ATI Med Surg Proctored Exam Part A – Newest Actual Exam Questions and Correct Detailed Solutions

This document contains a comprehensive set of exam questions and detailed solutions for the ATI Medical-Surgical Proctored Exam (Part A). Topics include: pharmacology (drugs withheld prior to cardioversion – digoxin; metformin held before contrast procedures; magnesium sulfate adverse effects; dantrolene indications; isoniazid for TB; theophylline toxicity; IV nitroprusside; adenosine; quinidine; linezolid; clozapine; valproic acid; sulfasalazine; phenytoin; naloxone; memantine); electrolyte imbalances (hypokalemia effects on GI system and respirations, deep tendon reflexes for magnesium, Trousseau’s sign for hypocalcemia/hypomagnesemia, EKG changes in hypo/hyperkalemia and hypo/hypercalcemia); endocrine disorders (exophthalmos in hyperthyroidism, diabetes insipidus treated with desmopressin, adrenal insufficiency from inhaled corticosteroids, primary hypothyroidism labs, Addison’s disease diet); cardiovascular conditions (cardiac tamponade findings – hypotension, pulsus paradoxus, muffled heart sounds; pericarditis findings; supraventricular tachycardia treatment with synchronized cardioversion; post-PTCA aspirin for stent patency; dobutamine effects; amlodipine/nifedipine for hypertension/angina; digoxin withheld before cardioversion; BNP in heart failure); respiratory conditions (wheezes, rhonchi, friction rub, crackles; Kussmaul respirations in DKA; Cheyne-Stokes respirations; flail chest/paradoxical breathing; post-extubation stridor and tracheal stenosis; pneumothorax with subcutaneous emphysema/crepitus); renal and urinary conditions (RIFLE system for kidney injury; renal biopsy pre/post care; post-TURP oxybutynin for bladder spasms; post-prostatectomy indwelling urinary catheter care); gastrointestinal conditions (post-sigmoid colon resection with colostomy – stoma edema and shrinkage, function 2-6 days after surgery; perforated peptic ulcer with board-like abdomen; liver biopsy labs; liver lobectomy for cancer; endoscopic sclerotherapy for esophageal varices; transjugular intrahepatic portosystemic shunt for portal hypertension; GGT for hepatobiliary monitoring; TPN complications – hypoglycemia upon withdrawal; post-gastric bypass clear liquids 30 mL per feeding, avoid sugar and carbonation; bowel sounds in perforation/ileus; ERCP for biliary obstruction; EGD for upper GI visualization; sigmoidoscopy/barium enema for colon polyps; NG tube irrigation for nausea); neurological conditions (encephalitis from West Nile virus – standard precautions, vital signs q2h, neuro checks q4h, HOB elevated 30-45°, dark low-stimulation environment; increased ICP signs – widened pulse pressure, bradycardia, pupil changes, LOC changes, nausea/vomiting; laminectomy/lumbar disk excision recovery; brain lobe functions – frontal (expressive speech), temporal (receptive speech), occipital (vision), limbic (memory/learning); cranial nerve assessments – CN I smell, CN VII raise eyebrows, CN IX gag reflex, CN X say “ah”); oncology (brachytherapy bed rest, 1-2 times/week; external radiation teletherapy; stereotactic body radiotherapy; mastectomy post-op arm exercises day 1, keep affected arm elevated, avoid flexed position; Jackson-Pratt drain care post-mastectomy; radical prostatectomy – shower only, change bag weekly, stool softeners, Kegels for incontinence; testicular self-exam technique; breast cancer risk factors; vanillylmandelic acid test for pheochromocytoma); dermatology (impetigo – honey-colored crusted lesions; furuncle – large tender nodule on hair follicle; herpes zoster/shingles – unilateral, localized, nodular vesicles; actinic keratosis – rough dry scaly lesion; basal cell carcinoma – pearly papule with ulcerated center; malignant melanoma – irregular shape with blue tones; squamous cell carcinoma – firm nodule with crust; frostbite degrees – first (red/waxy), second (large fluid-filled blisters), third (small blood-filled blisters, skin does not blanch), fourth (no blisters, muscles/bones affected)); immunizations and infectious disease (pneumococcal vaccine for adults 65+ – one shot, repeat if last shot 5 years ago; hepatitis A vaccine for travelers; hepatitis B immune globulin for infants of HBsAg-negative mothers – second dose at 1-4 months; HIV-positive children should receive all vaccines – full dose, no delay; West Nile virus encephalitis; anthrax prodromal symptom – sore throat); medications and adverse effects (feverfew interacts with naproxen – increased bleeding risk; St. John’s Wort decreases atorvastatin effect; epoetin alfa maximum effect in 2-3 months; aspirin post-PTCA for stent patency; oxybutynin post-TURP for bladder spasms; desmopressin for diabetes insipidus – monitor for headache as water intoxication sign; dantrolene hepatotoxic; teriflunomide adverse effect – alopecia; interferon beta-1a adverse effect – flu-like symptoms; dimethyl fumarate – GI discomfort; natalizumab – UTIs/dysuria; alosetron for IBS-D – monitor for constipation, tachycardia, notify provider if diarrhea persists after one month; imipenem adverse effect – seizures; aminoglycosides – ototoxicity; cephalosporins – increased bleeding risk; linezolid – irreversible peripheral neuropathy, reversible optic neuropathy; quinidine – cinchonism (tinnitus, headache, vertigo, visual disturbances); adenosine – dyspnea from bronchoconstriction, transient warmth/flushing; methotrexate – pruritis; asparaginase – hallucinations; cisplatin – tinnitus/ototoxicity; capecitabine – hand-foot syndrome; sulfasalazine – bone marrow suppression – monitor CBC; phenytoin – hypotension/bradycardia if given too quickly, GI upset; naloxone – increases RR, can cause hypo/hypertension, nausea/vomiting, return of pain; memantine – excreted by kidneys, monitor creatinine clearance); herbals and dietary supplements (feverfew, echinacea, garlic, ginger, ginkgo – increase bleeding risk; black cohosh for menopausal hot flashes; flaxseed for constipation and cholesterol reduction; ginkgo biloba for peripheral arterial disease); eye conditions (entropion – eyelid inversion; ectropion – eyelid eversion; ptosis – drooping; LASIK adverse effects – dry eyes, blurred vision); and other topics (cardiac catheterization post-procedure care – lie flat or HOB ≤30°, keep leg straight, increase fluids; lumbar puncture position; EEG instructions – eat regular meals, shampoo hair thoroughly, wake up at 2-3 AM day of procedure; PICC line care – flush with 10 mL syringe, 10 mL NS before/after meds, heparin flush daily, chlorhexidine site care, can remain in place months/years; Blumberg’s sign – rebound tenderness, positive in cholecystitis; tolvaptan for SIADH; unstable angina – lasts ≥15 minutes, not relieved by nitroglycerin or rest, can occur with exertion or at rest; well-controlled diabetes lab targets – A1C 7%, fasting BG 110, postprandial BG 160, casual BG 200; cirrhosis – vegetable protein-rich diet; vitamin A – highly teratogenic; homograft – cadaver skin; heterograft – pig skin).