ATI Medical-Surgical Proctored Exam
Comprehensive Practice Test Questions
And Answers Plus Rationales | Instant Pdf
Download 2026
1. A nurse is caring for a client with heart failure who
reports sudden shortness of breath, cough with pink, frothy
sputum, and anxiety. Vital signs: BP 168/94, HR 118, RR 32,
SpO₂ 84% on 2 L/min via nasal cannula. Which of the
following actions should the nurse take first?
A. Place the client in high-Fowler’s position
B. Increase oxygen to 100% via non-rebreather mask
C. Administer IV furosemide as prescribed
D. Prepare for endotracheal intubation
Answer: A
Rationale: High-Fowler’s position is the priority to improve
lung expansion and reduce venous return, which decreases
pulmonary congestion. Oxygen and diuretics are important, but
positioning is immediate and non-invasive. Intubation may be
needed if the client fails to improve.
,2. A nurse is assessing a client who is 1 hour post-cardiac
catheterization via the femoral artery. Which finding
requires immediate action?
A. The client reports back pain
B. The groin site has a small amount of dried blood
C. The toes on the affected leg are pale and cool
D. The pedal pulse is 2+ bilaterally
Answer: C
Rationale: Pale, cool toes on the affected leg suggest arterial
occlusion, a limb-threatening emergency. Immediate
notification of the provider is required. Back pain is common
from lying flat; dried blood is expected; 2+ pedal pulse is
normal.
3. A client with a history of chronic obstructive pulmonary
disease (COPD) has an oxygen saturation of 86% on room
air. The nurse applies oxygen at 2 L/min via nasal cannula.
Which assessment is most important to monitor?
A. Oxygen saturation every 2 hours
B. Respiratory rate and level of consciousness
C. Blood pressure and heart rate
D. Skin color and temperature
,Answer: B
Rationale: Clients with COPD may rely on a hypoxic respiratory
drive. Excessive oxygen can cause hypoventilation and CO₂
narcosis. The nurse must monitor for a decreased respiratory
rate or decreased level of consciousness.
4. A nurse is caring for a client with a chest tube connected
to a water-seal drainage system. The nurse notes
continuous bubbling in the water-seal chamber. Which
action should the nurse take?
A. Increase the suction pressure
B. Clamp the chest tube and notify the provider
C. Check the system for an air leak
D. Document the finding as expected
Answer: C
Rationale: Continuous bubbling in the water-seal chamber
indicates an air leak. The nurse should assess the system for
loose connections or cracks. Intermittent bubbling (with
exhalation or coughing) is normal.
5. A client with a history of heart failure is admitted with
shortness of breath. The nurse auscultates crackles and
notes an S3 gallop. Which medication does the nurse
, anticipate first?
A. Metoprolol
B. Furosemide IV
C. Digoxin
D. Spironolactone
Answer: B
Rationale: IV furosemide rapidly reduces preload and
pulmonary congestion in acute decompensated heart failure.
Metoprolol and spironolactone are long-term oral therapies;
digoxin is not first-line for acute decompensation.
6. A nurse is assessing a client with a suspected pulmonary
embolism. Which finding is most common?
A. Hemoptysis and fever
B. Pleuritic chest pain and dyspnea
C. Bradycardia and hypotension
D. Syncope without other symptoms
Answer: B
Rationale: The most common symptoms of pulmonary
embolism are sudden dyspnea, tachypnea, and pleuritic chest
pain. Hemoptysis occurs in fewer than 20% of cases.
Comprehensive Practice Test Questions
And Answers Plus Rationales | Instant Pdf
Download 2026
1. A nurse is caring for a client with heart failure who
reports sudden shortness of breath, cough with pink, frothy
sputum, and anxiety. Vital signs: BP 168/94, HR 118, RR 32,
SpO₂ 84% on 2 L/min via nasal cannula. Which of the
following actions should the nurse take first?
A. Place the client in high-Fowler’s position
B. Increase oxygen to 100% via non-rebreather mask
C. Administer IV furosemide as prescribed
D. Prepare for endotracheal intubation
Answer: A
Rationale: High-Fowler’s position is the priority to improve
lung expansion and reduce venous return, which decreases
pulmonary congestion. Oxygen and diuretics are important, but
positioning is immediate and non-invasive. Intubation may be
needed if the client fails to improve.
,2. A nurse is assessing a client who is 1 hour post-cardiac
catheterization via the femoral artery. Which finding
requires immediate action?
A. The client reports back pain
B. The groin site has a small amount of dried blood
C. The toes on the affected leg are pale and cool
D. The pedal pulse is 2+ bilaterally
Answer: C
Rationale: Pale, cool toes on the affected leg suggest arterial
occlusion, a limb-threatening emergency. Immediate
notification of the provider is required. Back pain is common
from lying flat; dried blood is expected; 2+ pedal pulse is
normal.
3. A client with a history of chronic obstructive pulmonary
disease (COPD) has an oxygen saturation of 86% on room
air. The nurse applies oxygen at 2 L/min via nasal cannula.
Which assessment is most important to monitor?
A. Oxygen saturation every 2 hours
B. Respiratory rate and level of consciousness
C. Blood pressure and heart rate
D. Skin color and temperature
,Answer: B
Rationale: Clients with COPD may rely on a hypoxic respiratory
drive. Excessive oxygen can cause hypoventilation and CO₂
narcosis. The nurse must monitor for a decreased respiratory
rate or decreased level of consciousness.
4. A nurse is caring for a client with a chest tube connected
to a water-seal drainage system. The nurse notes
continuous bubbling in the water-seal chamber. Which
action should the nurse take?
A. Increase the suction pressure
B. Clamp the chest tube and notify the provider
C. Check the system for an air leak
D. Document the finding as expected
Answer: C
Rationale: Continuous bubbling in the water-seal chamber
indicates an air leak. The nurse should assess the system for
loose connections or cracks. Intermittent bubbling (with
exhalation or coughing) is normal.
5. A client with a history of heart failure is admitted with
shortness of breath. The nurse auscultates crackles and
notes an S3 gallop. Which medication does the nurse
, anticipate first?
A. Metoprolol
B. Furosemide IV
C. Digoxin
D. Spironolactone
Answer: B
Rationale: IV furosemide rapidly reduces preload and
pulmonary congestion in acute decompensated heart failure.
Metoprolol and spironolactone are long-term oral therapies;
digoxin is not first-line for acute decompensation.
6. A nurse is assessing a client with a suspected pulmonary
embolism. Which finding is most common?
A. Hemoptysis and fever
B. Pleuritic chest pain and dyspnea
C. Bradycardia and hypotension
D. Syncope without other symptoms
Answer: B
Rationale: The most common symptoms of pulmonary
embolism are sudden dyspnea, tachypnea, and pleuritic chest
pain. Hemoptysis occurs in fewer than 20% of cases.
