fluid intake to dilute sodium
,B. Administer furosemide as prescribed and assess lung sounds
C. Restrict sodium and continue current medications
D. Weigh the client again in 4 hours
Correct Answer: B
Rationale: 2.7 kg gain in 3 days indicates acute fluid overload; furosemide
administration with respiratory assessment is the priority. Increasing fluids (A)
worsens overload; sodium restriction alone (C) is insufficient for acute
decompensation; reweighing (D) delays intervention. ATI Adult Med-Surg Chapter
42.
Q5. A client with a permanent pacemaker reports dizziness and palpitations. The
ECG shows pacemaker spikes without subsequent QRS complexes. Which term
describes this finding?
A. Pacemaker capture
B. Pacemaker failure to capture
C. Pacemaker oversensing
D. Pacemaker undersensing
Correct Answer: B
Rationale: Failure to capture is indicated by pacemaker spikes not followed by
depolarization (QRS). Capture (A) shows spike-QRS relationship; oversensing (C)
causes pauses from inhibition by extraneous signals; undersensing (D) causes
inappropriate pacing. ATI Adult Med-Surg Chapter 42.
Q6. A client with deep vein thrombosis is receiving heparin infusion at 1,200
units/hr. The aPTT is 110 seconds (control 30-40 seconds, therapeutic 1.5-2.5×
control). Which action should the nurse take?
, A. Continue the infusion and recheck in 4 hours
B. Decrease the infusion rate per protocol and recheck aPTT in 4-6 hours
C. Stop the infusion and administer protamine sulfate
D. Increase the infusion rate to achieve therapeutic range
Correct Answer: B
Rationale: aPTT 110 seconds is supratherapeutic (>2.5× control = 100 seconds); the
rate should be decreased per protocol with recheck. Continuing (A) risks bleeding;
protamine (C) is for life-threatening hemorrhage; increasing (D) worsens
supratherapeutic level. ATI Adult Med-Surg Chapter 42.
Q7. A client with hypertrophic cardiomyopathy (HCM) experiences syncope
during exertion. Which explanation by the nurse is most accurate?
A. "Syncope occurs from arrhythmias due to left ventricular outflow tract
obstruction."
B. "Syncope is caused by hypoglycemia during exercise."
C. "Syncope indicates you need a permanent pacemaker."
D. "Syncope is expected and requires no further evaluation."
Correct Answer: A
Rationale: HCM causes dynamic LVOT obstruction and arrhythmias leading to
syncope—a risk factor for sudden cardiac death. Hypoglycemia (B) is unrelated;
pacemaker (C) is not indicated for all syncope; dismissing (D) is dangerous. ATI Adult
Med-Surg Chapter 42.
Q8. A client with peripheral arterial disease has an ABI of 0.48. Which assessment
finding supports this diagnosis?
A. Warm, edematous extremities with brown discoloration
2026/2027 | Latest Combined Exam | Verified Answers |
Updated | Pass Guaranteed - A+ Graded
SECTION 1: CARDIOVASCULAR DISORDERS (Q1-20)
Q1. A client with heart failure is prescribed lisinopril 10 mg daily. The nurse notes
the client's serum potassium increased from 4.2 to 5.4 mEq/L after 2 weeks.
Which action should the nurse take FIRST?
A. Discontinue the lisinopril immediately
B. Assess for signs of hyperkalemia and notify the provider
C. Encourage increased potassium-rich foods
D. Administer sodium polystyrene sulfonate (Kayexalate)
Correct Answer: B
Rationale: ACE inhibitors cause potassium retention; the nurse must assess for
cardiac manifestations of hyperkalemia (peaked T waves, muscle weakness) and
notify the provider for possible dose adjustment. Discontinuing (A) is a provider
decision; increasing potassium (C) worsens hyperkalemia; Kayexalate (D) requires
provider orders. ATI Adult Med-Surg Chapter 42.
Q2. A client with atrial fibrillation is receiving warfarin 5 mg daily. The INR is 4.2
(therapeutic 2.0-3.0). The client has no active bleeding. Which action is most
appropriate?
A. Administer vitamin K 10 mg subcutaneously
B. Hold the next warfarin dose and recheck INR in 2-3 days
,C. Administer fresh frozen plasma immediately
D. Continue the current dose and increase monitoring
Correct Answer: B
Rationale: INR 4.2 without bleeding is managed by holding 1-2 doses and
rechecking; vitamin K (A) is for INR >10 or serious bleeding; FFP (C) is for life-
threatening hemorrhage; continuing (D) risks progression to bleeding. ATI Adult
Med-Surg Chapter 42.
Q3. A client with acute myocardial infarction develops cardiogenic shock. Blood
pressure is 78/50 mmHg, HR 118 bpm, urine output 18 mL/hr. Which medication
should the nurse anticipate FIRST?
A. Dopamine infusion
B. Norepinephrine infusion
C. Dobutamine infusion
D. Nitroprusside infusion
Correct Answer: B
Rationale: Norepinephrine is the first-line vasopressor for cardiogenic shock to
increase MAP >65 mmHg and restore coronary perfusion. Dopamine (A) is no longer
first-line; dobutamine (C) increases contractility but worsens hypotension without
vasopressor support; nitroprusside (D) causes vasodilation and worsens shock. ATI
Adult Med-Surg Chapter 42.
Q4. A client with heart failure has the following daily weights: Day 1: 72.4 kg, Day
2: 73.8 kg, Day 3: 75.1 kg. The client reports increased dyspnea. Which action is
the priority?
A. Increase oral fluid intake to dilute sodium
,B. Administer furosemide as prescribed and assess lung sounds
C. Restrict sodium and continue current medications
D. Weigh the client again in 4 hours
Correct Answer: B
Rationale: 2.7 kg gain in 3 days indicates acute fluid overload; furosemide
administration with respiratory assessment is the priority. Increasing fluids (A)
worsens overload; sodium restriction alone (C) is insufficient for acute
decompensation; reweighing (D) delays intervention. ATI Adult Med-Surg Chapter
42.
Q5. A client with a permanent pacemaker reports dizziness and palpitations. The
ECG shows pacemaker spikes without subsequent QRS complexes. Which term
describes this finding?
A. Pacemaker capture
B. Pacemaker failure to capture
C. Pacemaker oversensing
D. Pacemaker undersensing
Correct Answer: B
Rationale: Failure to capture is indicated by pacemaker spikes not followed by
depolarization (QRS). Capture (A) shows spike-QRS relationship; oversensing (C)
causes pauses from inhibition by extraneous signals; undersensing (D) causes
inappropriate pacing. ATI Adult Med-Surg Chapter 42.
Q6. A client with deep vein thrombosis is receiving heparin infusion at 1,200
units/hr. The aPTT is 110 seconds (control 30-40 seconds, therapeutic 1.5-2.5×
control). Which action should the nurse take?
, A. Continue the infusion and recheck in 4 hours
B. Decrease the infusion rate per protocol and recheck aPTT in 4-6 hours
C. Stop the infusion and administer protamine sulfate
D. Increase the infusion rate to achieve therapeutic range
Correct Answer: B
Rationale: aPTT 110 seconds is supratherapeutic (>2.5× control = 100 seconds); the
rate should be decreased per protocol with recheck. Continuing (A) risks bleeding;
protamine (C) is for life-threatening hemorrhage; increasing (D) worsens
supratherapeutic level. ATI Adult Med-Surg Chapter 42.
Q7. A client with hypertrophic cardiomyopathy (HCM) experiences syncope
during exertion. Which explanation by the nurse is most accurate?
A. "Syncope occurs from arrhythmias due to left ventricular outflow tract
obstruction."
B. "Syncope is caused by hypoglycemia during exercise."
C. "Syncope indicates you need a permanent pacemaker."
D. "Syncope is expected and requires no further evaluation."
Correct Answer: A
Rationale: HCM causes dynamic LVOT obstruction and arrhythmias leading to
syncope—a risk factor for sudden cardiac death. Hypoglycemia (B) is unrelated;
pacemaker (C) is not indicated for all syncope; dismissing (D) is dangerous. ATI Adult
Med-Surg Chapter 42.
Q8. A client with peripheral arterial disease has an ABI of 0.48. Which assessment
finding supports this diagnosis?
A. Warm, edematous extremities with brown discoloration
