ATI RN MEDICAL SURGICAL 2023

5. A nurse is caring for a client who has heart failure. Drag words from the choices below to fill
in each blank in the following sentence.

The client is at risk for developing _________ and_________

Word choices: dysrhythmias, respiratory alkalosis, acute kidney injury, fluid volume

Tdeficitoad A dentaration
Hyperventilation
Diagnostic Results (exhibit 1) Day of Admission:
Brain natriuretic peptide (BNP): 450 pg/mL (less than 100 pg/mL)
Potassium: 4.8 mEq/L (3.5 to 5 mEq/L)
Sodium: 132 mEq/L (136 to 145 mEq/L)
BUN: 10 mg/dL (10 to 20 mg/dL) Day 2 of
Hospitalization:
Brain natriuretic peptide: 110 pg/mL (less than 100 pg/mL)
Potassium: 3.3 mEq/L (3.5 to 5 mEq/L)
Sodium: 135 mEq/L (136 to 145 mEq/L)
BUN: 20 mg/dL (10 to 20 mg/dL)
Medical Administration Record (exhibit 2) Day of Admission:
Furosemide 80 mg IV 3 times per day
Vital Signs ( exhibit 3) Day of Admission:
Temperature 36.6°C (97.8°F)
Heart rate 112/min
Respiratory rate 24/min
Blood pressure 186/84 mmHg
Oxygen saturation 93% on room air
Weight 97.5 kg (215 lb) Day 2 of
Hospitalization:
Temperature 36.6°C (97.8°F)
Heart rate 78/min
Respiratory rate 18/min
Blood pressure 102/78 mmHg
Oxygen saturation 98% on 2 L/min oxygen via nasal cannula
Weight 90.7 kg (200 lb)

6. A nurse is providing teaching for a client who has diabetes mellitus about the
selfadministration of insulin. The client has prescriptions for regular and NPH insulins. Which
of the following statements by the client indicates an understanding of the
teaching? a. "I will draw up the regular insulin into the syringe first."
b. "I will shake the NPH vial vigorously before drawing up the insulin."
 ATI RN MEDICAL SURGICAL 2023
c. "I will store prefilled syringes in the refrigerator with the needle pointed downward."
d. "I will insert the needle at a 15-degree angle."

7. A nurse on a medical-surgical unit is planning care for a client who has dementia and a
history of wandering. Which of the following actions should the nurse plan to implement?
a. Move client to a double room.
b. Use chemical restraints at bedtime.
c. Use a bed alarm.
d. Encourage participation in activities that provide excessive stimulation.
8. A nurse is caring for a client receiving TPN. Which of the following actions should the
nurse take? For each potential nursing intervention, click to specify if the potential intervention
is anticipated, nonessential, or contraindicated for the client.

Exhibit 1- Medical History,

Dehydration, Hyperlipidemia, Hypertension, Coronary artery disease (CAD) Exhibit 2-
Diagnostic Results
WBC count 14,000/mm° (5,000 to 10,000/mm)
Hgb 14 g/dL (12 to 16 g/dL)
Hct 40% (34 to 47%)

Sodium 132 mEq/L (136 to 146 mEq/L)

Potassium 6.2 mEq/L (3.5 to 5 mEq/L)
 ATI RN MEDICAL SURGICAL 2023
d. Strike the client's patellar tendon with a percussion hammer and note any increase in
response.

12. A nurse is planning care for a client who is postoperative following insertion of an
arteriovenous graft in their left forearm. Which of the following actions should the nurse
include in the plan of care?
a. Splint the left forearm to prevent damage to the graft.
b. Collect blood specimens from the graft.
c. Check the pulse distal to the graft.
d. Keep the left forearm below the level of the heart.

13. A nurse in a clinic is assessing a client who has type 1 diabetes mellitus. The client is
diaphoretic, has a heart rate of 92/min, and reports palpitations. The client states, "I went for
my morning run and feel exhausted." Which of the following responses
should the nurse make?
a. "Did you decrease your insulin intake before you

exercised?" Ob. "It is normal to feel this way after a morning run."

c. "It becomes easier when exercise is a routine."

d. "Were you careful to not have carbohydrates after the run?"

14. A nurse is teaching about food choices to a client who has chronic kidney disease and must
limit potassium intake. Which of the following choices should the nurse recommend as
containing the least potassium?

Oa.1 cup white rice

b.1 medium baked potato with skin
c.2 tbsp peanut butter
d.1/2 cup nonfat yogurt

15. A nurse is preparing a teaching plan for a client who has mucositis related to chemotherapy
treatment. Which of the following instructions should the nurse include? a. "Brush your teeth
for 60 seconds twice daily."
b. "Wear your dentures only during meals."

Oc. "Floss your teeth gently following each meal."

d. "Rinse your mouth with hydrogen peroxide."
 16. A nurse is assessing a client who has myasthenia gravis. Which of the following client
statements should indicate to the nurse that the client needs a
referral for occupational therapy?
a. "I've been having problems with bladder control."
b. "I would rather be in a wheelchair than use a walker to get around."
c. "I have a hard time with brushing my hair."
d. "I have difficulty swallowing food."
17. A nurse is caring for a client in the ICU. The client's ECG monitor tracing reveals sinus
bradycardia and S-T segment elevation. The client reports shortness of breath and feeling

dizzy and faint. Which of the following medications should the nurse administer? Oa.
Atropine b. Lidocaine c
.Sotalol
d. Digoxin

18. A charge nurse receives a call from the house supervisor requesting room assignments for
four new clients. Based on the admission diagnoses, which of the following clients requires a
private room?
a. A client who has diabetes mellitus and is presenting with acute
ketoacidosis
b. A client who has a compound fracture of the right femur
c. An older adult client who was admitted with aspiration pneumonia

Od. A client who reports having fever, night sweats, and cough for 2 days
19.A nurse is caring for a client immediately following a cardiac catheterization through the
right femoral artery. Which of the following actions should the nurse take? a. Elevate the head

of the client's bed to a 45° angle. Ob. Instruct the client not to bend the affected leg.
c. Monitor the client's vital signs once every hour.
d. Restrict the client's fluid intake.

20. A nurse is caring for a client who is using a continuous passive motion (CPM) machine
following a total knee arthroplasty. Which of the following actions should the nurse take?
a. Increase the range of motion rapidly when the CPM machine is used
intermittently.
b. Check settings of the CPM machine every 12 hr.
c. Turn the CPM machine off while the client is eating.
d. Store the CPM machine on the floor when not in use.
 ATI RN MEDICAL SURGICAL 2023
21. A nurse is teaching a group of young adult clients about risk factors for hearing loss.
Which of the following factors should the nurse include in the teaching? (Select all that apply.)

Oa. Chronic infections of the middle ear

b.Frequent exposure to low-volume noise

c. Perforation of the eardrum 8 d. Use of a loop diuretic

d.Born with a high birth weight

22. A nurse is caring for a client who has been prescribed an antibiotic. The client tells
the nurse, "I don't like taking medications because I don't think I need them." Which of
the following responses should the nurse make?
a. "Your provider wouldn't prescribe this medication if it weren't necessary.

Ob. "I will tell your provider that you do not want to take this medication."
c. "If you don't take this medication, you will feel worse."
d. "Most clients feel better after taking the antibiotic."

23. A nurse is caring for a client who is postoperative following a complete thyroidectomy.
Which of the following findings is the priority for the nurse to report to the provider?

Oa. Muscle twitching

b. Client report of nausea
c. Client report of incisional pain
d. Serosanguineous drainage

24. A nurse is assessing a client who has heart failure and a new prescription for metoprolol.
Which of the following findings should the nurse identify as an adverse effect of the
medication?
a.Blood pressure 138/76 mm Hg
b.Respiratory rate 10/min
 c. Temperature 36.3° C (97.3° F) Od. Heart rate 48/min
25. A nurse is providing teaching for the family of a client who has Alzheimer's disease.
Which of the following statements should the nurse include?
a. "Keep the client's room dark at night to promote sleep." b.
"Display a monthly calendar in the client's room."

Oc. "Provide the client with structured activities to fill their time."
d. "Provide plenty of stimulation in the client's room."

26. A nurse is assessing a client following the administration of an initial dose of

captopril. Which of the following findings indicates an anaphylactic response? a.
Arrythmia

Ob. Laryngeal edema

c. Fever
d. Hypertension

27. A nurse is planning care for a client who has dementia. Which of the following interventions
should the nurse plan to include?

a. Assist the client with toileting at least once every 4 hr. Ob.
Place the client's bed at the lowest height.
c. Request a prescription for a nightly sedative.
d. Turn off all lights in the client's room at night.

28. A nurse is providing teaching to a client who is to start furosemide therapy for heart
failure. Which of the following statements indicates that the client
understands a potential adverse effect of this medication?
a. "I'm going to include more cantaloupe in my diet."
b. " I will try to limit foods that contain salt."
c. "I’Il check my blood pressure so it doesn't get too high."
d. "I will check my pulse before I take the medication."
 ATI RN MEDICAL SURGICAL 2023
29. A nurse suspects that a client who has diabetes mellitus is experiencing hypoglycemia.
Which of the following
assessment findings supports
c. Kussmaul respirations this suspicion? a. Cool,
d. Increased urine output clammy skin b. Acetone
breath

31. A charge nurse on a neurological unit is making room assignments for a group of clients.
Which of the following clients should the nurse assign to the room closest to the nurses'
station?
a. A client who has experienced brain death and is awaiting organ procurement
b. A client who has a headache following a grade 1 concussion

Oc. A client who has a score of 10 on the Glasgow Coma Scale following a motor vehicle crash
dA client who has a score of 0 on the NIH Stroke Scale following a transient ischemic attack
32. A nurse working in the emergency department is admitting a client who has pertussis.
Which of the following actions should the nurse take? a. Perform a Mantoux skin test on
the client.
b. Assign the client to a negative-pressure airflow room.
c. Recommend that the client's family members receive antiviral therapy.
d. Wear a surgical mask when providing care to the client.

33. A nurse is assessing a client who has skeletal traction for a femoral fracture. The nurse
notes that the weights are resting on the floor. Which of the following actions should the
nurse take?
 a. Remove one of the weights.
b. Tie knots in the ropes near the pulleys to shorten them.
c. Increase the elevation of the affected extremity.

Od. Pull the client up in bed.

34. A nurse is caring for a client who is receiving morphine through a PCA device. Which of the
following actions should the nurse take?

Oa. Teach the client how to self-medicate using the PCA device.
b. Encourage family members to press the PCA button for the client.
c. Monitor the client's respiratory status every 4 hr.
d. Administer an oral opioid for breakthrough pain.

35. A nurse is caring for a client in the emergency department. For each
assessment finding, click to specify if the assessment finding is consistent
with diabetic ketoacidosis or hyperglycemic-hyperosmolar state (HHS).

Urine ketonesBlood glucose greater than expected reference rangeDKA Both

Creatinine greater than expected reference rangeSkin turgor Both Both

Blood pH greater than expected reference range HHS

36. A nurse is caring for a client in the emergency department. The nurse is caring for the client
in the ED. The nurse understands that the client is at risk of developing which of the
following complications?

Septic shock I Select all that apply. IE

 ATI RN MEDICAL SURGICAL 2023
Renal failure
Respiratory alkalosis
Cardiac arrhythmias
Hypotension Cerebral
edema

37.
 ATI RN MEDICAL SURGICAL 2023

39.

41. A nurse is teaching a client who has AIDS and wishes to continue self-care at home despite
living alone. Which of the following actions by the nurse demonstrates client advocacy?
a. Instruct the client to avoid eating raw vegetables.
b. Remind the client of the importance of medication adherence.

c. Tell the client to avoid places where there are large crowds of people. 0d. Initiate a referral
for the client to a home health agency.
42. A nurse is caring for a client who has a peripherally inserted central catheter (PICC) line in
her left forearm. The client is receiving an antibiotic via intermittent IV bolus every 12 hr. Which
of the following actions should the nurse take in managing the client's
PICC line? a. Access the catheter using a non-coring needle.
 b. Change the transparent membrane dressing daily.
c. Maintain a continuous IV infusion through the PICC line.
d. Flush the catheter with a 0.9% sodium chloride solution after each use.

43. A nurse is providing discharge teaching for a client who is receiving treatment for genital
herpes. Which of the following statements by the client indicates effectiveness of the teaching?
a. "I should apply antibiotic ointment to the lesions."
b. "I should use natural skin condoms during sexual intercourse."
c. "I should expect my lesions to resolve in 6 weeks."

O d. "I should expect to take my medication for 3 weeks."

44. A nurse is caring for a client who has a new diagnosis of type 2 diabetes mellitus and has a
referral for dietary consult. The client tells the nurse, "I will have to eat whatever the dietitian
tells me." Which of the following statements by the nurse encourages the client's involvement
in their plan of care?
a. "The dietitian will provide you with the best food choices to manage your diabetes."

b. "I understand that the dietary choices can seem overwhelming."

Oc. "I can assist you with making a list of foods you like for the dietitian."
d. "Managing your diabetes will require you to make accommodations."

45. A nurse is planning care for a client who is 12 hr postoperative following a kidney
transplant. Which of the following actions should the nurse include in the plan of care? a.

Check the client's blood pressure every 8 hr. Ob. Assess urine output hourly.
c. Administer opioids PO.
d. Monitor for hypokalemia as a manifestation of acute rejection.

46.A nurse is caring for a client immediately following a lumbar puncture. Which of
the following actions should the nurse take? a. Limit the client's fluid intake. b.
Measure blood glucose every 2 hr.
c. Instruct the client to expect tingling in their extremities.
 ATI RN MEDICAL SURGICAL 2023
Od. Instruct the client to lie flat.
47. A nurse is planning care for a client who has a seizure disorder. Which of the
following equipment should the nurse place in the client's
room? a. NG tube b. Tongue blade
c. Wrist restraints
d. Oral airway

48. A PACU nurse is monitoring the drainage from a client's NG tube

following abdominal surgery. Which of the following findings in the first
postoperative hour should the nurse report to the provider?

Oa. 100 mL of red drainage

b. 75 mL of greenish-yellow drainage
c. 200 mL of brown drainage
d. 150 mL of serosanguineous drainage

49. A nurse in the PACU is caring for a client. Which of the following assessments is the nurse's
priority?
a. Level of consciousness
b. Surgical site
c. Pain level
d. Respiratory status

50. A nurse is caring for a client who has oral achalasia. The nurse should ask the client which of
the following questions to assess their ability to swallow?
a. "Do you feel like you have food stuck at the base of your throat?"
b. "Do you have any feelings of fullness in the neck?"
c. "Do you feel any burning sensations in your throat?"
d. "Do you have any problems with pain while swallowing?"

51. A nurse is admitting a client who reports tightness in their chest that radiates to left arm.
The nurse is reviewing the client's medical record. Select the four findings that require
immediate follow-up.
52.
ATI RN MEDICAL SURGICAL 2023
ATI RN MEDICAL SURGICAL 2023
ATI RN MEDICAL SURGICAL 2023
 ATI RN MEDICAL SURGICAL 2023

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