ATI Adult Medical-Surgical Proctored
Exam V2 | 2026 Q&A with Rationale (ATI
Adult Med-Surg Proctored Exam 2026)
1. A nurse is caring for a client who is 24 hours postoperative following a chest tube insertion.
Which of the following findings should the nurse report to the provider?
A. Drainage of 50 mL in the last hour
B. Continuous bubbling in the water-seal chamber
C. Oscillation of the water level with respiration
D. Presence of subcutaneous emphysema around the insertion site
Correct Answer: B
Rationale: Continuous bubbling in the water-seal chamber typically indicates an air leak in
the system, which requires immediate intervention. While intermittent bubbling is normal
during expiration or coughing, continuous bubbling suggests a problem. The nurse should
check the connections and the insertion site to locate the leak and notify the provider.
2. A nurse is assessing a client who has a suspected diagnosis of Cushing’s syndrome. Which
of the following findings should the nurse expect? (Select All That Apply)
A. Moon face
B. Truncal obesity
C. Hypertension
,D. Hypoglycemia
E. Striae on the abdomen
F. Thinning of the skin
Correct Answer: A, B, C, E, F
Rationale: Cushing’s syndrome is characterized by an overproduction of cortisol, which
leads to fat redistribution resulting in a moon face and truncal obesity. Elevated cortisol
levels also cause sodium retention and potassium depletion, often leading to hypertension.
Skin changes such as thinning and the appearance of purple striae are classic signs due to
protein wasting and loss of collagen.
3. A nurse is providing discharge instructions to a client who has a new prescription for
warfarin. Which of the following instructions should the nurse include?
A. Increase intake of green leafy vegetables
B. Use a soft-bristled toothbrush
C. Take aspirin for minor headaches
D. Report any metallic taste in the mouth
Correct Answer: B
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding, so the client
should use a soft-bristled toothbrush to prevent gingival trauma. The nurse must instruct
the client to avoid aspirin and other NSAIDs as they further increase the risk of
,hemorrhage. It is also important to maintain a consistent intake of Vitamin K rather than
increasing it, as Vitamin K is the antidote to warfarin.
4. A nurse is assessing a client who is 4 hours postoperative following a total hip arthroplasty.
Which of the following findings is the priority for the nurse to report?
A. Patient reporting pain as 6 on a scale of 0 to 10
B. Small amount of serosanguineous drainage on the dressing
C. The client has not voided since the surgery
D. The client’s affected leg is shorter than the unaffected leg
Correct Answer: D
Rationale: A shorter leg on the affected side is a classic sign of hip dislocation, which is a
surgical emergency. The nurse must immediately notify the surgeon to prevent further
damage and ensure the prosthesis is properly aligned. Other signs of dislocation include
intense pain, deformity, and limited range of motion in the joint.
5. A nurse is monitoring a client who has hyperkalemia and is receiving sodium polystyrene
sulfonate. Which of the following lab values indicates the treatment is effective?
A. Potassium 4.8 mEq/L
B. Sodium 132 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 1.8 mEq/L
, Correct Answer: A
Rationale: Sodium polystyrene sulfonate is a cation-exchange resin used to lower serum
potassium levels by exchanging sodium ions for potassium ions in the intestine. A
potassium level of 4.8 mEq/L falls within the normal reference range (3.5 to 5.0 mEq/L),
indicating the medication was effective. The nurse should continue to monitor the client’s
cardiac rhythm and bowel sounds while administering this medication.
6. A nurse is caring for a client who is experiencing a thyroid storm. Which of the following
interventions is the priority?
A. Administering aspirin for fever
B. Administering intravenous fluids
C. Administering a beta-blocker
D. Applying a cooling blanket
Correct Answer: C
Rationale: In a thyroid storm, the excessive release of thyroid hormones leads to severe
tachycardia and hypertension, which can cause cardiac failure. Administering a beta-
blocker such as propranolol is the priority to decrease heart rate and blood pressure and
reduce the cardiac workload. Aspirin is contraindicated because it can displace thyroid
hormone from binding proteins, worsening the condition.
Exam V2 | 2026 Q&A with Rationale (ATI
Adult Med-Surg Proctored Exam 2026)
1. A nurse is caring for a client who is 24 hours postoperative following a chest tube insertion.
Which of the following findings should the nurse report to the provider?
A. Drainage of 50 mL in the last hour
B. Continuous bubbling in the water-seal chamber
C. Oscillation of the water level with respiration
D. Presence of subcutaneous emphysema around the insertion site
Correct Answer: B
Rationale: Continuous bubbling in the water-seal chamber typically indicates an air leak in
the system, which requires immediate intervention. While intermittent bubbling is normal
during expiration or coughing, continuous bubbling suggests a problem. The nurse should
check the connections and the insertion site to locate the leak and notify the provider.
2. A nurse is assessing a client who has a suspected diagnosis of Cushing’s syndrome. Which
of the following findings should the nurse expect? (Select All That Apply)
A. Moon face
B. Truncal obesity
C. Hypertension
,D. Hypoglycemia
E. Striae on the abdomen
F. Thinning of the skin
Correct Answer: A, B, C, E, F
Rationale: Cushing’s syndrome is characterized by an overproduction of cortisol, which
leads to fat redistribution resulting in a moon face and truncal obesity. Elevated cortisol
levels also cause sodium retention and potassium depletion, often leading to hypertension.
Skin changes such as thinning and the appearance of purple striae are classic signs due to
protein wasting and loss of collagen.
3. A nurse is providing discharge instructions to a client who has a new prescription for
warfarin. Which of the following instructions should the nurse include?
A. Increase intake of green leafy vegetables
B. Use a soft-bristled toothbrush
C. Take aspirin for minor headaches
D. Report any metallic taste in the mouth
Correct Answer: B
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding, so the client
should use a soft-bristled toothbrush to prevent gingival trauma. The nurse must instruct
the client to avoid aspirin and other NSAIDs as they further increase the risk of
,hemorrhage. It is also important to maintain a consistent intake of Vitamin K rather than
increasing it, as Vitamin K is the antidote to warfarin.
4. A nurse is assessing a client who is 4 hours postoperative following a total hip arthroplasty.
Which of the following findings is the priority for the nurse to report?
A. Patient reporting pain as 6 on a scale of 0 to 10
B. Small amount of serosanguineous drainage on the dressing
C. The client has not voided since the surgery
D. The client’s affected leg is shorter than the unaffected leg
Correct Answer: D
Rationale: A shorter leg on the affected side is a classic sign of hip dislocation, which is a
surgical emergency. The nurse must immediately notify the surgeon to prevent further
damage and ensure the prosthesis is properly aligned. Other signs of dislocation include
intense pain, deformity, and limited range of motion in the joint.
5. A nurse is monitoring a client who has hyperkalemia and is receiving sodium polystyrene
sulfonate. Which of the following lab values indicates the treatment is effective?
A. Potassium 4.8 mEq/L
B. Sodium 132 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 1.8 mEq/L
, Correct Answer: A
Rationale: Sodium polystyrene sulfonate is a cation-exchange resin used to lower serum
potassium levels by exchanging sodium ions for potassium ions in the intestine. A
potassium level of 4.8 mEq/L falls within the normal reference range (3.5 to 5.0 mEq/L),
indicating the medication was effective. The nurse should continue to monitor the client’s
cardiac rhythm and bowel sounds while administering this medication.
6. A nurse is caring for a client who is experiencing a thyroid storm. Which of the following
interventions is the priority?
A. Administering aspirin for fever
B. Administering intravenous fluids
C. Administering a beta-blocker
D. Applying a cooling blanket
Correct Answer: C
Rationale: In a thyroid storm, the excessive release of thyroid hormones leads to severe
tachycardia and hypertension, which can cause cardiac failure. Administering a beta-
blocker such as propranolol is the priority to decrease heart rate and blood pressure and
reduce the cardiac workload. Aspirin is contraindicated because it can displace thyroid
hormone from binding proteins, worsening the condition.
