ATI MED SURG PROCTORED EXAM
2023 REAL EXAM QUESTIONS WITH
WELL DETAILED AND EXPLAINED
ANSWER KEY WITH RATIONALE.
BEST STUDY MATERIAL TO HELP
YOU PASS WITH A+ GRADE
1
,1. A nurse is caring for a client who has HIV. Which of the following
laboratory values is the nurse's priority?
A. Positive Western blot test
B. CD4-T-cell count 180 cells/mm3
C. Platelets 150,000/mm3
D. WBC 5,000/mm3
Rationale: A CD4-T-cell count of less than 180 cells/mm3 indicates that the client
is severely immunocompromised and is at high risk for infection. Therefore, this
value is the priority for the nurse to report to the provider.
2. A nurse is assessing a client who is admitted for elective surgery and has a
history of Addison's disease. Which of the following findings should the nurse
expect?
A. Hyperpigmentation
B. Intention tremors
C. Hirsutism
D. Purple striations
Rationale: Addison's disease is an endocrine disorder that occurs when the adrenal
glands do not produce enough of the hormone cortisol, and in some cases, the
hormone aldosterone. The disease is characterized by weight loss, muscle
weakness, fatigue, low blood pressure, and hyperpigmentation (darkening) of the
skin in both exposed and non-exposed parts of the body.
3. A nurse is caring for a client who is 1 day postoperative following a subtotal
thyroidectomy. The client reports a tingling sensation in the hands, the soles of
the feet, and around the lips. For which of the following findings should the
nurse assess the client?
2
,A. Chvostek's sign
B. Babinski's sign
C. Brudzinski's sign
D. Kernig's sign
Rationale: The nurse should suspect that the client has hypocalcemia, a possible
complication following subtotal thyroidectomy. Manifestations of hypocalcemia
include numbness and tingling in the hands, the soles of the feet, and around the
lips, typically appearing between 24 and 48 hr after surgery. To elicit Chvostek's
sign, the nurse should tap the client's face at a point just below and in front of the
ear. A positive response would be twitching of the ipsilateral (same side only)
facial muscles, suggesting neuromuscular excitability due to hypocalcemia.
4. A nurse is reviewing laboratory values for a client who has systemic lupus
erythematosus (SLE). Which of the following values should give the nurse the
best indication of the client's renal function?
A. Serum creatinine
B. Blood urea nitrogen (BUN)
C. Serum sodium
D. Urine-specific gravity
Rationale: A renal function disorder reduces the excretion of creatinine, resulting
in increased levels of blood creatinine. Creatinine is a specific and sensitive
indicator of renal function.
5. A nurse is assessing a client who has a long history of smoking and is
suspected of having laryngeal cancer. The nurse should anticipate that the
client will report that her earliest manifestation was
A. dysphagia.
B. hoarseness.
C. dyspnea.
D. weight loss.
3
, Rationale: Laryngeal cancer, a malignant tumor of the larynx, is most often caused
by long exposure to tobacco and alcohol. Hoarseness that does not resolve for
several weeks is the earliest manifestation of cancer of the larynx because the
tumor impedes the action of the vocal cords during speech. The voice may sound
harsh and lower in pitch than normal.
6. A nurse in a clinic is assessing a client who has AIDS and a significantly
decreased CD4-T-cell count. The nurse should recognize that the client is at
risk for developing which of the following infectious oral conditions?
A. Halitosis
B. Gingivitis
C. Xerostomia
D. Candidiasis
Rationale: Although oral candidiasis can affect anyone, it occurs most often in
infants, toddlers, older adults, and clients whose immune systems have been
compromised by illness, such as AIDS, or medications.
7. A nurse is reviewing the CBC findings for a female client who is receiving
combination chemotherapy for breast cancer. Which of the following findings
should the nurse report to the provider?
A. WBC 2300/mm3
B. RBC 5 million/mm3
C. Hemoglobin 12 g/dL
D. Platelets 155,000/mm3
Rationale: This WBC finding is below the expected reference range.
Chemotherapy treatment can cause leukopenia; the nurse should report this finding
to the provider and implement precautions to protect the client from infection.
8. A nurse is caring for a client who is 5 hr postoperative following a
transurethral resection of the prostate (TURP). The nurse notes that the
4
2023 REAL EXAM QUESTIONS WITH
WELL DETAILED AND EXPLAINED
ANSWER KEY WITH RATIONALE.
BEST STUDY MATERIAL TO HELP
YOU PASS WITH A+ GRADE
1
,1. A nurse is caring for a client who has HIV. Which of the following
laboratory values is the nurse's priority?
A. Positive Western blot test
B. CD4-T-cell count 180 cells/mm3
C. Platelets 150,000/mm3
D. WBC 5,000/mm3
Rationale: A CD4-T-cell count of less than 180 cells/mm3 indicates that the client
is severely immunocompromised and is at high risk for infection. Therefore, this
value is the priority for the nurse to report to the provider.
2. A nurse is assessing a client who is admitted for elective surgery and has a
history of Addison's disease. Which of the following findings should the nurse
expect?
A. Hyperpigmentation
B. Intention tremors
C. Hirsutism
D. Purple striations
Rationale: Addison's disease is an endocrine disorder that occurs when the adrenal
glands do not produce enough of the hormone cortisol, and in some cases, the
hormone aldosterone. The disease is characterized by weight loss, muscle
weakness, fatigue, low blood pressure, and hyperpigmentation (darkening) of the
skin in both exposed and non-exposed parts of the body.
3. A nurse is caring for a client who is 1 day postoperative following a subtotal
thyroidectomy. The client reports a tingling sensation in the hands, the soles of
the feet, and around the lips. For which of the following findings should the
nurse assess the client?
2
,A. Chvostek's sign
B. Babinski's sign
C. Brudzinski's sign
D. Kernig's sign
Rationale: The nurse should suspect that the client has hypocalcemia, a possible
complication following subtotal thyroidectomy. Manifestations of hypocalcemia
include numbness and tingling in the hands, the soles of the feet, and around the
lips, typically appearing between 24 and 48 hr after surgery. To elicit Chvostek's
sign, the nurse should tap the client's face at a point just below and in front of the
ear. A positive response would be twitching of the ipsilateral (same side only)
facial muscles, suggesting neuromuscular excitability due to hypocalcemia.
4. A nurse is reviewing laboratory values for a client who has systemic lupus
erythematosus (SLE). Which of the following values should give the nurse the
best indication of the client's renal function?
A. Serum creatinine
B. Blood urea nitrogen (BUN)
C. Serum sodium
D. Urine-specific gravity
Rationale: A renal function disorder reduces the excretion of creatinine, resulting
in increased levels of blood creatinine. Creatinine is a specific and sensitive
indicator of renal function.
5. A nurse is assessing a client who has a long history of smoking and is
suspected of having laryngeal cancer. The nurse should anticipate that the
client will report that her earliest manifestation was
A. dysphagia.
B. hoarseness.
C. dyspnea.
D. weight loss.
3
, Rationale: Laryngeal cancer, a malignant tumor of the larynx, is most often caused
by long exposure to tobacco and alcohol. Hoarseness that does not resolve for
several weeks is the earliest manifestation of cancer of the larynx because the
tumor impedes the action of the vocal cords during speech. The voice may sound
harsh and lower in pitch than normal.
6. A nurse in a clinic is assessing a client who has AIDS and a significantly
decreased CD4-T-cell count. The nurse should recognize that the client is at
risk for developing which of the following infectious oral conditions?
A. Halitosis
B. Gingivitis
C. Xerostomia
D. Candidiasis
Rationale: Although oral candidiasis can affect anyone, it occurs most often in
infants, toddlers, older adults, and clients whose immune systems have been
compromised by illness, such as AIDS, or medications.
7. A nurse is reviewing the CBC findings for a female client who is receiving
combination chemotherapy for breast cancer. Which of the following findings
should the nurse report to the provider?
A. WBC 2300/mm3
B. RBC 5 million/mm3
C. Hemoglobin 12 g/dL
D. Platelets 155,000/mm3
Rationale: This WBC finding is below the expected reference range.
Chemotherapy treatment can cause leukopenia; the nurse should report this finding
to the provider and implement precautions to protect the client from infection.
8. A nurse is caring for a client who is 5 hr postoperative following a
transurethral resection of the prostate (TURP). The nurse notes that the
4
