ATI Medical Surgical Nursing Proctored Exam With Answers (90 Solved Questions)

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ATI MED-SURG PROCTORED VERSION ACOMPLETE EXAM QUESTIONS AND CORRECTANSWERS AND RATIONALES1.A nurse is reinforcing discharge teaching about wound care with a familymember of a client who is postoperative. Which of the following should thenurse include in the teaching?a)Administer an analgesic following wound care. (The nurse should remind thefamily member to administer an analgesic prior to wound care to preventdiscomfort.)b)Irrigate the wound with povidone iodine. (The nurse should remind the familymember to irrigate the wound with 0.9% sodium chloride.)c)Cleanse the wound with a cotton-tipped applicator. (The nurse should remind thefamily member to avoid using a cotton-tipped applicator to cleanse the woundbecause the fibers can become embedded in the wound, cause infection, anddelay wound healing.)d)Report purulent drainage to the provider. (The nurse should remind the familymember to report signs of infection, including purulent drainage.)2.A nurse is caring for a client who has bacterial meningitis. Upon monitoringthe client, which of the following findings should the nurse expect?a)Flaccid neck (The nurse should recognize that nuchal rigidity, rather than aflaccid neck, is a manifestation of meningitis.)b)Stooped posture with shuffling gait (The nurse should recognize that a stoopedposture with shuffling gait is a manifestation of Parkinson's disease, not amanifestation of meningitis.)c)Red macular rash (The nurse should expect to find a red macular rash,sometimes called a petechial rash, which is a manifestation of meningococcalmeningitis.)d)Masklike facial expression (The nurse should recognize that a masklikeexpression is a manifestation of Parkinson's disease, not a manifestation ofmeningitis.)3.A nurse is contributing to the plan of care for an older adult client who is atrisk for osteoporosis. Which of the following interventions should the nurseinclude to prevent bone loss?a)Increase fluid intake. (Fluid intake is beneficial for general health and wellness,and it helps to treat some disorders. Caffeine and alcohol intake can increase theclient's risk of developing osteoporosis. However, fluid intake does not preventbone loss.)b)Encourage range-of-motion exercises. (Range-of-motion exercises are beneficialfor general health and wellness, and they help to maintain flexibility and preventcontractures. However, range-of-motion exercises do not prevent bone loss.)c)Massage bony prominences. (Massaging bony prominences should be avoidedbecause it can traumatize deep tissues.)lOMoARcPSD|13778330

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d)Encourage weight-bearing exercises. (Weight-bearing exercises, such as walking,can maintain bone mass by reducing bone demineralization, thus helping toprevent osteoporosis.)4.A nurse is collecting data from a client and notices several skin lesion.Which of the following findings should the nurse report as possiblemelanoma?a)Scaly patches (The nurse should report scaly patches as possible basal orsquamous cell carcinoma.b)Silvery white plaques (The nurse should report silvery white plaques as possiblepsoriasis.)c)Irregular borders (The nurse should report irregular borders of a skin lesion tothe provider because it can indicate malignant melanoma.)d)Raised edges (The nurse should report raised edges of a skin lesion as possiblebasal cell carcinoma.)5.A nurse is reinforcing discharge teaching to prevent dumping syndrome fora client following a partial gastrectomy for ulcers. Which of the followinginformation should the nurse include in the teaching?a)Avoid liquids at mealtimes. (The nurse should remind the client to avoid drinkingliquids at mealtimes to prevent the food from emptying into the small bowel tooquickly.)b)Exclude eating starchy vegetables. (The nurse should remind the client to includestarchy vegetables in the meal plan to slow gastric emptying.)c)Avoid eating high-protein meals. (The nurse should remind the client to eat high-protein meals to help slow gastric emptying.)d)Plan to increase intake of sweetened fruits. (The nurse should remind the clientto exclude sweetened fruits from the diet to help slow gastric emptying.)6.A nurse is collecting data on a client who is scheduled for a cardiaccatheterization. Which of the following laboratory levels should the nursereview prior to the procedure?a)Albumin (Albumin levels determine the amount of protein the liver produces inthe body and is an indication of hepatic function and nutritional status. However,it is not impacted by contrast media used for cardiac catheterization. Therefore,the nurse does not need to review this laboratory level prior to a cardiaccatheterization.)b)Phosphorus (Phosphorus is an electrolyte that combines with calcium tomaintain bone health and is involved as an energy source in metabolism.However, it is not impacted by contrast media used for cardiac catheterization.Therefore, the nurse does not need to review this laboratory level prior to acardiac catheterization.)c)TSH (TSH levels determine thyroid function. However, it is not impacted bycontrast media used for cardiac catheterization. Therefore, the nurse does notneed to review this laboratory level prior to a cardiac catheterization.)d)BUN (BUN levels indicate kidney function. Contrast media used during cardiaccatheterization can cause renal failure. The nurse should review this laboratorylOMoARcPSD|13778330

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level to determine if the client can tolerate the IV contrast dye during theprocedure.)7.A nurse is reinforcing glycosylated hemoglobin (HbA1c) testing with a clientwho has diabetes mellitus. Which of the following statements indicates thatthe client understands the teaching?a)"The HbA1c test should be performed 2 hr after I eat a meal that is high incarbohydrates." (The nurse should remind the client that carbohydrateconsumption is not required for HbA1c testing.)b)"The HbA1c test can help detect the presence of ketones in my body." (The nurseshould remind the client that urine testing can detect ketone bodies.)c)"I will have my HbA1c checked twice per year." (An HbA1c test provides theclient's average glucose level for the preceding 3 months. The nurse shouldinstruct the client to have her HbA1c tested twice yearly to manage her glucose.)d)"I will plan to fast before I have my HbA1c tested." (The nurse should remind theclient that fasting is not required for HbA1C testing.)8.A nurse is examining a client’s IV site andnotes a red line up his arm. Theclient reports a throbbing, burning pain at the IV site. The nurse shouldidentify that the client’s manifestations indicate which of the followingcomplications of IV therapy?a)Thrombophlebitis (The nurse should identify pain, warmth, and a red streak upthe arm as indications of thrombophlebitis.)b)Infiltration (The nurse should identify swelling and cool skin at the IV site asindications of infiltration.)c)Hematoma (The nurse should identify swelling and bruising as indications of ahematoma that can develop by not holding enough pressure after discontinuingthe IV.)d)Venous spasms (The nurse should identify cramping at or above the insertion siteand numbness as indications of venous spasms.)9.A nurse is reinforcing teaching about management of constipation with aclient who has hypothyroidism. Which of the following should the nurseinclude in the teaching?a)Increase intake of fiber-rich foods. (The nurse should instruct the client toincrease the amount of fiber-rich foods in his diet. Dried beans and brown riceare examples of fiber-rich foods.)b)Take a laxative every morning. (The nurse should instruct the client to initiallytake a laxative in the evening to stimulate the evacuation of stool. However, thenurse should instruct the client to use laxatives sparingly.)c)Maintain a fluid intake of 1200 mL per day. (The nurse should instruct the clientto increase his fluid intake to 2,000 mL per day to maintain soft stools.)d)Limit activity to preserve energy. (The nurse should instruct the client to increaseactivity to stimulate the evacuation of stool.)10.A nurse is caring for a client who is at risk for developing pressure ulcers.Which of the following actions should the nurse take?lOMoARcPSD|13778330

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a)Position pillows between the bony prominences. (The nurse should usepositioning devices to keep bony prominences from being in direct contact witheach other, which will prevent skin breakdown and pressure ulcer development.)b)Check for incontinence every 3 hr. (The nurse should check the client forincontinence at least every 2 hr to prevent skin breakdown.)c)Massage reddened areas of the skin. (The nurse should avoid massagingreddened areas of the skin, which can lead to the formation of a pressure ulcer bydamaging underlying tissue.)d)Elevate the head of the bed to 45∞. (The nurse should avoid elevating the head ofthe bed to an angle greater than 30∞. An angle greater than 30∞ can causeshearing of the skin, which leads to tissue injury and pressure ulcerdevelopment.)11.A nurse is contributing to the plan of care for a client who has peripheralarterial disease (PAD) of the lower extremities. Which of the followinginterventions should the nurse include?a)Place moist heat pads on the extremities. (The nurse should avoid applying heatto the client's extremities to prevent injury due to decreased sensation.)b)Perform manual massage of the affected extremities. (The nurse should avoidmassaging the client's lower extremities if the client is having pain from ischemia.A warm environment and keeping the client warm will help with circulation tothe extremities and decrease pain through vasodilation.)c)Dangle the extremities off the side of the bed. (The nurse should include in theplan of care to have the client dangle the lower extremities off the side of the bedto aid in reducing pain by increasing arterial blood flow. The client should notraise the lower extremities above the level of the heart when resting in bedbecause it impairs arterial blood flow.)d)Apply support stockings before getting out of bed. (The nurse should avoidapplying support stockings to the lower extremities because support stockingsinterfere with the arterial blood flow to the lower extremities.)12.A nurse is caring for a client who has meningococcal pneumonia. Which ofthe following personal protective equipment should the nurse use?a)Gown (The nurse should wear a gown when caring for a client who requirescontact precautions.)b)Mask (The nurse should identify that a client who has Meningococcal pneumoniarequires droplet precautions, which include wearing a mask when providing carewithin 3 feet of the client.)c)Sterile gloves (The performance of sterile dressing changes or tracheostomy carerequires the nurse to wear sterile gloves. However, clean gloves are used toprovide medical aseptic care.)d)Protective eyewear A nurse should wear protective eyewear when there is a riskfor splashing, such as during the irrigation of a wound.)13.A nurse is assisting with the care of a client who has a cardiaccatheterization via the right femoral artery. Which of the following actionsshould the nurse take to prevent post procedure complications (Select allthat apply?)lOMoARcPSD|13778330

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a)Should wait at least 2 hours after eating before going to bed." (The client shouldwait to lie down or go to bed at least 2 hr after eating to minimize reflux.)b)"I should eat three meals a day without eating snacks between meals." (The clientshould eat four to six small meals per day rather than three large meals tominimize bloating and abdominal distention.)c)"I should season my food with garlic." (The client should avoid spicy foods,including garlic, to minimize reflux.)d)"I should drink my liquids through a straw." (The client should avoid drinkingthrough a straw, which can promote belching and reflux.)14.A nurse is caring for a client who is postoperative and has an epiduralinfusion. Which of the following findings should the nurse recognize as thepriority?a)Pruritus (The nurse should identify pruritus as an adverse effect of an epiduralinfusion. However, another finding is the priority.)b)Nausea (The nurse should identify nausea as an adverse effect of an epiduralinfusion. However, another finding is the priority.)c)Urinary retention (The nurse should identify urinary retention as an adverseeffect of an epidural infusion. However, another finding is the priority.d)Dyspnea (When using the airway, breathing, circulation approach to client care,the nurse should determine that the priority finding is dyspnea, which is acomplication of the epidural infusion.)15.A nurse is reinforcing teaching about gastroesophageal reflux disease(GERD) with a client. Which of the understanding of the teaching?a)I should wait at least 2 hours after eating before going to bed." (The client shouldwait to lie down or go to bed at least 2 hr after eating to minimize reflux.)b)"I should eat three meals a day without eating snacks between meals." (The clientshould eat four to six small meals per day rather than three large meals tominimize bloating and abdominal distention.)c)"I should season my food with garlic." (The client should avoid spicy foods,including garlic, to minimize reflux.)d)"I should drink my liquids through a straw." (The client should avoid drinkingthrough a straw, which can promote belching and reflux.)16.A nurse is reinforcing teaching with a client who is taking insulin glargine.Which of the following information should the nurse include in theteaching?a)This type of insulin should be given at the same time every day." (Insulin glargineis released in the body over a 24 hr period. The nurse should instruct the client toadminister the insulin at the same time each day to maintain consistent serumlevels for optimal therapeutic effect.)b)"This insulin can be mixed with short-acting insulin in a single syringe." (Thenurse should remind the client that insulin glargine should not be mixed with anyother insulin.)c)"This type of insulin can be used in a pump." (The nurse should inform the clientinsulin glargine is a long-acting insulin that is administered once daily at thesame time and is not to be administered intravenously.)lOMoARcPSD|13778330

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d)"This insulin has an increased risk for hypoglycemia." (The nurse should informthe client that insulin glargine has a low risk for hypoglycemia because serumlevels of the insulin do not peak and remain consistent over time.)17.A nurse is preparing to administer phytonadione 7 mg subcutaneously to aclient who has an INR of 4. Available is phytonadione 10 mg/mL. How manymL should the nurse administer? (Round the answer to the nearest tenth.Use a leading zero if it applies. Do not use a trailing zero.)Ratio and ProportionStep 1: What is the unit of measurement the nurse should calculate? mLStep 2: What is the dose the nurse should administer? Dose to administer = Desired 7mgStep 3: What is the dose available? Dose available = Have 10 mgStep 4: Should the nurse convert the units of measurement? NoStep 5: What is the quantity of the dose available? 1 mLStep 6: Set up an equation and solve for X.Have/Quantity = Desired/X10 mg/1 mL = 7 mg/X mLX = 0.7Step 7: Round if necessary.Step 8: Reassess to determine whether the amount to administer makes sense. If thereare 10 mg/mL and the provider prescribed 7 mg, it makes sense to administer 0.7 mL.The nurse should administer phytonadione 0.7 mL subcutaneously.Desired Over HaveStep 1: What is the unit of measurement the nurse should calculate? mLStep 2: What is the dose the nurse should administer? Dose to administer = Desired 7mgStep 3: What is the dose available? Dose available = Have 10 mgStep 4: Should the nurse convert the units of measurement? NoStep 5: What is the quantity of the dose available? 1 mLStep 6: Set up an equation and solve for X.Desired x Quantity/Have = X7 mg x 1 mL/10 mg = X mL0.7 = XStep 7: Round if necessary.Step 8: Reassess to determine whether the amount to administer makes sense. If thereare 10 mg/mL and the provider prescribed 7 mg, it makes sense to administer 0.7 mL.The nurse should administer phytonadione 0.7 mL subcutaneously.Dimensional AnalysisStep 1: What is the unit of measurement the nurse should calculate? mLStep 2: What is the quantity of the dose available? 1 mLStep 3: What is the dose available? Dose available = Have 10 mgStep 4: What is the dose the nurse should administer? Dose to administer = Desired 7mgStep 5: Should the nurse convert the units of measurement? NoStep 6: Set up an equation and solve for X.lOMoARcPSD|13778330

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X = Quantity/Have x Conversion (Have)/Conversion (Desired) x Desired/X mL = 1 mL/10 mg x 7 mg/X = 0.7Step 7: Round if necessary.Step 8: Reassess to determine whether the amount to administer makes sense. If thereare 10 mg/mL and the provider prescribed 7 mg, it makes sense to administer 0.7 mL.The nurse should administer phytonadione 0.7 mL subcutaneously.18.A nurse is reinforcing teaching with an adolescent client regardingtesticular self-examination. Which of the following statements by the clientdemonstrates an understanding of the teaching?a)“I will perform the exam before I shower.”(Clients should perform a testicularself-examination after a warm shower.)b)“I will check my testicles every 6 months.”(Clients should perform a testicularself-examination monthly.)c)"I understand that testicular cancer is painless." (Clients should report a lumpthat is not painful because testicular cancer is typically painless.)d)"I understand that pea-sized lumps are normal." (Clients should report pea-sizedlumps in the testes to a provider.)19.A nurse is caring for a client who is scheduled for surgery and isexperiencing anxiety. Which of the following interventions should the nurseidentify as the priority?a)Determine the client's understanding of the procedure. (Using the nursingprocess, the first action the nurse should take is to collect data from the client.Therefore, the nurse should determine the client's understanding of theprocedure to provide necessary teaching, which can help manage his anxiety.)b)Encourage the client to express his feelings. (Encouraging the client to expresshis feelings can reduce anxiety. However, this is not the first action the nurseshould take.)c)Allow the client's family to stay with him. (Allowing the client's family to staywith him can reduce anxiety. However, this is not the first action the nurseshould take.)d)Provide music as a distraction. (Providing music as a distraction can reduceanxiety. However, this is not the first action the nurse should take.)20.A nurse is reinforcing teaching about home care with a client who hada knee arthroplasty. Which of the following factors should the nurse identifyas an indication that a barrier to learning might be present?a)The client asks questions each time the nurse stops talking. (The nurse shouldidentify that asking questions indicates active listening by the client andenhances learning.)b)The client stops the nurse and asks for pain medication. (The nurse shouldidentify that a client who is in pain will not be able to concentrate, which caninterfere with his ability to learn.)c)While the nurse is speaking, the client refers to the written materials. (The nurseshould identify that clients learn in different ways. Using multiple methods oflOMoARcPSD|13778330

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teaching, including hands-on practice and providing written materials, enhanceslearning.)d)A family member who is present asks the client to repeat important points. (Thenurse should identify that family member who are actively engaged in theteaching session and ask questions can enhance learning.)21.A nurse is reinforcing discharge instructions with a client who ispostoperative following a right hip arthroplasty. Which of the followingstatements should the nurse make?a)You may cross your legs in 60 days." (The nurse should instruct the client to wait90 days before crossing her legs. Crossing her legs early in the postoperativeperiod can result in dislocation of the replacement hip.)b)"Avoid lying on your operative side." (The nurse should inform the client that shemay lie on her operative side with a pillow between her legs. This will not injurethe suture site or cause dislocation of the replacement hip.)c)"Avoid bending your hips more than 90 degrees." (The nurse should instruct theclient to avoid bending her hips more than 90∞ to prevent dislocation of thereplacement hip.)d)"You may sleep on a soft mattress." (The nurse should instruct the client to sleepon a firm mattress to avoid potential dislocation of the replacement hip.)22.A nurse is caring for a client who has a compound fracture of the femur andwas placed in balanced suspension skeletal traction 4 days ago. Which of thefollowing actions should the nurse take?a)Perform pin site care daily. (The nurse should perform pin site care daily withchlorhexidine solution or use a solution according to facility protocol. The nurseshould also monitor the pin sites for manifestations of infection.)b)Remove the overbed trapeze.(The nurse should ensure the client has an overbedtrapeze to aid in lifting the upper body off the bed when necessary and to helpprevent skin breakdown of the heels and elbows with client repositioning.)c)Remove the boot every 2 hr. (The nurse should identify that balanced suspensionskeletal traction is managed through the use of pins, pulleys, weights, and framesand that the client does not wear a boot.)d)Keep the weights on a stable, flat surface. (The nurse should ensure the weightshang freely at all times.)23.A nurse is assisting the charge nurse with developing an in-service aboutcaring for clients who have internal sealed radiation implants. Which of thefollowing information should the nurse include?a)Restrict the time pregnant women are allowed in the client's room to 15 min.(Pregnant women and children should not be allowed to visit a client who isreceiving internal radiation therapy because of the risk for exposure to radiationemissions.)b)Pick up a radiation implant with a double-gloved hand if it becomes dislodged.(The nurse should use forceps to pick up a radiation implant if it becomesdislodged.c)Limit time spent in the client's room to 2 hr during an 8 hr shift. (The nurseshould limit time spent in the client's room to 30 min during an 8 hr shift.)lOMoARcPSD|13778330

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d)Dispose of radiation implants in a lead container. (Lead impairs the emission ofradiation. Therefore, the nurse should dispose of radiation implants in a leadcontainer in accordance with facility protocol.)24.A nurse in a long-term care facility is collecting data from a client whoreports fullness in the rectum and abdominal cramping. Which of thefollowing findings should indicates to the nurse that the client might have afecal impaction?a)Halitosis (Halitosis, or bad breath, is associated with the ingestion of certainfoods and medications, and it can also be an indication of infection.)b)Hemorrhoids (Hemorrhoids indicate that the client is straining when defecating.However, the presence of hemorrhoids does not indicate fecal impaction.)c)Rebound tenderness (Rebound tenderness is an indication of appendicitis. Aclient who has a fecal impaction can experience abdominal cramping anddistention.)d)Small liquid stools (Small liquid stools can be the result of fecal material beingexpelled around an impaction.)25.A nurse is providing discharge teaching for the family of a client who hasParkinson’s disease. Which of the following information should the nurseinclude in the teaching?a)Place the client on a low-calorie diet to prevent weight gain. (The nurse shouldinstruct the client's family to provide the client with extra calories and protein toprevent unintentional weight loss from expenditure of energy due to tremors,dyskinesia, and difficulty swallowing.)b)Remind the client to avoid watching her feet when walking. (The nurse shouldinstruct the client's family to frequently remind the client to maintain correctposture and prevent falls by not watching her feet when walking.)c)Use small area rugs in the client's home for traction. (The nurse should instructthe client's family to avoid using area rugs in the client's home because her footmay drag or be stiff and catch on an area rug, which can cause a fall.)d)Instruct the client to take tub baths instead of showers. (The nurse shouldinstruct the family to encourage the client to take walk-in, sit-down showers,because skeletal muscle rigidity can cause difficulty in moving, coordination, andbalance, which increases the risk of a fall.)26.A home health nurse is reinforcing teaching with a client about preventingcomplications of peripheral vascular disease. Which of the followingstatements indicates that client is adhering to the nurse’s instructions?a)"I apply rubbing alcohol to my feet every day to prevent infection." (Rubbingalcohol has a drying effect on skin and can increase cracking, allowing an entrypoint for infection. The client should apply lotions that do not contain alcohol.)b)"I will wear clean, knee-high wool socks every day to help improve mycirculation." (Wool socks can result in perspiration, which puts the client at riskfor developing a fungal infection. The client should use light-weight socks topromote arterial blood flow.)c)"I use hot water bottles to keep my feet warm at night." (Clients who haveperipheral vascular disease have decreased sensation of the affected extremities.lOMoARcPSD|13778330

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