ATI Medical-Surgical Review 2026 – Musculoskeletal, Gastrointestinal,
Immune & Infectious Exam Questions and Study Guide
A nurse is planning discharge teaching for a client who has systemic lupus
erythematous (SLE). Which of the following instructions should the nurse plan to
include?
A. "Avoid the use of NSAIDs."
B. "Stop taking the corticosteroids when your symptoms resolve."
C. "Exposure to ultraviolet light will help control the skin rashes."
D. "Monitor your body temperature and report any elevations promptly.": Mon-
itor your body temperature and report any elevations promptly."
SLE is a chronic autoimmune disorder that can attect any organ of the body. With SLE, the body's immune system
becomes hyperactive, forming antibodies that attack tissues and organs, including the skin, joints, kidneys, brain,
heart, lungs, and blood. SLE is characterized by periods of exacerbation and remissions. The nurse should teach the
client to monitor body temperature and report any elevations promptly, as fever can suggest either an exacerbation
or a potentially life-threatening infection.
2. A nurse is caring for a client who has systemic lupus erythematosus (SLE)
and is concerned about skin lesions on the face and neck. The client asks the
nurse, "what should I do about these spots?" which of the following nursing
responses should the nurse give?
A. "Keep the lesions covered with a light sterile dressing when going out-
doors"
B. "There is not much you can do. The lesions will go away when your disease
is in remission"
C. "Apply moisturizer after bathing the lesions with warm water"
D. "Apply antibiotic cream twice a day until scabs form on the lesions": "Apply
moisturizer after bathing the lesions with warm water."
The nurse should instruct the client to clean, dry, and moisturize the skin using warm (not hot) water, along with an
unscented lotion.
,3. A nurse is caring for a client who is 3 days postoperative following a right
total hip arthroplasty. While transferring to a chair, the client cries out in pain.
The nurse should assess the client for which of the following manifestations
of dislocation of the hip prosthesis?
A. Bulging in the area over the surgical incision
B. Shortening of the right leg
C. Sensation of warmth over the surgical incision
D. Pallor following elevation of the right leg: Shortening of the right leg
The nurse should monitor the client for shortening of the attected leg as an indication of dislocation of the prosthesis.
Other findings include increased hip pain, inability to move the extremity, and rotation of the hip internally or
externally.
4. A nurse is caring for a client who has a pelvic fracture. The client reports
sudden shortness of breath, stabbing chest pain, and feelings of doom. The
nurse should identify that the client is experiencing which of the following
complications?
A. Pneumonia
B. Pulmonary embolus
C. Tension pneumothorax
D. Tuberculosis: Pulmonary embolus
Immobility following musculoskeletal trauma places the client at an increased risk for pulmonary embolus. The client
might also exhibit tachycardia, chest petechiae, and have a decreased SaO2. The nurse should notify the rapid
response team immediately.
5. A nurse is caring for a client who is in skeletal traction following a femur
fracture. The nurse finds the client has slid down toward the foot of the bed
and the traction weight is resting on the floor. Which of the following actions
should the nurse take?
,A. Remove the weight temporarily to reposition the client to the correct
alignment in bed.
B. Have the client use a trapeze to pull himself up while ensuring the weight
hangs freely.
C. Lift the rope off the pulley while the client rocks back and forth to reposi-
tion.
D. Lift the weight manually while another staff member moves the client up
in bed.: Have the client use a trapeze to pull himself up while ensuring the weight hangs freely.
The nurse should ensure that traction weight is hanging freely. The client can use an overhead trapeze bar to move
up in bed, or the nurse can assist the client up, making sure to maintain proper alignment of the extremity.
6. A nurse is providing preoperative teaching for a client who is scheduled for
total knee arthroplasty. Which of the following statements by the client should
the nurse identify as understanding of the teaching?
A. "I will wear a continuous movement machine on my knee for 24 hours a
day."
B. "I should avoid taking NSAID medications for pain after surgery."
C. "I should wear elastic stockings on both of my legs."
D. "I will begin exercising my legs the day after surgery.": "I should wear elastic stockings
on both of my legs."
The purpose of elastic stockings is to prevent venous thromboembolism, which is a common complication following
orthopedic surgery. Therefore, the nurse should identify this statement as understanding of the teaching.
7. A nurse is discussing the difference between rheumatoid arthritis (RA) and
osteoarthritis with a newly licensed nurse. Which of the following information
should the nurse include about osteoarthritis?
A. "Osteoarthritis is caused by autoimmune processes."
B. "Osteoarthritis leads to a decreased erythrocyte sedimentation rate."
C. "Osteoarthritis affects other organ systems."
, D. "Osteoarthritis can impair a joint on a single side of the body.": "Osteoarthritis
can impair a joint on a single side of the body."
The nurse should identify unilateral joint involvement as a finding of osteoarthritis. A client who has RA experiences
symmetrical joint impairment.
8. A nurse is assessing a client who is 24 hr postoperative following an
above-the-elbow amputation. Which of the following findings should the
nurse identify as the priority?
A. Report of muscle spasms
B. Inability to get dressed without assistance
C. Report of feelings of anger
D. Refusal to look at the affected limb: Report of muscle spasms
The nurse should consider Maslow's hierarchy of needs, which includes five levels of priority. The first level consists
of physiological needs; the second level consists of safety and security needs; the third level consists of love and
belonging needs; the fourth level consists of personal achievement and self-esteem needs; and the fifth level consists
of achieving full potential and the ability to problem solve and cope with life situations. When applying Maslow's
hierarchy of needs priority-setting framework, the nurse should review physiological needs first. The nurse should
then address the client's needs by following the remaining four hierarchal levels. It is important, however, for the
nurse to consider all contributing client factors, as higher levels of the pyramid can compete with those at the lower
levels, depending on the specific client situation. The fourth level of Maslow's hierarchy of needs includes usefulness,
self-worth, and self-confidence in fulfilling self-esteem needs. Therefore, the nurse should identify the report of
muscle spasms, a physiological need, as the priority client finding.
9. A nurse in the emergency department is preparing to discharge a client fol-
lowing a Grade II (moderate) ankle sprain. Which of the following instructions
should the nurse plan to give to the client?
A. Perform passive range-of-motion exercises of the ankle hourly.
B. Keep the affected extremity in a dependent position.
C. Wrap a loose dressing around the affected ankle.
Immune & Infectious Exam Questions and Study Guide
A nurse is planning discharge teaching for a client who has systemic lupus
erythematous (SLE). Which of the following instructions should the nurse plan to
include?
A. "Avoid the use of NSAIDs."
B. "Stop taking the corticosteroids when your symptoms resolve."
C. "Exposure to ultraviolet light will help control the skin rashes."
D. "Monitor your body temperature and report any elevations promptly.": Mon-
itor your body temperature and report any elevations promptly."
SLE is a chronic autoimmune disorder that can attect any organ of the body. With SLE, the body's immune system
becomes hyperactive, forming antibodies that attack tissues and organs, including the skin, joints, kidneys, brain,
heart, lungs, and blood. SLE is characterized by periods of exacerbation and remissions. The nurse should teach the
client to monitor body temperature and report any elevations promptly, as fever can suggest either an exacerbation
or a potentially life-threatening infection.
2. A nurse is caring for a client who has systemic lupus erythematosus (SLE)
and is concerned about skin lesions on the face and neck. The client asks the
nurse, "what should I do about these spots?" which of the following nursing
responses should the nurse give?
A. "Keep the lesions covered with a light sterile dressing when going out-
doors"
B. "There is not much you can do. The lesions will go away when your disease
is in remission"
C. "Apply moisturizer after bathing the lesions with warm water"
D. "Apply antibiotic cream twice a day until scabs form on the lesions": "Apply
moisturizer after bathing the lesions with warm water."
The nurse should instruct the client to clean, dry, and moisturize the skin using warm (not hot) water, along with an
unscented lotion.
,3. A nurse is caring for a client who is 3 days postoperative following a right
total hip arthroplasty. While transferring to a chair, the client cries out in pain.
The nurse should assess the client for which of the following manifestations
of dislocation of the hip prosthesis?
A. Bulging in the area over the surgical incision
B. Shortening of the right leg
C. Sensation of warmth over the surgical incision
D. Pallor following elevation of the right leg: Shortening of the right leg
The nurse should monitor the client for shortening of the attected leg as an indication of dislocation of the prosthesis.
Other findings include increased hip pain, inability to move the extremity, and rotation of the hip internally or
externally.
4. A nurse is caring for a client who has a pelvic fracture. The client reports
sudden shortness of breath, stabbing chest pain, and feelings of doom. The
nurse should identify that the client is experiencing which of the following
complications?
A. Pneumonia
B. Pulmonary embolus
C. Tension pneumothorax
D. Tuberculosis: Pulmonary embolus
Immobility following musculoskeletal trauma places the client at an increased risk for pulmonary embolus. The client
might also exhibit tachycardia, chest petechiae, and have a decreased SaO2. The nurse should notify the rapid
response team immediately.
5. A nurse is caring for a client who is in skeletal traction following a femur
fracture. The nurse finds the client has slid down toward the foot of the bed
and the traction weight is resting on the floor. Which of the following actions
should the nurse take?
,A. Remove the weight temporarily to reposition the client to the correct
alignment in bed.
B. Have the client use a trapeze to pull himself up while ensuring the weight
hangs freely.
C. Lift the rope off the pulley while the client rocks back and forth to reposi-
tion.
D. Lift the weight manually while another staff member moves the client up
in bed.: Have the client use a trapeze to pull himself up while ensuring the weight hangs freely.
The nurse should ensure that traction weight is hanging freely. The client can use an overhead trapeze bar to move
up in bed, or the nurse can assist the client up, making sure to maintain proper alignment of the extremity.
6. A nurse is providing preoperative teaching for a client who is scheduled for
total knee arthroplasty. Which of the following statements by the client should
the nurse identify as understanding of the teaching?
A. "I will wear a continuous movement machine on my knee for 24 hours a
day."
B. "I should avoid taking NSAID medications for pain after surgery."
C. "I should wear elastic stockings on both of my legs."
D. "I will begin exercising my legs the day after surgery.": "I should wear elastic stockings
on both of my legs."
The purpose of elastic stockings is to prevent venous thromboembolism, which is a common complication following
orthopedic surgery. Therefore, the nurse should identify this statement as understanding of the teaching.
7. A nurse is discussing the difference between rheumatoid arthritis (RA) and
osteoarthritis with a newly licensed nurse. Which of the following information
should the nurse include about osteoarthritis?
A. "Osteoarthritis is caused by autoimmune processes."
B. "Osteoarthritis leads to a decreased erythrocyte sedimentation rate."
C. "Osteoarthritis affects other organ systems."
, D. "Osteoarthritis can impair a joint on a single side of the body.": "Osteoarthritis
can impair a joint on a single side of the body."
The nurse should identify unilateral joint involvement as a finding of osteoarthritis. A client who has RA experiences
symmetrical joint impairment.
8. A nurse is assessing a client who is 24 hr postoperative following an
above-the-elbow amputation. Which of the following findings should the
nurse identify as the priority?
A. Report of muscle spasms
B. Inability to get dressed without assistance
C. Report of feelings of anger
D. Refusal to look at the affected limb: Report of muscle spasms
The nurse should consider Maslow's hierarchy of needs, which includes five levels of priority. The first level consists
of physiological needs; the second level consists of safety and security needs; the third level consists of love and
belonging needs; the fourth level consists of personal achievement and self-esteem needs; and the fifth level consists
of achieving full potential and the ability to problem solve and cope with life situations. When applying Maslow's
hierarchy of needs priority-setting framework, the nurse should review physiological needs first. The nurse should
then address the client's needs by following the remaining four hierarchal levels. It is important, however, for the
nurse to consider all contributing client factors, as higher levels of the pyramid can compete with those at the lower
levels, depending on the specific client situation. The fourth level of Maslow's hierarchy of needs includes usefulness,
self-worth, and self-confidence in fulfilling self-esteem needs. Therefore, the nurse should identify the report of
muscle spasms, a physiological need, as the priority client finding.
9. A nurse in the emergency department is preparing to discharge a client fol-
lowing a Grade II (moderate) ankle sprain. Which of the following instructions
should the nurse plan to give to the client?
A. Perform passive range-of-motion exercises of the ankle hourly.
B. Keep the affected extremity in a dependent position.
C. Wrap a loose dressing around the affected ankle.
