ATI End of Course RN Adult Medical Surgical Nursing 2026 Proctored Exam

Free preview · Original latest version

Sample questions from ATI End of Course RN Adult Medical Surgical Nursing 2026 Proctored Exam

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

1. 1.During a home visit, a client with chronic heart failure reports gaining 2.3 kg (5 lb) in 3 days and needing three pillows to sleep. Which action should the nurse take?

   • A.Recommend limiting fluid intake to 500 mL per day without contacting the provider.
   • B.Explain that the weight gain is expected and should be reassessed at the next routine visit.
   • C.Instruct the client to contact the provider promptly about the weight gain and worsening orthopnea.
   • D.Encourage the client to skip the prescribed diuretic until the breathing improves.

   Rationale: Rapid weight gain and worsening orthopnea suggest fluid retention and exacerbation of heart failure, so prompt provider notification is appropriate. A severe fluid restriction should not be initiated without an individualized prescription. These changes are not expected findings to defer until a routine visit, and withholding a prescribed diuretic may worsen congestion. Teach clients with heart failure to track daily weight and report rapid increases or worsening symptoms.

2. 2.Refer to the client's chart. Which actions should the nurse take first in response to the client's current findings? Select all that apply.

   • A.Wait for the next troponin result before notifying the provider.
   • B.Activate the facility's emergency response system.
   • C.Obtain a 12-lead ECG while another team member prepares for treatment.
   • D.Encourage the client to walk to reduce anxiety.
   • E.Administer prescribed chewable aspirin if the client has no contraindication.

   Rationale: The client's new chest pressure, diaphoresis, and falling blood pressure require immediate emergency response and rapid assessment for acute coronary syndrome. A 12-lead ECG helps identify ischemia, and prescribed chewable aspirin is an appropriate early intervention when contraindications are absent. Ambulation increases cardiac workload and is unsafe during possible acute myocardial infarction. Waiting for troponin results delays evaluation and treatment despite the concerning clinical changes.

3. 3.A client taking warfarin for atrial fibrillation asks which finding to report to the clinic immediately. Which response should the nurse give?

   • A.A small bruise at the site of a recent blood draw
   • B.Bleeding from the gums that does not stop after brushing
   • C.A missed dose of a daily multivitamin
   • D.A brief episode of mild hunger before lunch

   Rationale: Persistent gum bleeding may indicate excessive anticoagulation and should be reported promptly. A small bruise can occur with anticoagulant therapy but should be monitored, especially if it enlarges or appears without injury. A missed multivitamin is not an urgent bleeding concern, although consistency with vitamin K intake should be discussed. Hunger before lunch is unrelated to warfarin complications; clients should also be taught to report blood in urine or stool and severe headache.

4. 4.Which assessment finding in a client with peripheral arterial disease requires the most immediate follow-up?

   • A.A cool, pale foot with sudden severe pain and an absent pedal pulse
   • B.A small ulcer on a toe that has been present for several weeks
   • C.Shiny skin and sparse hair on both lower legs
   • D.Bilateral calf discomfort after walking that resolves with rest

   Answer and rationale are in the full material.

5. 5.A client is 2 hours postoperative after a femoral cardiac catheterization. Which finding requires immediate action?

   • A.A warm foot with a palpable pedal pulse
   • B.A small, stable area of bruising at the insertion site
   • C.Mild tenderness at the insertion site when touched
   • D.New back pain, diaphoresis, and a blood pressure decrease from baseline

   Answer and rationale are in the full material.