MED SURG ATI ADVANCED FINAL EXAM /ATI MED
SURG ADVANCED FINAL PROCTORED 2023-2024
EXAM 350 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY GRADED
A+
A patient is admitted to the emergency department with severe fatigue and
confusion. Laboratory studies are done. Which laboratory value will require
the most immediate action by the nurse?
a. Arterial blood pH is 7.32.
b. Serum calcium is 18 mg/dL.
c. Serum potassium is 5.1 mEq/L.
d. Arterial oxygen saturation is 91%. - ANSWER--ANS: B
The serum calcium is well above the normal level and puts the patient at
risk for cardiac dysrhythmias. The nurse should initiate cardiac monitoring
and notify the health care provider. The potassium, oxygen saturation, and
pH are also abnormal, and the nurse should notify the healthcare provider
about these values as well, but they are not immediately life threatening.
A patient comes to the clinic complaining of frequent, watery stools for the
past2 days. Which action should the nurse take first?a. Obtain the baseline
weight.
b. Check the patient's blood pressure.
c. Draw blood for serum electrolyte levels.
d. Ask about extremity numbness or tingling. - ANSWER--ANS: B
Because the patient's history suggests that fluid volume deficit may be a
problem, assessment for adequate circulation is the highest priority. The
other actions are also appropriate, but are not as essential as determining
the patient's perfusion status.
After receiving change-of-shift report, which patient should the nurse
assess first?
, MED SURG ATI ADVANCED FINAL EXAM /ATI MED
SURG ADVANCED FINAL PROCTORED 2023-2024
EXAM 350 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY GRADED
A+
a. Patient with serum potassium level of 5.0 mEq/L who is complaining of
abdominal cramping
b. Patient with serum sodium level of 145 mEq/L who has a dry mouth and
is askingfor a glass of water
c. Patient with serum magnesium level of 1.1 mEq/L who has tremors and
hyperactive deep tendon reflexes
d. Patient with serum phosphorus level of 4.5 mg/dL who has multiple soft
tissue calcium-phosphate precipitates - ANSWER--ANS: C
The low magnesium level and neuromuscular irritability suggest that the
patient may be at risk for seizures. The other patients have mild electrolyte
disturbances or symptoms that require action, but they are not at risk for
life-threatening complications.
An older adult patient who is malnourished presents to the emergency
department with a serum protein level of 5.2 g/dL. The nurse would expect
which clinical manifestation?
a. Pallor
b. Edema
c. Confusion
d. Restlessness - ANSWER--ANS: B
The normal range for total protein is 6.4 to 8.3 g/dL. Low serum protein
levels cause a decrease in plasma oncotic pressure and allow fluid to
remain in interstitial tissues, causing edema. Confusion, restlessness, and
pallor are not associated with low serum protein levels.
, MED SURG ATI ADVANCED FINAL EXAM /ATI MED
SURG ADVANCED FINAL PROCTORED 2023-2024
EXAM 350 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY GRADED
A+
A 38-year-old female is admitted for an elective surgical procedure. Which
information obtained by the nurse during the preoperative assessment is
most important to report to the anesthesiologist before surgery?
a. The patient's lack of knowledge about postoperative pain control
measures
b. The patient's statement that her last menstrual period was 8 weeks
previously
c. The patient's history of a postoperative infection following a prior
cholecystectomy
d. The patient's concern that she will be unable to care for her children
postoperatively - ANSWER--ANS: B
This statement suggests that the patient may be pregnant, and pregnancy
testing is needed before administration of anesthetic agents. Although the
other data may also be communicated with the surgeon and
anesthesiologist, they will affect postoperative care and do not indicate a
need for further assessment before surgery
The nurse is preparing to witness the patient signing the operative consent
form when the patient says, "I do not really understand what the doctor
said." Which action is best for the nurse to take?
a. Provide an explanation of the planned surgical procedure.
b. Notify the surgeon that the informed consent process is not complete.
c. Administer the prescribed preoperative antibiotics and withhold any
ordered sedative medications.
d. Notify the operating room staff that the surgeon needs to give a more
complete explanation of the procedure. - ANSWER--ANS: B
, MED SURG ATI ADVANCED FINAL EXAM /ATI MED
SURG ADVANCED FINAL PROCTORED 2023-2024
EXAM 350 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY GRADED
A+
The surgeon is responsible for explaining the surgery to the patient, and
the nurse should wait until the surgeon has clarified the surgery before
having the patient sign the consent form. The nurse should communicate
directly with the surgeon about the consent form rather than asking other
staff to pass on the message. It is not within the nurse's legal scope of
practice to explain the surgical procedure. No preoperative medications
should be administered until the patient understands the surgical procedure
and signs the consent form.
A patient who has diabetes and uses insulin to control blood glucose has
been NPO since midnight before having a knee replacement surgery.
Which action should the nurse take?
a. Withhold the usual scheduled insulin dose because the patient is NPO.
b. Obtain a blood glucose measurement before any insulin administration.
c. Give the patient the usual insulin dose because stress will increase the
blood glucose.
d. Administer a lower dose of insulin because there will be no oral intake
before surgery. - ANSWER--ANS: B
Preoperative insulin administration is individualized to the patient, and the
current blood glucose will provide the most reliable information about
insulin needs. It is not possible to predict whether the patient will require no
insulin, a lower dose, or a higher dose without blood glucose monitoring
The outpatient surgery nurse reviews the complete blood cell (CBC) count
results for a patient who is scheduled for surgery in a few days. The results
are white blood cell (WBC) count 10.2 ´ 103/µL; hemoglobin 15 g/dL;
hematocrit 45%; platelets 150 ´ 103/µL. Which action should the nurse
take?
SURG ADVANCED FINAL PROCTORED 2023-2024
EXAM 350 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY GRADED
A+
A patient is admitted to the emergency department with severe fatigue and
confusion. Laboratory studies are done. Which laboratory value will require
the most immediate action by the nurse?
a. Arterial blood pH is 7.32.
b. Serum calcium is 18 mg/dL.
c. Serum potassium is 5.1 mEq/L.
d. Arterial oxygen saturation is 91%. - ANSWER--ANS: B
The serum calcium is well above the normal level and puts the patient at
risk for cardiac dysrhythmias. The nurse should initiate cardiac monitoring
and notify the health care provider. The potassium, oxygen saturation, and
pH are also abnormal, and the nurse should notify the healthcare provider
about these values as well, but they are not immediately life threatening.
A patient comes to the clinic complaining of frequent, watery stools for the
past2 days. Which action should the nurse take first?a. Obtain the baseline
weight.
b. Check the patient's blood pressure.
c. Draw blood for serum electrolyte levels.
d. Ask about extremity numbness or tingling. - ANSWER--ANS: B
Because the patient's history suggests that fluid volume deficit may be a
problem, assessment for adequate circulation is the highest priority. The
other actions are also appropriate, but are not as essential as determining
the patient's perfusion status.
After receiving change-of-shift report, which patient should the nurse
assess first?
, MED SURG ATI ADVANCED FINAL EXAM /ATI MED
SURG ADVANCED FINAL PROCTORED 2023-2024
EXAM 350 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY GRADED
A+
a. Patient with serum potassium level of 5.0 mEq/L who is complaining of
abdominal cramping
b. Patient with serum sodium level of 145 mEq/L who has a dry mouth and
is askingfor a glass of water
c. Patient with serum magnesium level of 1.1 mEq/L who has tremors and
hyperactive deep tendon reflexes
d. Patient with serum phosphorus level of 4.5 mg/dL who has multiple soft
tissue calcium-phosphate precipitates - ANSWER--ANS: C
The low magnesium level and neuromuscular irritability suggest that the
patient may be at risk for seizures. The other patients have mild electrolyte
disturbances or symptoms that require action, but they are not at risk for
life-threatening complications.
An older adult patient who is malnourished presents to the emergency
department with a serum protein level of 5.2 g/dL. The nurse would expect
which clinical manifestation?
a. Pallor
b. Edema
c. Confusion
d. Restlessness - ANSWER--ANS: B
The normal range for total protein is 6.4 to 8.3 g/dL. Low serum protein
levels cause a decrease in plasma oncotic pressure and allow fluid to
remain in interstitial tissues, causing edema. Confusion, restlessness, and
pallor are not associated with low serum protein levels.
, MED SURG ATI ADVANCED FINAL EXAM /ATI MED
SURG ADVANCED FINAL PROCTORED 2023-2024
EXAM 350 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY GRADED
A+
A 38-year-old female is admitted for an elective surgical procedure. Which
information obtained by the nurse during the preoperative assessment is
most important to report to the anesthesiologist before surgery?
a. The patient's lack of knowledge about postoperative pain control
measures
b. The patient's statement that her last menstrual period was 8 weeks
previously
c. The patient's history of a postoperative infection following a prior
cholecystectomy
d. The patient's concern that she will be unable to care for her children
postoperatively - ANSWER--ANS: B
This statement suggests that the patient may be pregnant, and pregnancy
testing is needed before administration of anesthetic agents. Although the
other data may also be communicated with the surgeon and
anesthesiologist, they will affect postoperative care and do not indicate a
need for further assessment before surgery
The nurse is preparing to witness the patient signing the operative consent
form when the patient says, "I do not really understand what the doctor
said." Which action is best for the nurse to take?
a. Provide an explanation of the planned surgical procedure.
b. Notify the surgeon that the informed consent process is not complete.
c. Administer the prescribed preoperative antibiotics and withhold any
ordered sedative medications.
d. Notify the operating room staff that the surgeon needs to give a more
complete explanation of the procedure. - ANSWER--ANS: B
, MED SURG ATI ADVANCED FINAL EXAM /ATI MED
SURG ADVANCED FINAL PROCTORED 2023-2024
EXAM 350 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY GRADED
A+
The surgeon is responsible for explaining the surgery to the patient, and
the nurse should wait until the surgeon has clarified the surgery before
having the patient sign the consent form. The nurse should communicate
directly with the surgeon about the consent form rather than asking other
staff to pass on the message. It is not within the nurse's legal scope of
practice to explain the surgical procedure. No preoperative medications
should be administered until the patient understands the surgical procedure
and signs the consent form.
A patient who has diabetes and uses insulin to control blood glucose has
been NPO since midnight before having a knee replacement surgery.
Which action should the nurse take?
a. Withhold the usual scheduled insulin dose because the patient is NPO.
b. Obtain a blood glucose measurement before any insulin administration.
c. Give the patient the usual insulin dose because stress will increase the
blood glucose.
d. Administer a lower dose of insulin because there will be no oral intake
before surgery. - ANSWER--ANS: B
Preoperative insulin administration is individualized to the patient, and the
current blood glucose will provide the most reliable information about
insulin needs. It is not possible to predict whether the patient will require no
insulin, a lower dose, or a higher dose without blood glucose monitoring
The outpatient surgery nurse reviews the complete blood cell (CBC) count
results for a patient who is scheduled for surgery in a few days. The results
are white blood cell (WBC) count 10.2 ´ 103/µL; hemoglobin 15 g/dL;
hematocrit 45%; platelets 150 ´ 103/µL. Which action should the nurse
take?
