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ATI MED-SURG ADVANCED CARE MANAGEMENT
2026-2027: COMPLETE STUDY GUIDE & EXAM BANK
– 200+ GRADED A+ QUESTIONS WITH RATIONALES –
RN PROCTORED EXAM – FIRST-TIME PASS
GUARANTEED
# SECTION 1: NEUROLOGICAL DISORDERS & HEAD TRAUMA (20
Questions)
**Q1.** A critical care nurse is assessing a client who has a severe head injury. In
response to painful stimuli, the client does not open her eyes, displays decerebrate
posturing, and makes incomprehensible sounds. Which of the following Glasgow
Coma Scale scores should the nurse assign the client?
A) 2
B) 5
C) 10
D) 13
**Answer: B** – Rationale: The Glasgow Coma Scale assesses eye opening (E),
verbal response (V), and motor response (M). Decerebrate posturing is a motor
response of 2 (extensor posturing), incomprehensible sounds is a verbal response
of 2, and no eye opening is 1. Total score = 1 + 2 + 2 = 5. A score of 8 or less
indicates severe brain injury .
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**Q2.** A nurse is caring for a client who has a seizure disorder. Which of the
following items should the nurse have available at the bedside? (Select all that
apply)
A) Wrist restraints
B) Oral airway
C) Tongue blade
D) Suction equipment
E) Oxygen
**Answer: D, E** – Rationale: During a seizure, the priority is maintaining the
airway and preventing injury. Suction equipment and oxygen should be available to
manage secretions and hypoxemia. Oral airways and tongue blades should never
be inserted during a seizure as they can cause injury, and restraints are
contraindicated as they can cause fractures .
**Q3.** A nurse is monitoring a client's heart rhythm following insertion of a
pacemaker. Which of the following EKG findings should the nurse expect to see?
A) Absence of P waves
B) Pacemaker spike followed by a QRS complex
C) Irregularly irregular rhythm
D) Widened QRS complexes without preceding spikes
**Answer: B** – Rationale: A properly functioning pacemaker will show a pacing
spike (vertical line) followed immediately by a QRS complex if the ventricle is
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being paced. The presence of a spike before the QRS confirms that the pacemaker
is capturing the ventricle .
**Q4.** A client with a severe head injury exhibits decerebrate posturing. The
nurse understands that this indicates damage to which area of the brain?
A) Cerebral cortex
B) Brainstem (midbrain)
C) Cerebellum
D) Basal ganglia
**Answer: B** – Rationale: Decerebrate posturing (extension of arms and legs
with internal rotation) indicates damage to the brainstem at the level of the
midbrain. This is a more severe finding than decorticate posturing (flexion), which
indicates cerebral hemisphere damage.
**Q5.** A nurse is assessing a client who reports numbness and tingling of his
toes and exhibits a positive Trousseau's sign. Which of the following electrolyte
imbalances should the nurse suspect?
A) Hypocalcemia
B) Hyponatremia
C) Hypermagnesemia
D) Hyperchloremia
**Answer: A** – Rationale: Hypocalcemia causes neuromuscular irritability,
leading to paresthesias (numbness and tingling) and positive Trousseau's sign
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(carpal spasm when blood pressure cuff is inflated). Hypocalcemia also causes
Chvostek's sign (facial twitching) .
**Q6.** A nurse is providing teaching to a client who has left-sided heart failure.
Which of the following findings should the nurse include as a manifestation of this
condition?
A) Neck vein distention
B) Anorexia
C) Ankle edema
D) Hacking cough
**Answer: D** – Rationale: Left-sided heart failure causes pulmonary congestion,
leading to a hacking cough, dyspnea, orthopnea, and crackles. Right-sided heart
failure causes systemic congestion (neck vein distention, anorexia, and peripheral
edema) .
**Q7.** The nurse is caring for a client who has a chest tube. The client asks why
the fluid in the water-seal chamber rises and falls. Which of the following
statements should the nurse make?
A) "Your breathing pattern causes this"
B) "Suction pressure that is too high causes this"
C) "This means your lung is fully expanded"
D) "This indicates a possible leak"
ATI MED-SURG ADVANCED CARE MANAGEMENT
2026-2027: COMPLETE STUDY GUIDE & EXAM BANK
– 200+ GRADED A+ QUESTIONS WITH RATIONALES –
RN PROCTORED EXAM – FIRST-TIME PASS
GUARANTEED
# SECTION 1: NEUROLOGICAL DISORDERS & HEAD TRAUMA (20
Questions)
**Q1.** A critical care nurse is assessing a client who has a severe head injury. In
response to painful stimuli, the client does not open her eyes, displays decerebrate
posturing, and makes incomprehensible sounds. Which of the following Glasgow
Coma Scale scores should the nurse assign the client?
A) 2
B) 5
C) 10
D) 13
**Answer: B** – Rationale: The Glasgow Coma Scale assesses eye opening (E),
verbal response (V), and motor response (M). Decerebrate posturing is a motor
response of 2 (extensor posturing), incomprehensible sounds is a verbal response
of 2, and no eye opening is 1. Total score = 1 + 2 + 2 = 5. A score of 8 or less
indicates severe brain injury .
,2|Page
**Q2.** A nurse is caring for a client who has a seizure disorder. Which of the
following items should the nurse have available at the bedside? (Select all that
apply)
A) Wrist restraints
B) Oral airway
C) Tongue blade
D) Suction equipment
E) Oxygen
**Answer: D, E** – Rationale: During a seizure, the priority is maintaining the
airway and preventing injury. Suction equipment and oxygen should be available to
manage secretions and hypoxemia. Oral airways and tongue blades should never
be inserted during a seizure as they can cause injury, and restraints are
contraindicated as they can cause fractures .
**Q3.** A nurse is monitoring a client's heart rhythm following insertion of a
pacemaker. Which of the following EKG findings should the nurse expect to see?
A) Absence of P waves
B) Pacemaker spike followed by a QRS complex
C) Irregularly irregular rhythm
D) Widened QRS complexes without preceding spikes
**Answer: B** – Rationale: A properly functioning pacemaker will show a pacing
spike (vertical line) followed immediately by a QRS complex if the ventricle is
,3|Page
being paced. The presence of a spike before the QRS confirms that the pacemaker
is capturing the ventricle .
**Q4.** A client with a severe head injury exhibits decerebrate posturing. The
nurse understands that this indicates damage to which area of the brain?
A) Cerebral cortex
B) Brainstem (midbrain)
C) Cerebellum
D) Basal ganglia
**Answer: B** – Rationale: Decerebrate posturing (extension of arms and legs
with internal rotation) indicates damage to the brainstem at the level of the
midbrain. This is a more severe finding than decorticate posturing (flexion), which
indicates cerebral hemisphere damage.
**Q5.** A nurse is assessing a client who reports numbness and tingling of his
toes and exhibits a positive Trousseau's sign. Which of the following electrolyte
imbalances should the nurse suspect?
A) Hypocalcemia
B) Hyponatremia
C) Hypermagnesemia
D) Hyperchloremia
**Answer: A** – Rationale: Hypocalcemia causes neuromuscular irritability,
leading to paresthesias (numbness and tingling) and positive Trousseau's sign
, 4|Page
(carpal spasm when blood pressure cuff is inflated). Hypocalcemia also causes
Chvostek's sign (facial twitching) .
**Q6.** A nurse is providing teaching to a client who has left-sided heart failure.
Which of the following findings should the nurse include as a manifestation of this
condition?
A) Neck vein distention
B) Anorexia
C) Ankle edema
D) Hacking cough
**Answer: D** – Rationale: Left-sided heart failure causes pulmonary congestion,
leading to a hacking cough, dyspnea, orthopnea, and crackles. Right-sided heart
failure causes systemic congestion (neck vein distention, anorexia, and peripheral
edema) .
**Q7.** The nurse is caring for a client who has a chest tube. The client asks why
the fluid in the water-seal chamber rises and falls. Which of the following
statements should the nurse make?
A) "Your breathing pattern causes this"
B) "Suction pressure that is too high causes this"
C) "This means your lung is fully expanded"
D) "This indicates a possible leak"
