ATI MED SURG
PROCTORED EXAM
(NGN-Style Questions & Case Scenario)
Actual Qs & Ans to Pass the Exam
This ATI test contains:
, 100 Qs & Ans
passing score Guarantee
Format Set of Multiple-choice
questions with incorporating Next Generation NCLEX (NGN) and Case
Scenario
Expert-Verified Explanations & Solutions
#### Question 1 (NGN Style – Clinical Judgment)
A nurse is caring for a client who is receiving dialysis treatment. At 0530, the nurse notes the client is
awake and alert. During assessment of the arteriovenous fistula (AVF) in the right forearm, the nurse
identifies loss of thrill and bruit. Whic7h of the following interventions should the nurse perform first?
A. Notify the provider immediately.
B. Administer 0.9% sodium chloride 200 mL IV bolus.
C. Apply oxygen at 2 L/min via nasal cannula.
D. Position the client’s legs elevated.
, Answer: A. Notify the provider immediately.
Explanation: The absence of a thrill and bruit over an AVF indicates potential AVF thrombosis or occlusion,
an emergent complication that requires immediate provider notification. Administering fluids (Option B) or
oxygen (Option C) would not directly address the underlying issue of thrombosis. Elevating the legs (Option
D) is not indicated for an AVF-related emergency. The priority nursing action aligns with SBAR
communication and immediate escalation.
---
#### Question 2 (NGN Style – Postoperative Care)
A nurse is caring for a client who is postoperative following abdominal surgery. At 1100, the client is
received from PACU with the following initial vital signs:
- Temperature: 98.8°F (37.1°C)
- Pulse: 92/min
- Respirations: 16/min
- Blood pressure: 132/84 mmHg
- Urine output: 50 mL/hr
Which of the following interventions should the nurse include in the client’s care plan? (Select all that
apply.)
A. Instruct the client to splint the abdomen with a pillow for coughing.
B. Plan to ambulate the client as soon as possible.
C. Report urinary output to the provider.
D. Ask the client to rate their pain on a 0 to 10 pain scale.
Answer: A, B, D.
Explanation:
- Option A: Splinting the abdomen reduces pain and minimizes the risk of dehiscence when coughing.
- Option B: Early ambulation promotes circulation, prevents venous thromboembolism (VTE), and expedites
recovery.
- Option D: Assessing pain levels using a validated pain scale aids in effective pain management.
- Option C is incorrect, as urinary output of 50 mL/hr is within the expected range postoperatively.
---
#### Question 3 (Medication Management)
A nurse is caring for a client who is receiving total parenteral nutrition (TPN). A new TPN bag is not yet
available, and the current infusion is nearly complete. What action should the nurse take?
A. Stop the infusion until the new TPN bag is available.
B. Administer 0.9% sodium chloride instead until the TPN is available.
C. Administer dextrose 10% in water until the new bag arrives.
D. Notify the provider immediately and document the incident.
Answer: C. Administer dextrose 10% in water until the new bag arrives.
Explanation: Discontinuing TPN abruptly (Option A) risks hypoglycemia due to the body's reliance on
continuous glucose infusion. Dextrose 10% (Option C) maintains adequate glucose levels to prevent
complications. Option B isn't appropriate replacement therapy. Option D does not address immediate client
safety.
---
, #### Question 4 (NGN Style – Assessment and Intervention)
A nurse is caring for a client who had a nephrostomy tube inserted 12 hours ago. The client reports severe
back pain. Which of the following scenarios best reflects the nurse's priority action?
A. Remove the nephrostomy tube and notify the provider.
B. Administer prescribed analgesics and reassess.
C. Flush the nephrostomy tube with sterile saline to check for obstruction.
D. Notify the provider immediately and assess tube function.
Answer: D. Notify the provider immediately and assess tube function.
Explanation: Severe back pain following nephrostomy tube insertion could indicate obstruction or infection,
both of which require immediate provider intervention. Flushing the tube (Option C) should be done only
after provider direction. Removing the tube (Option A) is not within the nurse’s scope. Analgesics (Option B)
do not resolve the underlying complication.
---
#### Question 5 (Seizure Management)
A nurse is caring for a client experiencing a tonic-clonic seizure. Which priority action should the nurse
take?
A. Insert a padded tongue blade into the client’s mouth.
B. Attach the client to continuous cardiac monitoring.
C. Turn the client to the side.
D. Restrain the client to prevent injury.
Answer: C. Turn the client to the side.
Explanation: Positioning the client laterally reduces the risk of aspiration by allowing drainage of
secretions. Inserting a tongue blade (Option A) is contraindicated due to risk of injury. Continuous cardiac
monitoring (Option B) may be secondary but is not the priority during a seizure. Restraint (Option D) can
cause harm and is not appropriate.
---
#### Question 6 (NGN Style – Adverse Effects of Medications)
A nurse in a provider’s office is assessing a client who has hypertension and takes propranolol. The client
reports a persistent night cough. Which of the following is the nurse's priority action?
A. Document the finding and monitor.
B. Teach the client about non-pharmacologic cough remedies.
C. Notify the provider immediately.
D. Instruct the client to take propranolol in the morning instead of at night.
Answer: C. Notify the provider immediately.
Explanation: A persistent night cough could indicate bronchospasm, a potential side effect of propranolol
(a non-selective beta-blocker). This finding requires immediate provider notification to evaluate the need for
a medication change.
---
#### Question 7 (Pressure Injury Wound Care)
PROCTORED EXAM
(NGN-Style Questions & Case Scenario)
Actual Qs & Ans to Pass the Exam
This ATI test contains:
, 100 Qs & Ans
passing score Guarantee
Format Set of Multiple-choice
questions with incorporating Next Generation NCLEX (NGN) and Case
Scenario
Expert-Verified Explanations & Solutions
#### Question 1 (NGN Style – Clinical Judgment)
A nurse is caring for a client who is receiving dialysis treatment. At 0530, the nurse notes the client is
awake and alert. During assessment of the arteriovenous fistula (AVF) in the right forearm, the nurse
identifies loss of thrill and bruit. Whic7h of the following interventions should the nurse perform first?
A. Notify the provider immediately.
B. Administer 0.9% sodium chloride 200 mL IV bolus.
C. Apply oxygen at 2 L/min via nasal cannula.
D. Position the client’s legs elevated.
, Answer: A. Notify the provider immediately.
Explanation: The absence of a thrill and bruit over an AVF indicates potential AVF thrombosis or occlusion,
an emergent complication that requires immediate provider notification. Administering fluids (Option B) or
oxygen (Option C) would not directly address the underlying issue of thrombosis. Elevating the legs (Option
D) is not indicated for an AVF-related emergency. The priority nursing action aligns with SBAR
communication and immediate escalation.
---
#### Question 2 (NGN Style – Postoperative Care)
A nurse is caring for a client who is postoperative following abdominal surgery. At 1100, the client is
received from PACU with the following initial vital signs:
- Temperature: 98.8°F (37.1°C)
- Pulse: 92/min
- Respirations: 16/min
- Blood pressure: 132/84 mmHg
- Urine output: 50 mL/hr
Which of the following interventions should the nurse include in the client’s care plan? (Select all that
apply.)
A. Instruct the client to splint the abdomen with a pillow for coughing.
B. Plan to ambulate the client as soon as possible.
C. Report urinary output to the provider.
D. Ask the client to rate their pain on a 0 to 10 pain scale.
Answer: A, B, D.
Explanation:
- Option A: Splinting the abdomen reduces pain and minimizes the risk of dehiscence when coughing.
- Option B: Early ambulation promotes circulation, prevents venous thromboembolism (VTE), and expedites
recovery.
- Option D: Assessing pain levels using a validated pain scale aids in effective pain management.
- Option C is incorrect, as urinary output of 50 mL/hr is within the expected range postoperatively.
---
#### Question 3 (Medication Management)
A nurse is caring for a client who is receiving total parenteral nutrition (TPN). A new TPN bag is not yet
available, and the current infusion is nearly complete. What action should the nurse take?
A. Stop the infusion until the new TPN bag is available.
B. Administer 0.9% sodium chloride instead until the TPN is available.
C. Administer dextrose 10% in water until the new bag arrives.
D. Notify the provider immediately and document the incident.
Answer: C. Administer dextrose 10% in water until the new bag arrives.
Explanation: Discontinuing TPN abruptly (Option A) risks hypoglycemia due to the body's reliance on
continuous glucose infusion. Dextrose 10% (Option C) maintains adequate glucose levels to prevent
complications. Option B isn't appropriate replacement therapy. Option D does not address immediate client
safety.
---
, #### Question 4 (NGN Style – Assessment and Intervention)
A nurse is caring for a client who had a nephrostomy tube inserted 12 hours ago. The client reports severe
back pain. Which of the following scenarios best reflects the nurse's priority action?
A. Remove the nephrostomy tube and notify the provider.
B. Administer prescribed analgesics and reassess.
C. Flush the nephrostomy tube with sterile saline to check for obstruction.
D. Notify the provider immediately and assess tube function.
Answer: D. Notify the provider immediately and assess tube function.
Explanation: Severe back pain following nephrostomy tube insertion could indicate obstruction or infection,
both of which require immediate provider intervention. Flushing the tube (Option C) should be done only
after provider direction. Removing the tube (Option A) is not within the nurse’s scope. Analgesics (Option B)
do not resolve the underlying complication.
---
#### Question 5 (Seizure Management)
A nurse is caring for a client experiencing a tonic-clonic seizure. Which priority action should the nurse
take?
A. Insert a padded tongue blade into the client’s mouth.
B. Attach the client to continuous cardiac monitoring.
C. Turn the client to the side.
D. Restrain the client to prevent injury.
Answer: C. Turn the client to the side.
Explanation: Positioning the client laterally reduces the risk of aspiration by allowing drainage of
secretions. Inserting a tongue blade (Option A) is contraindicated due to risk of injury. Continuous cardiac
monitoring (Option B) may be secondary but is not the priority during a seizure. Restraint (Option D) can
cause harm and is not appropriate.
---
#### Question 6 (NGN Style – Adverse Effects of Medications)
A nurse in a provider’s office is assessing a client who has hypertension and takes propranolol. The client
reports a persistent night cough. Which of the following is the nurse's priority action?
A. Document the finding and monitor.
B. Teach the client about non-pharmacologic cough remedies.
C. Notify the provider immediately.
D. Instruct the client to take propranolol in the morning instead of at night.
Answer: C. Notify the provider immediately.
Explanation: A persistent night cough could indicate bronchospasm, a potential side effect of propranolol
(a non-selective beta-blocker). This finding requires immediate provider notification to evaluate the need for
a medication change.
---
#### Question 7 (Pressure Injury Wound Care)
