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:
A nurse is caring for a client diagnosed with atopic dermatitis who has a prescription for triamcinolone
ointment. During the follow-up assessment, the nurse should monitor for which of the following adverse
effects?
A. Increased pigmentation of the skin
B. Localized hair loss
C. Thinning of the skin
D. Increased sensitivity to sunlight
, Answer: C. Thinning of the skin
Explanation:
Triamcinolone is a topical glucocorticoid, and its prolonged use can lead to skin atrophy, thinning, and
potentially delayed wound healing. The client should only apply the cream as instructed, avoiding sensitive
areas or thin skin to minimize adverse effects. Education update: Teach the client to monitor for signs of
skin sensitivity and avoid prolonged use without provider supervision.
---
### Question 2 (NGN-Style Case Study):
Case Details:
A 70-year-old male client presents to the clinic with complaints of difficulty breathing and fatigue. Past
medical history includes long-standing hypertension and diabetes. He denies chest pain but reports waking
up at night short of breath.
Vital Signs:
- BP: 160/95 mmHg
- HR: 110/min, irregular
- RR: 24/min
- O2 Saturation: 88% (room air)
- Temperature: 98.6°F (37°C)
Which clinical finding would indicate left-sided heart failure in this client?
A. Dependent edema in bilateral lower extremities
B. Jugular vein distention (JVD)
C. Frothy, pink-tinged sputum
D. Significant weight gain in the past week
Answer: C. Frothy, pink-tinged sputum
Explanation:
Left-sided heart failure results in pulmonary congestion, which may present as dyspnea, crackles, and
frothy sputum production. Classic manifestations include exertional dyspnea, orthopnea, and paroxysmal
nocturnal dyspnea. JVD and dependent edema are more indicative of right-sided heart failure.
---
### Question 3:
A nurse is caring for a client who is anxious and reporting numbness and tingling of the lips and fingers.
The client’s ABGs are as follows:
- pH: 7.48
- PCO2: 30 mm Hg
- HCO3–: 24 mEq/L
- PaO2: 85 mm Hg
Which acid-base imbalance should the nurse identify?
, A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Answer: A. Respiratory alkalosis
Explanation:
In this scenario, the increased pH (alkaline) and decreased PCO2 indicate respiratory alkalosis caused by
hyperventilation. Numbness and tingling around the lips and fingers are classic findings of this condition.
Interventions should focus on managing the anxiety and slowing the client’s respirations using guided
breathing exercises (non-invasive).
---
### Question 4:
A nurse is assessing a client diagnosed with Cushing's syndrome. Which clinical finding should the nurse
expect?
A. Vitiligo on the hands and face
B. Osteoporosis and increased risk of fractures
C. Myxedema and periorbital swelling
D. Heat intolerance and tachycardia
Answer: B. Osteoporosis and increased risk of fractures
Explanation:
Chronic excess corticosteroids in Cushing’s syndrome lead to osteoporosis due to mineral loss from bones.
Other findings include abdominal weight gain, moon face, buffalo hump, and muscle wasting. Vitiligo is
associated with autoimmune conditions like Addison's disease, not Cushing's syndrome.
---
### Question 5:
A nurse is inspecting the skin of a client who has a diagnosis of basal cell carcinoma. Which lesion
characteristic should the nurse document as most consistent with this condition?
A. A pearly, waxy nodule with well-defined borders
B. Irregularly shaped lesion with variegated coloring
C. A crusty, ulcerated lesion that is firm to touch
D. A weeping, vesicular lesion
Answer: A. A pearly, waxy nodule with well-defined borders
Explanation:
Basal cell carcinoma (BCC) is associated with prolonged sun exposure and is commonly found on the
head, neck, or face. This slow-growing lesion typically appears pearly or waxy, which differentiates it from
squamous cell carcinoma or melanoma. Early diagnosis and intervention are key.
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:
A nurse is caring for a client diagnosed with atopic dermatitis who has a prescription for triamcinolone
ointment. During the follow-up assessment, the nurse should monitor for which of the following adverse
effects?
A. Increased pigmentation of the skin
B. Localized hair loss
C. Thinning of the skin
D. Increased sensitivity to sunlight
, Answer: C. Thinning of the skin
Explanation:
Triamcinolone is a topical glucocorticoid, and its prolonged use can lead to skin atrophy, thinning, and
potentially delayed wound healing. The client should only apply the cream as instructed, avoiding sensitive
areas or thin skin to minimize adverse effects. Education update: Teach the client to monitor for signs of
skin sensitivity and avoid prolonged use without provider supervision.
---
### Question 2 (NGN-Style Case Study):
Case Details:
A 70-year-old male client presents to the clinic with complaints of difficulty breathing and fatigue. Past
medical history includes long-standing hypertension and diabetes. He denies chest pain but reports waking
up at night short of breath.
Vital Signs:
- BP: 160/95 mmHg
- HR: 110/min, irregular
- RR: 24/min
- O2 Saturation: 88% (room air)
- Temperature: 98.6°F (37°C)
Which clinical finding would indicate left-sided heart failure in this client?
A. Dependent edema in bilateral lower extremities
B. Jugular vein distention (JVD)
C. Frothy, pink-tinged sputum
D. Significant weight gain in the past week
Answer: C. Frothy, pink-tinged sputum
Explanation:
Left-sided heart failure results in pulmonary congestion, which may present as dyspnea, crackles, and
frothy sputum production. Classic manifestations include exertional dyspnea, orthopnea, and paroxysmal
nocturnal dyspnea. JVD and dependent edema are more indicative of right-sided heart failure.
---
### Question 3:
A nurse is caring for a client who is anxious and reporting numbness and tingling of the lips and fingers.
The client’s ABGs are as follows:
- pH: 7.48
- PCO2: 30 mm Hg
- HCO3–: 24 mEq/L
- PaO2: 85 mm Hg
Which acid-base imbalance should the nurse identify?
, A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Answer: A. Respiratory alkalosis
Explanation:
In this scenario, the increased pH (alkaline) and decreased PCO2 indicate respiratory alkalosis caused by
hyperventilation. Numbness and tingling around the lips and fingers are classic findings of this condition.
Interventions should focus on managing the anxiety and slowing the client’s respirations using guided
breathing exercises (non-invasive).
---
### Question 4:
A nurse is assessing a client diagnosed with Cushing's syndrome. Which clinical finding should the nurse
expect?
A. Vitiligo on the hands and face
B. Osteoporosis and increased risk of fractures
C. Myxedema and periorbital swelling
D. Heat intolerance and tachycardia
Answer: B. Osteoporosis and increased risk of fractures
Explanation:
Chronic excess corticosteroids in Cushing’s syndrome lead to osteoporosis due to mineral loss from bones.
Other findings include abdominal weight gain, moon face, buffalo hump, and muscle wasting. Vitiligo is
associated with autoimmune conditions like Addison's disease, not Cushing's syndrome.
---
### Question 5:
A nurse is inspecting the skin of a client who has a diagnosis of basal cell carcinoma. Which lesion
characteristic should the nurse document as most consistent with this condition?
A. A pearly, waxy nodule with well-defined borders
B. Irregularly shaped lesion with variegated coloring
C. A crusty, ulcerated lesion that is firm to touch
D. A weeping, vesicular lesion
Answer: A. A pearly, waxy nodule with well-defined borders
Explanation:
Basal cell carcinoma (BCC) is associated with prolonged sun exposure and is commonly found on the
head, neck, or face. This slow-growing lesion typically appears pearly or waxy, which differentiates it from
squamous cell carcinoma or melanoma. Early diagnosis and intervention are key.
