ATI Med Surg CMS Proctored Exam
Questions And Answers Practice
Questions with Solutions Newest |
Already Graded A+
1. A nurse is caring for a client with heart failure who reports shortness
of breath and crackles in both lung bases. Which action should the
nurse take first?
A) Administer furosemide IV push
B) Place the client in high-Fowler’s position
C) Check oxygen saturation
D) Increase the IV fluid rate
Answer: B) Place the client in high-Fowler’s position
Rationale: Priority is to improve ventilation and reduce preload by
positioning. High-Fowler’s facilitates breathing; then assess SpO₂ and give
diuretics as ordered.
2. A client on a telemetry unit has a heart rate of 210 bpm, blood pressure
80/50, and is confused. The rhythm shows absent P waves and wide QRS
complexes. Which intervention should the nurse anticipate?
A) Synchronized cardioversion
B) Defibrillation
C) Vagal maneuvers
D) Adenosine 6 mg IV push
Answer: A) Synchronized cardioversion
Rationale: Wide-complex tachycardia with hypotension and altered mental
, status is unstable ventricular tachycardia; synchronized cardioversion is
indicated. Defibrillation is for pulseless VT/VF.
3. A nurse is teaching a client with new-onset angina about sublingual
nitroglycerin. Which statement by the client indicates understanding?
A) “I will take one tablet every 10 minutes until pain stops, up to 5 doses.”
B) “I will store the tablets in the refrigerator.”
C) “I should expect a mild headache or dizziness after taking it.”
D) “I can swallow the tablet with a glass of water if I have dry mouth.”
Answer: C) “I should expect a mild headache or dizziness after taking it.”
Rationale: Headache and dizziness are common due to vasodilation; do
not refrigerate (store in dark bottle), take q5min x3 doses, and place under
tongue – do not swallow.
4. A client with COPD has an SpO₂ of 88% on room air and is on 2 L/min
oxygen via nasal cannula. Which finding indicates the oxygen therapy is
effective?
A) Respiratory rate 28/min
B) Client reports decreased dyspnea
C) PaCO₂ 58 mm Hg
D) Use of accessory muscles
Answer: B) Client reports decreased dyspnea
Rationale: Goal of oxygen in COPD is to maintain SpO₂ 88–92% and relieve
dyspnea. Increased CO₂ may occur but is not the immediate indicator of
effectiveness.
5. A nurse is caring for a client after a thoracotomy with a chest tube to
water-seal drainage. Continuous bubbling is noted in the water-seal
chamber. What is the priority action?
A) Increase wall suction
B) Clamp the chest tube near the insertion site
C) Check the chest tube connections for air leaks
, D) Document this as an expected finding
Answer: C) Check the chest tube connections for air leaks
Rationale: Continuous bubbling in the water-seal chamber indicates an air
leak. Assess all connections; bubbling in suction control chamber is normal.
6. A client with pulmonary embolism is receiving heparin infusion. Which
laboratory value requires immediate action?
A) aPTT 75 seconds (control 35)
B) Platelets 80,000/mm³
C) INR 1.2
D) Hemoglobin 13 g/dL
Answer: B) Platelets 80,000/mm³
Rationale: Severe thrombocytopenia (<100,000) may indicate heparin-
induced thrombocytopenia (HIT); stop heparin immediately and notify
provider.
7. A nurse is auscultating breath sounds. A high-pitched, musical sound
heard primarily during expiration is documented as:
A) Crackles
B) Rhonchi
C) Wheezes
D) Stridor
Answer: C) Wheezes
Rationale: Wheezes are high-pitched, continuous sounds often from
narrowed airways (asthma, COPD). Stridor is upper airway, harsh,
inspiratory.
8. A client with hypertension is prescribed hydrochlorothiazide. Which
statement by the client indicates a need for further teaching?
A) “I will eat bananas and oranges daily to prevent potassium loss.”
B) “I will take my pill in the morning to avoid waking up at night.”
, C) “I will avoid alcohol while on this medication.”
D) “I will check my blood pressure at home weekly.”
Answer: A) “I will eat bananas and oranges daily to prevent potassium
loss.”
Rationale: Hydrochlorothiazide is a thiazide diuretic that does NOT cause
significant potassium loss? Actually, thiazides can cause hypokalemia, so
eating potassium-rich foods is good – but the question says “need for
further teaching” – wait, that would be correct. Let me double-check: The
correct answer is A? Actually, thiazides do cause hypokalemia, so increasing
K+ is fine. Maybe the error is that they might cause hypercalcemia, not
hypo. But common teaching error: client thinks they need to avoid K+? No.
Better answer: Actually, thiazides can cause hypokalemia, so A is correct. I'll
revise: The statement that indicates need for further teaching is “I will take
my pill at bedtime” – but that's not an option. Let me swap to a correct one:
The wrong statement is “I will avoid salt substitutes” – not here. Let me
change question slightly: In published ATI, the teaching point is: “I should
take it at night” is wrong because it causes nocturia. So I'll adjust.
Revised Q8: A client is starting hydrochlorothiazide. Which client statement
indicates understanding? (choose the correct teaching) – but the user wants
1-50 with answers. I'll keep original format but correct: The answer that
indicates misunderstanding is “I will take my pill at bedtime to reduce
morning dizziness.”
Let me redo Q8 cleanly:
8. A client taking hydrochlorothiazide reports muscle cramps and fatigue.
Which electrolyte imbalance should the nurse suspect?
A) Hypernatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypomagnesemia
Questions And Answers Practice
Questions with Solutions Newest |
Already Graded A+
1. A nurse is caring for a client with heart failure who reports shortness
of breath and crackles in both lung bases. Which action should the
nurse take first?
A) Administer furosemide IV push
B) Place the client in high-Fowler’s position
C) Check oxygen saturation
D) Increase the IV fluid rate
Answer: B) Place the client in high-Fowler’s position
Rationale: Priority is to improve ventilation and reduce preload by
positioning. High-Fowler’s facilitates breathing; then assess SpO₂ and give
diuretics as ordered.
2. A client on a telemetry unit has a heart rate of 210 bpm, blood pressure
80/50, and is confused. The rhythm shows absent P waves and wide QRS
complexes. Which intervention should the nurse anticipate?
A) Synchronized cardioversion
B) Defibrillation
C) Vagal maneuvers
D) Adenosine 6 mg IV push
Answer: A) Synchronized cardioversion
Rationale: Wide-complex tachycardia with hypotension and altered mental
, status is unstable ventricular tachycardia; synchronized cardioversion is
indicated. Defibrillation is for pulseless VT/VF.
3. A nurse is teaching a client with new-onset angina about sublingual
nitroglycerin. Which statement by the client indicates understanding?
A) “I will take one tablet every 10 minutes until pain stops, up to 5 doses.”
B) “I will store the tablets in the refrigerator.”
C) “I should expect a mild headache or dizziness after taking it.”
D) “I can swallow the tablet with a glass of water if I have dry mouth.”
Answer: C) “I should expect a mild headache or dizziness after taking it.”
Rationale: Headache and dizziness are common due to vasodilation; do
not refrigerate (store in dark bottle), take q5min x3 doses, and place under
tongue – do not swallow.
4. A client with COPD has an SpO₂ of 88% on room air and is on 2 L/min
oxygen via nasal cannula. Which finding indicates the oxygen therapy is
effective?
A) Respiratory rate 28/min
B) Client reports decreased dyspnea
C) PaCO₂ 58 mm Hg
D) Use of accessory muscles
Answer: B) Client reports decreased dyspnea
Rationale: Goal of oxygen in COPD is to maintain SpO₂ 88–92% and relieve
dyspnea. Increased CO₂ may occur but is not the immediate indicator of
effectiveness.
5. A nurse is caring for a client after a thoracotomy with a chest tube to
water-seal drainage. Continuous bubbling is noted in the water-seal
chamber. What is the priority action?
A) Increase wall suction
B) Clamp the chest tube near the insertion site
C) Check the chest tube connections for air leaks
, D) Document this as an expected finding
Answer: C) Check the chest tube connections for air leaks
Rationale: Continuous bubbling in the water-seal chamber indicates an air
leak. Assess all connections; bubbling in suction control chamber is normal.
6. A client with pulmonary embolism is receiving heparin infusion. Which
laboratory value requires immediate action?
A) aPTT 75 seconds (control 35)
B) Platelets 80,000/mm³
C) INR 1.2
D) Hemoglobin 13 g/dL
Answer: B) Platelets 80,000/mm³
Rationale: Severe thrombocytopenia (<100,000) may indicate heparin-
induced thrombocytopenia (HIT); stop heparin immediately and notify
provider.
7. A nurse is auscultating breath sounds. A high-pitched, musical sound
heard primarily during expiration is documented as:
A) Crackles
B) Rhonchi
C) Wheezes
D) Stridor
Answer: C) Wheezes
Rationale: Wheezes are high-pitched, continuous sounds often from
narrowed airways (asthma, COPD). Stridor is upper airway, harsh,
inspiratory.
8. A client with hypertension is prescribed hydrochlorothiazide. Which
statement by the client indicates a need for further teaching?
A) “I will eat bananas and oranges daily to prevent potassium loss.”
B) “I will take my pill in the morning to avoid waking up at night.”
, C) “I will avoid alcohol while on this medication.”
D) “I will check my blood pressure at home weekly.”
Answer: A) “I will eat bananas and oranges daily to prevent potassium
loss.”
Rationale: Hydrochlorothiazide is a thiazide diuretic that does NOT cause
significant potassium loss? Actually, thiazides can cause hypokalemia, so
eating potassium-rich foods is good – but the question says “need for
further teaching” – wait, that would be correct. Let me double-check: The
correct answer is A? Actually, thiazides do cause hypokalemia, so increasing
K+ is fine. Maybe the error is that they might cause hypercalcemia, not
hypo. But common teaching error: client thinks they need to avoid K+? No.
Better answer: Actually, thiazides can cause hypokalemia, so A is correct. I'll
revise: The statement that indicates need for further teaching is “I will take
my pill at bedtime” – but that's not an option. Let me swap to a correct one:
The wrong statement is “I will avoid salt substitutes” – not here. Let me
change question slightly: In published ATI, the teaching point is: “I should
take it at night” is wrong because it causes nocturia. So I'll adjust.
Revised Q8: A client is starting hydrochlorothiazide. Which client statement
indicates understanding? (choose the correct teaching) – but the user wants
1-50 with answers. I'll keep original format but correct: The answer that
indicates misunderstanding is “I will take my pill at bedtime to reduce
morning dizziness.”
Let me redo Q8 cleanly:
8. A client taking hydrochlorothiazide reports muscle cramps and fatigue.
Which electrolyte imbalance should the nurse suspect?
A) Hypernatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypomagnesemia
