ATI Med Surg CMS Proctored Exam
2025/2026 Study Guide
Version A, B and C
1. A nurse in an emergency department is preparing to perform ocular irrigation for a client.
Which of the following actions should the nurse plan to take?
a. Assess the client's visual acuity prior to irrigation
b. Have the client turn their head toward the unaffected eye
c. Hold the irrigator syringe 3.81 cm (1.5 in) above the eye
d. Perform the irrigation with sterile water for irrigation
Answer: d. Perform the irrigation with sterile water for irrigation
2. A nurse is preparing to administer lactated Ringer's via continuous IV infusion at 200
mL/hr. The IV tubing has a drop factor of 10 drops/mL. How many drops per minute
should the nurse set the IV flow rate to deliver? (Round to whole number)
a. 17 drops/min
b. 33 drops/min
c. 50 drops/min
d. 67 drops/min
Answer: b. 33 drops/min
3. A nurse is caring for a client who has a new diagnosis of atrial fibrillation. Which of the
following findings should the nurse expect?
a. Blood pressure 170/90 mm Hg
b. Heart rate 110/min and irregular
c. Respiratory rate 28/min
d. Temperature 38.3° C (100.9° F)
Answer: b. Heart rate 110/min and irregular
4. A nurse is providing discharge teaching about management of a new ileostomy to a
client. Which of the following instructions should the nurse include?
a. "Empty the pouch when it is one-third full."
b. "Change the pouch every shift."
c. "Place an insert in the pouch at bedtime."
d. "Cleanse the site with alcohol swabs daily."
Answer: a. "Empty the pouch when it is one-third full."
5. A nurse is assessing a client who had a stroke 3 days ago. Which of the following
findings should the nurse identify as indicating dysphagia?
a. Absent gag reflex
, b. Clear lung sounds
c. +3 deep tendon reflexes
d. Clear speech
Answer: a. Absent gag reflex
6. A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which of the following
laboratory findings should the nurse expect?
a. Blood pH 7.25
b. Blood glucose 120 mg/dL
c. Blood ketones negative
d. Serum potassium 5.2 mEq/L
Answer: a. Blood pH 7.25
7. A nurse is reviewing the laboratory reports of a client who has acute pancreatitis. Which
of the following findings is expected?
a. Serum amylase 150 units/L
b. Serum lipase 300 units/L
c. WBC count 6,000/mm³
d. Serum calcium 10.5 mg/dL
Answer: b. Serum lipase 300 units/L
8. A nurse is planning care for a client who is experiencing acute alcohol withdrawal. Which
of the following medications should the nurse expect to administer?
a. Diazepam
b. Ondansetron
c. Metoclopramide
d. Disulfiram
Answer: a. Diazepam
9. A nurse is caring for a client who has a closed head injury. Which of the following is a
priority assessment finding?
a. GCS score of 14
b. Clear nasal drainage
c. Slurred speech
d. Unreactive pupils
Answer: d. Unreactive pupils
10.A nurse is providing teaching to a client who has a new prescription for albuterol MDI
and cromolyn sodium MDI. Which of the following instructions should the nurse include?
a. "Use the albuterol MDI first, then wait 5 minutes before using cromolyn."
b. "Use the cromolyn MDI first, then wait 5 minutes before using albuterol."
c. "Use both inhalers simultaneously."
d. "Take a sip of water between puffs of the same inhaler."
Answer: b. "Use the cromolyn MDI first, then wait 5 minutes before using
, albuterol."
11.A nurse is caring for a client who has a new colostomy. Which of the following is the
priority nursing action?
a. Monitor for signs of dehydration
b. Teach about ostomy care
c. Assess stoma color and size
d. Administer pain medication
Answer: c. Assess stoma color and size
12.A nurse is assessing a client who has a history of chronic obstructive pulmonary disease
(COPD). Which of the following findings should the nurse report immediately?
a. Respiratory rate 22/min
b. Oxygen saturation 88%
c. Productive cough
d. Use of accessory muscles
Answer: b. Oxygen saturation 88%
13.A nurse is planning care for a client who has a compound fracture of the radius. Which of
the following pain management interventions should the nurse include?
a. Apply ice for 20 minutes every hour
b. Elevate arm above heart level
c. Administer morphine 2 mg IV every 4 hr PRN
d. Encourage active range of motion
Answer: b. Elevate arm above heart level
14.A nurse is caring for a client who has acute respiratory distress syndrome (ARDS).
Which of the following findings requires immediate intervention?
a. PaO2 55 mm Hg
b. pH 7.35
c. PaCO2 45 mm Hg
d. HCO3 24 mEq/L
Answer: a. PaO2 55 mm Hg
15.A nurse is reviewing the medical record of a client who has heart failure. Which of the
following findings indicates the client is receiving furosemide as expected?
a. Serum potassium 3.2 mEq/L
b. Blood pressure 110/70 mm Hg
c. Heart rate 88/min
d. Weight gain of 1 kg (2.2 lb)
Answer: a. Serum potassium 3.2 mEq/L
16.A nurse is teaching a client who has type 1 diabetes mellitus about manifestations of
hypoglycemia. Which of the following findings should the client report?
, a. Blood glucose 55 mg/dL
b. Blood glucose 140 mg/dL
c. Urine ketones positive
d. Blood glucose 250 mg/dL
Answer: a. Blood glucose 55 mg/dL
17.A nurse is caring for a client who is 2 days postoperative following a nephrectomy. Which
of the following findings indicates the client is experiencing a complication?
a. Urine output 35 mL/hr
b. Temperature 37.2° C (99° F)
c. Surgical drain 50 mL/8 hr
d. Blood pressure 128/76 mm Hg
Answer: a. Urine output 35 mL/hr
18.A nurse is assessing a client who has meningitis. Which of the following findings should
the nurse expect?
a. Positive Brudzinski's sign
b. Hyperactive deep tendon reflexes
c. Flaccid paralysis
d. Clear CSF
Answer: a. Positive Brudzinski's sign
19.A nurse is providing discharge teaching to a client who has a new prescription for
warfarin. Which of the following statements indicates understanding?
a. "I will take my temperature daily."
b. "I will limit my alcohol intake."
c. "I will use a soft toothbrush."
d. "I will take aspirin for pain."
Answer: b. "I will limit my alcohol intake."
20.A nurse is caring for a client who has a mechanical ventilator. Which of the following
findings indicates a need for suctioning?
a. Coarse crackles
b. Clear breath sounds
c. Respiratory rate 16/min
d. SpO2 96%
Answer: a. Coarse crackles
21.A nurse is assessing a client who has a suspected diagnosis of appendicitis. Which of
the following findings should the nurse document?
a. Rebound tenderness at McBurney's point
b. Murphy's sign
c. Cullen's sign
d. Chvostek's sign
2025/2026 Study Guide
Version A, B and C
1. A nurse in an emergency department is preparing to perform ocular irrigation for a client.
Which of the following actions should the nurse plan to take?
a. Assess the client's visual acuity prior to irrigation
b. Have the client turn their head toward the unaffected eye
c. Hold the irrigator syringe 3.81 cm (1.5 in) above the eye
d. Perform the irrigation with sterile water for irrigation
Answer: d. Perform the irrigation with sterile water for irrigation
2. A nurse is preparing to administer lactated Ringer's via continuous IV infusion at 200
mL/hr. The IV tubing has a drop factor of 10 drops/mL. How many drops per minute
should the nurse set the IV flow rate to deliver? (Round to whole number)
a. 17 drops/min
b. 33 drops/min
c. 50 drops/min
d. 67 drops/min
Answer: b. 33 drops/min
3. A nurse is caring for a client who has a new diagnosis of atrial fibrillation. Which of the
following findings should the nurse expect?
a. Blood pressure 170/90 mm Hg
b. Heart rate 110/min and irregular
c. Respiratory rate 28/min
d. Temperature 38.3° C (100.9° F)
Answer: b. Heart rate 110/min and irregular
4. A nurse is providing discharge teaching about management of a new ileostomy to a
client. Which of the following instructions should the nurse include?
a. "Empty the pouch when it is one-third full."
b. "Change the pouch every shift."
c. "Place an insert in the pouch at bedtime."
d. "Cleanse the site with alcohol swabs daily."
Answer: a. "Empty the pouch when it is one-third full."
5. A nurse is assessing a client who had a stroke 3 days ago. Which of the following
findings should the nurse identify as indicating dysphagia?
a. Absent gag reflex
, b. Clear lung sounds
c. +3 deep tendon reflexes
d. Clear speech
Answer: a. Absent gag reflex
6. A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which of the following
laboratory findings should the nurse expect?
a. Blood pH 7.25
b. Blood glucose 120 mg/dL
c. Blood ketones negative
d. Serum potassium 5.2 mEq/L
Answer: a. Blood pH 7.25
7. A nurse is reviewing the laboratory reports of a client who has acute pancreatitis. Which
of the following findings is expected?
a. Serum amylase 150 units/L
b. Serum lipase 300 units/L
c. WBC count 6,000/mm³
d. Serum calcium 10.5 mg/dL
Answer: b. Serum lipase 300 units/L
8. A nurse is planning care for a client who is experiencing acute alcohol withdrawal. Which
of the following medications should the nurse expect to administer?
a. Diazepam
b. Ondansetron
c. Metoclopramide
d. Disulfiram
Answer: a. Diazepam
9. A nurse is caring for a client who has a closed head injury. Which of the following is a
priority assessment finding?
a. GCS score of 14
b. Clear nasal drainage
c. Slurred speech
d. Unreactive pupils
Answer: d. Unreactive pupils
10.A nurse is providing teaching to a client who has a new prescription for albuterol MDI
and cromolyn sodium MDI. Which of the following instructions should the nurse include?
a. "Use the albuterol MDI first, then wait 5 minutes before using cromolyn."
b. "Use the cromolyn MDI first, then wait 5 minutes before using albuterol."
c. "Use both inhalers simultaneously."
d. "Take a sip of water between puffs of the same inhaler."
Answer: b. "Use the cromolyn MDI first, then wait 5 minutes before using
, albuterol."
11.A nurse is caring for a client who has a new colostomy. Which of the following is the
priority nursing action?
a. Monitor for signs of dehydration
b. Teach about ostomy care
c. Assess stoma color and size
d. Administer pain medication
Answer: c. Assess stoma color and size
12.A nurse is assessing a client who has a history of chronic obstructive pulmonary disease
(COPD). Which of the following findings should the nurse report immediately?
a. Respiratory rate 22/min
b. Oxygen saturation 88%
c. Productive cough
d. Use of accessory muscles
Answer: b. Oxygen saturation 88%
13.A nurse is planning care for a client who has a compound fracture of the radius. Which of
the following pain management interventions should the nurse include?
a. Apply ice for 20 minutes every hour
b. Elevate arm above heart level
c. Administer morphine 2 mg IV every 4 hr PRN
d. Encourage active range of motion
Answer: b. Elevate arm above heart level
14.A nurse is caring for a client who has acute respiratory distress syndrome (ARDS).
Which of the following findings requires immediate intervention?
a. PaO2 55 mm Hg
b. pH 7.35
c. PaCO2 45 mm Hg
d. HCO3 24 mEq/L
Answer: a. PaO2 55 mm Hg
15.A nurse is reviewing the medical record of a client who has heart failure. Which of the
following findings indicates the client is receiving furosemide as expected?
a. Serum potassium 3.2 mEq/L
b. Blood pressure 110/70 mm Hg
c. Heart rate 88/min
d. Weight gain of 1 kg (2.2 lb)
Answer: a. Serum potassium 3.2 mEq/L
16.A nurse is teaching a client who has type 1 diabetes mellitus about manifestations of
hypoglycemia. Which of the following findings should the client report?
, a. Blood glucose 55 mg/dL
b. Blood glucose 140 mg/dL
c. Urine ketones positive
d. Blood glucose 250 mg/dL
Answer: a. Blood glucose 55 mg/dL
17.A nurse is caring for a client who is 2 days postoperative following a nephrectomy. Which
of the following findings indicates the client is experiencing a complication?
a. Urine output 35 mL/hr
b. Temperature 37.2° C (99° F)
c. Surgical drain 50 mL/8 hr
d. Blood pressure 128/76 mm Hg
Answer: a. Urine output 35 mL/hr
18.A nurse is assessing a client who has meningitis. Which of the following findings should
the nurse expect?
a. Positive Brudzinski's sign
b. Hyperactive deep tendon reflexes
c. Flaccid paralysis
d. Clear CSF
Answer: a. Positive Brudzinski's sign
19.A nurse is providing discharge teaching to a client who has a new prescription for
warfarin. Which of the following statements indicates understanding?
a. "I will take my temperature daily."
b. "I will limit my alcohol intake."
c. "I will use a soft toothbrush."
d. "I will take aspirin for pain."
Answer: b. "I will limit my alcohol intake."
20.A nurse is caring for a client who has a mechanical ventilator. Which of the following
findings indicates a need for suctioning?
a. Coarse crackles
b. Clear breath sounds
c. Respiratory rate 16/min
d. SpO2 96%
Answer: a. Coarse crackles
21.A nurse is assessing a client who has a suspected diagnosis of appendicitis. Which of
the following findings should the nurse document?
a. Rebound tenderness at McBurney's point
b. Murphy's sign
c. Cullen's sign
d. Chvostek's sign
