ATI RN ADULT MEDICAL SURGICAL
EXAM WITH CORRECT QUESTIONS
AND ANSWERS 2025
A nurse is providing postoperative teaching for a client who had a total knee arthroplasty.
Which of the following instructions should the nurse include? - CORRECT ANSWERSFlex the
foot every hour when awake.
Rationale: The nurse should instruct the client to flex the foot every hour to reduce the risk for
thromboembolism and promote venous return.
A nurse is caring for a client who has a pneumothorax and a closed-chest drainage system.
Which of the following findings is an indication of lung re-expansion? - CORRECT
ANSWERSBubbling in the water seal chamber has ceased.
Rationale: Bubbling in the water seal chamber ceases when the lung re-expands.
A nurse is reviewing the medical record of a client who is taking warfarin for chronic atrial
fibrillation. Which of the following values should the nurse identify as a desired outcome for
this therapy? - CORRECT ANSWERSINR 2.5
,Rationale: Clients receive warfarin therapy to decrease the risk of stroke, myocardial infarction
(MI), or pulmonary emboli (PE) from blood clots. Since warfarin is an anticoagulant, the
medication must be monitored to ensure the anticoagulation is within the therapeutic range
and prevent hemorrhage (high levels of anticoagulation) or stroke, MI, or PE (low levels of
anticoagulation). An INR of 2.5 is within the targeted therapeutic range of 2 to 3 for a client
who has atrial fibrillation.
A home health nurse is providing teaching to a client who has a stage 1 pressure injury on the
greater trochanter of his left hip. Which of the following instructions should the nurse include in
the teaching? - CORRECT ANSWERSChange position every hour
Rationale: Changing position every 1 to 2 hr decreases pressure on bony prominences. The
nurse should also instruct the client to limit the angle of the hips when in a lateral position to
no more than 30°. This positioning prevents direct pressure on the trochanter.
A nurse is assessing a client following the completion of hemodialysis. Which of the following
findings is the nurse's priority to report to the provider? - CORRECT ANSWERSRestlessness
Rationale: Using the urgent vs. nonurgent approach to client care, the nurse should determine
that the priority finding to report to the provider is restlessness, which can be an indication the
client is experiencing disequilibrium syndrome. Disequilibrium syndrome is caused by the rapid
,removal of electrolytes from the client's blood and can lead to dysrhythmias or seizures. Other
manifestations include nausea, vomiting, fatigue, and headache.
A nurse is caring for a client who is 8 hr postoperative following a total hip arthroplasty. The
client is unable to void on the bedpan. Which of the following actions should the nurse take
first? - CORRECT ANSWERSScan the bladder with a portable ultrasound.
Rationale: The first action the nurse should take using the nursing process is to assess the client.
Scanning the bladder with a portable ultrasound device will determine the amount of urine in
the bladder
A nurse is planning a health promotional presentation for a group of African American clients
at a community center. Which of the following disorders presents the greatest risk to this group
of clients? - CORRECT ANSWERSHypertension
Rationale: When using the safety/risk reduction approach to client care, the nurse should
determine that the disorder with the greatest risk for this group of clients is hypertension. The
prevalence of hypertension is highest among African American clients, followed by Caucasian
clients, and then Hispanic clients.
, A nurse is caring for a client who has DKA. Which of the following findings should indicate to
the nurse that the client's condition is improving? - CORRECT ANSWERSGlucose 272 mg/Dl
Rationale: A glucose reading less than 300 mg/dL indicates improvement in the client's status.
A nurse is caring for a client following extubation of an endotracheal tube 10 min. ago. Which
of the following findings should the nurse report to the provider immediately? - CORRECT
ANSWERSStridor
Rationale: Using the urgent vs. nonurgent approach to client care, the nurse should determine
that the priority finding is stridor. Stridor can indicate a narrowing airway or possible
obstruction caused by edema or laryngeal spasms. The nurse should report the finding
immediately and implement an intervention.
A nurse is caring for a client who had a nephrostomy tube inserted 112 hr ago. Which of the
following findings should the nurse report to the provider? - CORRECT ANSWERSThe client
reports back pain
Rationale: The nurse should notify the provider if the client reports back pain, which can
indicate that the nephrostomy tube is dislodged or clogged.
A nurse is admitting a client who has active TB. Which of the following types of transmission
precautions should the nurse initiate? - CORRECT ANSWERSAirborne
EXAM WITH CORRECT QUESTIONS
AND ANSWERS 2025
A nurse is providing postoperative teaching for a client who had a total knee arthroplasty.
Which of the following instructions should the nurse include? - CORRECT ANSWERSFlex the
foot every hour when awake.
Rationale: The nurse should instruct the client to flex the foot every hour to reduce the risk for
thromboembolism and promote venous return.
A nurse is caring for a client who has a pneumothorax and a closed-chest drainage system.
Which of the following findings is an indication of lung re-expansion? - CORRECT
ANSWERSBubbling in the water seal chamber has ceased.
Rationale: Bubbling in the water seal chamber ceases when the lung re-expands.
A nurse is reviewing the medical record of a client who is taking warfarin for chronic atrial
fibrillation. Which of the following values should the nurse identify as a desired outcome for
this therapy? - CORRECT ANSWERSINR 2.5
,Rationale: Clients receive warfarin therapy to decrease the risk of stroke, myocardial infarction
(MI), or pulmonary emboli (PE) from blood clots. Since warfarin is an anticoagulant, the
medication must be monitored to ensure the anticoagulation is within the therapeutic range
and prevent hemorrhage (high levels of anticoagulation) or stroke, MI, or PE (low levels of
anticoagulation). An INR of 2.5 is within the targeted therapeutic range of 2 to 3 for a client
who has atrial fibrillation.
A home health nurse is providing teaching to a client who has a stage 1 pressure injury on the
greater trochanter of his left hip. Which of the following instructions should the nurse include in
the teaching? - CORRECT ANSWERSChange position every hour
Rationale: Changing position every 1 to 2 hr decreases pressure on bony prominences. The
nurse should also instruct the client to limit the angle of the hips when in a lateral position to
no more than 30°. This positioning prevents direct pressure on the trochanter.
A nurse is assessing a client following the completion of hemodialysis. Which of the following
findings is the nurse's priority to report to the provider? - CORRECT ANSWERSRestlessness
Rationale: Using the urgent vs. nonurgent approach to client care, the nurse should determine
that the priority finding to report to the provider is restlessness, which can be an indication the
client is experiencing disequilibrium syndrome. Disequilibrium syndrome is caused by the rapid
,removal of electrolytes from the client's blood and can lead to dysrhythmias or seizures. Other
manifestations include nausea, vomiting, fatigue, and headache.
A nurse is caring for a client who is 8 hr postoperative following a total hip arthroplasty. The
client is unable to void on the bedpan. Which of the following actions should the nurse take
first? - CORRECT ANSWERSScan the bladder with a portable ultrasound.
Rationale: The first action the nurse should take using the nursing process is to assess the client.
Scanning the bladder with a portable ultrasound device will determine the amount of urine in
the bladder
A nurse is planning a health promotional presentation for a group of African American clients
at a community center. Which of the following disorders presents the greatest risk to this group
of clients? - CORRECT ANSWERSHypertension
Rationale: When using the safety/risk reduction approach to client care, the nurse should
determine that the disorder with the greatest risk for this group of clients is hypertension. The
prevalence of hypertension is highest among African American clients, followed by Caucasian
clients, and then Hispanic clients.
, A nurse is caring for a client who has DKA. Which of the following findings should indicate to
the nurse that the client's condition is improving? - CORRECT ANSWERSGlucose 272 mg/Dl
Rationale: A glucose reading less than 300 mg/dL indicates improvement in the client's status.
A nurse is caring for a client following extubation of an endotracheal tube 10 min. ago. Which
of the following findings should the nurse report to the provider immediately? - CORRECT
ANSWERSStridor
Rationale: Using the urgent vs. nonurgent approach to client care, the nurse should determine
that the priority finding is stridor. Stridor can indicate a narrowing airway or possible
obstruction caused by edema or laryngeal spasms. The nurse should report the finding
immediately and implement an intervention.
A nurse is caring for a client who had a nephrostomy tube inserted 112 hr ago. Which of the
following findings should the nurse report to the provider? - CORRECT ANSWERSThe client
reports back pain
Rationale: The nurse should notify the provider if the client reports back pain, which can
indicate that the nephrostomy tube is dislodged or clogged.
A nurse is admitting a client who has active TB. Which of the following types of transmission
precautions should the nurse initiate? - CORRECT ANSWERSAirborne
