ATI Med-Surg Proctored Exam Study Guide
2024/2025 – Revised Questions with Complete
Detailed Answers (A+ Graded)
ATI Med-Surg Proctored Exam Study Guide (100 Q&A)
Cardiovascular Disorders
1. A client with heart failure is experiencing shortness of breath and has crackles in the lungs.
Which action should the nurse take first?
A. Administer prescribed furosemide (Lasix).
B. Check the client's oxygen saturation.
C. Place the client in a high-Fowler's position.
D. Weigh the client.
✓ C. Place the client in a high-Fowler's position. (This is the first priority to maximize lung
expansion and ease breathing before administering medications or performing assessments.)
2. The nurse is teaching a client about taking warfarin (Coumadin). Which statement by the
client indicates a need for further teaching?
A. "I will avoid playing contact sports."
B. "I will use a soft-bristled toothbrush."
C. "I will eat more spinach and kale in my salads."
D. "I will have my blood drawn regularly as scheduled."
✓ C. "I will eat more spinach and kale in my salads." (Foods high in Vitamin K, like leafy greens,
can antagonize the effects of warfarin and should be consumed in consistent amounts, not
suddenly increased.)
3. A client with an acute myocardial infarction (MI) is receiving tissue plasminogen activator
(tPA). The nurse should be most concerned by which finding?
A. Blood pressure 150/90 mmHg.
B. Reports of mild headache.
C. Sudden, severe back pain.
D. Heart rate of 110 bpm.
✓ C. Sudden, severe back pain. (This can indicate a serious complication of tPA therapy, such as
aortic dissection or retroperitoneal bleeding.)
4. The nurse is assessing a client with peripheral arterial disease (PAD). Which finding is most
characteristic of this condition?
,A. Bilateral pitting edema.
B. Brownish discoloration of the ankles.
C. Pain in the legs that is relieved by rest.
D. Ulcers on the tips of the toes.
✓ C. Pain in the legs that is relieved by rest. (Intermittent claudication is a classic sign of PAD.
The pain occurs with activity and is relieved by rest.)
5. For a client with a potassium level of 6.2 mEq/L, the nurse should anticipate the
administration of:
A. Potassium chloride IV.
B. Sodium polystyrene sulfonate (Kayexalate).
C. Calcium gluconate IV.
D. Regular insulin IV.
✓ B. Sodium polystyrene sulfonate (Kayexalate). (This is a cation exchange resin that helps
remove potassium from the body. Calcium gluconate is given to stabilize the cardiac membrane
but does not lower potassium levels.)
6. A client's cardiac monitor shows a pattern of no P waves, an irregular rhythm, and a QRS
complex within normal limits. The nurse interprets this as:
A. Atrial Fibrillation.
B. Ventricular Tachycardia.
C. Sinus Tachycardia.
D. Asystole.
✓ A. Atrial Fibrillation. (The hallmark of A-fib is the absence of distinct P waves and an
irregularly irregular rhythm.)
7. The nurse is caring for a client with a new permanent pacemaker. Which instruction is most
important for discharge?
A. "Avoid lifting your arm above your shoulder on the affected side for 1-2 weeks."
B. "You can no longer use a microwave oven."
C. "Avoid close contact with people who have infections."
D. "Take your pulse once a week."
✓ A. "Avoid lifting your arm above your shoulder on the affected side for 1-2 weeks." (This
prevents dislodgement of the newly placed leads.)
8. A client with deep vein thrombosis (DVT) is on a heparin infusion. The nurse should ensure
which antidote is available at the bedside?
A. Vitamin K.
B. Naloxone (Narcan).
C. Protamine Sulfate.
,D. Flumazenil (Romazicon).
✓ C. Protamine Sulfate. (This is the specific antidote for heparin.)
Respiratory Disorders
9. A client with COPD has a PaO2 of 50 mmHg and an oxygen saturation of 80%. Which oxygen
delivery device is most appropriate?
A. Nasal cannula at 2 L/min.
B. Simple face mask at 5 L/min.
C. Venturi mask at 24% FiO2.
D. Non-rebreather mask at 10 L/min.
✓ D. Non-rebreather mask at 10 L/min. (This client is severely hypoxemic and requires high-
flow, high-concentration oxygen. Clients with COPD who are in acute respiratory failure are
treated with high O2; the risk of CO2 narcosis is secondary to correcting life-threatening
hypoxia.)
10. The nurse is suctioning a client with a tracheostomy. To prevent hypoxia during the
procedure, the nurse should:
A. Apply suction for a maximum of 30 seconds.
B. Hyperoxygenate before and after suctioning.
C. Use a sterile wet-saline lavage during suctioning.
D. Apply suction while inserting the catheter.
✓ B. Hyperoxygenate before and after suctioning. (This helps prevent hypoxia. Suction should
be applied only while withdrawing the catheter and for no more than 10-15 seconds.)
11. A client is admitted with a suspected pulmonary embolism. Which finding is most
commonly associated with this condition?
A. Productive cough with yellow sputum.
B. Bradypnea.
C. Pleuritic chest pain.
D. Bradycardia.
✓ C. Pleuritic chest pain. (Sharp, stabbing chest pain that worsens on inspiration is a classic
symptom of PE.)
12. The nurse is preparing a client for a thoracentesis. In which position should the client be
placed?
A. Sims' position.
B. Sitting on the edge of the bed, leaning forward over a bedside table.
C. Trendelenburg.
D. Supine with legs elevated.
, ✓ B. Sitting on the edge of the bed, leaning forward over a bedside table. (This position
spreads the intercostal spaces and allows fluid to pool at the lung bases for easier removal.)
13. A client with tuberculosis is placed on Airborne Precautions. Which type of room is
required?
A. A private room with positive pressure airflow.
B. A private room with negative pressure airflow.
C. A room with the door kept open.
D. A room with standard precautions only.
✓ B. A private room with negative pressure airflow. (This prevents contaminated air from
flowing out into the hallway.)
14. Which finding for a client with asthma indicates that therapy has been effective?
A. Wheezing becomes louder.
B. PaCO2 increases to 45 mmHg.
C. Peak expiratory flow rate increases.
D. Respiratory rate decreases to 8 breaths/minute.
✓ C. Peak expiratory flow rate increases. (This indicates improved airflow and bronchodilation.
Louder wheezing can mean air movement is still severely obstructed.)
15. The nurse is teaching a client about using an albuterol inhaler and a fluticasone inhaler.
The client should be instructed to use the albuterol inhaler:
A. Only at bedtime.
B. 5 minutes after the fluticasone inhaler.
C. Only when experiencing an acute attack.
D. 5 minutes before the fluticasone inhaler.
✓ D. 5 minutes before the fluticasone inhaler. (The bronchodilator (albuterol) opens the
airways first, allowing the corticosteroid (fluticasone) to penetrate deeper into the lungs.)
16. After a client undergoes a total laryngectomy, the nurse should expect:
A. The client will have a temporary voice loss.
B. The client will breathe through a stoma in the neck.
C. The client will be able to swallow normally immediately.
D. The client can aspirate easily.
✓ B. The client will breathe through a stoma in the neck. (A total laryngectomy creates a
permanent stoma; the upper and lower airways are no longer connected.)
Neurological Disorders
2024/2025 – Revised Questions with Complete
Detailed Answers (A+ Graded)
ATI Med-Surg Proctored Exam Study Guide (100 Q&A)
Cardiovascular Disorders
1. A client with heart failure is experiencing shortness of breath and has crackles in the lungs.
Which action should the nurse take first?
A. Administer prescribed furosemide (Lasix).
B. Check the client's oxygen saturation.
C. Place the client in a high-Fowler's position.
D. Weigh the client.
✓ C. Place the client in a high-Fowler's position. (This is the first priority to maximize lung
expansion and ease breathing before administering medications or performing assessments.)
2. The nurse is teaching a client about taking warfarin (Coumadin). Which statement by the
client indicates a need for further teaching?
A. "I will avoid playing contact sports."
B. "I will use a soft-bristled toothbrush."
C. "I will eat more spinach and kale in my salads."
D. "I will have my blood drawn regularly as scheduled."
✓ C. "I will eat more spinach and kale in my salads." (Foods high in Vitamin K, like leafy greens,
can antagonize the effects of warfarin and should be consumed in consistent amounts, not
suddenly increased.)
3. A client with an acute myocardial infarction (MI) is receiving tissue plasminogen activator
(tPA). The nurse should be most concerned by which finding?
A. Blood pressure 150/90 mmHg.
B. Reports of mild headache.
C. Sudden, severe back pain.
D. Heart rate of 110 bpm.
✓ C. Sudden, severe back pain. (This can indicate a serious complication of tPA therapy, such as
aortic dissection or retroperitoneal bleeding.)
4. The nurse is assessing a client with peripheral arterial disease (PAD). Which finding is most
characteristic of this condition?
,A. Bilateral pitting edema.
B. Brownish discoloration of the ankles.
C. Pain in the legs that is relieved by rest.
D. Ulcers on the tips of the toes.
✓ C. Pain in the legs that is relieved by rest. (Intermittent claudication is a classic sign of PAD.
The pain occurs with activity and is relieved by rest.)
5. For a client with a potassium level of 6.2 mEq/L, the nurse should anticipate the
administration of:
A. Potassium chloride IV.
B. Sodium polystyrene sulfonate (Kayexalate).
C. Calcium gluconate IV.
D. Regular insulin IV.
✓ B. Sodium polystyrene sulfonate (Kayexalate). (This is a cation exchange resin that helps
remove potassium from the body. Calcium gluconate is given to stabilize the cardiac membrane
but does not lower potassium levels.)
6. A client's cardiac monitor shows a pattern of no P waves, an irregular rhythm, and a QRS
complex within normal limits. The nurse interprets this as:
A. Atrial Fibrillation.
B. Ventricular Tachycardia.
C. Sinus Tachycardia.
D. Asystole.
✓ A. Atrial Fibrillation. (The hallmark of A-fib is the absence of distinct P waves and an
irregularly irregular rhythm.)
7. The nurse is caring for a client with a new permanent pacemaker. Which instruction is most
important for discharge?
A. "Avoid lifting your arm above your shoulder on the affected side for 1-2 weeks."
B. "You can no longer use a microwave oven."
C. "Avoid close contact with people who have infections."
D. "Take your pulse once a week."
✓ A. "Avoid lifting your arm above your shoulder on the affected side for 1-2 weeks." (This
prevents dislodgement of the newly placed leads.)
8. A client with deep vein thrombosis (DVT) is on a heparin infusion. The nurse should ensure
which antidote is available at the bedside?
A. Vitamin K.
B. Naloxone (Narcan).
C. Protamine Sulfate.
,D. Flumazenil (Romazicon).
✓ C. Protamine Sulfate. (This is the specific antidote for heparin.)
Respiratory Disorders
9. A client with COPD has a PaO2 of 50 mmHg and an oxygen saturation of 80%. Which oxygen
delivery device is most appropriate?
A. Nasal cannula at 2 L/min.
B. Simple face mask at 5 L/min.
C. Venturi mask at 24% FiO2.
D. Non-rebreather mask at 10 L/min.
✓ D. Non-rebreather mask at 10 L/min. (This client is severely hypoxemic and requires high-
flow, high-concentration oxygen. Clients with COPD who are in acute respiratory failure are
treated with high O2; the risk of CO2 narcosis is secondary to correcting life-threatening
hypoxia.)
10. The nurse is suctioning a client with a tracheostomy. To prevent hypoxia during the
procedure, the nurse should:
A. Apply suction for a maximum of 30 seconds.
B. Hyperoxygenate before and after suctioning.
C. Use a sterile wet-saline lavage during suctioning.
D. Apply suction while inserting the catheter.
✓ B. Hyperoxygenate before and after suctioning. (This helps prevent hypoxia. Suction should
be applied only while withdrawing the catheter and for no more than 10-15 seconds.)
11. A client is admitted with a suspected pulmonary embolism. Which finding is most
commonly associated with this condition?
A. Productive cough with yellow sputum.
B. Bradypnea.
C. Pleuritic chest pain.
D. Bradycardia.
✓ C. Pleuritic chest pain. (Sharp, stabbing chest pain that worsens on inspiration is a classic
symptom of PE.)
12. The nurse is preparing a client for a thoracentesis. In which position should the client be
placed?
A. Sims' position.
B. Sitting on the edge of the bed, leaning forward over a bedside table.
C. Trendelenburg.
D. Supine with legs elevated.
, ✓ B. Sitting on the edge of the bed, leaning forward over a bedside table. (This position
spreads the intercostal spaces and allows fluid to pool at the lung bases for easier removal.)
13. A client with tuberculosis is placed on Airborne Precautions. Which type of room is
required?
A. A private room with positive pressure airflow.
B. A private room with negative pressure airflow.
C. A room with the door kept open.
D. A room with standard precautions only.
✓ B. A private room with negative pressure airflow. (This prevents contaminated air from
flowing out into the hallway.)
14. Which finding for a client with asthma indicates that therapy has been effective?
A. Wheezing becomes louder.
B. PaCO2 increases to 45 mmHg.
C. Peak expiratory flow rate increases.
D. Respiratory rate decreases to 8 breaths/minute.
✓ C. Peak expiratory flow rate increases. (This indicates improved airflow and bronchodilation.
Louder wheezing can mean air movement is still severely obstructed.)
15. The nurse is teaching a client about using an albuterol inhaler and a fluticasone inhaler.
The client should be instructed to use the albuterol inhaler:
A. Only at bedtime.
B. 5 minutes after the fluticasone inhaler.
C. Only when experiencing an acute attack.
D. 5 minutes before the fluticasone inhaler.
✓ D. 5 minutes before the fluticasone inhaler. (The bronchodilator (albuterol) opens the
airways first, allowing the corticosteroid (fluticasone) to penetrate deeper into the lungs.)
16. After a client undergoes a total laryngectomy, the nurse should expect:
A. The client will have a temporary voice loss.
B. The client will breathe through a stoma in the neck.
C. The client will be able to swallow normally immediately.
D. The client can aspirate easily.
✓ B. The client will breathe through a stoma in the neck. (A total laryngectomy creates a
permanent stoma; the upper and lower airways are no longer connected.)
Neurological Disorders
