ATI Adult Medical Surgical Nursing Content Mastery Series (CMS
p p p p p p p p
) Exams STUDY GUIDE ACTUAL EXAM
p p p p p
Apclientphaspbeenpadmittedptopthepintensivepcarepunitpwithpworseningppul
monarypmanifestationspofpheartpfailure.pWhatpispthepnurse'spbestpaction?
A) Administerplooppdiureticspaspprescribed.
B) Beginpcardiopulmonarypresuscitationp(CPR).
C) Promoteprestpandpminimizepactivities.
D) PlacepthepclientpinpaphighpFowler'spposition.p-pCORRECTp ANSWER A
Thepclientpwithpworseningpheartpfailurepispmostpatpriskpforppulmonaryped
emapaspapconsequencepofpfluidpretention.pAdministeringpdiureticspwillpd
ecreasepthepfluidpoverload,ptherebypdecreasingpthepincidencepofppulmon
arypedema.pHighpFowler'sppositionpmightphelppthepclientpbreathepeasierpb
utpwillpnotpsolvepthepproblem.pCPRpispnotpwarrantedpinpthispsituation.pRes
tpispimportantpforpclientspwithpheartpfailure,pbutpthispispnotptheppriority.
Whatpinformationpaboutpnutritionpdoespthepnursepteachpapclientpwithpchr
onicpobstructiveppulmonarypdiseasep(COPD)?p(Selectpallpthatpapply.)
A) "Eatpdrypfoodspratherpthanpwetpfoods,pwhichparepheavier."
B) "Increasepcarbohydratepintakepforpenergy."
C) "Havepaboutpsixpsmallpmealspapday."
D) "Practicepdiaphragmaticpbreathingpagainstpresistancepfourptimesp
daily."
E) "Avoidpdrinkingpfluidspjustpbeforepandpduringpmeals."
F) "Eatphigh-fiberpfoodsptoppromotepgastricpemptying."
G) "Restpbeforepmealspifpyouphavepdyspnea."p-pCORRECTp ANSWER
C,pE,pG
Fluidspcanpmakepapclientpfeelpbloatedpandpshouldpbepavoidedpwithpmeals.
pRestingpbeforepthepmealpwillphelppapclientpwithpdyspnea.pSixpsmallpmeals
papdaypalsopwillphelpptopdecreasepbloating.pDrypfoodspcanpcausepcoughing
.pFibrouspfoodspcanpproducepgas,pwhichpcanpcause
,abdominalpbloatingpandpcanpincreasepshortnesspofpbreath.pDiaphragmati
cpbreathingpwillpnotpnecessarilyphelppnutrition.
Whichppersonpispatpgreatestpriskpforpdevelopingpapcommunity-
acquiredppneumonia?
A) Youngpadultpaerobicspinstructorpwhopispapvegetarian
B) Middle-agedpteacherpwhoptypicallypeatspapdietpofpAsianpfoods
C) Olderpadultpwhopsmokespandphaspapsubstancepabusepproblem
D) Olderpadultpwithpexercise-inducedpwheezingp-pCORRECTp ANSWER
C
Althoughpagepispapfactorpinpthepdevelopmentpofpcommunity-
acquiredppneumonia,potherplifestylepandpexposurepfactorspincreasepthepr
iskptopapgreaterpextentpthanpage.pTwopconditionspthatpheavilyppredispose
ptopthepdevelopmentpofppneumoniaparepcigarettepsmokingpandpalcoholis
m.
Dietarypchoicesptypicallypdopnotppredisposeptopthepdevelopmentpofppneu
monia.pCigarettepsmokingpinterferespwithpthepciliarypfunctionpofpremoval
pofpinvasivepmaterials.pAlcoholismpusuallypresultspinpunbalancedpnutritio
n,paspwellpaspdecreasedpimmunepfunction.pApmiddle-
pagedpadult,panpolderpadultpwithpwheezingpinducedpbypexercise,pandpapyo
ungpadultpvegetarianpwouldpnotpbepatpriskpforpcommunity-
acquiredppneumoniapbecauseptheyphavepnoppredisposingpconditions.
Inporderptopprovidepthepbestpinterventionpforpappatient,pthepnursepispofte
npresponsiblepforpobtainingpapsamplepofpexudatepforpculture.pThisptestpwi
llpidentify:
A) whatpcellsparepbeingputilizedpbypthepbodyptopattackpanpinfection.
B) whetherpappatientphaspanpinfection.
C) wherepanpinfectionpisplocated.
D) whatpspecificptypepofppathogenpispcausingpanpinfection.p-
pCORRECTpANSWER D
Peoplepcanptransmitppathogenspevenpifptheypdon'tpcurrentlypfeelpill.pSome
pcarrierspneverpexperiencepthepfullpsymptomspofpappathogen.pApCBCpwillpi
dentifypthatptheppatientphaspanpinfection.pInspectionpandpradiographypwil
lphelppidentifypwherepanpinfectionpisplocated.pThepCBC
,withpdifferentialpwillpidentifypthepwhitepbloodpcellspbeingpusedpbypthepbod
yptopfightpanpinfection.pThepculturepwillpgrowpthepmicroorganismspinptheps
amplepforpidentificationpofpthepspecificptypepofppathogen.
Thepnursepispcaringpforpapclientpwhopispexperiencingpexcessivepbleedingp
afterpreceivingpunfractionatedpheparin.pWhatporderspdoespthepnursepanti
cipatepfrompthephealthpcarepprovider?p(Selectpallpthatpapply.)
A) Laboratorypdrawpforpprothrombinptimep(PT)/internationalpnormalizedp
ratiop(INR)
B) Laboratorypdrawpforpactivatedppartialpthromboplastinptimep(aPTT)
C) Administerpenoxaparinp(Lovenox)
D) Administerpprotaminepsulfate
E) AdministerpvitaminpKp-pCORRECTp ANSWER B,D
Protaminepsulfatepispthepantidotepforpheparin-
inducedpbleeding.pVitaminpKpispthepantidotepforpwarfarin.pWarfarinp(Coum
adin)pwouldpincreasepbleeding.pEnoxaparinpispanotherpnamepforpheparin.
Apclientpwithpheartpfailurepispprescribedpenalaprilp(Vasotec).pWhatpispthep
nurse'spprioritypteachingpforpthispclient?
A) "Avoidpusingpaspirin-containingpproducts."
B) "Takepyourpmedicationpwithpfood."
C) "Checkpyourppulsepdaily."
D) "Avoidpusingpsaltpsubstitutes."p-pCORRECTp ANSWER D
Angiotensin-
convertingpenzymep(ACE)pinhibitorspinhibitpthepexcretionpofppotassium.pH
yperkalemiapcanpbepaplife-
threateningpsidepeffect,pandpclientspshouldpbeptaughtptoplimitppotassiump
intake.pSaltpsubstitutesparepcomposedpofppotassiumpchloride.
Thepnursepispassessingpapclientpwhopreportspclaudicationpafterpwalkingpa
pdistancepofponepblock.pThepnursepnotespappainfulpulcerponpthepfourthptoep
ofpthepclient'sprightpfoot.pWhatpconditionpdopthesepfindingspcorrelatepwith
?
A) Peripheralparterialpdisease
, B) Deeppveinpthrombosis
C) Diabeticpfootpulceration
D) Peripheralpvenouspdiseasep-pCORRECTp ANSWER A
Arterialpdiseasepispcharacterizedpbypclaudicationpafterpwalkingpshortpdis
tances.pUlcerationspcausedpbypperipheralparterialpdiseasepareppainfulpa
ndpinitiallypareplocatedpatpthepmostpdistalppointsponpthepextremity.pDiabe
ticpulcerspandpvenouspulcersparepseldomppainfulpandpusuallyptendptopocc
urpwhereppressurepispapplied.
Followingpsurgery,pMariopcomplainspofpmildpincisionalppainpwhilepperfor
mingpdeep-
pbreathingpandpcoughingpexercises.pThepnurse'spbestpresponsepwouldpbe:
A. "Painpwillpbecomeplesspeachpday."
B. "Thispispapnormalpreactionpafterpsurgery."
C. "Withpappillow,papplyppressurepagainstpthepincision."
D. "Ipwillpgivepyouptheppainpmedicationpthepphysicianpordered."p-
pCORRECTp ANSWER
Answer:p(C)p"Withpappillow,papplyppressurepagainstpthepincision
."
Applyingppressurepagainstpthepincisionpwithpappillowpwillphelpplessenpthe
pintra-
abdominalppressurepcreatedpbypcoughingpwhichpcausesptensionponpthepi
ncisionpthatpleadsptoppain.
Thepnursepneedsptopcarefullypassesspthepcomplaintpofppainpofpthepelderly
pbecausepolderppeople
A. arepexpectedptopexperiencepchronicppain
B. havepapdecreasedppainpthreshold
C. experiencepreducedpsensorypperception
D. havepalteredpmentalpfunctionp-pCORRECTp ANSWER
Answer:p(C)pexperiencepreducedpsensorypperception
Degenerativepchangespoccurpinpthepelderly.pThepresponseptoppainpinpthep
elderlypmaybeplessenedpbecausepofpreducedpacuitypofptouch,palterations
pinpneuralppathwayspandpdiminishedpprocessingpofpsensorypdata.
MarypreceivedpAtropineSO4paspappre-
medicationp30pminutespagopandpispnowpcomplainingpofpdrypmouthpandpher
pPRpisphigher,pthanpbeforepthepmedicationpwaspadministered.pThepnurse's
pbest
p p p p p p p p
) Exams STUDY GUIDE ACTUAL EXAM
p p p p p
Apclientphaspbeenpadmittedptopthepintensivepcarepunitpwithpworseningppul
monarypmanifestationspofpheartpfailure.pWhatpispthepnurse'spbestpaction?
A) Administerplooppdiureticspaspprescribed.
B) Beginpcardiopulmonarypresuscitationp(CPR).
C) Promoteprestpandpminimizepactivities.
D) PlacepthepclientpinpaphighpFowler'spposition.p-pCORRECTp ANSWER A
Thepclientpwithpworseningpheartpfailurepispmostpatpriskpforppulmonaryped
emapaspapconsequencepofpfluidpretention.pAdministeringpdiureticspwillpd
ecreasepthepfluidpoverload,ptherebypdecreasingpthepincidencepofppulmon
arypedema.pHighpFowler'sppositionpmightphelppthepclientpbreathepeasierpb
utpwillpnotpsolvepthepproblem.pCPRpispnotpwarrantedpinpthispsituation.pRes
tpispimportantpforpclientspwithpheartpfailure,pbutpthispispnotptheppriority.
Whatpinformationpaboutpnutritionpdoespthepnursepteachpapclientpwithpchr
onicpobstructiveppulmonarypdiseasep(COPD)?p(Selectpallpthatpapply.)
A) "Eatpdrypfoodspratherpthanpwetpfoods,pwhichparepheavier."
B) "Increasepcarbohydratepintakepforpenergy."
C) "Havepaboutpsixpsmallpmealspapday."
D) "Practicepdiaphragmaticpbreathingpagainstpresistancepfourptimesp
daily."
E) "Avoidpdrinkingpfluidspjustpbeforepandpduringpmeals."
F) "Eatphigh-fiberpfoodsptoppromotepgastricpemptying."
G) "Restpbeforepmealspifpyouphavepdyspnea."p-pCORRECTp ANSWER
C,pE,pG
Fluidspcanpmakepapclientpfeelpbloatedpandpshouldpbepavoidedpwithpmeals.
pRestingpbeforepthepmealpwillphelppapclientpwithpdyspnea.pSixpsmallpmeals
papdaypalsopwillphelpptopdecreasepbloating.pDrypfoodspcanpcausepcoughing
.pFibrouspfoodspcanpproducepgas,pwhichpcanpcause
,abdominalpbloatingpandpcanpincreasepshortnesspofpbreath.pDiaphragmati
cpbreathingpwillpnotpnecessarilyphelppnutrition.
Whichppersonpispatpgreatestpriskpforpdevelopingpapcommunity-
acquiredppneumonia?
A) Youngpadultpaerobicspinstructorpwhopispapvegetarian
B) Middle-agedpteacherpwhoptypicallypeatspapdietpofpAsianpfoods
C) Olderpadultpwhopsmokespandphaspapsubstancepabusepproblem
D) Olderpadultpwithpexercise-inducedpwheezingp-pCORRECTp ANSWER
C
Althoughpagepispapfactorpinpthepdevelopmentpofpcommunity-
acquiredppneumonia,potherplifestylepandpexposurepfactorspincreasepthepr
iskptopapgreaterpextentpthanpage.pTwopconditionspthatpheavilyppredispose
ptopthepdevelopmentpofppneumoniaparepcigarettepsmokingpandpalcoholis
m.
Dietarypchoicesptypicallypdopnotppredisposeptopthepdevelopmentpofppneu
monia.pCigarettepsmokingpinterferespwithpthepciliarypfunctionpofpremoval
pofpinvasivepmaterials.pAlcoholismpusuallypresultspinpunbalancedpnutritio
n,paspwellpaspdecreasedpimmunepfunction.pApmiddle-
pagedpadult,panpolderpadultpwithpwheezingpinducedpbypexercise,pandpapyo
ungpadultpvegetarianpwouldpnotpbepatpriskpforpcommunity-
acquiredppneumoniapbecauseptheyphavepnoppredisposingpconditions.
Inporderptopprovidepthepbestpinterventionpforpappatient,pthepnursepispofte
npresponsiblepforpobtainingpapsamplepofpexudatepforpculture.pThisptestpwi
llpidentify:
A) whatpcellsparepbeingputilizedpbypthepbodyptopattackpanpinfection.
B) whetherpappatientphaspanpinfection.
C) wherepanpinfectionpisplocated.
D) whatpspecificptypepofppathogenpispcausingpanpinfection.p-
pCORRECTpANSWER D
Peoplepcanptransmitppathogenspevenpifptheypdon'tpcurrentlypfeelpill.pSome
pcarrierspneverpexperiencepthepfullpsymptomspofpappathogen.pApCBCpwillpi
dentifypthatptheppatientphaspanpinfection.pInspectionpandpradiographypwil
lphelppidentifypwherepanpinfectionpisplocated.pThepCBC
,withpdifferentialpwillpidentifypthepwhitepbloodpcellspbeingpusedpbypthepbod
yptopfightpanpinfection.pThepculturepwillpgrowpthepmicroorganismspinptheps
amplepforpidentificationpofpthepspecificptypepofppathogen.
Thepnursepispcaringpforpapclientpwhopispexperiencingpexcessivepbleedingp
afterpreceivingpunfractionatedpheparin.pWhatporderspdoespthepnursepanti
cipatepfrompthephealthpcarepprovider?p(Selectpallpthatpapply.)
A) Laboratorypdrawpforpprothrombinptimep(PT)/internationalpnormalizedp
ratiop(INR)
B) Laboratorypdrawpforpactivatedppartialpthromboplastinptimep(aPTT)
C) Administerpenoxaparinp(Lovenox)
D) Administerpprotaminepsulfate
E) AdministerpvitaminpKp-pCORRECTp ANSWER B,D
Protaminepsulfatepispthepantidotepforpheparin-
inducedpbleeding.pVitaminpKpispthepantidotepforpwarfarin.pWarfarinp(Coum
adin)pwouldpincreasepbleeding.pEnoxaparinpispanotherpnamepforpheparin.
Apclientpwithpheartpfailurepispprescribedpenalaprilp(Vasotec).pWhatpispthep
nurse'spprioritypteachingpforpthispclient?
A) "Avoidpusingpaspirin-containingpproducts."
B) "Takepyourpmedicationpwithpfood."
C) "Checkpyourppulsepdaily."
D) "Avoidpusingpsaltpsubstitutes."p-pCORRECTp ANSWER D
Angiotensin-
convertingpenzymep(ACE)pinhibitorspinhibitpthepexcretionpofppotassium.pH
yperkalemiapcanpbepaplife-
threateningpsidepeffect,pandpclientspshouldpbeptaughtptoplimitppotassiump
intake.pSaltpsubstitutesparepcomposedpofppotassiumpchloride.
Thepnursepispassessingpapclientpwhopreportspclaudicationpafterpwalkingpa
pdistancepofponepblock.pThepnursepnotespappainfulpulcerponpthepfourthptoep
ofpthepclient'sprightpfoot.pWhatpconditionpdopthesepfindingspcorrelatepwith
?
A) Peripheralparterialpdisease
, B) Deeppveinpthrombosis
C) Diabeticpfootpulceration
D) Peripheralpvenouspdiseasep-pCORRECTp ANSWER A
Arterialpdiseasepispcharacterizedpbypclaudicationpafterpwalkingpshortpdis
tances.pUlcerationspcausedpbypperipheralparterialpdiseasepareppainfulpa
ndpinitiallypareplocatedpatpthepmostpdistalppointsponpthepextremity.pDiabe
ticpulcerspandpvenouspulcersparepseldomppainfulpandpusuallyptendptopocc
urpwhereppressurepispapplied.
Followingpsurgery,pMariopcomplainspofpmildpincisionalppainpwhilepperfor
mingpdeep-
pbreathingpandpcoughingpexercises.pThepnurse'spbestpresponsepwouldpbe:
A. "Painpwillpbecomeplesspeachpday."
B. "Thispispapnormalpreactionpafterpsurgery."
C. "Withpappillow,papplyppressurepagainstpthepincision."
D. "Ipwillpgivepyouptheppainpmedicationpthepphysicianpordered."p-
pCORRECTp ANSWER
Answer:p(C)p"Withpappillow,papplyppressurepagainstpthepincision
."
Applyingppressurepagainstpthepincisionpwithpappillowpwillphelpplessenpthe
pintra-
abdominalppressurepcreatedpbypcoughingpwhichpcausesptensionponpthepi
ncisionpthatpleadsptoppain.
Thepnursepneedsptopcarefullypassesspthepcomplaintpofppainpofpthepelderly
pbecausepolderppeople
A. arepexpectedptopexperiencepchronicppain
B. havepapdecreasedppainpthreshold
C. experiencepreducedpsensorypperception
D. havepalteredpmentalpfunctionp-pCORRECTp ANSWER
Answer:p(C)pexperiencepreducedpsensorypperception
Degenerativepchangespoccurpinpthepelderly.pThepresponseptoppainpinpthep
elderlypmaybeplessenedpbecausepofpreducedpacuitypofptouch,palterations
pinpneuralppathwayspandpdiminishedpprocessingpofpsensorypdata.
MarypreceivedpAtropineSO4paspappre-
medicationp30pminutespagopandpispnowpcomplainingpofpdrypmouthpandpher
pPRpisphigher,pthanpbeforepthepmedicationpwaspadministered.pThepnurse's
pbest
