ATI MEDSURG PROCTORED EXAM
2024 UPDATE 100% CORRECT
COMPLETE AND CORRECT ANSWERS
💔 Cardiovascular & Hematologic Disorders
1. A nurse is assessing a client who is 12 hours post-
cardiac catheterization via the right femoral artery. The
nurse notes the client's right foot is pale, cool to the
touch, and the client reports numbness. Which action
should the nurse take FIRST?
o A) Apply warm blankets to the right foot
o B) Elevate the head of the bed to 45 degrees
o C) Assess the right femoral pulse
o D) Document the findings as normal
o Correct Answer: C
o Rationale: Pale, cool, and numb extremity post-
catheterization suggests arterial occlusion or thrombus
formation. Assessing the femoral pulse checks for perfusion.
Warm blankets treat symptoms but delay emergent
intervention. Elevating HOB does not restore arterial flow.
These findings are abnormal and require immediate action.
2. A nurse is monitoring a client receiving a blood
transfusion. Which finding indicates a hemolytic
transfusion reaction?
o A) Hypertension and bradycardia
o B) Low back pain and tachycardia
o C) Flushed skin and fever
,o D) Hypothermia and urticaria
o Correct Answer: B
o Rationale: Low back pain (from kidney stress), tachycardia,
hypotension, and hemoglobinuria are hallmark signs of an
acute hemolytic reaction due to RBC destruction. Hemolytic
reactions usually cause hypotension, not hypertension.
3. A client with heart failure is prescribed furosemide
(Lasix) 40 mg IV push. Which laboratory value should the
nurse monitor most closely?
o A) Sodium
o B) Potassium
o C) Calcium
o D) Magnesium
o Correct Answer: B
o Rationale: Furosemide is a loop diuretic that causes
excretion of potassium (hypokalemia). Hypokalemia can lead
to cardiac arrhythmias, especially in clients taking digoxin.
Monitor potassium levels before and after administration.
4. A client is prescribed warfarin (Coumadin) for chronic
atrial fibrillation. Which lab value indicates therapeutic
effectiveness?
o A) aPTT of 60 seconds
o B) INR of 2.5
o C) Platelet count of 150,000
o D) Bleeding time of 8 minutes
o Correct Answer: B
o Rationale: For most indications, a therapeutic INR on
warfarin is between 2.0 and 3.0 (e.g., for atrial fibrillation).
aPTT monitors heparin, not warfarin.
, 5. A nurse is assessing a client following a cardiac
catheterization. The client's blood pressure is 88/52,
heart rate 120, and the client reports feeling dizzy. The
nurse notes the dressing over the femoral insertion site is
dry. Which of the following should the nurse suspect?
o A) Anaphylactic reaction to contrast dye
o B) Retroperitoneal bleeding
o C) Myocardial infarction
o D) Vagal response
o Correct Answer: B
o Rationale: Hypotension, tachycardia, and dizziness after
cardiac catheterization can indicate significant blood loss.
Since the dressing is dry, bleeding may be occult into the
retroperitoneal space, which is a life-threatening
complication.
6. A nurse is caring for a client with right-sided heart
failure. Which of the following findings should the nurse
expect to find? (Select all that apply)
o A) Peripheral edema
o B) Jugular vein distention
o C) Crackles in the lungs
o D) Hepatomegaly
o E) Ascites
o Correct Answer: A, B, D, E
o Rationale: Right-sided heart failure leads to backup of blood
into the systemic venous system, causing peripheral edema,
JVD, hepatomegaly, and ascites. Crackles in the lungs are a
manifestation of left-sided heart failure.
, 7. A nurse is reinforcing teaching with a client about
preventing the onset of Raynaud's phenomenon
manifestations. Which statement by the client indicates a
need for further teaching?
o A) "I will wear gloves when going outside in cold weather."
o B) "I will keep my house at a cool temperature."
o C) "I will avoid smoking cigarettes."
o D) "I will manage my stress with relaxation techniques."
o Correct Answer: B
o Rationale: Cold temperatures trigger vasospasm in
Raynaud's phenomenon. Keeping the house at a cool
temperature is incorrect and would exacerbate symptoms.
The client should keep the house warm.
8. A client with a history of deep vein thrombosis (DVT) is
prescribed enoxaparin (Lovenox). Which of the following
instructions should the nurse include in the discharge
teaching?
o A) "Massage the injection site to help absorption."
o B) "Hold the skin fold during injection to administer into
subcutaneous tissue."
o C) "Inject the medication into the deltoid muscle."
o D) "Aspirate before injecting to ensure you're not in a blood
vessel."
o Correct Answer: B
o Rationale: Enoxaparin is given subcutaneously; the nurse
should pinch the skin fold and inject at a 90-degree angle.
Massaging can cause bruising; aspirating is not
recommended; deltoid is not an appropriate site. Reference:
ATI Pharmacology Review.
2024 UPDATE 100% CORRECT
COMPLETE AND CORRECT ANSWERS
💔 Cardiovascular & Hematologic Disorders
1. A nurse is assessing a client who is 12 hours post-
cardiac catheterization via the right femoral artery. The
nurse notes the client's right foot is pale, cool to the
touch, and the client reports numbness. Which action
should the nurse take FIRST?
o A) Apply warm blankets to the right foot
o B) Elevate the head of the bed to 45 degrees
o C) Assess the right femoral pulse
o D) Document the findings as normal
o Correct Answer: C
o Rationale: Pale, cool, and numb extremity post-
catheterization suggests arterial occlusion or thrombus
formation. Assessing the femoral pulse checks for perfusion.
Warm blankets treat symptoms but delay emergent
intervention. Elevating HOB does not restore arterial flow.
These findings are abnormal and require immediate action.
2. A nurse is monitoring a client receiving a blood
transfusion. Which finding indicates a hemolytic
transfusion reaction?
o A) Hypertension and bradycardia
o B) Low back pain and tachycardia
o C) Flushed skin and fever
,o D) Hypothermia and urticaria
o Correct Answer: B
o Rationale: Low back pain (from kidney stress), tachycardia,
hypotension, and hemoglobinuria are hallmark signs of an
acute hemolytic reaction due to RBC destruction. Hemolytic
reactions usually cause hypotension, not hypertension.
3. A client with heart failure is prescribed furosemide
(Lasix) 40 mg IV push. Which laboratory value should the
nurse monitor most closely?
o A) Sodium
o B) Potassium
o C) Calcium
o D) Magnesium
o Correct Answer: B
o Rationale: Furosemide is a loop diuretic that causes
excretion of potassium (hypokalemia). Hypokalemia can lead
to cardiac arrhythmias, especially in clients taking digoxin.
Monitor potassium levels before and after administration.
4. A client is prescribed warfarin (Coumadin) for chronic
atrial fibrillation. Which lab value indicates therapeutic
effectiveness?
o A) aPTT of 60 seconds
o B) INR of 2.5
o C) Platelet count of 150,000
o D) Bleeding time of 8 minutes
o Correct Answer: B
o Rationale: For most indications, a therapeutic INR on
warfarin is between 2.0 and 3.0 (e.g., for atrial fibrillation).
aPTT monitors heparin, not warfarin.
, 5. A nurse is assessing a client following a cardiac
catheterization. The client's blood pressure is 88/52,
heart rate 120, and the client reports feeling dizzy. The
nurse notes the dressing over the femoral insertion site is
dry. Which of the following should the nurse suspect?
o A) Anaphylactic reaction to contrast dye
o B) Retroperitoneal bleeding
o C) Myocardial infarction
o D) Vagal response
o Correct Answer: B
o Rationale: Hypotension, tachycardia, and dizziness after
cardiac catheterization can indicate significant blood loss.
Since the dressing is dry, bleeding may be occult into the
retroperitoneal space, which is a life-threatening
complication.
6. A nurse is caring for a client with right-sided heart
failure. Which of the following findings should the nurse
expect to find? (Select all that apply)
o A) Peripheral edema
o B) Jugular vein distention
o C) Crackles in the lungs
o D) Hepatomegaly
o E) Ascites
o Correct Answer: A, B, D, E
o Rationale: Right-sided heart failure leads to backup of blood
into the systemic venous system, causing peripheral edema,
JVD, hepatomegaly, and ascites. Crackles in the lungs are a
manifestation of left-sided heart failure.
, 7. A nurse is reinforcing teaching with a client about
preventing the onset of Raynaud's phenomenon
manifestations. Which statement by the client indicates a
need for further teaching?
o A) "I will wear gloves when going outside in cold weather."
o B) "I will keep my house at a cool temperature."
o C) "I will avoid smoking cigarettes."
o D) "I will manage my stress with relaxation techniques."
o Correct Answer: B
o Rationale: Cold temperatures trigger vasospasm in
Raynaud's phenomenon. Keeping the house at a cool
temperature is incorrect and would exacerbate symptoms.
The client should keep the house warm.
8. A client with a history of deep vein thrombosis (DVT) is
prescribed enoxaparin (Lovenox). Which of the following
instructions should the nurse include in the discharge
teaching?
o A) "Massage the injection site to help absorption."
o B) "Hold the skin fold during injection to administer into
subcutaneous tissue."
o C) "Inject the medication into the deltoid muscle."
o D) "Aspirate before injecting to ensure you're not in a blood
vessel."
o Correct Answer: B
o Rationale: Enoxaparin is given subcutaneously; the nurse
should pinch the skin fold and inject at a 90-degree angle.
Massaging can cause bruising; aspirating is not
recommended; deltoid is not an appropriate site. Reference:
ATI Pharmacology Review.
