ATI MED-SURG PROCTORED EXAM 2019 (84QA)
WITH VERIFIED AND CORRECT ANSWERS AND
EXPLANATIONS
ATI MED-SURG PROCTORED EXAM 1
1. A nurse is reinforcing teaching with an older adult client who has
osteoporosis. Which of the following instructions should the nurse in the
teaching?
a) "Place throw rugs on wooden floors at home.
b) " b) "Supplement your diet with vitamin E."
c) "Swim laps for 20 minutes twice per week."
d) "Take calcium supplements with meals." (The nurse should instruct the
client to take calcium carbonate supplements with or following meals to
increase absorption and effectiveness.)
2. A nurse is reviewing the medication record of a client who is taking
digoxin. Which of the following medications should the nurse identify as
increasing the risk for the client to develop digoxin toxicity?
a) Potassium chloride
b) Famotidine
c) Levothyroxine
d) Furosemide (The nurse should identify that loop diuretics, such as
furosemide, increase the urinary excretion of potassium, which can lead to
hypokalemia. Hypokalemia increases the risk for the development of
digoxin toxicity.)
3. A nurse is reinforcing teaching about insulin injections with an adult
client who weighs 45.4 kg (100 lb.). Which of the following statements by
the client indicates an understanding of the teaching?
a) "I should insert the needle at a 90-degree angle.
b) "I should give my shot in my belly tissue." (Clients who have low body
weights can have very little subcutaneous tissue. Therefore, the nurse should
instruct the client to administer the medication in the upper abdomen for
proper absorption.)
c) "I will pull back on the syringe plunger to look for blood before I push the
medication in."
d) "I will use the side of my hand to pull my skin to the side prior to
administering the insulin."
4. A nurse is reinforcing discharge teaching for a client who had a
mechanical mitral valve replacement. Which of the following statements by
the client indicates an understanding of the teaching?
,a) "I will notify my dentist about this procedure." (The nurse should instruct
the client to notify his dentist about the mechanical mitral valve
replacement before any procedures so antibiotic therapy can be initiated to
reduce the risk of endocardial infection.)
b) "I will take an enteric-coated aspirin daily."
c) "I will use a firm-bristled toothbrush."
d) "I will weigh myself once a week."
5. A nurse is reviewing the medical record for an older adult client who is
experiencing nausea and vomiting. Based on the client data, which of the
following actions should the nurse take? (Click on the “Exhibit” button for
additional client information. There are three tabs that contain separate
categories of data.) View the Exhibit
Exhibit 1 Exhibit 2 Exhibit 3
Diagnosis Results Nurses’ Notes 1200: Graphic Record
Sodium 142 mEq/ Alert and oriented x3 Temperature 0800:
Potassium 4.2 mEq/L Lungs clear to 37.7° C (99.9° F) 1200:
BUN 36 mg/dL auscultation Decreased 37.2° C (99.0° F) Pulse
Creatinine 1.4 mg/dL skin turgor Dry mucous 0800: 96/min
membranes 1200:105/min
Respiratory rate 0800:
18/min 1200: 20/min
Blood pressure 0800;
118/62 mmHg 1200:
104/65 mm Hg
a) Encourage the client to ambulate.
b) Administer an antipyretic medication.
c) Notify the charge nurse of the client's BUN level (The client's BUN level
is above the expected reference range of 10 to 20 mg/dL, which indicates
dehydration and impaired renal function. The nurse should notify the
charge nurse of this finding and anticipate interventions to restore the
client's fluid volume.)
d) Keep the temperature in the client's room warm.
6. A nurse is providing information regarding transmission-based
precautions for a client who has Clostridium difficileto an assistive
personnel (AP). Which of the following instructions should the nurse
include? (Select all that apply).
a) "Provide the client with disposable utensils and dishes for meals."
(Clients who have C. difficile require contact precautions, which include
, using disposable utensils and dishes during meals to prevent exposure to
contaminants by others.)
b) "Leave blood pressure equipment in the client's room." (When using
contact precautions, the health care staff should dedicate equipment to
single-client use to prevent transmission of the pathogen.)
c) "Clean contaminated surfaces with a bleach solution." (The health care
staff should use a bleach solution to clean equipment to prevent
transmission of the pathogen.)
d) "Use an alcohol-based hand sanitizer after client care."
e) "Wear a face mask when in the client's room."
7. A nurse is admitting a client who is suspected having active tuberculosis
(TB). Which of the following actions should the nurse take first? (chap. 20)
a) Administer antituberculosis medication.
b) Institute airborne precautions. (The greatest risk from this client is
transmitting TB to staff and other clients. Therefore, the first action the
nurse should take is to implement airborne precautions.)
c) Obtain sputum cultures.
d) Auscultate breath sounds.
8. A nurse is caring for a client who is postoperative and has a Jackson-Pratt
drain. Which of the following actions should the nurse take?
a) Fill the bulb reservoir with 0.9% sodium chloride.
b) Allow the Jackson-Pratt drain to hang freely.
c) Cut a slit in a gauze sponge and apply it around the tubing insertion site.
d) Compress the bulb reservoir and then close the drainage valve. (The
nurse should fully compress the bulb reservoir and then replace the valve
plug using aseptic technique to establish suction after emptying or activating
a Jackson-Pratt drain.)
9. A nurse is reinforcing teaching with the parent of a toddler who has type I
diabetes mellitus and whose prescription has been changed from regular
insulin to lispro insulin. Which of the following information should the
nurse include in the teaching?
a) Lispro is given once a day.
b) Lispro should be given before eating. (Lispro insulin should be given
around mealtime, within 15 min before or after eating.)
c) Lispro cannot be given with other insulin.
d) Lispro does not cause hypoglycemia.
10. A nurse is reinforcing teaching with a client who has microcytic anemia
and is prescribed a daily iron supplement. The nurse tells the client to
consume foods containing vitamin C when taking the supplement to
WITH VERIFIED AND CORRECT ANSWERS AND
EXPLANATIONS
ATI MED-SURG PROCTORED EXAM 1
1. A nurse is reinforcing teaching with an older adult client who has
osteoporosis. Which of the following instructions should the nurse in the
teaching?
a) "Place throw rugs on wooden floors at home.
b) " b) "Supplement your diet with vitamin E."
c) "Swim laps for 20 minutes twice per week."
d) "Take calcium supplements with meals." (The nurse should instruct the
client to take calcium carbonate supplements with or following meals to
increase absorption and effectiveness.)
2. A nurse is reviewing the medication record of a client who is taking
digoxin. Which of the following medications should the nurse identify as
increasing the risk for the client to develop digoxin toxicity?
a) Potassium chloride
b) Famotidine
c) Levothyroxine
d) Furosemide (The nurse should identify that loop diuretics, such as
furosemide, increase the urinary excretion of potassium, which can lead to
hypokalemia. Hypokalemia increases the risk for the development of
digoxin toxicity.)
3. A nurse is reinforcing teaching about insulin injections with an adult
client who weighs 45.4 kg (100 lb.). Which of the following statements by
the client indicates an understanding of the teaching?
a) "I should insert the needle at a 90-degree angle.
b) "I should give my shot in my belly tissue." (Clients who have low body
weights can have very little subcutaneous tissue. Therefore, the nurse should
instruct the client to administer the medication in the upper abdomen for
proper absorption.)
c) "I will pull back on the syringe plunger to look for blood before I push the
medication in."
d) "I will use the side of my hand to pull my skin to the side prior to
administering the insulin."
4. A nurse is reinforcing discharge teaching for a client who had a
mechanical mitral valve replacement. Which of the following statements by
the client indicates an understanding of the teaching?
,a) "I will notify my dentist about this procedure." (The nurse should instruct
the client to notify his dentist about the mechanical mitral valve
replacement before any procedures so antibiotic therapy can be initiated to
reduce the risk of endocardial infection.)
b) "I will take an enteric-coated aspirin daily."
c) "I will use a firm-bristled toothbrush."
d) "I will weigh myself once a week."
5. A nurse is reviewing the medical record for an older adult client who is
experiencing nausea and vomiting. Based on the client data, which of the
following actions should the nurse take? (Click on the “Exhibit” button for
additional client information. There are three tabs that contain separate
categories of data.) View the Exhibit
Exhibit 1 Exhibit 2 Exhibit 3
Diagnosis Results Nurses’ Notes 1200: Graphic Record
Sodium 142 mEq/ Alert and oriented x3 Temperature 0800:
Potassium 4.2 mEq/L Lungs clear to 37.7° C (99.9° F) 1200:
BUN 36 mg/dL auscultation Decreased 37.2° C (99.0° F) Pulse
Creatinine 1.4 mg/dL skin turgor Dry mucous 0800: 96/min
membranes 1200:105/min
Respiratory rate 0800:
18/min 1200: 20/min
Blood pressure 0800;
118/62 mmHg 1200:
104/65 mm Hg
a) Encourage the client to ambulate.
b) Administer an antipyretic medication.
c) Notify the charge nurse of the client's BUN level (The client's BUN level
is above the expected reference range of 10 to 20 mg/dL, which indicates
dehydration and impaired renal function. The nurse should notify the
charge nurse of this finding and anticipate interventions to restore the
client's fluid volume.)
d) Keep the temperature in the client's room warm.
6. A nurse is providing information regarding transmission-based
precautions for a client who has Clostridium difficileto an assistive
personnel (AP). Which of the following instructions should the nurse
include? (Select all that apply).
a) "Provide the client with disposable utensils and dishes for meals."
(Clients who have C. difficile require contact precautions, which include
, using disposable utensils and dishes during meals to prevent exposure to
contaminants by others.)
b) "Leave blood pressure equipment in the client's room." (When using
contact precautions, the health care staff should dedicate equipment to
single-client use to prevent transmission of the pathogen.)
c) "Clean contaminated surfaces with a bleach solution." (The health care
staff should use a bleach solution to clean equipment to prevent
transmission of the pathogen.)
d) "Use an alcohol-based hand sanitizer after client care."
e) "Wear a face mask when in the client's room."
7. A nurse is admitting a client who is suspected having active tuberculosis
(TB). Which of the following actions should the nurse take first? (chap. 20)
a) Administer antituberculosis medication.
b) Institute airborne precautions. (The greatest risk from this client is
transmitting TB to staff and other clients. Therefore, the first action the
nurse should take is to implement airborne precautions.)
c) Obtain sputum cultures.
d) Auscultate breath sounds.
8. A nurse is caring for a client who is postoperative and has a Jackson-Pratt
drain. Which of the following actions should the nurse take?
a) Fill the bulb reservoir with 0.9% sodium chloride.
b) Allow the Jackson-Pratt drain to hang freely.
c) Cut a slit in a gauze sponge and apply it around the tubing insertion site.
d) Compress the bulb reservoir and then close the drainage valve. (The
nurse should fully compress the bulb reservoir and then replace the valve
plug using aseptic technique to establish suction after emptying or activating
a Jackson-Pratt drain.)
9. A nurse is reinforcing teaching with the parent of a toddler who has type I
diabetes mellitus and whose prescription has been changed from regular
insulin to lispro insulin. Which of the following information should the
nurse include in the teaching?
a) Lispro is given once a day.
b) Lispro should be given before eating. (Lispro insulin should be given
around mealtime, within 15 min before or after eating.)
c) Lispro cannot be given with other insulin.
d) Lispro does not cause hypoglycemia.
10. A nurse is reinforcing teaching with a client who has microcytic anemia
and is prescribed a daily iron supplement. The nurse tells the client to
consume foods containing vitamin C when taking the supplement to
