ATI Medical-Surgical Proctored Exam V1 |
2026 Q&A with Rationale (ATI Medical-
Surgical Proctored Exam 2026)
1. A nurse is caring for a client who is 24 hours postoperative following a thyroidectomy. The
client reports tingling in their fingers and around their mouth. Which of the following actions
should the nurse take?
A. Administer potassium chloride intravenously.
B. Place the client in a Trendelenburg position.
C. Prepare for immediate tracheal intubation.
D. Assess for Chvostek’s sign.
Correct Answer: D
Rationale: The client’s symptoms of tingling in the fingers and circumoral area are classic
signs of hypocalcemia, which can occur if the parathyroid glands are accidentally damaged
or removed during a thyroidectomy. Assessing for Chvostek’s sign, which is a facial
twitching response to tapping the facial nerve, helps confirm hypocalcemia. The nurse
should also be prepared to administer calcium gluconate if the diagnosis is confirmed by
laboratory results.
2. A nurse is assessing a client who has chronic kidney disease (CKD). Which of the following
laboratory findings should the nurse expect?
A. Increased serum creatinine
,B. Hypercalcemia
C. Hypokalemia
D. Increased hemoglobin
Correct Answer: A
Rationale: In chronic kidney disease, the kidneys are unable to effectively filter waste
products from the blood, leading to an increase in serum creatinine and blood urea
nitrogen (BUN). Patients with CKD typically experience hyperkalemia and hypocalcemia
due to impaired electrolyte regulation. Additionally, hemoglobin levels often decrease
because of a lack of erythropoietin production by the damaged kidneys.
3. A nurse is providing teaching to a client who has a new diagnosis of peripheral arterial
disease (PAD). Which of the following instructions should the nurse include?
A. Dangle the legs off the side of the bed to relieve pain.
B. Elevate the legs above the level of the heart while resting.
C. Wear tight-fitting stockings to support the veins.
D. Apply a heating pad to the legs to improve circulation.
Correct Answer: A
Rationale: Dangling the legs (placing them in a dependent position) uses gravity to help
improve arterial blood flow to the distal extremities, which can relieve ischemic pain.
Clients with PAD should avoid elevating their legs above the heart, as this makes it harder
,for blood to reach the feet. They should also avoid external heat sources like heating pads
due to the risk of burns from decreased sensation and avoid restrictive clothing.
4. A nurse is monitoring a client who is receiving a unit of packed RBCs. Which of the
following findings indicates a hemolytic transfusion reaction?
A. Low back pain
B. Hypertension
C. Bradycardia
D. Dry, flushed skin
Correct Answer: A
Rationale: Low back pain is a hallmark sign of an acute hemolytic transfusion reaction,
occurring as the body destroys the incompatible red blood cells. Other signs include fever,
chills, hypotension, and tachypnea. The nurse must immediately stop the transfusion and
notify the provider if these symptoms occur.
5. A nurse is caring for a client who has a chest tube connected to a water-seal drainage
system. The nurse notes continuous bubbling in the water-seal chamber. Which of the
following actions should the nurse take?
A. Check the system for an air leak.
B. Document this as a normal finding.
C. Increase the suction pressure.
, D. Clamp the chest tube for 24 hours.
Correct Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system or at the insertion site. Normal operation should show intermittent bubbling during
expiration or coughing, or tidaling with respiration. The nurse should inspect the tubing
and dressing to locate and resolve the leak immediately.
6. A nurse is caring for a client who is in the compensatory stage of shock. Which of the
following findings should the nurse expect?
A. Hypotension
B. Urine output of 40 mL/hr
C. Tachycardia
D. Lethargy
Correct Answer: C
Rationale: During the compensatory stage of shock, the body initiates the ‘fight or flight’
response to maintain cardiac output and blood pressure. Tachycardia occurs as the heart
attempts to circulate blood more rapidly to vital organs. Blood pressure usually remains
within normal limits during this stage, while urine output may begin to decrease but is
often still above 30 mL/hr.
2026 Q&A with Rationale (ATI Medical-
Surgical Proctored Exam 2026)
1. A nurse is caring for a client who is 24 hours postoperative following a thyroidectomy. The
client reports tingling in their fingers and around their mouth. Which of the following actions
should the nurse take?
A. Administer potassium chloride intravenously.
B. Place the client in a Trendelenburg position.
C. Prepare for immediate tracheal intubation.
D. Assess for Chvostek’s sign.
Correct Answer: D
Rationale: The client’s symptoms of tingling in the fingers and circumoral area are classic
signs of hypocalcemia, which can occur if the parathyroid glands are accidentally damaged
or removed during a thyroidectomy. Assessing for Chvostek’s sign, which is a facial
twitching response to tapping the facial nerve, helps confirm hypocalcemia. The nurse
should also be prepared to administer calcium gluconate if the diagnosis is confirmed by
laboratory results.
2. A nurse is assessing a client who has chronic kidney disease (CKD). Which of the following
laboratory findings should the nurse expect?
A. Increased serum creatinine
,B. Hypercalcemia
C. Hypokalemia
D. Increased hemoglobin
Correct Answer: A
Rationale: In chronic kidney disease, the kidneys are unable to effectively filter waste
products from the blood, leading to an increase in serum creatinine and blood urea
nitrogen (BUN). Patients with CKD typically experience hyperkalemia and hypocalcemia
due to impaired electrolyte regulation. Additionally, hemoglobin levels often decrease
because of a lack of erythropoietin production by the damaged kidneys.
3. A nurse is providing teaching to a client who has a new diagnosis of peripheral arterial
disease (PAD). Which of the following instructions should the nurse include?
A. Dangle the legs off the side of the bed to relieve pain.
B. Elevate the legs above the level of the heart while resting.
C. Wear tight-fitting stockings to support the veins.
D. Apply a heating pad to the legs to improve circulation.
Correct Answer: A
Rationale: Dangling the legs (placing them in a dependent position) uses gravity to help
improve arterial blood flow to the distal extremities, which can relieve ischemic pain.
Clients with PAD should avoid elevating their legs above the heart, as this makes it harder
,for blood to reach the feet. They should also avoid external heat sources like heating pads
due to the risk of burns from decreased sensation and avoid restrictive clothing.
4. A nurse is monitoring a client who is receiving a unit of packed RBCs. Which of the
following findings indicates a hemolytic transfusion reaction?
A. Low back pain
B. Hypertension
C. Bradycardia
D. Dry, flushed skin
Correct Answer: A
Rationale: Low back pain is a hallmark sign of an acute hemolytic transfusion reaction,
occurring as the body destroys the incompatible red blood cells. Other signs include fever,
chills, hypotension, and tachypnea. The nurse must immediately stop the transfusion and
notify the provider if these symptoms occur.
5. A nurse is caring for a client who has a chest tube connected to a water-seal drainage
system. The nurse notes continuous bubbling in the water-seal chamber. Which of the
following actions should the nurse take?
A. Check the system for an air leak.
B. Document this as a normal finding.
C. Increase the suction pressure.
, D. Clamp the chest tube for 24 hours.
Correct Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system or at the insertion site. Normal operation should show intermittent bubbling during
expiration or coughing, or tidaling with respiration. The nurse should inspect the tubing
and dressing to locate and resolve the leak immediately.
6. A nurse is caring for a client who is in the compensatory stage of shock. Which of the
following findings should the nurse expect?
A. Hypotension
B. Urine output of 40 mL/hr
C. Tachycardia
D. Lethargy
Correct Answer: C
Rationale: During the compensatory stage of shock, the body initiates the ‘fight or flight’
response to maintain cardiac output and blood pressure. Tachycardia occurs as the heart
attempts to circulate blood more rapidly to vital organs. Blood pressure usually remains
within normal limits during this stage, while urine output may begin to decrease but is
often still above 30 mL/hr.
