ATI Medical-Surgical Proctored Exam 2025 (Full
NGN Upgrade Pack) – Form A/B/C | 180
Questions with Rationales | Graded A+
1. A nurse is caring for a client who has chronic kidney disease and is
scheduled for hemodialysis. Which laboratory value should the nurse
expect to be decreased as a result of the dialysis treatment?
A. Hemoglobin
B. Potassium
C. Creatinine
D. Calcium
Correct Answer: C. Creatinine
Rationale: Hemodialysis removes waste products like creatinine from
the blood, decreasing its serum level. Potassium may also decrease, but
creatinine is the most direct indicator of kidney function and dialysis
clearance. Hemoglobin and calcium are not directly removed during
dialysis.
,2. A nurse is assessing a client who has a new prescription for
furosemide for heart failure. Which of the following is the priority
assessment?
A. Bowel sounds
B. Serum potassium
C. Pupillary reaction
D. Skin turgor
Correct Answer: B. Serum potassium
Rationale: Furosemide (a loop diuretic) causes potassium loss, placing
the client at risk for hypokalemia, which can lead to dysrhythmias.
Monitoring potassium is the priority.
3. A nurse is providing discharge teaching to a client who has a new
prescription for warfarin. Which statement by the client indicates a need
for further teaching?
A. "I will use an electric razor when shaving."
B. "I can eat green leafy vegetables as long as I do it consistently."
C. "I will take aspirin for mild headaches."
D. "I will notify my provider if I develop bruising."
Correct Answer: C. "I will take aspirin for mild headaches."
Rationale: Aspirin increases bleeding risk and should be avoided in
clients taking warfarin. The client needs further education on drug
interactions.
4. A nurse is caring for a client who has pneumonia and is receiving
oxygen therapy. Which assessment finding requires immediate
intervention?
,A. Respiratory rate of 28/min
B. Cough productive of yellow sputum
C. Crackles in bilateral lung bases
D. Temperature of 38.5°C (101.3°F)
Correct Answer: A. Respiratory rate of 28/min
Rationale: A respiratory rate above 24/min indicates respiratory distress
or worsening oxygenation and needs prompt intervention. The other
findings are expected in pneumonia.
5. A nurse is caring for a client who has a chest tube. Which of the
following findings should the nurse report to the provider?
A. Gentle bubbling in the suction control chamber
B. Fluctuation of fluid in the water seal chamber with respiration
C. Continuous bubbling in the water seal chamber
D. Drainage of 70 mL over the past hour
Correct Answer: C. Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber suggests an
air leak in the system, which requires provider notification.
6. A nurse is assessing a client who has acute pancreatitis. Which of the
following lab findings should the nurse expect?
A. Decreased amylase
B. Decreased lipase
C. Elevated serum lipase
D. Elevated blood glucose
, Correct Answer: C. Elevated serum lipase
Rationale: Lipase is a key pancreatic enzyme that becomes elevated in
pancreatitis. While glucose can rise, lipase is more diagnostic.
7. A nurse is caring for a client who has liver cirrhosis with ascites.
Which intervention is appropriate?
A. Measure abdominal girth daily
B. Encourage increased sodium intake
C. Limit fluid intake to 3 liters/day
D. Provide high-protein meals
Correct Answer: A. Measure abdominal girth daily
Rationale: Measuring abdominal girth helps monitor fluid accumulation
due to ascites. Sodium and fluids are usually restricted, and protein
intake is moderated.
8. A client is admitted with a diagnosis of myasthenia gravis. Which
finding should the nurse expect?
A. Bradycardia
B. Hyperreflexia
C. Muscle weakness that improves with rest
D. Cogwheel rigidity
Correct Answer: C. Muscle weakness that improves with rest
Rationale: Myasthenia gravis is characterized by fatigable muscle
weakness that improves with rest and worsens with activity.
NGN Upgrade Pack) – Form A/B/C | 180
Questions with Rationales | Graded A+
1. A nurse is caring for a client who has chronic kidney disease and is
scheduled for hemodialysis. Which laboratory value should the nurse
expect to be decreased as a result of the dialysis treatment?
A. Hemoglobin
B. Potassium
C. Creatinine
D. Calcium
Correct Answer: C. Creatinine
Rationale: Hemodialysis removes waste products like creatinine from
the blood, decreasing its serum level. Potassium may also decrease, but
creatinine is the most direct indicator of kidney function and dialysis
clearance. Hemoglobin and calcium are not directly removed during
dialysis.
,2. A nurse is assessing a client who has a new prescription for
furosemide for heart failure. Which of the following is the priority
assessment?
A. Bowel sounds
B. Serum potassium
C. Pupillary reaction
D. Skin turgor
Correct Answer: B. Serum potassium
Rationale: Furosemide (a loop diuretic) causes potassium loss, placing
the client at risk for hypokalemia, which can lead to dysrhythmias.
Monitoring potassium is the priority.
3. A nurse is providing discharge teaching to a client who has a new
prescription for warfarin. Which statement by the client indicates a need
for further teaching?
A. "I will use an electric razor when shaving."
B. "I can eat green leafy vegetables as long as I do it consistently."
C. "I will take aspirin for mild headaches."
D. "I will notify my provider if I develop bruising."
Correct Answer: C. "I will take aspirin for mild headaches."
Rationale: Aspirin increases bleeding risk and should be avoided in
clients taking warfarin. The client needs further education on drug
interactions.
4. A nurse is caring for a client who has pneumonia and is receiving
oxygen therapy. Which assessment finding requires immediate
intervention?
,A. Respiratory rate of 28/min
B. Cough productive of yellow sputum
C. Crackles in bilateral lung bases
D. Temperature of 38.5°C (101.3°F)
Correct Answer: A. Respiratory rate of 28/min
Rationale: A respiratory rate above 24/min indicates respiratory distress
or worsening oxygenation and needs prompt intervention. The other
findings are expected in pneumonia.
5. A nurse is caring for a client who has a chest tube. Which of the
following findings should the nurse report to the provider?
A. Gentle bubbling in the suction control chamber
B. Fluctuation of fluid in the water seal chamber with respiration
C. Continuous bubbling in the water seal chamber
D. Drainage of 70 mL over the past hour
Correct Answer: C. Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber suggests an
air leak in the system, which requires provider notification.
6. A nurse is assessing a client who has acute pancreatitis. Which of the
following lab findings should the nurse expect?
A. Decreased amylase
B. Decreased lipase
C. Elevated serum lipase
D. Elevated blood glucose
, Correct Answer: C. Elevated serum lipase
Rationale: Lipase is a key pancreatic enzyme that becomes elevated in
pancreatitis. While glucose can rise, lipase is more diagnostic.
7. A nurse is caring for a client who has liver cirrhosis with ascites.
Which intervention is appropriate?
A. Measure abdominal girth daily
B. Encourage increased sodium intake
C. Limit fluid intake to 3 liters/day
D. Provide high-protein meals
Correct Answer: A. Measure abdominal girth daily
Rationale: Measuring abdominal girth helps monitor fluid accumulation
due to ascites. Sodium and fluids are usually restricted, and protein
intake is moderated.
8. A client is admitted with a diagnosis of myasthenia gravis. Which
finding should the nurse expect?
A. Bradycardia
B. Hyperreflexia
C. Muscle weakness that improves with rest
D. Cogwheel rigidity
Correct Answer: C. Muscle weakness that improves with rest
Rationale: Myasthenia gravis is characterized by fatigable muscle
weakness that improves with rest and worsens with activity.
