2019 ATI Medical Surgical Practice Exam
1. A nurse is providing teaching to a client who has a sever form of stage 2 Lyme Disease. Which
of the following statements made by the client reflects an understanding of the teaching?
a. My joints ache because I have Lyme disease.
b. I can stop taking my antibiotics as soon as I start feeling better.
c. Lyme disease is transmitted through contact with infected urine.
d. I should take aspirin if I start running a fever.
Answer: a. My joints ache because I have Lyme disease.
2. A nurse is caring for a client who is 4 hr postop following an open reduction internal fixation
of the right ankle. Which of the following assessment findings should the nurse report to the
provider?
a. Extremity cool upon palpation
b. Serosanguineous drainage on the surgical dressing.
c. Pain level of 6 on a scale from 0 to 10.
d. Capillary refill time of 2 seconds in the toes.
Answer: a. Extremity cool upon palpation
3. A client is assessing a client while suctioning the client's tracheostomy tube. Which of the
following findings should indicate to the nurse the client is experiencing hypoxia?
a. The clients HR increases
b. The client’s blood pressure decreases.
c. The client’s respiratory rate decreases.
d. The client’s temperature increases.
Answer: a. The clients HR increases
4. A nurse is caring for a client who is 8 hr postoperative following a total hip arthroplasty. The
client is unable to void on the bedpan. Which of the following actions should the nurse take first?
a. Scan the bladder with a portable ultrasound
b. Insert a straight urinary catheter.
c. Encourage fluid intake.
d. Pour warm water over the client’s perineum.
Answer: a. Scan the bladder with a portable ultrasound
5. A nurse is providing discharge instructions to a client who has active tuberculosis. Which of
the following information should the nurse include in the instructions
a. sputum specimens are necessary every 2 to 4 weeks until there are three negative cultures
b. Wear a mask at all times until completing the medication regimen.
c. Airborne precautions are necessary while at home.
d. The medication regimen must be followed for 3 months.
Answer: a. sputum specimens are necessary every 2 to 4 weeks until there are three negative
cultures
6. A nurse is caring for a client who has increased intracranial pressure (ICP) and is receiving
mannitol via continuous IV infusion. The nurse should report which of the following adverse
effects of this medication to the provider?
a. Crackles heard on auscultation
b. Decreased deep tendon reflexes.
c. Weight loss.
d. Increased urinary output.
Answer: a. Crackles heard on auscultation
7. A nurse is providing discharge teaching to a client who is postoperative following a modified
radical mastectomy. Which of the following instructions should the nurse include
a. numbness can occur along the inside of the affected arm
b. Avoid lying on your back while resting.
c. Expect moderate arm swelling for several months.
d. Begin range-of-motion exercises 1 day after surgery.
Answer: a. numbness can occur along the inside of the affected arm
8. A nurse is providing education to a client who has TB and their family. Which of the following
information should the nurse include in the teaching.
a. Family members in the household should undergo TB testing
b. The client will no longer be contagious after 2 weeks of medication therapy.
c. The client should remain in airborne isolation for 1 month.
d. The client should have a repeat purified protein derivative (PPD) test in 3 months.
Answer: a. Family members in the household should undergo TB testing
9. A nurse is providing discharge teaching about infection prevention to a client who has AIDS.
Which of the following statements by the client indicates understanding of the teaching?
a. I will no longer floss my teeth after brushing my teeth
b. I will eat fresh fruits and vegetables to boost my immune system.
c. I will take my temperature once a week to monitor for infection.
d. I will wash my dishes separately from those of other family members.
Answer: a. I will no longer floss my teeth after brushing my teeth
10. A nurse is assessing a client who is at risk for development of pernicious anaemia resulting
from peptic ulcer disease. Which of the following images depicts a condition caused by
pernicious anaemia?
a. depicts oral candidiasis/thrush
b. depicts dry oral mucous membrane
c. depicts glossitis
d. depicts a healthy tongue dull in colour
Answer: c. depicts glossitis
11. A nurse is reviewing the laboratory results of a client who has aplastic anaemia. Which of the
following findings indicates a potential complication.
a. WBC count 2,000
b. RBC count 5 million
c. Platelet count 150,000
d. Haemoglobin 15 g/dL
Answer: a. WBC count 2,000
12. A nurse is assessing heart sounds of a client who reports substernal precordial pain. Identify
which of the following sounds the nurse should document in the client's medical record by
listening to audio clip.
a. Pericardial friction rub
b. S3 heart sound
c. S4 heart sound
d. Murmur
Answer: a. Pericardial friction rub
13. A nurse is admitting a client who has active tb. which of the following types of transmission
precautions should the nurse initiate?
a. Airborne
b. Droplet
c. Contact
d. Protective
Answer: a. Airborne
14. A nurse is preparing to present a program about prevention of atherosclerosis at a health fair.
Which of the following recommendations should the nurse plan to include? (select all)
a. Follow a smoking cessation program
b. Maintain an appropriate weight
c. Eat a low-fat diet
d. Increase intake of saturated fats.
e. Limit physical activity.
Answer: a. Follow a smoking cessation program
b. Maintain an appropriate weight
c. Eat a low-fat diet
15. Family teaching, alzheimers
a. Create complete outfits
b. Place a large mirror in the hallway.
c. Teach the client new activities to stimulate cognitive function.
d. Keep frequently used items in different locations each day.
Answer: a. Create complete outfits
16. Post op thyroidectomy
a. Temperature of 102°F (38.9°C).
b. Blood pressure 138/82 mm Hg.
c. Hoarse voice.
d. Pain level of 5 on a scale of 0 to 10.
Answer: a. Temperature of 102°F (38.9°C).
17. Mechanical ventilation via trach tube.
a. Stress ulcers
b. Seizures.
c. Hyperkalaemia.
d. Hyponatremia.
Answer: a. Stress ulcers
18. Lung cancer and receiving palliative care, thoracentesis
a. Dyspnea
b. Bradycardia
c. Weight loss
d. Chest pain
Answer: a. Dyspnea
19. New prescription of psyllium
a. Drink 240 mL water after administration
b. Take psyllium with your meals.
c. Expect results in 4 to 6 hours.
d. Decrease your daily fibre intake.
Answer: a. Drink 240 mL water after administration
20. Gingkgo biloba
a. Can cause an increased risk for bleeding
b. Decreases the risk for migraine headaches.
c. Can cause urinary retention.
d. Decreases the risk for deep vein thrombosis.
Answer: a. Can cause an increased risk for bleeding
21. Home health teaching client who has stage 1 pressure injury
a. Change position every hour
b. Massage the reddened area.
c. Apply a heat lamp to the area.
d. Keep the head of the bed elevated to 45 degrees.
Answer: a. Change position every hour
22. Medical record of an older adult who is receiving IV fluid therapy. Re-evaluation of the IV
therapy prescription?
a. BUN 29
b. Haematocrit 45%
c. Sodium 138 mEq/L
d. Potassium 4.0 mEq/L
Answer: a. BUN 29
23. Scheduled for a mastectomy.
a. Refer you to a community resources that can provide support
b. Discuss the need for chemotherapy immediately after surgery.
c. Explain that breast reconstruction will occur during the same surgery.
d. Advise the client to avoid discussing feelings about the diagnosis.
Answer: a. Refer you to a community resources that can provide support
24. Extubation of endotracheatube 10 minutes ago, report immediately?
a. Stridor
b. Slight coughing.
c. Oxygen saturation 95%.
d. Respiratory rate of 22 breaths/min.
Answer: a. Stridor
25. Diabetes insipidus, what to expect?
a. Low urine specific gravity
b. High urine specific gravity.
c. Decreased thirst.
d. Decreased urine output.
Answer: a. Low urine specific gravity
26. Postop following TURP
a. Irrigate
b. Administer pain medication as needed.
c. Encourage fluid intake to 2 litres per day.
d. Perform bladder training.
Answer: a. Irrigate
27. Arterial line, what action should nurse take?
a. Place pressure bag around the flush solution
b. Change the dressing every 24 hours.
c. Maintain the arterial line at the level of the heart.
d. Flush the arterial line with heparin every hour.
Answer: a. Place pressure bag around the flush solution
28. Promotional presentation for group of African Americans at community centre, greatest risk
for?
a. Hypertension
b. Diabetes mellitus.
c. Osteoporosis.
d. Lung cancer.
Answer: a. Hypertension
29. Dementia and require acute care for a respiratory infection. Client agitated and attempting to
remove IV catheter
a. Keep client occupied with manual activity
b. Restrain the client to prevent removal.
c. Administer a sedative to calm the client.
d. Explain to the client the importance of the IV.
Answer: a. Keep client occupied with manual activity
30. External fixation device for a fracture in lower extremity
a. Use crutches with rubber tips
b. Weight-bear on the affected leg as tolerated.
c. Apply heat to the pins to reduce swelling.
d. Remove the device for bathing.
Answer: a. Use crutches with rubber tips
31. Peripheral arterial disease, what to expect
a. Hair loss on the lower legs
b. Redness and swelling in the legs.
c. Thickened toenails.
d. Warmth in the lower extremities.
Answer: a. Hair loss on the lower legs
32. Warfarin for chronic atrial fib
a. INR 2.5
b. PT 10 seconds.
c. aPTT 35 seconds.
d. INR 1.0.
Answer: a. INR 2.5
33. Osteomyelitis, prescription for gentamicin
a. Serum creatinine
b. Liver function tests.
c. Electrolyte levels.
d. Complete blood count.
Answer: a. Serum creatinine
34. Anaemia and new prescription for oral iron supplement
a. Eat more high-fibre foods
b. Increase intake of dairy products.
c. Decrease vitamin C consumption.
d. Limit red meat intake.
Answer: a. Eat more high-fibre foods
35. Cervical spinal cord injury 1 month ago, experiencing autonomic dysreflexia?
a. HR 52
b. Blood pressure of 180/100 mm Hg.
c. Temperature of 100.4°F (38°C).
d. Respiratory rate of 8 breaths/min.
Answer: a. HR 52
36. Gastric haemorrhage going into shock
a. administer oxygen
b. initiate IV therapy
c. insert an NG tube
d. administer ranitidine
Answer: a. administer oxygen
b. initiate IV therapy
c. insert an NG tube
d. administer ranitidine
37. Thoracentesis, following interventions should nurse include in the plan
a. encourage to take deep breaths
b. Have the client lie flat during the procedure.
c. Instruct the client to avoid coughing during the procedure.
d. Administer analgesics immediately before the procedure.
Answer: a. encourage to take deep breaths
38. Client receiving chemotherapy, what is propriety
a. report of sore throat
b. Nausea and vomiting.
c. Fatigue and weakness.
d. Hair loss.
Answer: a. report of sore throat
39. Compound fracture 3 weeks ago, unexpected finding manifestation of osteomyelitis
a. sedimentation rate
b. Localized pain and swelling.
c. Fever above 101°F (38.3°C).
d. Delayed healing of the fracture site.
Answer: a. sedimentation rate
40. Nephrostomy tube 12 hours ago
a. client reports back pain
b. Urine output of 30 mL/hr.
c. Clear urine in the drainage bag.
d. No signs of leakage around the nephrostomy site.
Answer: a. client reports back pain
41. Constipation-predominant irritable bowel syndrome
a. Consume 30 g of fibre daily.
b. Increase intake of dairy products.
c. Limit fluid intake to decrease bloating.
d. Avoid high-fibre foods until symptoms resolve.
Answer: a. Consume 30 g of fibre daily.
42. Dementia, interventions to include in plan of care
a. Place personal items at bedside
b. Use a calendar with the date marked.
c. Provide frequent changes in the environment.
d. Encourage the client to maintain independence in all activities.
Answer: a. Place personal items at bedside
43. Postop parathyroidectomy
a. Tracheostomy tray at the bedside
b. Cardiac monitor.
c. Resuscitation bag.
d. IV medication for pain control.
Answer: a. Tracheostomy tray at the bedside
44. Completion of haemodialysis
a. Restlessness
b. Decreased blood pressure.
c. Slight headache.
d. Dizziness upon standing.
Answer: a. Restlessness
45. Administering packed RBC, what indications haemolytic transfusions reaction
a. Low back pain and apprehension
b. Fever and chills.
c. Rash and itching.
d. Shortness of breath and cough.
Answer: a. Low back pain and apprehension
46. Modified radical mastectomy of right breast
a. Drain removed when 25ml or less over 24 hours
b. Drain removed after 48 hours postoperatively.
c. Drain removed when there is no more serosanguinous drainage.
d. Drain removed when the incision is fully healed.
Answer: a. Drain removed when 25ml or less over 24 hours
47. AIDS, statements by client indicates understanding of teaching
a. Take temperature once a day
b. I will avoid taking my temperature if I feel fine.
c. I will only take my temperature when I feel sick.
d. I will take my temperature every other day.
Answer: a. Take temperature once a day
48. Lab findings client who developed chest pain 6 hours ago, indication of MI
a. Troponin 8ng
b. Creatine kinase (CK) of 100 U/L.
c. B-type natriuretic peptide (BNP) of 50 pg/mL.
d. Myoglobin of 20 ng/mL.
Answer: a. Troponin 8ng
49. Osteoporosis prevention, medication increases risk
a. Prednisone
b. Alendronate.
c. Raloxifene.
d. Calcitonin.
Answer: a. Prednisone
50. Phenytoin 600 mg PO daily
a. Monitor serum drug levels.
b. Check for signs of liver dysfunction.
c. Assess for signs of anaemia.
d. Evaluate kidney function tests.
Answer: a. Monitor serum drug levels.
51. Urgent care clinic experiencing anaphylactic reaction
a. Applying oxygen via face mask
b. Administering epinephrine.
c. Establishing IV access.
d. Initiating a saline infusion.
Answer: a. Applying oxygen via face mask
52. Administer a blood transfusion to client who has anaemia
a. Check for the type and number of units of blood
b. Obtain the client's vital signs.
c. Administer premedication’s for transfusion.
d. Confirm the blood compatibility with another nurse.
Answer: a. Check for the type and number of units of blood
53. Sealed radiation implant for cervical cancer
a. Lead-lined container in room
b. Encourage visitors to stay for long periods.
c. Use disposable utensils for meals.
d. Allow family members to sit on the bed.
Answer: a. Lead-lined container in room
54. Breast cancer tells nurse they would like to have acupuncture
a. Speak to the provider about incorporating acupuncture
b. Schedule an acupuncture session immediately.
c. Discourage the use of alternative therapies.
d. Recommend acupuncture only after chemotherapy.
Answer: a. Speak to the provider about incorporating acupuncture
55. TPN and is NPO, capillary blood glucose AC and HS
a. Contact PCP
b. Monitor blood glucose levels as ordered.
c. Document the blood glucose results.
d. Adjust the TPN rate if blood glucose is elevated.
Answer: a. Contact PCP
56. Positive culture for MRSA
a. Bathe client using chlorhexidine solution
b. Administer intravenous antibiotics.
c. Isolate the client in a negative-pressure room.
d. Use a standard face mask when providing care.
Answer: a. Bathe client using chlorhexidine solution
57. Pneumothorax and closed-chest drainage system
a. Bubbling in water seal chamber has ceased
b. The drainage system is positioned below the level of the chest.
c. There is intermittent bubbling in the suction control chamber.
d. The client reports decreased chest pain.
Answer: a. Bubbling in water seal chamber has ceased
58. Asthma about use of metered-dose inhaler.
a. Hold breath for 10 seconds after inhaling
b. Exhale forcefully before using the inhaler.
c. Use the inhaler every 15 minutes as needed.
d. Shake the inhaler only before using it in the morning.
Answer: a. Hold breath for 10 seconds after inhaling
59. DKA
a. Regular insulin 20 u IV bolus
b. Glucagon 1 mg subcutaneously.
c. Metformin 500 mg PO.
d. NPH insulin 10 units subcutaneously.
Answer: a. Regular insulin 20 u IV bolus
60. At risk for osteoporosis
a. Walk for 30 min four times per week
b. Limit calcium intake to 500 mg daily.
c. Engage in weight lifting exercises once a month.
d. Reduce vitamin D supplementation to 200 IU daily.
Answer: a. Walk for 30 min four times per week
61. Hypertension and new prescription for verapamil
a. Increase fibre intake to avoid constipation
b. Limit fluid intake to prevent fluid overload.
c. Avoid high-potassium foods.
d. Discontinue the medication if dizziness occurs.
Answer: a. Increase fibre intake to avoid constipation
62. Undergo cataract surgery, medication is contraindicated
a. Warfarin
b. Aspirin.
c. Acetaminophen.
d. Dexamethasone.
Answer: a. Warfarin
63. Assessing client’s hydration status, indicated FVO
a. Distended neck veins
b. Dry mucous membranes.
c. Decreased urine output.
d. Weight loss.
Answer: a. Distended neck veins
64. Postoperative teaching for total knee arthroplasty
a. Flex the foot every hour when awake
b. Limit movement of the knee for the first week.
c. Avoid using a continuous passive motion (CPM) machine.
d. Apply ice directly to the surgical site.
Answer: a. Flex the foot every hour when awake
65. Zenker’s diverticulum
a. Pharyngeal pouch
b. Hematemesis.
c. Dysphagia with solids only.
d. Persistent cough with exertion.
Answer: a. Pharyngeal pouch
66. ECG Rhythm strip who has temporary pacemaker
a. Document that depolarization has occurred
b. Report any irregularities in heart rate.
c. Note the presence of ST elevation.
d. Record any changes in pacemaker settings.
Answer: a. Document that depolarization has occurred
67. AIDS and taking amphotericin B for fungal in function
a. BUN 34
b. Potassium 4.5 mEq/L.
c. Serum sodium 136 mEq/L.
d. Haemoglobin 12 g/dL.
Answer: a. BUN 34
68. Client who has end-stage kidney disease waiting for kidney transplant
a. Haemodialysis is sometimes required following surgery
b. You will not need any medications after the transplant.
c. The transplant will cure your kidney disease completely.
d. You can resume normal activities immediately after surgery.
Answer: a. Haemodialysis is sometimes required following surgery
69. Perimenopausal and has a prescription for hormone replacement therapy
a. Calf pain
b. Intense headaches
c. Numbness in the arm
d. Hot flashes.
Answer: a. Calf pain
70. Terminal cancer, “stop these treatments, I’m ready to die.”
a. “Discontinuing with the treatments is your choice if it is your wish to do so.”
b. “You shouldn’t feel that way; we can help you.”
c. “Let’s discuss this with your family first.”
d. “You have to keep trying; there might still be hope.”
Answer: a. “Discontinuing with the treatments is your choice if it is your wish to do so.”
71. Tonic-clonic seizure while in bed and has become cyanotic
a. Prepare to suction
b. Loosen restrictive clothing
c. Place the client in a lateral position.
d. Administer oxygen.
Answer: b. Loosen restrictive clothing
72. Caring for a client who is receiving a blood transfusion. Client becomes restless, dyspneic
and has crackles
a. Slow the infusion rate
b. Administer a prescribed antihistamine.
c. Notify the healthcare provider.
d. Take the client’s vital signs.
Answer: a. Slow the infusion rate
73. Performing a preoperative assessment for a client. Allergy to food indicate latex allergy
a. Avocados
b. Strawberries.
c. Peanuts.
d. Shellfish.
Answer: a. Avocados
74. Evaluating the plan of care for four clients after 2 days of hospitalization. Revise which plan
a. Reports something “popped” when they coughed
b. States they are feeling better and want to go home.
c. Has a stable vital signs and is ambulating independently.
d. Requests a change in diet due to nausea.
Answer: a. Reports something “popped” when they coughed
75. ABG with advanced COPD
a. PaCO2 of 56 mmHg
b. pH of 7.45.
c. HCO3 of 24 mEq/L.
d. PaO2 of 90 mmHg.
Answer: a. PaCO2 of 56 mmHg
76. Transcutaneous electrical nerve stimulation for management of bone cancer pain
a. A tingling sensation replacing the pain
b. I will feel a sharp pain during the treatment.
c. This will completely eliminate my pain.
d. The electrodes should be placed directly on the bone.
Answer: a. A tingling sensation replacing the pain
77. Teaching a group of newly licensed nurses about pain management for older adult clients
a. Ibuprofen can cause gastrointestinal bleeding in older adult clients
b. Older adults do not experience pain as intensely as younger adults.
c. Morphine is the first-line medication for pain management in older adults.
d. Older adults are less likely to experience side effects from medications.
Answer: a. Ibuprofen can cause gastrointestinal bleeding in older adult clients
78. ED assessing older adult client who has fractured wrist following a fall. “last week I crashed
my car because my vision suddenly became blurry.”
a. Check neuro status
b. Assess the client's wrist for swelling.
c. Obtain a history of the fall.
d. Provide pain medication.
Answer: a. Check neuro status
79. Cardiac dysrhythmia about the purpose of undergoing continuous telemetry monitoring
a. Identifies if the pacemaker cells of my heart are working properly
b. Monitors my blood pressure continuously.
c. Tells me how well my heart is pumping blood.
d. Tracks my cholesterol levels over time.
Answer: a. Identifies if the pacemaker cells of my heart are working properly
80. Stage 2 cervical cancer scheduled for brachytherapy
a. You will need to stay still in the bed during each treatment session
b. You can eat a regular meal before each session.
c. You will need to take a laxative before treatment.
d. You will be able to go home immediately after each session.
Answer: a. You will need to stay still in the bed during each treatment session
81. DKA, condition is improving
a. Glucose 272 mg/dL
b. Blood pH of 7.25.
c. Serum bicarbonate level of 12 mEq/L.
d. Urine ketones present.
Answer: a. Glucose 272 mg/dL
82. Laryngeal cancer and is receiving radiation therapy
a. I will avoid direct exposure to the sun
b. I can continue to smoke as long as I reduce the amount.
c. I do not need to modify my diet during treatment.
d. I can skip follow-up appointments if I feel fine.
Answer: a. I will avoid direct exposure to the sun
83. Self-administer heparin subcutaneously
a. Electric razor to shave
b. I will massage the injection site after administration.
c. I can inject the heparin into the muscle for better absorption.
d. I will administer the injection in the same site every time.
Answer: a. Electric razor to shave
84. PACU assessing postop following right nephrectomy
a. HR 110
b. Blood pressure of 120/80 mmHg.
c. Respiratory rate of 18 breaths/min.
d. Temperature of 98.6°F (37°C).
Answer: a. HR 110
85. Hypothyroidism, which manifestation should nurse expect
a. Constipation
b. Weight loss.
c. Tachycardia.
d. Increased appetite.
Answer: a. Constipation
86. Assessing for compartment syndrome
a. Pain that increases with passive movement
b. Numbness in the affected extremity.
c. Weak pulse in the affected extremity.
d. Swelling of the extremity.
Answer: a. Pain that increases with passive movement
87. Homonymous hemianopsia as a result of a stroke, to reduce risk of falls when ambulating
a. Scan environment by turning hour head from side to side
b. Use a cane on the unaffected side.
c. Avoid using a walker for stability.
d. Ambulate only in familiar environments.
Answer: a. Scan environment by turning hour head from side to side
88. Nurse planning care for a client who is postop following a laparotomy, closed suction drain
a. Compress the drain reservoir after emptying
b. Change the drain dressing daily.
c. Keep the drain tubing clamped at all times.
d. Allow the drain to fill to its maximum capacity before emptying.
Answer: a. Compress the drain reservoir after emptying
89. Medical record of client who has SLE
a. Facial butterfly rash
b. Elevated liver enzymes.
c. Positive Rho(D) factor.
d. Increased platelet count.
Answer: a. Facial butterfly rash
90. Diagnosis of rheumatoid arthritis, nonpharmacological intervention should nurse suggest to
the client to reduce pain
a. Alternate application of heat and cold to the affected joints
b. Engage in vigorous exercise to maintain mobility.
c. Avoid any physical activity to rest the joints.
d. Apply ice packs continuously for 24 hours.
Answer: a. Alternate application of heat and cold to the affected joints
