ATI Medical-Surgical Proctored Exam

ATI Medical-Surgical Proctored Exam (NGN) | 2025/2026 Latest Edition

Next Gen NCLEX (NGN) Style Questions | Verified Answers | 100% Correct | Top Score Guaranteed | Nursing Exams Introduction This resource includes 100 Next Generation NCLEX (NGN)-style questions from the ATI Medical-Surgical Proctored Exam updated for 2025/2026. It contains verified answers with detailed rationales, aligned with the latest clinical judgment model and competency- based testing approach to help nursing students achieve top scores on high-stakes assessments.Answer Format All correct answers are marked in bold and green with accompanying rationales that support accurate clinical reasoning, fast review, and concept mastery in the NGN format.Question 1 (Multiple Choice) A nurse is assessing a client with suspected heart failure. The client reports dyspnea and bilateral leg edema. Which intervention should the nurse prioritize to address clinical judgment needs?

• Administer supplemental oxygen at 2 L/min
• Place the client in a high Fowler’s position
• Encourage increased fluid intake
• Administer a beta-blocker immediately

Rationale: High Fowler’s position facilitates lung expansion and reduces preload in heart failure, addressing dyspnea and edema (Recognize Cues, Prioritize Interventions). Oxygen is secondary unless hypoxia is confirmed, fluids worsen overload, and beta-blockers require a prescription.Question 2 (Select All That Apply) A nurse is caring for a client with diabetic ketoacidosis (DKA). Which findings should the nurse expect during the Recognize Cues phase? (Select all that apply.)

• Blood glucose 500 mg/dL
• Kussmaul respirations
• Hypertension
• Fruity breath odor
• Bradycardia

Rationale: DKA is characterized by hyperglycemia (500 mg/dL), Kussmaul respirations (compensatory hyperventilation), and fruity breath (ketones). Hypotension and tachycardia are more common than hypertension or bradycardia due to dehydration (Recognize Cues).Question 3 (Case Study - Enhanced Hot Spot) 1 / 3

Case Study: A 62-year-old client presents with chest pain, diaphoresis, and nausea for 1 hour. Vital signs: BP 100/60 mmHg, HR 110 bpm, RR 24/min, SpO2 92%. ECG shows ST elevation in leads V1–V4.

Question: Highlight the findings indicating a need for immediate intervention.

Answer: Chest pain, diaphoresis, hypotension (BP 100/60 mmHg), tachycardia (HR 110 bpm), ST elevation on ECG Rationale: These findings suggest acute myocardial infarction (Analyze Cues). Chest pain, diaphoresis, hypotension, tachycardia, and ST elevation require urgent interventions like oxygen or catheterization (Prioritize Interventions).Question 4 (Multiple Choice) A nurse is planning care for a client with a COPD exacerbation. Which intervention demonstrates effective clinical judgment in the Generate Solutions phase?

• Administer furosemide IV
• Administer albuterol via nebulizer
• Encourage supine bed rest
• Restrict oxygen to 1 L/min

Rationale: Albuterol relieves bronchospasm in COPD exacerbation, improving airflow (Generate Solutions). Furosemide is for heart failure, supine position worsens dyspnea, and oxygen should maintain SpO2 88–92%.Question 5 (Select All That Apply) A nurse is evaluating a client post-thyroidectomy. Which findings indicate potential complications requiring immediate action? (Select all that apply.)

• Mild incisional pain
• Muscle twitching
• Stridor
• Low-grade fever
• Numbness around the mouth

Rationale: Muscle twitching, stridor, and numbness post-thyroidectomy indicate

hypocalcemia or airway obstruction (Evaluate Outcomes). Pain and fever are expected.Question 6 (Case Study - Matrix) Case Study: A 55-year-old client with hypertension and diabetes mellitus is admitted with acute pancreatitis. Labs show elevated amylase, lipase, and blood glucose. The client reports severe epigastric pain radiating to the back.Question: Match the nursing interventions to the appropriate clinical judgment step: Intervention Clinical Judgment Step Administer IV fluids Take Action Assess pain level and location Recognize Cues Monitor blood glucose levels Evaluate Outcomes 2 / 3

Intervention Clinical Judgment Step Plan for NPO status Generate Solutions

Rationale: IV fluids address dehydration (Take Action), pain assessment

identifies symptoms (Recognize Cues), glucose monitoring evaluates treatment (Evaluate Outcomes), and NPO status reduces pancreatic stimulation (Generate Solutions).

Question 7 (Multiple Choice) A nurse is prioritizing care for a client with suspected pulmonary embolism. Which action demonstrates effective clinical judgment in the Prioritize Hypotheses phase?

• Administer heparin immediately
• Assess for sudden dyspnea and tachycardia
• Encourage ambulation
• Apply warm compresses

Rationale: Assessing dyspnea and tachycardia confirms pulmonary embolism (Prioritize Hypotheses). Heparin follows confirmation, ambulation risks clot dislodgement, and compresses are irrelevant.Question 8 (Select All That Apply) A nurse is teaching a client with a new colostomy. Which points promote self-management?(Select all that apply.)

• Change the appliance daily
• Monitor for skin irritation around the stoma
• Empty the pouch when one-third full
• Avoid cleaning the stoma site
• Ensure a proper fit of the skin barrier

Rationale: Monitoring skin irritation, emptying the pouch, and proper skin barrier fit prevent complications in colostomy care (Generate Solutions). Daily changes are unnecessary, and cleaning is essential.Question 9 (Case Study - Bowtie) Case Study: A 70-year-old client presents with confusion, asterixis, and jaundice. Labs show elevated ammonia and bilirubin. History of cirrhosis.Question: Identify the primary diagnosis, two priority interventions, and two potential complications.

Answer:

• Primary Diagnosis: Hepatic encephalopathy

• Priority Interventions: Administer lactulose, Monitor neurological status

• Potential Complications: Coma, Gastrointestinal bleeding

Rationale: Hepatic encephalopathy is indicated by confusion and asterixis

(Recognize Cues). Lactulose reduces ammonia, and neurological monitoring

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