ATI RN Adult Medical Surgical 2026

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Sample questions from ATI RN Adult Medical Surgical 2026

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A client with acute coronary syndrome reports chest pressure and has a prescription for sublingual nitroglycerin. Which assessment finding should the nurse report before administering the medication?

   • A.The client rates the pain as 8 on a 0-to-10 scale.
   • B.The client took sildenafil 6 hours ago.
   • C.The client has a history of hypertension.
   • D.The client's heart rate is 96/min.

   Rationale: Nitroglycerin combined with sildenafil can cause profound, potentially life-threatening hypotension, so the nurse should withhold it and notify the provider. Severe chest pain supports treatment rather than withholding it. A heart rate of 96/min and a history of hypertension do not create the same contraindication; assess blood pressure as well before giving nitroglycerin.

2. 2.A nurse is teaching a client with heart failure how to reduce the risk of worsening fluid retention. Which instructions should the nurse include? Select all that apply.

   • A.Use a salt substitute freely in place of table salt.
   • B.Stop taking the diuretic when ankle swelling improves.
   • C.Follow the prescribed sodium restriction.
   • D.Weigh yourself every morning after urinating.
   • E.Report a weight gain of 2 lb (0.9 kg) in 24 hours.

   Rationale: Daily weights under consistent conditions can reveal fluid retention early, and a rapid gain such as 2 lb in a day should be reported according to the care plan. Following the prescribed sodium restriction helps limit fluid retention. Salt substitutes may contain potassium, which can be hazardous with some heart-failure medications, and stopping a diuretic without direction can lead to fluid overload.

3. 3.A client with atrial fibrillation is prescribed warfarin. Which laboratory test should the nurse use to evaluate the medication's therapeutic effect?

   • A.Activated partial thromboplastin time (aPTT).
   • B.Platelet aggregation time.
   • C.International normalized ratio (INR).
   • D.Serum troponin.

   Rationale: The INR standardizes prothrombin-time monitoring and is used to guide warfarin therapy. The aPTT is commonly used to monitor unfractionated heparin, not warfarin. Troponin evaluates myocardial injury, and platelet aggregation time does not guide routine warfarin dosing.

4. 4.A nurse is caring for a client with acute decompensated heart failure and pulmonary edema. Which findings or actions require prompt attention? Select all that apply.

   • A.New pink, frothy sputum.
   • B.Encourage the client to drink extra fluids to thin secretions.
   • C.Increasing work of breathing and falling oxygen saturation.
   • D.Administer prescribed IV loop diuretic and reassess response.
   • E.Place the client in high-Fowler position.

   Answer and rationale are in the full material.

5. 5.A nurse is teaching a client with peripheral arterial disease about foot care and activity. Which instructions should the nurse include? Select all that apply.

   • A.Apply a heating pad to cold feet to improve circulation.
   • B.Wear well-fitting shoes and avoid walking barefoot.
   • C.Avoid smoking and discuss cessation support.
   • D.Walk regularly as prescribed, stopping to rest when claudication occurs.
   • E.Inspect the feet daily for skin changes or injury.

   Answer and rationale are in the full material.