ATI RN ADULT MEDICAL SURGICAL
PROCTORED RETAKE EXAM PRACTICE
ASSESSMENT 2026 CERTIFICATION
EVALUATION EXPERT CHECKED
◉ Medications affecting coagulation: Heparin Contraindications.
Answer: Avoid NSAIDS while on heparin
◉ Antibiotics affecting protein synthesis: Adverse effects of
gentamicin Answer: -Ototoxicity: cochlear damage (hearing loss)
and vestibular damage (loss of balance).
-Nephrotoxicity (proteinuria, elevated BUN, creatinine levels).
-Hypersensitivity ( rash, pruritis, parathesia of hands and feet, and
urticaria).
◉ Electrolyte imbalance: manifestations of hypokalemia Answer:
Weak, irregular pulse, hypotension, respiratory distress
Premature ventricular contractions, bradycardia, inverted T waves,
ST depression
Decreased GI motility, abdominal distension, constipation, n/v,
anorexia, polyuria
,Decreased K (<3.5)
ABG: Metabolic alkalosis (pH > 7.45)
◉ Electrolyte imbalance: Priority assessment for hypokalemia
Answer: Assessing for a patent and open airway
◉ Blood and blood product transfusions: Administering Fresh
Frozen Plasma Answer: Initiate a large bore IV access: 20 gauge
needle
Complete transfusion withing 2-4 hours time frame
If reaction occurs:
-Stop transfusion immediately
- Initiate 0.9% NaCl in a separate line
- Save blood bag and blood tubing
◉ Cardiovascular Diagnostic and Therapeutic Procedures: Caring for
a client who has a PICC Answer: -Assessing site every 8 hours. Note
redness, swelling, drainage, tenderness and condition of dressing
-Change tube and positive pressure cap per facility protocol
-Using 10mL or larger syringe to flush the line
-Cleanse with alcohol for 3 seconds before accessing it
, -Use transparent dressing
◉ Cardiovascular Diagnostic and Therapeutic Procedures: Teaching
about a PICC Answer: -Advise client not to immerse arm in water, to
cover dressing site to avoid water exposure
-Avoid BP in the arm with PICC
◉ Cardiovascular Diagnostic and Therapeutic Procedures: PICC care
Answer: - Apply an initial dressing of gauze and replace with
transparent dressing within 24 hours
- An initial x-ray should be taken to ensure proper placement
◉ Cardiovascular and Hematologic Disorders: teaching client about
food interaction with Warfarin Answer: -Kale, spinach
-Brussels sprouts
-collard greens, mustard greens
-green tea
-grapefruit juice, alcohol
◉ Angina and MI: Client teaching about nitroglycerin Answer:
Nitrogylcerin prevents coronary artery vasospasm and reduces
preload and afterload. Used to treat angina and help with BP.
- Place nitro under tongue to dissolve
PROCTORED RETAKE EXAM PRACTICE
ASSESSMENT 2026 CERTIFICATION
EVALUATION EXPERT CHECKED
◉ Medications affecting coagulation: Heparin Contraindications.
Answer: Avoid NSAIDS while on heparin
◉ Antibiotics affecting protein synthesis: Adverse effects of
gentamicin Answer: -Ototoxicity: cochlear damage (hearing loss)
and vestibular damage (loss of balance).
-Nephrotoxicity (proteinuria, elevated BUN, creatinine levels).
-Hypersensitivity ( rash, pruritis, parathesia of hands and feet, and
urticaria).
◉ Electrolyte imbalance: manifestations of hypokalemia Answer:
Weak, irregular pulse, hypotension, respiratory distress
Premature ventricular contractions, bradycardia, inverted T waves,
ST depression
Decreased GI motility, abdominal distension, constipation, n/v,
anorexia, polyuria
,Decreased K (<3.5)
ABG: Metabolic alkalosis (pH > 7.45)
◉ Electrolyte imbalance: Priority assessment for hypokalemia
Answer: Assessing for a patent and open airway
◉ Blood and blood product transfusions: Administering Fresh
Frozen Plasma Answer: Initiate a large bore IV access: 20 gauge
needle
Complete transfusion withing 2-4 hours time frame
If reaction occurs:
-Stop transfusion immediately
- Initiate 0.9% NaCl in a separate line
- Save blood bag and blood tubing
◉ Cardiovascular Diagnostic and Therapeutic Procedures: Caring for
a client who has a PICC Answer: -Assessing site every 8 hours. Note
redness, swelling, drainage, tenderness and condition of dressing
-Change tube and positive pressure cap per facility protocol
-Using 10mL or larger syringe to flush the line
-Cleanse with alcohol for 3 seconds before accessing it
, -Use transparent dressing
◉ Cardiovascular Diagnostic and Therapeutic Procedures: Teaching
about a PICC Answer: -Advise client not to immerse arm in water, to
cover dressing site to avoid water exposure
-Avoid BP in the arm with PICC
◉ Cardiovascular Diagnostic and Therapeutic Procedures: PICC care
Answer: - Apply an initial dressing of gauze and replace with
transparent dressing within 24 hours
- An initial x-ray should be taken to ensure proper placement
◉ Cardiovascular and Hematologic Disorders: teaching client about
food interaction with Warfarin Answer: -Kale, spinach
-Brussels sprouts
-collard greens, mustard greens
-green tea
-grapefruit juice, alcohol
◉ Angina and MI: Client teaching about nitroglycerin Answer:
Nitrogylcerin prevents coronary artery vasospasm and reduces
preload and afterload. Used to treat angina and help with BP.
- Place nitro under tongue to dissolve
