Medical Surgical Proctored ATI Exam A
A nurse is caring for a client who has pancreatitis. The nurse should expect which of the
following lab results to be BELOW the expected reference range?
A. Amylase
B. Alkaline phosphatase
C. Bilirubin
D. Calcium - Answer - D. Calcium
A client who has pancreatitis is expected to have a DECREASED calcium and
magnesium d/t fat necrosis.
The other options would all be increased.
A nurse is caring for a client who has DKA. Which of the following lab findings should
the nurse expect?
A. negative urine ketones
B. BUN 32 mg/dL
C. pH 7.43
D. HCO3 23 mEq/L - Answer - B. BUN 32 mg/dL
DKA results in osmotic diuresis and subsequent dehydration. The nurse should expect
a client who has DKA to have elevated BUN, creatinine, and specific gravity levels
resulting from the excess glucose present in the urine.
A. DKA causes ketones in the urine and blood.
C. You would expect the pH to be <7.35 (because of the production of ketones)
D. You would expect HCO3 <15 d/t increased production of ketones causing metabolic
acidosis.
A nurse is providing d/c instructions to a client who has a partial-thickness burn on the
hand. Which of the following instructions should the nurse include?
A. Change the dressing q 72 hr.
B. Immobilize the hand with a pressure dressing.
C. Take pain medication 30 min after changing the dressing.
D. Wrap fingers with individual dressings. - Answer - D. Wrap the fingers with individual
dressings.
The nurse should instruct the client to wrap the fingers individually to allow for functional
use of the hand while healing occurs. The nurse should also instruct the client to
,perform range-of-motion exercises to each finger every hour while awake to promote
function of the injured hand.
A. q 12-24 hr
B. With skin grafts, you should elevate and immobilize the graft site with cotton pressure
dressings for 3-5 days following the
procedure.
C. 30 min before dressing change
A nurse is planning care for a client who has extensive burn injuries and is
immunocompromised. Which of the following precautions should the nurse include in
the POC to prevent Pseudomonas aeruginosa infection?
A. Encourage the client to eat raw fruits and veggies.
B. Avoid placing plants or flowers in the client's room.
C. Limit visitors to members of the client's immediate family.
D. Wear an N95 respirator mask when providing care to the client. - Answer - B. Avoid
placing plants or flowers in the client's room.
Live plants can harbor P. aeruginosa, and this bacterium can infect burn wounds and
cause life-threatening complications. The nurse should ensure no one brings live plants
or flowers into the client's room.
A. P. aeruginosa can be found in raw fruits and veggies.
C. Prohibit visits from those at risk for P. aeruginosa infections (i.e. anyone who is ill,
other hospitalized clients, and small children)
D. spread by contact not airborne
A nurse in an ED is caring for a client who reports v/d for the past 3 days. Which of the
following findings should indicate to the nurse that the client is experiencing fluid volume
deficit?
A. HR 110/min
B. BP 138/90 mmHg
C. Urine specific gravity 1.020
D. BUN 15 mg/dL - Answer - A. HR 110/min
A client who has a 3-day history of vomiting and diarrhea is likely to have fluid volume
deficit and an elevated heart rate.
B. WNL (would expect hypotension for this client)
,C. WNL (would expect >1.030 for this client)
D. WNL (would expect BUN >20 for this client)
A nurse in an ED is reviewing the provider's prescriptions for a client who sustained a
rattlesnake bite to the lower leg. Which of the following prescriptions should the nurse
expect?
A. Apply ice to the client's puncture wound.
B. Initiate corticosteroid therapy for the client.
C. Keep the client's leg above heart level.
D. Administer an opioid analgesic to the client. - Answer - D. Administer an opioid
analgesic to the client.
The nurse should expect a prescription for an opioid analgesic to promote comfort
following a rattlesnake bite.
A. Apply ice for a bite from a black widow to reduce the action of the neurotoxin from the
spider.
B. Expect a prescription for antihistamines and corticosteroids from bees and wasps.
C. Keep the affected extremity AT HEART LEVEL, not above or below it.
A nurse is providing teaching to a client who has chronic kidney disease and a new
prescription for erythropoietin. Which of the following statements by the client indicates
an understanding of the teaching?
A. "I should take calcium supplements so the medication will work better in my system."
B. "I am taking this medication to increase my energy level."
C. "This medication can cause my BP to drop."
D. "I will not need to restrict protein in my diet while taking this medication." - Answer -
B. "I am taking this medication to increase my energy level."
The goal of erythropoietin therapy is to increase the level of hematocrit in clients who
have anemia. When the medication is effective, the client should have a decrease in
fatigue and an improvement in activity tolerance.
A. A client who has chronic kidney disease should have adequate iron stores for
erythropoietin therapy to be effective. Clients are encouraged to consume foods high in
iron such as beef, liver, pork, and veal.
C. Increased RBC productions, leading to HYPERtension
D. Does not affect the client's protein requirements
, A nurse is reviewing the lab results of a client who has cirrhosis. Which of the following
lab values should the nurse expect?
A. decreased prothrombin time
B. elevated bilirubin level
C. decreased ammonia level
D. elevated albumin level - Answer - B. elevated bilirubin level
Bilirubin levels reflect the liver's ability to conjugate and excrete bilirubin, a byproduct of
the hemolysis of red blood cells. Bilirubin levels rise with liver disease and clinically
reflect the client's degree of jaundice.
A. Liver disease and severe liver cell damage causes the liver cells to produce less
prothrombin, which prolongs prothrombin time.
C. Expect elevated ammonia levels because the liver converts ammonia to urea. When
this is interrupted, ammonia levels rise.
D. Albumin is formed in the liver. With an impaired liver function, albumin levels
decrease.
A nurse in a community clinic is caring for a client who reports an increase in the
frequency of migraine headaches. To help reduce the risk for migraine headaches,
which of the following foods should the nurse recommend the client to avoid?
A. shellfish
B. aged cheese
C. peppermint candy
D. enriched pasta - Answer - B. aged cheese
Foods that contain tyramine, such as aged cheese and sausage, can trigger migraine
headaches.
A. Not a common trigger. However, smoked fish and fermented or pickled foods are a
common trigger.
C. Not a common trigger. However, chocolate is a common trigger.
D. Not a common trigger. However, yeast (an ingredient in pastries and bread) is a
common trigger.
A nurse is planning to provide d/c teaching for the family of an older adult client who has
hemianopsia and is at risk for falls. Which of the following instructions should the nurse
include?
A. Keep the client's personal care items in the bathroom.
A nurse is caring for a client who has pancreatitis. The nurse should expect which of the
following lab results to be BELOW the expected reference range?
A. Amylase
B. Alkaline phosphatase
C. Bilirubin
D. Calcium - Answer - D. Calcium
A client who has pancreatitis is expected to have a DECREASED calcium and
magnesium d/t fat necrosis.
The other options would all be increased.
A nurse is caring for a client who has DKA. Which of the following lab findings should
the nurse expect?
A. negative urine ketones
B. BUN 32 mg/dL
C. pH 7.43
D. HCO3 23 mEq/L - Answer - B. BUN 32 mg/dL
DKA results in osmotic diuresis and subsequent dehydration. The nurse should expect
a client who has DKA to have elevated BUN, creatinine, and specific gravity levels
resulting from the excess glucose present in the urine.
A. DKA causes ketones in the urine and blood.
C. You would expect the pH to be <7.35 (because of the production of ketones)
D. You would expect HCO3 <15 d/t increased production of ketones causing metabolic
acidosis.
A nurse is providing d/c instructions to a client who has a partial-thickness burn on the
hand. Which of the following instructions should the nurse include?
A. Change the dressing q 72 hr.
B. Immobilize the hand with a pressure dressing.
C. Take pain medication 30 min after changing the dressing.
D. Wrap fingers with individual dressings. - Answer - D. Wrap the fingers with individual
dressings.
The nurse should instruct the client to wrap the fingers individually to allow for functional
use of the hand while healing occurs. The nurse should also instruct the client to
,perform range-of-motion exercises to each finger every hour while awake to promote
function of the injured hand.
A. q 12-24 hr
B. With skin grafts, you should elevate and immobilize the graft site with cotton pressure
dressings for 3-5 days following the
procedure.
C. 30 min before dressing change
A nurse is planning care for a client who has extensive burn injuries and is
immunocompromised. Which of the following precautions should the nurse include in
the POC to prevent Pseudomonas aeruginosa infection?
A. Encourage the client to eat raw fruits and veggies.
B. Avoid placing plants or flowers in the client's room.
C. Limit visitors to members of the client's immediate family.
D. Wear an N95 respirator mask when providing care to the client. - Answer - B. Avoid
placing plants or flowers in the client's room.
Live plants can harbor P. aeruginosa, and this bacterium can infect burn wounds and
cause life-threatening complications. The nurse should ensure no one brings live plants
or flowers into the client's room.
A. P. aeruginosa can be found in raw fruits and veggies.
C. Prohibit visits from those at risk for P. aeruginosa infections (i.e. anyone who is ill,
other hospitalized clients, and small children)
D. spread by contact not airborne
A nurse in an ED is caring for a client who reports v/d for the past 3 days. Which of the
following findings should indicate to the nurse that the client is experiencing fluid volume
deficit?
A. HR 110/min
B. BP 138/90 mmHg
C. Urine specific gravity 1.020
D. BUN 15 mg/dL - Answer - A. HR 110/min
A client who has a 3-day history of vomiting and diarrhea is likely to have fluid volume
deficit and an elevated heart rate.
B. WNL (would expect hypotension for this client)
,C. WNL (would expect >1.030 for this client)
D. WNL (would expect BUN >20 for this client)
A nurse in an ED is reviewing the provider's prescriptions for a client who sustained a
rattlesnake bite to the lower leg. Which of the following prescriptions should the nurse
expect?
A. Apply ice to the client's puncture wound.
B. Initiate corticosteroid therapy for the client.
C. Keep the client's leg above heart level.
D. Administer an opioid analgesic to the client. - Answer - D. Administer an opioid
analgesic to the client.
The nurse should expect a prescription for an opioid analgesic to promote comfort
following a rattlesnake bite.
A. Apply ice for a bite from a black widow to reduce the action of the neurotoxin from the
spider.
B. Expect a prescription for antihistamines and corticosteroids from bees and wasps.
C. Keep the affected extremity AT HEART LEVEL, not above or below it.
A nurse is providing teaching to a client who has chronic kidney disease and a new
prescription for erythropoietin. Which of the following statements by the client indicates
an understanding of the teaching?
A. "I should take calcium supplements so the medication will work better in my system."
B. "I am taking this medication to increase my energy level."
C. "This medication can cause my BP to drop."
D. "I will not need to restrict protein in my diet while taking this medication." - Answer -
B. "I am taking this medication to increase my energy level."
The goal of erythropoietin therapy is to increase the level of hematocrit in clients who
have anemia. When the medication is effective, the client should have a decrease in
fatigue and an improvement in activity tolerance.
A. A client who has chronic kidney disease should have adequate iron stores for
erythropoietin therapy to be effective. Clients are encouraged to consume foods high in
iron such as beef, liver, pork, and veal.
C. Increased RBC productions, leading to HYPERtension
D. Does not affect the client's protein requirements
, A nurse is reviewing the lab results of a client who has cirrhosis. Which of the following
lab values should the nurse expect?
A. decreased prothrombin time
B. elevated bilirubin level
C. decreased ammonia level
D. elevated albumin level - Answer - B. elevated bilirubin level
Bilirubin levels reflect the liver's ability to conjugate and excrete bilirubin, a byproduct of
the hemolysis of red blood cells. Bilirubin levels rise with liver disease and clinically
reflect the client's degree of jaundice.
A. Liver disease and severe liver cell damage causes the liver cells to produce less
prothrombin, which prolongs prothrombin time.
C. Expect elevated ammonia levels because the liver converts ammonia to urea. When
this is interrupted, ammonia levels rise.
D. Albumin is formed in the liver. With an impaired liver function, albumin levels
decrease.
A nurse in a community clinic is caring for a client who reports an increase in the
frequency of migraine headaches. To help reduce the risk for migraine headaches,
which of the following foods should the nurse recommend the client to avoid?
A. shellfish
B. aged cheese
C. peppermint candy
D. enriched pasta - Answer - B. aged cheese
Foods that contain tyramine, such as aged cheese and sausage, can trigger migraine
headaches.
A. Not a common trigger. However, smoked fish and fermented or pickled foods are a
common trigger.
C. Not a common trigger. However, chocolate is a common trigger.
D. Not a common trigger. However, yeast (an ingredient in pastries and bread) is a
common trigger.
A nurse is planning to provide d/c teaching for the family of an older adult client who has
hemianopsia and is at risk for falls. Which of the following instructions should the nurse
include?
A. Keep the client's personal care items in the bathroom.
