Exam with NGN and Answers - 220 Questions and Answers
Already Graded A+ Premium Exam Tested And Verified
Subject Area Adult Medical-Surgical Nursing
Description This exam assesses the practical nurse's ability to manage care for adult patients
with medical-surgical conditions, integrating pathophysiology, pharmacology, and
evidence-based interventions. It includes Next Generation NCLEX (NGN) style
items requiring clinical judgment and prioritization.
Expected Grade A+
Total Questions 220
Duration 3 hours
Learning Outcomes 1. Apply clinical reasoning to prioritize care for patients with acute and chronic
medical-surgical conditions.
2. Interpret diagnostic data and adjust nursing interventions accordingly.
3. Identify complications and implement appropriate nursing actions.
Accreditation Accredited by the Accreditation Commission for Education in Nursing (ACEN)
and aligned with NCLEX-PN test plan standards for US nursing programs.
Page 1
,ati. ATI PN Adult Medical Surgical (Med-Surg) 2023 Proctored Exam with NGN and
Answers - 220 Questions and Answers Already Graded A+ Premium Exam Tested
Question: 1 of 220
A patient with chronic obstructive pulmonary disease (COPD) presents with increasing
dyspnea, a productive cough with purulent sputum, and a pulse oximetry reading of
88% on room air. The provider prescribes oxygen via nasal cannula at 2 L/min, a
sputum culture, and intravenous antibiotics. Which finding would indicate that the
Presence of rhonchi and wheezing on auscultation
Elevated white blood cell count with left shift
New onset of peripheral edema and jugular venous distention
Decreased breath sounds at the lung bases
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Question: 2 of 220
A patient with type 2 diabetes mellitus is admitted with diabetic ketoacidosis (DKA).
The initial laboratory results show serum glucose 450 mg/dL, pH 7.20, bicarbonate 12
mEq/L, and positive serum ketones. The nurse administers intravenous fluids and an
insulin infusion per protocol. After 2 hours, the glucose decreases to 300 mg/dL, but
Increase the insulin infusion rate to correct acidosis more rapidly
Administer sodium bicarbonate intravenously
Check serum potassium level and administer potassium if needed
Switch to subcutaneous insulin to prevent hypoglycemia
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Page 2
,ati. ATI PN Adult Medical Surgical (Med-Surg) 2023 Proctored Exam with NGN and
Answers - 220 Questions and Answers Already Graded A+ Premium Exam Tested
Question: 3 of 220
A patient with heart failure is receiving furosemide 40 mg intravenously. The nurse
monitors urine output and vital signs. One hour after administration, the patient's
blood pressure drops from 130/80 to 95/60 mmHg, and the urine output is 50 mL over
the hour. The nurse notes the patient is dizzy. What is the priority nursing
Administer a normal saline bolus
Hold the next dose of furosemide and notify the provider
Elevate the head of the bed and administer oxygen
Obtain a serum potassium level
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Question: 4 of 220
A patient with end-stage renal disease (ESRD) on hemodialysis is admitted with
confusion and muscle twitching. Vital signs: BP 160/90, HR 60, RR 14. Laboratory
results show serum sodium 135 mEq/L, potassium 5.8 mEq/L, calcium 7.2 mg/dL,
phosphate 6.5 mg/dL. Which assessment finding is most consistent with the patient's
Hyperactive deep tendon reflexes
Trousseau's sign positive
Peaked T waves on ECG
Bradycardia with irregular rhythm
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, ati. ATI PN Adult Medical Surgical (Med-Surg) 2023 Proctored Exam with NGN and
Answers - 220 Questions and Answers Already Graded A+ Premium Exam Tested
Question: 5 of 220
A patient is 24 hours post-operative after a total hip arthroplasty. The nurse notes the
patient has sudden onset of dyspnea, chest pain, and oxygen saturation of 85% on
room air. The patient's leg is swollen and tender. Which action should the nurse take
first?
Apply anti-embolism stockings
Administer oxygen via non-rebreather mask
Notify the provider of suspected pulmonary embolism
Elevate the affected leg and apply warm compress
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Question: 6 of 220
A patient with liver cirrhosis is admitted with ascites and jaundice. The nurse assesses
the patient and notes asterixis, confusion, and a serum ammonia level of 150 mcg/dL.
Which dietary modification should the nurse anticipate being prescribed?
High-protein, low-carbohydrate diet
Low-protein, high-carbohydrate diet
Low-sodium, low-fat diet
High-calorie, low-potassium diet
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