ATI Medical-Surgical Nursing Proctored
Exam Practice Questions
SECTION 1: CARDIOVASCULAR DISORDERS
Question 1
A nurse is caring for a client who is 1 day postoperative
following an open cholecystectomy. The client's vital signs are:
BP 148/92 mmHg, HR 102 bpm, RR 22/min, SpO2 95% on 2
L/min oxygen. The client reports pain at the surgical site rated 7
on a scale of 0 to 10. Which of the following actions should the
nurse take first?
A. Notify the healthcare provider of the elevated blood pressure
B. Administer the prescribed IV opioid analgesic
C. Apply ice to the surgical site
D. Assess the client's surgical incision
Correct Answer: B
Rationale: The elevated blood pressure and heart rate are likely
due to uncontrolled pain. Pain should be addressed promptly
,after surgery to prevent complications. Administering the
prescribed analgesic is the appropriate first action. The nurse
can reassess pain and vital signs after medication
administration. Assessment of the incision is important but
should not delay pain management when pain is clearly the
priority issue.
Question 2
A nurse is assessing a client who is receiving a continuous
heparin infusion for a deep vein thrombosis. The client's
platelet count has dropped from 150,000/mm³ to 100,000/mm³
over 24 hours. Which of the following actions should the nurse
take?
A. Continue the heparin infusion as prescribed
B. Notify the healthcare provider and prepare to discontinue
the heparin
C. Administer a platelet transfusion
D. Increase the heparin infusion rate
Correct Answer: B
,Rationale: A significant drop in platelet count (typically >50%
from baseline or a fall below 100,000/mm³) in a client receiving
heparin may indicate heparin-induced thrombocytopenia (HIT),
a life-threatening complication. The heparin should be
discontinued and the provider notified immediately. Platelet
transfusions are contraindicated in HIT as they can worsen
thrombosis.
Question 3
A nurse is providing discharge teaching to a client who has a
new prescription for warfarin (Coumadin). Which of the
following statements by the client indicates an understanding
of the teaching?
A. "I will take aspirin for pain instead of acetaminophen."
B. "I will eat more green leafy vegetables to increase my vitamin
K."
C. "I will report any unusual bruising or bleeding to my
provider."
D. "I will have my PT/INR checked only if I feel unwell."
Correct Answer: C
, Rationale: Clients taking warfarin should report any signs of
bleeding (unusual bruising, bleeding gums, dark stools,
hematuria) to their healthcare provider. Aspirin should be
avoided due to increased bleeding risk. Vitamin K intake should
be consistent (not increased or decreased abruptly). PT/INR
monitoring is required regularly, not only when symptomatic.
Question 4
A nurse is caring for a client with heart failure who has crackles
in the lung bases, 2+ pitting edema in the lower extremities,
and jugular venous distention. Which of the following
medications should the nurse anticipate administering first?
A. Metoprolol
B. Furosemide
C. Lisinopril
D. Digoxin
Correct Answer: B
Rationale: The client is exhibiting signs of fluid overload
(crackles, edema, JVD). Furosemide is a loop diuretic that
Exam Practice Questions
SECTION 1: CARDIOVASCULAR DISORDERS
Question 1
A nurse is caring for a client who is 1 day postoperative
following an open cholecystectomy. The client's vital signs are:
BP 148/92 mmHg, HR 102 bpm, RR 22/min, SpO2 95% on 2
L/min oxygen. The client reports pain at the surgical site rated 7
on a scale of 0 to 10. Which of the following actions should the
nurse take first?
A. Notify the healthcare provider of the elevated blood pressure
B. Administer the prescribed IV opioid analgesic
C. Apply ice to the surgical site
D. Assess the client's surgical incision
Correct Answer: B
Rationale: The elevated blood pressure and heart rate are likely
due to uncontrolled pain. Pain should be addressed promptly
,after surgery to prevent complications. Administering the
prescribed analgesic is the appropriate first action. The nurse
can reassess pain and vital signs after medication
administration. Assessment of the incision is important but
should not delay pain management when pain is clearly the
priority issue.
Question 2
A nurse is assessing a client who is receiving a continuous
heparin infusion for a deep vein thrombosis. The client's
platelet count has dropped from 150,000/mm³ to 100,000/mm³
over 24 hours. Which of the following actions should the nurse
take?
A. Continue the heparin infusion as prescribed
B. Notify the healthcare provider and prepare to discontinue
the heparin
C. Administer a platelet transfusion
D. Increase the heparin infusion rate
Correct Answer: B
,Rationale: A significant drop in platelet count (typically >50%
from baseline or a fall below 100,000/mm³) in a client receiving
heparin may indicate heparin-induced thrombocytopenia (HIT),
a life-threatening complication. The heparin should be
discontinued and the provider notified immediately. Platelet
transfusions are contraindicated in HIT as they can worsen
thrombosis.
Question 3
A nurse is providing discharge teaching to a client who has a
new prescription for warfarin (Coumadin). Which of the
following statements by the client indicates an understanding
of the teaching?
A. "I will take aspirin for pain instead of acetaminophen."
B. "I will eat more green leafy vegetables to increase my vitamin
K."
C. "I will report any unusual bruising or bleeding to my
provider."
D. "I will have my PT/INR checked only if I feel unwell."
Correct Answer: C
, Rationale: Clients taking warfarin should report any signs of
bleeding (unusual bruising, bleeding gums, dark stools,
hematuria) to their healthcare provider. Aspirin should be
avoided due to increased bleeding risk. Vitamin K intake should
be consistent (not increased or decreased abruptly). PT/INR
monitoring is required regularly, not only when symptomatic.
Question 4
A nurse is caring for a client with heart failure who has crackles
in the lung bases, 2+ pitting edema in the lower extremities,
and jugular venous distention. Which of the following
medications should the nurse anticipate administering first?
A. Metoprolol
B. Furosemide
C. Lisinopril
D. Digoxin
Correct Answer: B
Rationale: The client is exhibiting signs of fluid overload
(crackles, edema, JVD). Furosemide is a loop diuretic that
