Exam Latest Edition

ATI RN Adult Medical-Surgical Proctored Exam | 2025/2026 Latest Edition

Next Generation NCLEX (NGN) Version | 250 Verified Questions and Correct Answers | 100% Accurate | Nursing Exams Introduction This updated resource contains 250 fully verified questions and correct answers from the ATI RN Adult Medical-Surgical Proctored Exam (NGN Version), aligned with 2025/2026 testing standards. Each item is designed to reflect real-world clinical scenarios and critical thinking pathways required for NCLEX-RN success and confident bedside decision-making.Answer Format All correct answers are clearly marked in bold and green, with NGN-style formatting and rationales to ensure mastery of clinical judgment.Question 1 (Multiple Choice) A nurse is caring for a client with a new diagnosis of chronic obstructive pulmonary disease (COPD). Which instruction should the nurse include in the teaching plan?

• Avoid using oxygen at home
• Use pursed-lip breathing during exacerbations
• Increase dietary sodium intake
• Limit physical activity to bed rest

Rationale: Pursed-lip breathing prolongs exhalation, reduces air trapping, and improves oxygenation during COPD exacerbations. Oxygen is often prescribed, sodium restriction may be needed, and activity should be encouraged as tolerated.Question 2 (Select All That Apply) A nurse is assessing a client with suspected heart failure. Which findings should the nurse expect? (Select all that apply.)

• Dyspnea on exertion
• Peripheral edema
• Jugular vein distension
• Increased appetite
• Bradycardia

Rationale: Dyspnea on exertion, peripheral edema, and jugular vein distension are classic signs of heart failure due to fluid overload and reduced cardiac output. Decreased appetite and tachycardia are more common than increased appetite or bradycardia.Question 3 (Case Study/NGN) 1 / 4

Case Study: A 62-year-old male presents to the ED with chest pain, diaphoresis, and nausea for 2 hours. ECG shows ST-elevation in leads V1-V4. Troponin levels are elevated. The client is diagnosed with an acute myocardial infarction (MI).

Question: Which intervention should the nurse prioritize?

• Administer acetaminophen
• Administer aspirin and prepare for catheterization
• Start a high-dose statin
• Encourage ambulation

Rationale: Aspirin and catheterization are critical for acute MI to reduce clot formation and restore coronary blood flow. Acetaminophen is not indicated, statins are secondary, and ambulation is unsafe during acute MI.Question 4 (Multiple Choice) A nurse is caring for a client post-thyroidectomy. Which assessment finding requires immediate intervention?

• Mild incisional pain
• Stridor and difficulty breathing
• Hoarseness
• Hypocalcemia

Rationale: Stridor and difficulty breathing indicate potential airway obstruction from hematoma or swelling, a life-threatening emergency. Hoarseness and hypocalcemia are expected but less urgent.Question 5 (Multiple Choice) A client with type 1 diabetes mellitus is prescribed insulin glargine. Which teaching point should the nurse emphasize?

• Take the insulin with meals
• Administer at the same time daily
• Rotate injection sites monthly
• Expect peak action in 2 hours

Rationale: Insulin glargine is a long-acting insulin administered at the same time daily to provide basal coverage. It is not meal-related, requires site rotation with each dose, and has no peak.Question 6 (Select All That Apply) A nurse is teaching a client with chronic kidney disease about dietary modifications. Which instructions should the nurse include? (Select all that apply.)

• Limit potassium intake
• Restrict protein consumption
• Increase sodium intake
• Reduce phosphorus intake 2 / 4

• Avoid complex carbohydrates

Rationale: Limiting potassium, restricting protein, and reducing phosphorus are key to managing CKD to prevent hyperkalemia, uremia, and bone disease. Sodium restriction, not increase, is needed, and carbohydrates are not restricted.Question 7 (Multiple Choice) A nurse is caring for a client with a new prescription for warfarin. Which laboratory test should the nurse monitor?

• Platelet count
• Prothrombin time (PT/INR)
• White blood cell count
• Activated partial thromboplastin time (aPTT)

Rationale: PT/INR monitors warfarin’s anticoagulant effect on the extrinsic clotting pathway. aPTT is for heparin, and other tests are not specific to warfarin.Question 8 (Case Study/NGN) Case Study: A 55-year-old female with a history of hypertension presents with sudden severe headache, confusion, and left-sided weakness. BP is 190/110 mmHg. CT scan confirms an acute ischemic stroke.

Question: What is the priority nursing action?

• Administer mannitol
• Prepare for thrombolytic therapy
• Start a beta-blocker
• Encourage oral fluids

Rationale: Thrombolytic therapy (e.g., tPA) is time-sensitive for ischemic stroke to restore blood flow if within the treatment window. Mannitol is for hemorrhagic stroke, beta-blockers are secondary, and fluids are not prioritized.Question 9 (Multiple Choice) A nurse is caring for a client receiving a blood transfusion who develops chills and back pain.What is the nurse’s first action?

• Slow the infusion rate
• Stop the transfusion
• Administer acetaminophen
• Check vital signs

Rationale: Stopping the transfusion is critical for suspected transfusion reaction to prevent further complications. Slowing the rate is incorrect, and other actions follow cessation.Question 10 (Multiple Choice) 3 / 4

A client with pancreatitis has elevated lipase levels. Which dietary instruction should the nurse provide?

• High-fat diet
• Low-fat diet
• High-protein diet
• Unrestricted diet

Rationale: Low-fat diet reduces pancreatic stimulation in pancreatitis. High-fat diets worsen symptoms, and protein or unrestricted diets are not specific.Question 11 (Select All That Apply) A nurse is caring for a client with a new colostomy. Which interventions should the nurse include in the care plan? (Select all that apply.)

• Monitor stoma color for viability
• Teach the client to empty the pouch when one-third full
• Restrict fluid intake
• Apply a skin barrier around the stoma
• Change the pouch weekly

Rationale: Monitoring stoma color, emptying the pouch when one-third full, and

applying a skin barrier prevent complications and maintain skin integrity. Fluid restriction is unnecessary, and pouches are typically changed every 3-7 days.Question 12 (Multiple Choice) A nurse is assessing a client with suspected appendicitis. Which finding is most concerning?

• Nausea and vomiting
• Rebound tenderness
• Low-grade fever
• Anorexia

Rationale: Rebound tenderness indicates peritoneal irritation, a critical sign of appendicitis requiring urgent surgical evaluation. Other symptoms are common but less specific.Question 13 (Multiple Choice) A client with a history of atrial fibrillation is prescribed dabigatran. Which instruction should the nurse include?

• Take with grapefruit juice
• Store in the original container
• Discontinue aspirin
• Monitor for weight gain

Rationale: Dabigatran must be stored in its original container to maintain stability and prevent moisture exposure. Grapefruit juice is not contraindicated, aspirin use depends on provider orders, and weight gain is not a primary concern.

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