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NUR 265 ATI Medical-Surgical Proctored Exam: Spring Nursing Practice Questions & Rationales

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This comprehensive study resource is designed for nursing students enrolled in NUR 265 (Advanced Medical-Surgical Nursing) at Galen College of Nursing, preparing for the ATI Med-Surg Proctored Exam during the Spring semester. The guide features exam-style questions and detailed answer rationales covering high-priority topics frequently tested on ATI proctored assessments. Content areas include fluid and electrolyte imbalances (hyperkalemia, hypokalemia, SIADH), cardiovascular emergencies (heart failure, cardiac tamponade, pericarditis), respiratory disorders (COPD, pulmonary embolism, pneumothorax), endocrine crises (DKA, HHS, thyroidectomy complications), renal and gastrointestinal conditions (CKD, hepatic encephalopathy, pancreatitis), immunological disorders (AIDS, anaphylaxis, neutropenic precautions), oncology emergencies (tumor lysis syndrome, febrile neutropenia), and neurological emergencies (autonomic dysreflexia, spinal cord injury).

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ATI Med Surg Proctored Exam Questions & Answers
Spring 2025-2026

1. A nurse is caring for a client who experienced a traumatic head injury and has an intraventricular
catheter (Ventriculostomy) for ICP monitoring. The nurse should monitor the client for which of the
following complications related to the ventriculostomy?:



a. Headache

b. Infection

c. Aphasia

d. Hypertension (Correct Answer)

- ✅ b. Infection

Monitor for infection and use strict asepsis to avoid life-threatening meningitis.



2. A nurse is providing education to a client who is to undergo an EEG the next day. Which of the
followinginfo should the nurse include in the teaching?



a. "Do not wash your hair the morning of the procedure."

b. "Try and stay awake most of the night prior to the procedure."

c. "The procedure will take approximately 15 mins."

d. "You will need to lie flat for 4 hours after the procedure."

(Correct Answer) - ✅ b. "Try and stayawake most of the night prior to the procedure."

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Tell the client to remain awake to provide cranial stress and increase the possibility of abnormal
electrical activity



3. A nurse is caring for a client who is postprocedural following a lumbar puncture and reports a
throbbingheadache when sitting upright. Which of the following actions should the nurse take? SATA.


a. Use the GCS scale to assess the client

b. Assist the client into a supine position

c. Administer an opioid analgesic

d. Encourage the client to increase PO fluid intake

e. Instruct the client to perform coughing and deep breathing

(Correct Answer) - ✅ B, D



4. A nurse is caring for a client who has continuous bladder irrigation following a transurethral
resection ofthe prostate (TURP). Which of the following findings should the nurse report to the
provider?



a Output equal to the instilled irrigate

b. Client reports bladder spasms

c. Viscous urinary output with clots

d. Reports of strong urge to urinate

(Correct Answer) - ✅ c. Viscous urinary output with clots



Urine that is bright red with clots is an indication of arterial bleeding.



5. A nurse is monitoring the ECG of a client who has hypocalcemia. Which of the following findings
shouldthe nurse expect?

a. Flattened T waves

b. Prolonged QT intervals

c. Shortened QT intervals

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d Widened QRS complexes

(Correct Answer) - ✅ b. Prolonged QT intervals

Manifestations of hypocalcemia include tingling, numbness, tetany, seizures, prolonged QT intervals,
and laryngospasm.


6. A nurse is preparing a client who has a brain tumor for a CT scan. Which of the following factors
affectsthe manner in which the nurse will prepare the client for the scan?



a. No food or fluids consumed for 4 hours

b. Difficulty recalling recent events

c. Development of hives while eating shrimp

d. Paresthesia in both hands

(Correct Answer) - ✅ c. Development of hives while eating shrimp

Shellfish allergy is contraindication of use of contrast media during a CT scan.



7. A nurse is preparing an in-service program about the stages of acute kidney injury. Which of the
following pieces of info should the nurse include about prerenal azotemia?



a. Prerenal azotemia begins prior to the onset of symptoms

b. Interference with renal perfusion causes renal azotemia

c. Prerenal azotemia is irreversible, even in early stages

d. Infections and tumors cause prerenal azotemia

(Correct Answer) - ✅ b. Interference with renalperfusion causes prerenal azotemia.

Prerenal = interference with renal perfusion, such as from heart failure or hypovolemic shock.


8. A nurse is teaching a client who has CAD about the difference between angina pectoris and MI.
Which ofthe following should the nurse identify as indications of MI? SATA.

a. N/V

b. Diaphoresis and dizziness

c. Chest and left arm pain that subsides with rest

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d. Anxiety and feelings of doom
e. Bounding pulse and bradypnea
(Correct Answer) - ✅ A, B, D



9. A nurse is reviewing the lab results of a lumbar puncture for a client who has manifestations of
bacterialmeningitis. Which of the following findings should the nurse expect?



a. Elevated glucose

b. Elevated protein

c. Presence of RBCs

d. Presence of D-dimer

(Correct Answer) - ✅ b. Elevated protein



Manifestations of bacterial meningitis include increase protein in the CSF, decreased glucose. RBCs can
indicate bleeding, however, WBCs are what indicates bacterial meningitis.



10. A nurse is providing teaching to a client who has a new diagnosis of myasthenia gravis (MG).
Which ofthe following pieces of information should the nurse include?



A. Use enemas to treat constipation caused by daily medications

B. Take a hot bath when muscles ache

C. Eat a low-calorie diet

D. Set an alarm to ensure medication dosages are taken on time

(Correct Answer) - ✅ D. Set an alarmto ensure medication dosages are taken on time



The nurse should instruct the client to take medication dosages on time to maintain a therapeutic blood
level. Dosages should not be missed or postponed because this can cause an exacerbation of the
disease.


11. A nurse is teaching a client who has a new diagnosis of primary open-angle glaucoma (POAG).
Which ofthe following pieces of information should the nurse include in the teaching? (Select all that

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