MED SURG ATI EXAM

Question 1

A nurse is reinforcing teaching with an older adult client who has osteoporosis. Which of
the following instructions should the nurse in the teaching?
a) “Place throw rugs on wooden floors at home.”
b) “Supplement your diet with vitamin E.”
c) “Swim laps for 20 minutes twice per week.”
d) “Take calcium supplements with meals.”

Answer 1

D - (The nurse should instruct the client to take
calcium carbonate supplements with or following meals to increase absorption and
effectiveness.)

Question 2

A nurse is reviewing the medication record of a client who is taking digoxin. Which of the
following medications should the nurse identify as increasing the risk for the client to
develop digoxin toxicity?
a) Potassium chloride
b) Famotidine
c) Levothyroxine
d) Furosemide

Answer 2

D - (The nurse should identify that loop diuretics, such as furosemide, increase
the urinary excretion of potassium, which can lead to hypokalemia. Hypokalemia
increases the risk for the development of digoxin toxicity.)

Question 3

A nurse is reinforcing teaching about insulin injections with an adult client who weighs 45.4
kg (100 lb.). Which of the following statements by the client indicates an understanding of
the teaching?
a) “I should insert the needle at a 90-degree angle.”
b) “I should give my shot in my belly tissue.”
c) “I will pull back on the syringe plunger to look for blood before I push the medication
in.”
d) “I will use the side of my hand to pull my skin to the side prior to administering the
insulin.”

Answer 3

B - (Clients who have low body weights can have very little subcutaneous tissue. Therefore, the nurse should instruct the client to
administer the medication in the upper abdomen for proper absorption.)

Question 4

A nurse is reinforcing discharge teaching for a client who had a mechanical mitral valve
replacement. Which of the following statements by the client indicates an understanding of
the teaching?
a) “I will notify my dentist about this procedure.”
b) “I will take an enteric-coated aspirin daily.”
c) “I will use a firm-bristled toothbrush.”
d) “I will weigh myself once a week.”

Answer 4

A - (The nurse should instruct the client to
notify his dentist about the mechanical mitral valve replacement before any procedures so
antibiotic therapy can be initiated to reduce the risk of endocardial infection.)

Question 5

A nurse is reviewing the medical record for an older adult client who is experiencing nausea
and vomiting. Based on the client data, which of the following actions should the nurse
take? (Click on the “Exhibit” button for additional client information. There are three tabs
that contain separate categories of data.)

Answer 5

Notify the charge nurse of the client’s BUN level (The client’s BUN level is above the
expected reference range of 10 to 20 mg/dL, which indicates dehydration and impaired
renal function. The nurse should notify the charge nurse of this finding and anticipate
interventions to restore the client’s fluid volume.)

Question 6

A nurse is providing information regarding transmission-based precautions for a client who
has Clostridium difficileto an assistive personnel (AP). Which of the following instructions
should the nurse include? (Select all that apply).
a) “Provide the client with disposable utensils and dishes for meals.”
b) “Leave blood pressure equipment in the client’s room.”
c) “Clean contaminated surfaces with a bleach solution.”
d) “Use an alcohol-based hand sanitizer after client care.”
e) “Wear a face mask when in the client’s room.”

Answer 6

A,B,C
- (Clients who have C.
difficile require contact precautions, which include using disposable utensils and dishes
during meals to prevent exposure to contaminants by others.)
- (When using contact precautions,
the health care staff should dedicate equipment to single-client use to prevent
transmission of the pathogen.)
- (The health care staff should use a
bleach solution to clean equipment to prevent transmission of the pathogen.)

Question 7

A nurse is admitting a client who is suspected having active tuberculosis (TB). Which of the
following actions should the nurse take first? (chap. 20)
a) Administer antituberculosis medication.
b) Institute airborne precautions.
c) Obtain sputum cultures.
d) Auscultate breath sounds.

Answer 7

B - (The greatest risk from this client is transmitting TB to
staff and other clients. Therefore, the first action the nurse should take is to implement
airborne precautions.)

Question 8

A nurse is caring for a client who is postoperative and has a Jackson-Pratt drain. Which of
the following actions should the nurse take?
a) Fill the bulb reservoir with 0.9% sodium chloride
b) Allow the Jackson-Pratt drain to hang freely.
c) Cut a slit in a gauze sponge and apply it around the tubing insertion site.
d) Compress the bulb reservoir and then close the drainage valve.

Answer 8

D - (The nurse should fully
compress the bulb reservoir and then replace the valve plug using aseptic technique to
establish suction after emptying or activating a Jackson-Pratt drain

Question 9

A nurse is reinforcing teaching with the parent of a toddler who has type I diabetes mellitus
and whose prescription has been changed from regular insulin to lispro insulin. Which of
the following information should the nurse include in the teaching?
a) Lispro is given once a day.
b) Lispro should be given before eating.
c) Lispro cannot be given with other insulin.
d) Lispro does not cause hypoglycemia.

Answer 9

B - (Lispro insulin should be given around mealtime,

within 15 min before or after eating.)

Question 10

A nurse is reinforcing teaching with a client who has microcytic anemia and is prescribed a
daily iron supplement. The nurse tells the client to consume foods containing vitamin C
when taking the supplement to enhance iron absorption. Which of the following client food
choices indicates an understanding of the teaching?
a) 1 cup cooked brown rice
b) 1 cup boiled broccoli
c) 1 cup cottage cheese
d) 1 cup cooked kidney beans

Answer 10

B - (The nurse should determine that choosing boiled broccoli indicates
an understanding of the teaching because 1 cup contains 101 mg of vitamin C per
serving.)

Question 11

A nurse is assisting with the development of a plan of care to manage pain for a client who
has herpes zoster with lesions on the lower extremities. Which of the following interventions
should the nurse include in the plan of care?
a) Keep bed linens off of the affected areas.
b) Position a heat lamp over the lower extremities.
c) Apply warm, moist compresses to the affected areas.
d) Initiate droplet isolation precautions.

Answer 11

A - (The nurse should keep bed linens off of the
affected areas using a bed cradle, which will relieve pain caused by the linens rubbing
against the lesions.

Question 12

A nurse is reinforcing teaching with a client about increasing dietary fiber. The nurse
should recommend which of the following foods as the best source of fiber?
a) ½ cup cooked kidney beans
b) ½ cup raw cauliflower
c) 1 cup cucumber with peel
d) 1 cup parboiled brown rice

Answer 12

A - (The nurse should recommend kidney beans as the best

source of fiber because ½ cup contains 6.5 g of fiber per serving.)

Question 13

A nurse is assisting in the care of a client who has AIDS-related pneumonia. The client is
receiving antibiotic therapy and albuterol nebulizer treatments daily. Which of the
following findings should indicate to the nurse that the client’s therapeutic regimen is
effective?
a) Adventitious lung sounds
b) Decrease in exertional dyspnea
c) Respiratory rate of 26/min while sitting in a chair
d) Elevation of the head of the bed is required to sleep

Answer 13

B - (A decrease in exertional dyspnea indicates the antibiotics
are resolving the infection and the albuterol treatments are facilitating effective
ventilation. Therefore, the nurse should evaluate the therapeutic regimen as effective for
the client.)

Question 14

A nurse is monitoring a client who has a wrist cast and reports intense itching underneath
the cast. Which of the following actions should the nurse take?
a) Blow cool air into the cast using a blow dryer on a cool setting.
b) Obtain a prescription for pregabalin.
c) Ask the provider to bivalve the cast.
d) Provide the client with a tongue blade to rub the skin under the cast.

Answer 14

A - (Using a blow dryer on a
cool setting to blow cold air into the cast is an effective way to relieve the client’s itching
without damaging the skin.)

Question 15

A nurse is preparing to insert a double-lumen gastric (Salem) sump tube for a client who
has peptic disease and has developed gastrointestinal bleeding. Which of the following
images indicates the tube that the nurse should select?

Answer 15

In a double-lumen gastric (Salem) sump tube, the clear portion of the tube allows for
aspiration of stomach contents. The blue portion of the tube, or the “pig tail”, vents the tube
to the atmosphere, which prevents the tube from becoming lodged against the wall of the
stomach and protects the stomach from damage

Question 16

A nurse is caring for a client who has just returned to the unit following a bronchoscopy.
Which of the following findings should the nurse report to the provider?
a) Absent gag reflex
b) Blood-tinged mucus
c) Diminished breath sounds
d) Oxygen saturation 95%

Answer 16

C - (Diminished breath sounds might indicate a pneumothorax or
laryngeal edema. The nurse should report this finding to the provider for further
evaluation of the client.)

Question 17

A nurse is caring for a client who has been taking enalapril. The nurse should monitor the
client for which of the following adverse effects?
a) Bradycardia
b) Tremors
c) Cough
d) Hyperglycemia

Answer 17

C - (Enalapril is an ACE inhibitor, which can cause a dry, nonproductive cough.
Therefore, the nurse should monitor the client for this adverse effect.)

Question 18

A nurse is preparing a client for a cardiac catheterization. Which of the following actions
should the nurse take first?
a) Verify the client has given informed consent.
b) Administer preoperative medication.
c) Mark the location of the pedal pulses.
d) Have the client void.

Answer 18

A - (The greatest risk to the client in this
situation is performing an unauthorized invasive procedure. Therefore, the first action the
nurse should take is to verify that the client has given informed consent. If documentation
of informed consent is not on the client’s medical record, the nurse should withhold
medications, which can alter the client’s consciousness until consent is obtained.)

Question 19

A nurse is caring for an adult client who has age-related macular degeneration. Which of
the following findings should the nurse expect?
a) Seeing halos around artificial lights
b) Distorted central vision of the eyes
c) Colored spots before the visual fields
d) Spontaneous tearing of the eyes

Answer 19

B - (Macular degeneration results in a distortion and
blurring of central vision. The client might completely lose central vision and view a dark
spot in the center.)

Question 20

A nurse is planning care for a group of clients after receiving change-of-shift report. Which
of the following clients should the nurse plan to see first?
a) A client who had a colectomy 2 days ago and has a nasogastric tube, Jackson-Pratt drain,
and indwelling urinary catheter
b) A client who is dehydrated, has mental confusion, and was found getting out of bed
several times during the night
c) A client who had a right lower lobe lobectomy 4 days ago and has a chest tube set to
continuous suction
d) A client who has pneumonia and an oral temperature of 38.7º C (101.7º F)

Answer 20

B - (When using the urgent vs. nonurgent approach to client
care, the nurse determines to first see the client who has mental confusion and is getting
out of bed without assistance. The client is experiencing manifestations of dehydration
that can cause injury due to falls. Therefore, the nurse should see this client first.)

Question 21

A nurse is collecting data from a client who is receiving sumatriptan. Which of the following
is an outcome?
a) Reduced cough
b) Diminished headache 
c) Relaxed muscles
d) Decreased peripheral edema

Answer 21

B - (Sumatriptan is a vascular headache suppressant prescribed for
relief of migraines or cluster headaches. Therefore, the nurse should monitor the client
for a diminished headache as an expected outcome of the medication.)

Question 22

A nurse is caring for a client who reports shortness of breath and has an oxygen saturation
of 90%. Which of the following actions should the nurse take?
a) Prepare for intubation of the client.
b) Administer opioid medication.
c) Administer oxygen via nasal cannula.
d) Place the client in low-Fowler’s position

Answer 22

C - (The nurse should administer oxygen via nasal
cannula to a client who reports shortness of breath and has an oxygen saturation below
the expected reference range. The nurse should continue to monitor the client and adjust
the oxygen flow rate as needed.)

Question 23

A nurse is caring for a client who has a prescription for digoxin 0.25 mg PO daily. While
taking the client’s apical pulse, the nurse notes a rate of 58/min. which of the following
actions should the nurse takes?
a) Give the dose as prescribed.
b) Use a different route to administer the medication.
c) Administer half of the prescribed dose.
d) Withhold the dose.

Answer 23

D - (The nurse should withhold the digoxin dose for an apical pulse less
than 60/min and notify the provider. Digoxin slows the heart rate, so administering the
dose can cause harm to the client.)

Question 24

A nurse is caring for a client who has neutropenia. Which of the following nursing
interventions should the nurse implement?
a) Offer the client fresh fruits and vegetables.
b) Monitor the client’s platelet count daily
c) Limit visitors to healthy adults.
d) Apply firm pressure to injection sites.

Answer 24

C - (The nurse should limit visitors to healthy adults to

minimize the client’s risk of exposure to infection.)

Question 25

A nurse is caring for client who has an intestinal obstruction and reports a new onset of
nausea. The client has an NG tube set at low intermittent suction and is receiving
continuous IV infusion of 0.9% sodium chloride. Which of the following actions should the
nurse take first?
a) Check for kinks in the NG tube.
b) Increase the IV fluid rate.
c) Provide ice chips.
d) Administer an antiemetic.

Answer 25

A - (The first action the nurse should take when using the
nursing process is to collect data from the client. Therefore, the priority action is to check
the NG tube to determine if the tube is kinked, which can interfere with the suctioning
function and result in nausea.)

Question 26

A nurse in a clinic is assisting with the development of a pamphlet about STIs. Which of the
following information should the nurse recommend to include in the pamphlet?
a) The number of sexual partners does not affect the risk for STIs.
b) Oral contraceptive use decreases the risk for STIs.
c) Men seek treatment for STIs later than women.
d) Women have a higher risk of contracting STIs than men.

Answer 26

D - (The nurse should include that
oral contraceptive use, prolonged contact with male secretions, and increased cervical
permeability during hormone fluctuations increase a woman’s risk of acquiring STIs

Question 27

A nurse is reinforcing teaching with a client who is postoperative following a cemented total
hip arthroplasty. Which of the following instructions should the nurse include in the
teaching?
a) Avoid weight-bearing until healing of the hip incision is complete.
b) Cross legs intermittently several times a day.
c) Lean forward to change positions when sitting in a chair.
d) Maintain hip flexion to 90° or less when sitting.

Answer 27

D - (A client who has had a cemented total
hip arthroplasty should maintain hip flexion to 90° or less when sitting to prevent hip
dislocation.)

Question 28

A nurse is caring for a client who is 24 hr postoperative following an abdominal surgery.
Which of the following findings requires immediate attention from the nurse?
a) Reported pain level of 6 on a scale of 0 to 10
b) Urinary output of 110 mL in the past 4 hr
c) Temperature of 38.0º C (100.4º F)
d) Oxygen saturation of 88%

Answer 28

D - (When using the airway, breathing, circulation approach to
client care, the nurse determines that the finding that requires immediate attention is an
oxygen saturation of 88%. This finding is below the expected reference range of 95% to
100% and requires intervention to restore oxygenation to the client’s tissues.)

Question 29

A nurse is caring for a client following a gastrectomy. Which of the following actions should
the nurse take to decrease episodes of dumping syndrome?
a) Place the client in the supine position after meals.
b) Administer pancreatic enzymes before meals.
c) Encourage the client to drink 240 mL (8 oz) of fluids with meals.
d) Offer the client three meals daily.

Answer 29

A - (The nurse should encourage the client
to lie in the supine position for a short time following meals to decrease rapid gastric
emptying.

Question 30

A nurse is assisting with the care of a client who has a stroke and is unable to speak. The nurse
should identify that the client’s injury occurred in which of the following lobes of the brain? (You
will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your
answer.)

Answer 30

A is correct. Injury to the frontal lobe can result in alterations to motor function or
voluntary movement. This involves the ability to speak and the ability to move
purposefully.

Question 31

A home health nurse is caring for a client who has COPD. The client tells the nurse that he
becomes short of breath while eating despite the use of home oxygen. Which of the following
instructions should the nurse include?
a) Limit protein in daily meal plan.
b) Use a bronchodilator 1 hr before meals.
c) Drink beverages at the end of meals.
d) Lie down for 1 hr. after meals.

Answer 31

C - (Lie down for 1 hr after meals.The client should
drink beverages at the end of meals, rather than during meals, to prevent shortness of
breath while eating. This also prevents early satiety and promotes adequate nutrient
intake during the meal)

Question 32

A nurse is reinforcing teaching with a client who has chronic kidney disease about
management. Which of the following statements by the client indicates an understanding of
the teaching?
a) “I will add a banana to my morning cereal.”
b) “I will decrease my intake of carbohydrates.”
c) “I will limit my daily intake of protein.”
d) “I will season my foods with a salt substitute.”

Answer 32

C - (The client should decrease his intake of protein
to slow the progression of kidney failure. Therefore, the nurse should identify this
statement as an understanding of the teaching.)

Question 33

A nurse is caring for a client who has dementia due to Alzheimer’s disease. Which of the
following actions should the nurse take to reduce the client’s confusion?
a) Restrict visitors to three at a time.
b) Avoid touching the client during care.
c) Encourage reminiscence of past experiences.
d) Give the client multiple options for daily events.

Answer 33

C - (The nurse should encourage reminiscence

of past experiences to reduce the client’s confusion.)

Question 34

A nurse is caring for a client who has Cushing’s syndrome and expresses concern regarding
body image changes. Which of the following should the nurse recognize as a physical change
caused by this disease?
a) Bronze skin
b) Truncal obesity
c) Lordosis
d) Exophthalmos

Answer 34

B - (Truncal obesity is a manifestation of Cushing’s syndrome that occurs
due to a redistribution of fat. The client also usually has fatty tissue edema between the
scapula, also known as “buffalo hump”. The nurse should use therapeutic communication
techniques to investigate the client’s body image concerns.)

Question 35

A nurse is delegating the task of repositioning a client who is in skeletal traction to an
assistant personnel (AP). Which of the following instructions should the nurse give the AP?
a) Allow the weights to hang freely.
b) Release the tension of the ropes.
c) Remove the weights when rewrapping bandages.
d) Manually lift the weights when moving the client up in bed.

Answer 35

A - (The nurse should instruct the AP to allow the weights
to hang freely and to refrain from bumping the weights. Skeletal traction maintains
alignment of fractured bones through the use of counterweights. If these weights rest on
the floor or another object, they do not maintain the counterbalance necessary to maintain
the alignment of the fracture, which can result in client injury or pain.)

Question 36

A nurse is contributing to the plan of care for a client who has a head injury and is at risk
for increased intracranial pressure (ICP). Which of the following actions should the nurse
include in the plan?
a) Measure rectal temperature every 4 hr.
b) Remind the client to cough as needed.
c) Use a turn sheet to reposition the client.
d) Apply wrist restraints.

Answer 36

C - (The nurse should change the client’s position
slowly to prevent sudden increases in ICP. The use of a turn sheet to reposition the client
provides the nurse with the ability to better control the client’s movement and alignment.
The nurse should instruct the client to exhale during the position change to prevent an
increase in ICP.)

Question 37

A nurse is preparing to administer an influenza vaccine to a client. Which of the following
statements by the client should cause the nurse to postpone administration of the vaccine?
a) “I am allergic to shrimp.”
b) “I am allergic to latex balloons.”
c) “I had a tuberculosis skin test 2 days ago.”
d) “I had a low fever this morning.”

Answer 37

D - (Clients who have a febrile illness should not receive

the influenza vaccine.)

Question 38

A nurse is repositioning a client who has lower back pain. Which of the following position is
appropriate for the client?
a) Semi-Fowler's with knees flexed 
b) Orthopneic
c) Dorsal recumbent
d) Prone with legs straight

Answer 38

A - (Sitting in semi-Fowler’s position with the head of bed
elevated 15° to 45° and flexing the knees will help relax the lumbar area of the client’s
back and relieve pressure on the nerves.)

Question 39

A nurse is reinforcing teaching with a client who has a new diagnosis of genital herpes.
Which of the following information should the nurse include in the teaching?
a) “Use condoms when lesions are present.”
b) “Look for lesions that have a wart-like appearance.”
c) “The virus can be transmitted without lesions present.”
d) “The lesions resolve in 2 weeks and usually do not recur.”

Answer 39

C - (The nurse should inform the
client that viral shedding and spreading of the infection can occur even when lesions are
not present)

Question 40

A nurse is reinforcing teaching regarding the use of a continuous passive motion motion
(CPM) machine with a client who is schedules for a total knee arthroplasty. Which of the
following information should the nurse include in the teaching? (Select all that apply.)
a) “Your knee is flexed and extended as prescribed by your provider.”
b) “The machine is padded with sheep skin.”
c) “You might have the head of the bed elevated to 45 degrees while using this machine.”
d) “To use the machine, you must pedal as if you are riding a bike.”

Answer 40

A,B -
- (The provider will
give specific instructions concerning the CPM flexion and extension motion each day.)
- (Padding the CPM machine with sheep skin
prevents injury to pressure points on the extremity.)