Page 1 of 33
Med surg- proctored ATI EXAM GRADED A+ QUESTIONS WITH
CORRECT ANSWERS
A nurse in the emergency department is caring for a client who has Addison's
disease and reports nausea, vomiting, diarrhea, and abdominal pain. To
prevent an Addisonian crisis, the nurse should prepare to administer which of
the following medications?
Hydrocortisone
Addison's disease causes adrenal gland hypofunction and inadequate production of
glucocorticoids. Acute adrenal insufficiency is life-threatening and can lead to severe
fluid and electrolyte imbalances. Without treatment, sodium levels fall, and
potassium levels increase. Rapid infusion of IV fluids such as 0.9% sodium chloride
and IV administer of high dose corticosteroids such as hydrocortisone are vital to
correct the glucocorticoid deficiency.
A nurse in the PACU is assessing a newly admitted client and observes
intercostal retractions and a high-pitched inspiratory sound. The nurse should
identify these findings as manifestations of which of the following
complications?
Respiratory obstruction
Intercostal retractions and a high-pitched inspiratory noise (i.e. stridor) are
manifestations of an airway obstruction caused by laryngospasm and edema. The
nurse should notify the rapid response team and plan to administer racemic
epinephrine.
A nurse is providing discharge teaching to a client who is post-operative
following a right mastectomy for breast cancer. The client will be discharged
with 2 Jackson-Pratt drains. Which of the following pieces of information
should the nurse include in the teaching?
"The drainage tubes often are removed at the same time as the stitches."
, Page 2 of 33
The nurse should instruct the client that the provider will remove the drainage tubes
at the same time the stitches are removed, usually within 7 to 10 days.
A nurse is caring for a client who is concerned about the possibility of
contracting Lyme disease after receiving a tick bite. For which of the following
early manifestations of Lyme disease should the nurse asses the client?
Progressive circular rash
Early Lyme disease is characterized by a fever, influenza-like manifestations, and
erythema migrans, which is distinct, progressive, circular or bullseye rash that often
develops at the bite site but can also develop at other sites such as the thighs and
knees.
A nurse is caring for client who has a demand pacemaker inserted with a set
rate of 72/min. Which of the following findings should the nurse expect?
Telemetry monitoring showing QRS complexes occurring at a rate of 74/min with no
pacing spikes.
The nurse should not expect pacer spikes when the client's pulse is greater than the
set rate of 72/min because the client's intrinsic rate overrides the set rate of the
pacemaker.
A nurse is caring for a client who has urolithiasis and requires further
diagnostic testing after an initial test indicated hypercalcemia. Which of the
following structures controls calcium concentration?
Parathyroid gland
The parathyroid gland secretes parathyroid hormones, which are substances that
help the kidneys reabsorb calcium and increase calcium absorption from the
gastrointestinal tract.
A nurse is assessing a client who has peripheral vascular disease and a
venous ulcer on the right ankle. Which of the following should the nurse
expect in the client's affected extremity?
Ankle swelling
The nurse should identify that swelling of the ankle is a manifestation of venous
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insufficiency due to poor venous return. Other manifestations can include brown
pigmentation and cellulitis.
A nurse is providing teaching to a client who has a chronic cough and is
scheduled for a bronchoscopy. Which of the following client statements
indicates an understanding of the teaching?
"A tissue sample might be obtained during the procedure."
The nurse should inform the client that a tissue sample might be obtained during the
procedure for biopsy testing.
A nurse is caring for a client following a stroke. Which of the following actions
should the nurse take first?
Keep the client NPO
The first action the nurse should take when using the airway, breathing, and
circulation (ABC) approach to client care is to keep the client NPO due to the risk of
aspiration as a result of the stroke. The client should be screened for the ability to
swallow and should not receive anything by mouth until this has been completed. A
client who has experienced a cerebrovascular accident is at risk for dysphagia,
which increases the change of life-threatening aspiration.
A nurse is checking the laboratory values of a client who has chronic kidney
disease. The nurse should expect elevations in which of the following values?
Potassium and magnesium
Clients who have chronic kidney disease have hyperkalemia, hyperphosphatemia,
and hypermagnesemia as well as elevations in serum creatinine and blood urea
nitrogen.
An older adult is brought to an emergency department by a family member.
Which of the following assessment findings should cause the nurse to suspect
that the client has hypertonic dehydration?
Urine Specific gravity 1.045
A urine specific gravity greater than 1.030 indicates a decrease in urine volume and
an increase in osmolarity, which is a manifestation of hypertonic dehydration.
, Page 4 of 33
A nurse in a community clinic is caring for a client who reports an increase in
the frequency of migraine headaches. To help reduce the risk for migraine
headaches, which of the following foods should the nurse recommend the
client avoid?
Aged cheese
Foods that contain tyramine, such as aged cheese and sausage, can trigger
migraine headaches.
A nurse is planning teaching for a client who has bladder cancer and is to
undergo a cutaneous diversion procedure to establish a ureterostomy. Which
of the following statements should the nurse include in the teaching?
"You should cut the opening of the skin barrier one-eight inch wider than the stoma."
The client should cut the opening of the skin barrier 0.3 cm (1/8in) wider than the
stoma to minimize irritation of the skin from exposure to urine.
A nurse is providing teaching to a client who has hypothyroidism and is
receiving levothyroxine. The nurse should instruct the client that which of the
following supplements can interfere with the effectiveness of the medication?
Calcium
Calcium limits the development of osteoporosis in clients who are postmenopausal
and works as an antacid. Calcium supplements can interfere with the metabolism of
a number of medications, including levothyroxine. The nurse should instruct the
client to avoid taking calcium within 4 hr of levothyroxine administration.
A nurse is conducting an admission history for a client who is to undergo a CT
scan with an IV contrast agent. The nurse should identify that which of the
following findings requires further assessment?
History of asthma
A client who has a history of asthma has a greater risk of reacting to the contrast dye
used during the procedure. Other conditions that can result in a reaction to contrast
media include allergies to foods, such as shellfish, eggs, milk, and chocolate.
Med surg- proctored ATI EXAM GRADED A+ QUESTIONS WITH
CORRECT ANSWERS
A nurse in the emergency department is caring for a client who has Addison's
disease and reports nausea, vomiting, diarrhea, and abdominal pain. To
prevent an Addisonian crisis, the nurse should prepare to administer which of
the following medications?
Hydrocortisone
Addison's disease causes adrenal gland hypofunction and inadequate production of
glucocorticoids. Acute adrenal insufficiency is life-threatening and can lead to severe
fluid and electrolyte imbalances. Without treatment, sodium levels fall, and
potassium levels increase. Rapid infusion of IV fluids such as 0.9% sodium chloride
and IV administer of high dose corticosteroids such as hydrocortisone are vital to
correct the glucocorticoid deficiency.
A nurse in the PACU is assessing a newly admitted client and observes
intercostal retractions and a high-pitched inspiratory sound. The nurse should
identify these findings as manifestations of which of the following
complications?
Respiratory obstruction
Intercostal retractions and a high-pitched inspiratory noise (i.e. stridor) are
manifestations of an airway obstruction caused by laryngospasm and edema. The
nurse should notify the rapid response team and plan to administer racemic
epinephrine.
A nurse is providing discharge teaching to a client who is post-operative
following a right mastectomy for breast cancer. The client will be discharged
with 2 Jackson-Pratt drains. Which of the following pieces of information
should the nurse include in the teaching?
"The drainage tubes often are removed at the same time as the stitches."
, Page 2 of 33
The nurse should instruct the client that the provider will remove the drainage tubes
at the same time the stitches are removed, usually within 7 to 10 days.
A nurse is caring for a client who is concerned about the possibility of
contracting Lyme disease after receiving a tick bite. For which of the following
early manifestations of Lyme disease should the nurse asses the client?
Progressive circular rash
Early Lyme disease is characterized by a fever, influenza-like manifestations, and
erythema migrans, which is distinct, progressive, circular or bullseye rash that often
develops at the bite site but can also develop at other sites such as the thighs and
knees.
A nurse is caring for client who has a demand pacemaker inserted with a set
rate of 72/min. Which of the following findings should the nurse expect?
Telemetry monitoring showing QRS complexes occurring at a rate of 74/min with no
pacing spikes.
The nurse should not expect pacer spikes when the client's pulse is greater than the
set rate of 72/min because the client's intrinsic rate overrides the set rate of the
pacemaker.
A nurse is caring for a client who has urolithiasis and requires further
diagnostic testing after an initial test indicated hypercalcemia. Which of the
following structures controls calcium concentration?
Parathyroid gland
The parathyroid gland secretes parathyroid hormones, which are substances that
help the kidneys reabsorb calcium and increase calcium absorption from the
gastrointestinal tract.
A nurse is assessing a client who has peripheral vascular disease and a
venous ulcer on the right ankle. Which of the following should the nurse
expect in the client's affected extremity?
Ankle swelling
The nurse should identify that swelling of the ankle is a manifestation of venous
, Page 3 of 33
insufficiency due to poor venous return. Other manifestations can include brown
pigmentation and cellulitis.
A nurse is providing teaching to a client who has a chronic cough and is
scheduled for a bronchoscopy. Which of the following client statements
indicates an understanding of the teaching?
"A tissue sample might be obtained during the procedure."
The nurse should inform the client that a tissue sample might be obtained during the
procedure for biopsy testing.
A nurse is caring for a client following a stroke. Which of the following actions
should the nurse take first?
Keep the client NPO
The first action the nurse should take when using the airway, breathing, and
circulation (ABC) approach to client care is to keep the client NPO due to the risk of
aspiration as a result of the stroke. The client should be screened for the ability to
swallow and should not receive anything by mouth until this has been completed. A
client who has experienced a cerebrovascular accident is at risk for dysphagia,
which increases the change of life-threatening aspiration.
A nurse is checking the laboratory values of a client who has chronic kidney
disease. The nurse should expect elevations in which of the following values?
Potassium and magnesium
Clients who have chronic kidney disease have hyperkalemia, hyperphosphatemia,
and hypermagnesemia as well as elevations in serum creatinine and blood urea
nitrogen.
An older adult is brought to an emergency department by a family member.
Which of the following assessment findings should cause the nurse to suspect
that the client has hypertonic dehydration?
Urine Specific gravity 1.045
A urine specific gravity greater than 1.030 indicates a decrease in urine volume and
an increase in osmolarity, which is a manifestation of hypertonic dehydration.
, Page 4 of 33
A nurse in a community clinic is caring for a client who reports an increase in
the frequency of migraine headaches. To help reduce the risk for migraine
headaches, which of the following foods should the nurse recommend the
client avoid?
Aged cheese
Foods that contain tyramine, such as aged cheese and sausage, can trigger
migraine headaches.
A nurse is planning teaching for a client who has bladder cancer and is to
undergo a cutaneous diversion procedure to establish a ureterostomy. Which
of the following statements should the nurse include in the teaching?
"You should cut the opening of the skin barrier one-eight inch wider than the stoma."
The client should cut the opening of the skin barrier 0.3 cm (1/8in) wider than the
stoma to minimize irritation of the skin from exposure to urine.
A nurse is providing teaching to a client who has hypothyroidism and is
receiving levothyroxine. The nurse should instruct the client that which of the
following supplements can interfere with the effectiveness of the medication?
Calcium
Calcium limits the development of osteoporosis in clients who are postmenopausal
and works as an antacid. Calcium supplements can interfere with the metabolism of
a number of medications, including levothyroxine. The nurse should instruct the
client to avoid taking calcium within 4 hr of levothyroxine administration.
A nurse is conducting an admission history for a client who is to undergo a CT
scan with an IV contrast agent. The nurse should identify that which of the
following findings requires further assessment?
History of asthma
A client who has a history of asthma has a greater risk of reacting to the contrast dye
used during the procedure. Other conditions that can result in a reaction to contrast
media include allergies to foods, such as shellfish, eggs, milk, and chocolate.
