1 of 101
ATI MED-SURG TEST BANKS LATERST VERSION
2025/2026 NGN 500 QUESTIONS INCLUDED
WITH RATIONALE/A+ GRADE
1. When planning appropriate nursing interventions for a patient with metastatic lung
cancer and a 60-pack-year history of cigarette smoking, the nurse recognizes that
the smoking has most likely decreased the patient's underlying respiratory defenses
because of impairment of which of the following? A. Reflex bronchoconstriction B.
Ability to filter particles from the air C. Cough reflex D. Mucociliary clearance -
ANSWER - D. Mucociliary clearance Smoking decreases the ciliary action in the
tracheobronchial tree, resulting in impaired clearance of respiratory secretions,
chronic cough, and frequent respiratory infections.
2. When reviewing the results of a 83-year-old patient's blood tests, which of the
following findings would be of most concern to the nurse? A. Platelets of 150,000/µl
B. Serum iron of 50 mcg/dl C. Partial thromboplastin time (PTT) of 60 seconds D.
Erythrocyte sedimentation rate (ESR) of 35 mm in 1 hour - ANSWER - C. Partial
thromboplastin time (PTT) of 60 seconds In aging, the partial thromboplastin time
(PTT) is normally decreased, so an abnormally high PTT of 60 seconds is an
indication that bleeding could readily occur. Platelets are unaffected by aging, and
150,000 is a normal count. Serum iron levels are decreased, and the erythrocyte
sedimentation rate (ESR) is significantly increased with aging, as are reflected in
these values.
3. If a patient with blood type O Rh- is given AB Rh- blood, the nurse would expect A.
the patient's Rh factor to react with the RBCs of the donor blood. B. no adverse
reaction because the patient has no antibodies against the donor blood. C. the anti-
A and anti-B antibodies in the patient's blood to hemolyze the donor blood. D. the
anti-A and anti-B antibodies in the donor blood to hemolyze the patient's blood. -
ANSWER - C. the anti-A and anti-B antibodies in the patient's blood to hemolyze the
donor blood. A patient with O Rh+ blood has no A or B antigens on the red cell but
does have anti-A and anti-B antibodies in the blood and has an Rh antigen. AB Rh-
blood has both A and B antigens on the red cell but no Rh antigen and no anti-A or
anti-B antibodies. If the AB Rh- blood is given to the patient with O Rh+ blood, the
antibodies in the patient's blood will react with the antigens in the donor blood,
causing hemolysis of the donor cells. There will be no Rh reaction because the
donor blood has no Rh antigen.
,2 of 101
4. To ensure the correct amount of oxygen delivery for a patient receiving 35% oxygen
via a Venturi mask, it is most important that the nurse A. keep the air-entrainment
ports clean and unobstructed. B. apply an adaptor to increase humidification of the
oxygen. C. drain moisture condensation from the oxygen tubing every hour. D. keep
the flow rate high enough to keep the bag from collapsing during inspiration. -
ANSWER - A. keep the air-entrainment ports clean and unobstructed. Oxygen is
delivered to a small jet in the center of a wide-based cone. Air is entrained (pulled
through) openings in the cone as oxygen flows through the small jet. The degree of
restriction or narrowness of the jet determines the amount of entrainment and the
dilution of pure oxygen with room air and thus the concentration of oxygen.
Although applying an adaptor can increase the humidification with the Venturi
mask, it is not the best answer, because an open port is essential to proper
functioning. Draining moisture condensation from the oxygen tubing is performed
as often as needed, not on an hourly schedule. A plastic face mask with a reservoir
bag needs to have sufficient flow rate to keep the bag inflated.
5. While ambulating a patient with metastatic lung cancer, the nurse observes a drop
in oxygen saturation from 93% to 86%. Which of the following nursing interventions
is most appropriate based upon these findings? A. Continue with ambulation as this
is a normal response to activity. B. Move the oximetry probe from the finger to the
earlobe for more accurate monitoring during activity. C. Obtain a physician's order
for supplemental oxygen to be used during ambulation and other activity. D. Obtain
a physician's order for arterial blood gas determinations to verify the oxygen
saturation. - ANSWER - C. Obtain a physician's order for supplemental oxygen to be
used during ambulation and other activity. An oxygen saturation level that drops
below 90% with activity indicates that the patient is not tolerating the exercise and
needs to have supplemental oxygen applied.
6. The nurse evaluates that teaching for the patient with iron deficiency anemia has
been effective when the patient states A. "I will need to take the iron supplements
the rest of my life." B. "I will increase my dietary intake of milk and milk products."
C. "I should increase my activity to increase my aerobic capacity." D. "I should take
the iron for several months after my blood is normal." - ANSWER - D. "I should take
the iron for several months after my blood is normal." To replace the body's iron
stores, iron supplements should be continued for 2 to 3 months after the Hb level
returns to normal, but if the cause of the iron deficiency is corrected, the
supplements do not need to be taken for a lifetime. Milk and milk products are poor
sources of dietary iron. Activity should be gradually increased as Hb levels return to
normal because aerobic capacity can be increased when adequate Hb is available.
,3 of 101
7. The nurse is caring for a 73-year-old patient who underwent a left total knee
arthroplasty. On the third postoperative day, the patient complains of shortness of
breath, slight chest pain, and that "something is wrong." Temperature is 98.4o F,
blood pressure 130/88, respirations 36, and oxygen saturation 91% on room air.
Which of the following should the nurse first suspect as the etiology of this episode?
A. Septic embolus from the knee joint B. Pulmonary embolus from deep vein
thrombosis C. New onset of angina pectoris D. Pleural effusion related to
positioning in the operating room - ANSWER - B. Pulmonary embolus from deep vein
thrombosis The patient presents the classic symptoms of pulmonary embolus:
acute onset of symptoms, tachypnea, shortness of breath, and chest pain.
8. While caring for a patient with respiratory disease, a nurse observes that the oxygen
saturation drops from 94% to 85% when the patient ambulates. The nurse should
determine that A. supplemental oxygen should be used when the patient exercises.
B. ABG determinations should be done to verify the oxygen saturation reading. C.
this finding is a normal response to activity and that the patient should continue to
be monitored. D. the oximetry probe should be moved from the finger to the earlobe
for an accurate oxygen saturation measurement during activity. - ANSWER - A.
supplemental oxygen should be used when the patient exercises. An oxygen
saturation lower than 90% indicates inadequate oxygenation. If the drop is related
to activity of some type, supplemental oxygen is indicated.
9. A nurse establishes the presence of a tension pneumothorax when assessment
findings reveal a(n) A. absence of lung sounds on the affected side. B. inability to
auscultate tracheal breath sounds. C. deviation of the trachea toward the side
opposite the pneumothorax. D. shift of the point of maximal impulse (PMI) to the
left, with bounding pulses. - ANSWER - C. deviation of the trachea toward the side
opposite the pneumothorax. Tension pneumothorax is caused by rapid
accumulation of air in the pleural space, causing severely high intrapleural
pressure. This results in collapse of the lung, and the mediastinum shifts toward the
unaffected side, which is subsequently compressed.
10. In the case of pulmonary embolus from deep vein thrombosis, which of the
following actions should the nurse take first? A. Notify the physician. B. Administer
a nitroglycerin tablet sublingually. C. Conduct a thorough assessment of the chest
pain. D. Sit the patient up in bed as tolerated and apply oxygen. - ANSWER - D. Sit
the patient up in bed as tolerated and apply oxygen. The patient's clinical picture is
consistent with pulmonary embolus, and the first action the nurse takes should be
to assist the patient. For this reason, the nurse should sit the patient up as tolerated
and apply oxygen before notifying the physician.
, 4 of 101
11. Nursing interventions for the patient with aplastic anemia are directed toward the
prevention of the complications of A. fatigue and dyspnea. B. hemorrhage and
infection. C. thromboembolic and gangrene. D. cardiac arrhythmias and heart
failure. - ANSWER - B. hemorrhage and infection. Hemorrhage from
thrombocytopenia and infection from neutropenia are the greatest risks for the
patient with aplastic anemia. The patient will experience fatigue from anemia, but
bleeding and infection are the major causes of death in aplastic anemia.
12. A patient with hemophilia is hospitalized with acute knee pain and swelling. An
appropriate nursing intervention for the patient includes A. wrapping the knee with
an elastic bandage. B. placing the patient on bed rest and applying ice to the joint.
C. gently performing range-of-motion (ROM) exercises to the knee to prevent
adhesions. D. administering nonsteroidal anti-inflammatory drugs (NSAIDs) as
needed for pain. - ANSWER - B. placing the patient on bed rest and applying ice to
the joint. During an acute bleeding episode in a joint, it is important to totally rest
the involved joint and slow bleeding with application of ice. Drugs that decrease
platelet aggregation, such as aspirin or NSAIDs, should not be used for pain. As
soon as bleeding stops, mobilization of the affected area is encouraged with range-
of-motion (ROM) exercises and physical therapy.
13. The nurse is caring for a postoperative patient with sudden onset of respiratory
distress. The physician orders a STAT ventilation-perfusion scan. Which of the
following explanations should the nurse provide to the patient about the
procedure? A. This test involves injection of a radioisotope to outline the blood
vessels in the lungs, followed by inhalation of a radioisotope gas. B. This test will
use special technology to examine cross sections of the chest with use of a
contrast dye. C. This test will use magnetic fields to produce images of the lungs
and chest. D. This test involves injecting contrast dye into a blood vessel to outline
the blood vessels of the lungs. - ANSWER - A. This test involves injection of a
radioisotope to outline the blood vessels in the lungs, followed by inhalation of a
radioisotope gas. A ventilation-perfusion scan has two parts. In the perfusion
portion, a radioisotope is injected into the blood, and the pulmonary vasculature is
outlined. In the ventilation part, the patient inhales a radioactive gas that outlines
the alveoli.
14. Which of the following statements made by a nurse would indicate proper teaching
principles regarding feeding and tracheostomies? A. "Follow each spoon of food
consumed with a drink of fluid." B. "Thin your foods to a liquid consistency
whenever possible." C. "Tilt your chin forward toward the chest when swallowing
your food." D. "Make sure your cuff is overinflated before eating if you have
swallowing problems." - ANSWER - C. "Tilt your chin forward toward the chest when
ATI MED-SURG TEST BANKS LATERST VERSION
2025/2026 NGN 500 QUESTIONS INCLUDED
WITH RATIONALE/A+ GRADE
1. When planning appropriate nursing interventions for a patient with metastatic lung
cancer and a 60-pack-year history of cigarette smoking, the nurse recognizes that
the smoking has most likely decreased the patient's underlying respiratory defenses
because of impairment of which of the following? A. Reflex bronchoconstriction B.
Ability to filter particles from the air C. Cough reflex D. Mucociliary clearance -
ANSWER - D. Mucociliary clearance Smoking decreases the ciliary action in the
tracheobronchial tree, resulting in impaired clearance of respiratory secretions,
chronic cough, and frequent respiratory infections.
2. When reviewing the results of a 83-year-old patient's blood tests, which of the
following findings would be of most concern to the nurse? A. Platelets of 150,000/µl
B. Serum iron of 50 mcg/dl C. Partial thromboplastin time (PTT) of 60 seconds D.
Erythrocyte sedimentation rate (ESR) of 35 mm in 1 hour - ANSWER - C. Partial
thromboplastin time (PTT) of 60 seconds In aging, the partial thromboplastin time
(PTT) is normally decreased, so an abnormally high PTT of 60 seconds is an
indication that bleeding could readily occur. Platelets are unaffected by aging, and
150,000 is a normal count. Serum iron levels are decreased, and the erythrocyte
sedimentation rate (ESR) is significantly increased with aging, as are reflected in
these values.
3. If a patient with blood type O Rh- is given AB Rh- blood, the nurse would expect A.
the patient's Rh factor to react with the RBCs of the donor blood. B. no adverse
reaction because the patient has no antibodies against the donor blood. C. the anti-
A and anti-B antibodies in the patient's blood to hemolyze the donor blood. D. the
anti-A and anti-B antibodies in the donor blood to hemolyze the patient's blood. -
ANSWER - C. the anti-A and anti-B antibodies in the patient's blood to hemolyze the
donor blood. A patient with O Rh+ blood has no A or B antigens on the red cell but
does have anti-A and anti-B antibodies in the blood and has an Rh antigen. AB Rh-
blood has both A and B antigens on the red cell but no Rh antigen and no anti-A or
anti-B antibodies. If the AB Rh- blood is given to the patient with O Rh+ blood, the
antibodies in the patient's blood will react with the antigens in the donor blood,
causing hemolysis of the donor cells. There will be no Rh reaction because the
donor blood has no Rh antigen.
,2 of 101
4. To ensure the correct amount of oxygen delivery for a patient receiving 35% oxygen
via a Venturi mask, it is most important that the nurse A. keep the air-entrainment
ports clean and unobstructed. B. apply an adaptor to increase humidification of the
oxygen. C. drain moisture condensation from the oxygen tubing every hour. D. keep
the flow rate high enough to keep the bag from collapsing during inspiration. -
ANSWER - A. keep the air-entrainment ports clean and unobstructed. Oxygen is
delivered to a small jet in the center of a wide-based cone. Air is entrained (pulled
through) openings in the cone as oxygen flows through the small jet. The degree of
restriction or narrowness of the jet determines the amount of entrainment and the
dilution of pure oxygen with room air and thus the concentration of oxygen.
Although applying an adaptor can increase the humidification with the Venturi
mask, it is not the best answer, because an open port is essential to proper
functioning. Draining moisture condensation from the oxygen tubing is performed
as often as needed, not on an hourly schedule. A plastic face mask with a reservoir
bag needs to have sufficient flow rate to keep the bag inflated.
5. While ambulating a patient with metastatic lung cancer, the nurse observes a drop
in oxygen saturation from 93% to 86%. Which of the following nursing interventions
is most appropriate based upon these findings? A. Continue with ambulation as this
is a normal response to activity. B. Move the oximetry probe from the finger to the
earlobe for more accurate monitoring during activity. C. Obtain a physician's order
for supplemental oxygen to be used during ambulation and other activity. D. Obtain
a physician's order for arterial blood gas determinations to verify the oxygen
saturation. - ANSWER - C. Obtain a physician's order for supplemental oxygen to be
used during ambulation and other activity. An oxygen saturation level that drops
below 90% with activity indicates that the patient is not tolerating the exercise and
needs to have supplemental oxygen applied.
6. The nurse evaluates that teaching for the patient with iron deficiency anemia has
been effective when the patient states A. "I will need to take the iron supplements
the rest of my life." B. "I will increase my dietary intake of milk and milk products."
C. "I should increase my activity to increase my aerobic capacity." D. "I should take
the iron for several months after my blood is normal." - ANSWER - D. "I should take
the iron for several months after my blood is normal." To replace the body's iron
stores, iron supplements should be continued for 2 to 3 months after the Hb level
returns to normal, but if the cause of the iron deficiency is corrected, the
supplements do not need to be taken for a lifetime. Milk and milk products are poor
sources of dietary iron. Activity should be gradually increased as Hb levels return to
normal because aerobic capacity can be increased when adequate Hb is available.
,3 of 101
7. The nurse is caring for a 73-year-old patient who underwent a left total knee
arthroplasty. On the third postoperative day, the patient complains of shortness of
breath, slight chest pain, and that "something is wrong." Temperature is 98.4o F,
blood pressure 130/88, respirations 36, and oxygen saturation 91% on room air.
Which of the following should the nurse first suspect as the etiology of this episode?
A. Septic embolus from the knee joint B. Pulmonary embolus from deep vein
thrombosis C. New onset of angina pectoris D. Pleural effusion related to
positioning in the operating room - ANSWER - B. Pulmonary embolus from deep vein
thrombosis The patient presents the classic symptoms of pulmonary embolus:
acute onset of symptoms, tachypnea, shortness of breath, and chest pain.
8. While caring for a patient with respiratory disease, a nurse observes that the oxygen
saturation drops from 94% to 85% when the patient ambulates. The nurse should
determine that A. supplemental oxygen should be used when the patient exercises.
B. ABG determinations should be done to verify the oxygen saturation reading. C.
this finding is a normal response to activity and that the patient should continue to
be monitored. D. the oximetry probe should be moved from the finger to the earlobe
for an accurate oxygen saturation measurement during activity. - ANSWER - A.
supplemental oxygen should be used when the patient exercises. An oxygen
saturation lower than 90% indicates inadequate oxygenation. If the drop is related
to activity of some type, supplemental oxygen is indicated.
9. A nurse establishes the presence of a tension pneumothorax when assessment
findings reveal a(n) A. absence of lung sounds on the affected side. B. inability to
auscultate tracheal breath sounds. C. deviation of the trachea toward the side
opposite the pneumothorax. D. shift of the point of maximal impulse (PMI) to the
left, with bounding pulses. - ANSWER - C. deviation of the trachea toward the side
opposite the pneumothorax. Tension pneumothorax is caused by rapid
accumulation of air in the pleural space, causing severely high intrapleural
pressure. This results in collapse of the lung, and the mediastinum shifts toward the
unaffected side, which is subsequently compressed.
10. In the case of pulmonary embolus from deep vein thrombosis, which of the
following actions should the nurse take first? A. Notify the physician. B. Administer
a nitroglycerin tablet sublingually. C. Conduct a thorough assessment of the chest
pain. D. Sit the patient up in bed as tolerated and apply oxygen. - ANSWER - D. Sit
the patient up in bed as tolerated and apply oxygen. The patient's clinical picture is
consistent with pulmonary embolus, and the first action the nurse takes should be
to assist the patient. For this reason, the nurse should sit the patient up as tolerated
and apply oxygen before notifying the physician.
, 4 of 101
11. Nursing interventions for the patient with aplastic anemia are directed toward the
prevention of the complications of A. fatigue and dyspnea. B. hemorrhage and
infection. C. thromboembolic and gangrene. D. cardiac arrhythmias and heart
failure. - ANSWER - B. hemorrhage and infection. Hemorrhage from
thrombocytopenia and infection from neutropenia are the greatest risks for the
patient with aplastic anemia. The patient will experience fatigue from anemia, but
bleeding and infection are the major causes of death in aplastic anemia.
12. A patient with hemophilia is hospitalized with acute knee pain and swelling. An
appropriate nursing intervention for the patient includes A. wrapping the knee with
an elastic bandage. B. placing the patient on bed rest and applying ice to the joint.
C. gently performing range-of-motion (ROM) exercises to the knee to prevent
adhesions. D. administering nonsteroidal anti-inflammatory drugs (NSAIDs) as
needed for pain. - ANSWER - B. placing the patient on bed rest and applying ice to
the joint. During an acute bleeding episode in a joint, it is important to totally rest
the involved joint and slow bleeding with application of ice. Drugs that decrease
platelet aggregation, such as aspirin or NSAIDs, should not be used for pain. As
soon as bleeding stops, mobilization of the affected area is encouraged with range-
of-motion (ROM) exercises and physical therapy.
13. The nurse is caring for a postoperative patient with sudden onset of respiratory
distress. The physician orders a STAT ventilation-perfusion scan. Which of the
following explanations should the nurse provide to the patient about the
procedure? A. This test involves injection of a radioisotope to outline the blood
vessels in the lungs, followed by inhalation of a radioisotope gas. B. This test will
use special technology to examine cross sections of the chest with use of a
contrast dye. C. This test will use magnetic fields to produce images of the lungs
and chest. D. This test involves injecting contrast dye into a blood vessel to outline
the blood vessels of the lungs. - ANSWER - A. This test involves injection of a
radioisotope to outline the blood vessels in the lungs, followed by inhalation of a
radioisotope gas. A ventilation-perfusion scan has two parts. In the perfusion
portion, a radioisotope is injected into the blood, and the pulmonary vasculature is
outlined. In the ventilation part, the patient inhales a radioactive gas that outlines
the alveoli.
14. Which of the following statements made by a nurse would indicate proper teaching
principles regarding feeding and tracheostomies? A. "Follow each spoon of food
consumed with a drink of fluid." B. "Thin your foods to a liquid consistency
whenever possible." C. "Tilt your chin forward toward the chest when swallowing
your food." D. "Make sure your cuff is overinflated before eating if you have
swallowing problems." - ANSWER - C. "Tilt your chin forward toward the chest when
