ATI MED-SURG PROCTORED (BRAND NEW VERSION!!) 2025
ACTUAL EXAM COMPLETE 180 QUESTIONS AND CORRECT
DETAILED ANSWERS
Question 1
A nurse is caring for a client who is 2 days postoperative following an
abdominal hysterectomy. The client reports abdominal pain rated 7 on a 0-10
scale. The nurse assesses the client and notes a distended abdomen and
absent bowel sounds. Which of the following actions should the nurse take
first?
A) Administer a prescribed opioid analgesic.
B) Encourage the client to ambulate.
C) Obtain an order for a nasogastric tube insertion.
D) Notify the provider of the findings.
E) Provide a warm compress to the abdomen.
Correct Answer: D) Notify the provider of the findings.
Rationale: The client's symptoms (severe pain, distended abdomen,
absent bowel sounds 2 days post-op) suggest a potentially serious
complication like a paralytic ileus or bowel obstruction, which
requires immediate medical evaluation and intervention. Notifying
the provider is the priority action to ensure prompt treatment.
Question 2
A nurse is providing discharge teaching to a client who has a new
prescription for enoxaparin. Which of the following statements by the client
indicates an understanding of the teaching?
A) "I will inject the medication into my thigh muscle."
B) "I will aspirate for blood return before injecting."
C) "I will rub the injection site vigorously after injecting."
D) "I will alternate injection sites on my abdomen."
E) "I will take this medication with meals."
Correct Answer: D) "I will alternate injection sites on my abdomen."
Rationale: Enoxaparin is a low molecular weight heparin administered
subcutaneously, typically in the abdomen, and injection sites should
be rotated to prevent tissue damage. It should not be injected into
muscle, aspirated, or rubbed, as these can increase bruising and
hematoma formation. It is not affected by food.
Question 3
A nurse is caring for a client who has hypervolemia. Which of the following
laboratory findings should the nurse expect?
A) Increased hematocrit
B) Decreased serum sodium
,C) Increased serum osmolality
D) Increased urine specific gravity
E) Increased blood urea nitrogen (BUN)
Correct Answer: B) Decreased serum sodium
Rationale: Hypervolemia (fluid volume excess) leads to a dilutional
effect on electrolytes, causing a decrease in serum sodium
(hyponatremia) due to the excess water diluting the sodium
concentration. Hematocrit, serum osmolality, and BUN would likely
be decreased due to dilution, and urine specific gravity would be
decreased as the kidneys excrete excess water.
Question 4
A nurse is assessing a client who has a suspected fractured ankle. Which of
the following findings should the nurse identify as a priority?
A) Pain rating of 6 on a 0-10 scale.
B) Swelling and ecchymosis around the ankle.
C) Inability to bear weight on the affected extremity.
D) Numbness and tingling in the toes.
E) Visible deformity of the ankle.
Correct Answer: D) Numbness and tingling in the toes.
Rationale: Numbness and tingling (paresthesia) in the toes distal to
the suspected fracture site can indicate nerve damage or, more
critically, compartment syndrome due to increased pressure
compromising circulation. This is a neurovascular impairment that
requires immediate attention to prevent permanent tissue damage.
While other options are signs of fracture, they are not immediately
life- or limb-threatening.
Question 5
A nurse is providing discharge teaching to a client who has heart failure and
a new prescription for carvedilol. Which of the following instructions should
the nurse include?
A) "Report a sudden weight gain of 2 pounds in one day to your provider."
B) "Discontinue this medication immediately if you feel dizzy."
C) "You should expect your pulse rate to increase significantly."
D) "This medication may cause constipation."
E) "Avoid consuming potassium-rich foods."
Correct Answer: A) "Report a sudden weight gain of 2 pounds in one
day to your provider."
Rationale: Carvedilol is a beta-blocker often used in heart failure. A
sudden weight gain (e.g., 2-3 pounds in 24 hours or 5 pounds in a
,week) can indicate fluid retention and worsening heart failure,
which requires prompt notification of the provider. Clients should be
taught not to discontinue beta-blockers abruptly. Dizziness can be a
side effect, but often improves; significant dizziness or syncope
should be reported. Beta-blockers decrease pulse rate.
Question 6
A nurse is teaching a client who has a new diagnosis of type 2 diabetes
mellitus about managing their condition. Which of the following
recommendations should the nurse prioritize?
A) "You will need to take insulin injections daily."
B) "Limit your intake of all carbohydrates to less than 50 grams per day."
C) "Engage in regular physical activity and follow a balanced meal plan."
D) "Avoid checking your blood glucose more than once a week."
E) "Focus only on weight loss, as it will cure your diabetes."
Correct Answer: C) "Engage in regular physical activity and follow a
balanced meal plan."
Rationale: Regular physical activity and a balanced, healthy meal
plan are foundational for managing type 2 diabetes. They improve
insulin sensitivity, help control blood glucose, and can contribute to
weight management. While insulin may eventually be needed, it's
not the initial priority for all type 2 diabetics. Extreme carbohydrate
restriction is generally not recommended, and daily glucose
monitoring is often essential.
Question 7
A nurse is preparing to administer an opioid analgesic to a client who has a
pain level of 9 on a 0-10 scale. The client's respiratory rate is 10 breaths/min.
Which of the following actions should the nurse take?
A) Administer the opioid as prescribed and closely monitor the respiratory
rate.
B) Administer a reduced dose of the opioid.
C) Withhold the opioid and notify the provider.
D) Obtain an order for naloxone to have at the bedside.
E) Encourage the client to take deep breaths before administration.
Correct Answer: C) Withhold the opioid and notify the provider.
Rationale: A respiratory rate of 10 breaths/min is indicative of
respiratory depression, which is a significant adverse effect of
opioid analgesics. Administering an opioid to a client with an
already depressed respiratory rate could dangerously worsen their
, breathing. The nurse's priority is to withhold the medication and
immediately notify the provider for further orders or evaluation.
Question 8
A nurse is caring for a client who has Clostridium difficile (C. diff) infection.
Which of the following infection control precautions should the nurse
implement?
A) Airborne precautions.
B) Droplet precautions.
C) Contact precautions, including washing hands with soap and water.
D) Standard precautions with an N95 respirator.
E) Protective environment.
Correct Answer: C) Contact precautions, including washing hands with
soap and water.
Rationale: C. diff is spread through spores, which are not effectively
killed by alcohol-based hand rubs. Therefore, contact precautions
(gown and gloves upon room entry) and thorough handwashing with
soap and water are mandatory for C. diff isolation to prevent its
transmission.
Question 9
A nurse is assessing a client who has a traumatic brain injury (TBI) and notes
a Glasgow Coma Scale (GCS) score of 7. Which of the following nursing
interventions is the priority?
A) Obtaining a comprehensive neurological assessment.
B) Elevating the head of the bed to 30 degrees.
C) Preparing for endotracheal intubation.
D) Administering a prescribed sedative.
E) Inserting an indwelling urinary catheter.
Correct Answer: C) Preparing for endotracheal intubation.
Rationale: A GCS score of 8 or less indicates a severe TBI and an
inability to protect the airway. Securing the airway with
endotracheal intubation is the immediate priority to ensure
adequate oxygenation and ventilation, which are critical for
preventing secondary brain injury. Other actions are important but
follow airway management.
Question 10
A nurse is providing discharge teaching to a client who has a new permanent
pacemaker. Which of the following statements by the client indicates a need
for further teaching?
ACTUAL EXAM COMPLETE 180 QUESTIONS AND CORRECT
DETAILED ANSWERS
Question 1
A nurse is caring for a client who is 2 days postoperative following an
abdominal hysterectomy. The client reports abdominal pain rated 7 on a 0-10
scale. The nurse assesses the client and notes a distended abdomen and
absent bowel sounds. Which of the following actions should the nurse take
first?
A) Administer a prescribed opioid analgesic.
B) Encourage the client to ambulate.
C) Obtain an order for a nasogastric tube insertion.
D) Notify the provider of the findings.
E) Provide a warm compress to the abdomen.
Correct Answer: D) Notify the provider of the findings.
Rationale: The client's symptoms (severe pain, distended abdomen,
absent bowel sounds 2 days post-op) suggest a potentially serious
complication like a paralytic ileus or bowel obstruction, which
requires immediate medical evaluation and intervention. Notifying
the provider is the priority action to ensure prompt treatment.
Question 2
A nurse is providing discharge teaching to a client who has a new
prescription for enoxaparin. Which of the following statements by the client
indicates an understanding of the teaching?
A) "I will inject the medication into my thigh muscle."
B) "I will aspirate for blood return before injecting."
C) "I will rub the injection site vigorously after injecting."
D) "I will alternate injection sites on my abdomen."
E) "I will take this medication with meals."
Correct Answer: D) "I will alternate injection sites on my abdomen."
Rationale: Enoxaparin is a low molecular weight heparin administered
subcutaneously, typically in the abdomen, and injection sites should
be rotated to prevent tissue damage. It should not be injected into
muscle, aspirated, or rubbed, as these can increase bruising and
hematoma formation. It is not affected by food.
Question 3
A nurse is caring for a client who has hypervolemia. Which of the following
laboratory findings should the nurse expect?
A) Increased hematocrit
B) Decreased serum sodium
,C) Increased serum osmolality
D) Increased urine specific gravity
E) Increased blood urea nitrogen (BUN)
Correct Answer: B) Decreased serum sodium
Rationale: Hypervolemia (fluid volume excess) leads to a dilutional
effect on electrolytes, causing a decrease in serum sodium
(hyponatremia) due to the excess water diluting the sodium
concentration. Hematocrit, serum osmolality, and BUN would likely
be decreased due to dilution, and urine specific gravity would be
decreased as the kidneys excrete excess water.
Question 4
A nurse is assessing a client who has a suspected fractured ankle. Which of
the following findings should the nurse identify as a priority?
A) Pain rating of 6 on a 0-10 scale.
B) Swelling and ecchymosis around the ankle.
C) Inability to bear weight on the affected extremity.
D) Numbness and tingling in the toes.
E) Visible deformity of the ankle.
Correct Answer: D) Numbness and tingling in the toes.
Rationale: Numbness and tingling (paresthesia) in the toes distal to
the suspected fracture site can indicate nerve damage or, more
critically, compartment syndrome due to increased pressure
compromising circulation. This is a neurovascular impairment that
requires immediate attention to prevent permanent tissue damage.
While other options are signs of fracture, they are not immediately
life- or limb-threatening.
Question 5
A nurse is providing discharge teaching to a client who has heart failure and
a new prescription for carvedilol. Which of the following instructions should
the nurse include?
A) "Report a sudden weight gain of 2 pounds in one day to your provider."
B) "Discontinue this medication immediately if you feel dizzy."
C) "You should expect your pulse rate to increase significantly."
D) "This medication may cause constipation."
E) "Avoid consuming potassium-rich foods."
Correct Answer: A) "Report a sudden weight gain of 2 pounds in one
day to your provider."
Rationale: Carvedilol is a beta-blocker often used in heart failure. A
sudden weight gain (e.g., 2-3 pounds in 24 hours or 5 pounds in a
,week) can indicate fluid retention and worsening heart failure,
which requires prompt notification of the provider. Clients should be
taught not to discontinue beta-blockers abruptly. Dizziness can be a
side effect, but often improves; significant dizziness or syncope
should be reported. Beta-blockers decrease pulse rate.
Question 6
A nurse is teaching a client who has a new diagnosis of type 2 diabetes
mellitus about managing their condition. Which of the following
recommendations should the nurse prioritize?
A) "You will need to take insulin injections daily."
B) "Limit your intake of all carbohydrates to less than 50 grams per day."
C) "Engage in regular physical activity and follow a balanced meal plan."
D) "Avoid checking your blood glucose more than once a week."
E) "Focus only on weight loss, as it will cure your diabetes."
Correct Answer: C) "Engage in regular physical activity and follow a
balanced meal plan."
Rationale: Regular physical activity and a balanced, healthy meal
plan are foundational for managing type 2 diabetes. They improve
insulin sensitivity, help control blood glucose, and can contribute to
weight management. While insulin may eventually be needed, it's
not the initial priority for all type 2 diabetics. Extreme carbohydrate
restriction is generally not recommended, and daily glucose
monitoring is often essential.
Question 7
A nurse is preparing to administer an opioid analgesic to a client who has a
pain level of 9 on a 0-10 scale. The client's respiratory rate is 10 breaths/min.
Which of the following actions should the nurse take?
A) Administer the opioid as prescribed and closely monitor the respiratory
rate.
B) Administer a reduced dose of the opioid.
C) Withhold the opioid and notify the provider.
D) Obtain an order for naloxone to have at the bedside.
E) Encourage the client to take deep breaths before administration.
Correct Answer: C) Withhold the opioid and notify the provider.
Rationale: A respiratory rate of 10 breaths/min is indicative of
respiratory depression, which is a significant adverse effect of
opioid analgesics. Administering an opioid to a client with an
already depressed respiratory rate could dangerously worsen their
, breathing. The nurse's priority is to withhold the medication and
immediately notify the provider for further orders or evaluation.
Question 8
A nurse is caring for a client who has Clostridium difficile (C. diff) infection.
Which of the following infection control precautions should the nurse
implement?
A) Airborne precautions.
B) Droplet precautions.
C) Contact precautions, including washing hands with soap and water.
D) Standard precautions with an N95 respirator.
E) Protective environment.
Correct Answer: C) Contact precautions, including washing hands with
soap and water.
Rationale: C. diff is spread through spores, which are not effectively
killed by alcohol-based hand rubs. Therefore, contact precautions
(gown and gloves upon room entry) and thorough handwashing with
soap and water are mandatory for C. diff isolation to prevent its
transmission.
Question 9
A nurse is assessing a client who has a traumatic brain injury (TBI) and notes
a Glasgow Coma Scale (GCS) score of 7. Which of the following nursing
interventions is the priority?
A) Obtaining a comprehensive neurological assessment.
B) Elevating the head of the bed to 30 degrees.
C) Preparing for endotracheal intubation.
D) Administering a prescribed sedative.
E) Inserting an indwelling urinary catheter.
Correct Answer: C) Preparing for endotracheal intubation.
Rationale: A GCS score of 8 or less indicates a severe TBI and an
inability to protect the airway. Securing the airway with
endotracheal intubation is the immediate priority to ensure
adequate oxygenation and ventilation, which are critical for
preventing secondary brain injury. Other actions are important but
follow airway management.
Question 10
A nurse is providing discharge teaching to a client who has a new permanent
pacemaker. Which of the following statements by the client indicates a need
for further teaching?
