1|Page
MED SURG ATI ADVANCED FINAL EXAM /ATI MED SURG ADVANCED FINAL
PROCTORED 2025-2026 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS
A patient with myasthenia gravis is admitted to the hospital with respiratory insufficiency
and severe weakness. When is a diagnosis of cholinergic crisis made?
a. The patient's respiration is impaired because of muscle weakness.
b. Administration of edrophonium (Tensilon) increases muscle weakness.
c. Administration of edrophonium (Tensilon) results in improved muscle contractility.
d. EMG reveals decreased response to repeated stimulation of muscles. - CORRECT
ANSWER b.
The reduction of the acetylcholine (ACh) effect in myasthenia gravis (MG) is treated with
anticholinesterase drugs, which prolong the action of ACh at the neuromuscular synapse,
but too much of these drugs will cause a cholinergic crisis with symptoms very similar to
those of MG. To determine whether the patient's manifestations are due to a deficiency of
ACh or to too much anticholinesterase drug, the anticholinesterase drug edrophonium
chloride (Tensilon) is administered. If the patient is in cholinergic crisis, the patient's
symptoms will worsen; if the patient is in a myasthenic crisis, the patient will improve.
QUESTION :During care of a patient in myasthenic crisis, maintenance of what is the
nurse's first priority for the patient?
a. Mobility
b. Nutrition
c. Respiratory function
d. Verbal communication - CORRECT ANSWER c.
The patient in myasthenic crisis has severe weakness and fatigability of all skeletal muscles,
affecting the patient's ability to breathe, swallow, talk, and move. However, the priority of
nursing care is monitoring and maintaining adequate ventilation.
2026 2027 GRADED A+
,2|Page
QUESTION :When providing care for a patient with ALS, the nurse recognizes what as
one of the most distressing problems experienced by the patient?
a. Painful spasticity of the face and extremities
b. Retention of cognitive function with total degeneration of motor function
c. Uncontrollable writhing and twisting movements of the face, limbs, and body
d. Knowledge that there is a 50% chance the disease has been passed to any offspring -
CORRECT ANSWER b.
In ALS there is gradual degeneration of motor neurons with extreme muscle wasting from
lack of stimulation and use. However, cognitive function is not impaired and patients feel
trapped in a dying body. Chorea manifested by writhing, involuntary movements is
characteristic of HD. As an autosomal dominant genetic disease, HD also has a 50% chance
of being passed to each offspring.
QUESTION :In providing care for patients with chronic, progressive neurologic disease,
what is the major goal of treatment that the nurse works toward?
a. Meet the patient's personal care needs.
b. Return the patient to normal neurologic function.
c. Maximize neurologic functioning for as long as possible.
d. Prevent the development of additional chronic diseases. - CORRECT ANSWER c.
Many chronic neurologic diseases involve progressive deterioration in physical or mental
capabilities and have no cure, with devastating results for patients and families. Health
care providers can only attempt to alleviate physical symptoms, prevent complications, and
assist patients in maximizing function and self-care abilities for as long as possible.
QUESTION :The nurse determines that teaching about management of migraine
headaches has been effective when the patient says which of the following?
2026 2027 GRADED A+
,3|Page
a. "I can take the (Topamax) as soon as a headache starts."
b. "A glass of wine might help me relax and prevent a headache."
c. "I will lie down someplace dark and quiet when the headaches begin."
d. "I should avoid taking aspirin and sumatriptan (Imitrex) at the same time." -
CORRECT ANSWER C.
It is recommended that the patient with a migraine rest in a dark, quiet area. Topiramate
(Topamax) is used to prevent migraines and must be taken for several months to determine
effectiveness. Aspirin or other nonsteroidal antiinflammatory medications can be taken
with the triptans. Alcohol may precipitate migraine headaches.
QUESTION :A patient who is having an acute exacerbation of multiple sclerosis has a
prescription for methylprednisolone (Solu-Medrol) 160 mg IV. The label on the vial reads:
methylprednisolone 125 mg in 2 mL. How many mL will the nurse administer? -
CORRECT ANSWER 2.56. With a concentration of 125 mg/2 mL, the nurse will need
to administer 2.56 mL to obtain 160 mg of methylprednisolone.
QUESTION :The nurse will assess a 67-year-old patient who is experiencing a cluster
headache for
a. nuchal rigidity.
b. unilateral ptosis.
c. projectile vomiting.
d. throbbing, bilateral facial pain. - CORRECT ANSWER B.
Unilateral eye edema, tearing, and ptosis are characteristic of cluster headaches. Nuchal
rigidity suggests meningeal irritation, such as occurs with meningitis. Although nausea and
vomiting may occur with migraine headaches, projectile vomiting is more consistent with
increased intracranial pressure (ICP). Unilateral sharp, stabbing pain, rather than
throbbing pain, is characteristic of cluster headaches.
2026 2027 GRADED A+
, 4|Page
QUESTION :While the nurse is transporting a patient on a stretcher to the radiology
department, the patient begins having a tonic-clonic seizure. Which action should the nurse
take?
a. Insert an oral airway during the seizure to maintain a patent airway.
b. Restrain the patient's arms and legs to prevent injury during the seizure.
c. Time and observe and record the details of the seizure and postictal state.
d. Avoid touching the patient to prevent further nervous system stimulation. - CORRECT
ANSWER C.
Because the diagnosis and treatment of seizures frequently are based on the description of
the seizure, recording the length and details of the seizure is important. Insertion of an oral
airway and restraining the patient during the seizure are contraindicated. The nurse may
need to move the patient to decrease the risk of injury during the seizure.
QUESTION :A high school teacher who has just been diagnosed with epilepsy after having
a generalized tonic-clonic seizure tells the nurse, "I cannot teach anymore, it will be too
upsetting if I have a seizure at work." Which response by the nurse is best?
a. "You might benefit from some psychologic counseling."
b. "Epilepsy usually can be well controlled with medications."
c. "You will want to contact the Epilepsy Foundation for assistance."
d. "The Department of Vocational Rehabilitation can help with work retraining." -
CORRECT ANSWER B.
The nurse should inform the patient that most patients with seizure disorders are
controlled with medication. The other information may be necessary if the seizures persist
after treatment with antiseizure medications is implemented.
2026 2027 GRADED A+
MED SURG ATI ADVANCED FINAL EXAM /ATI MED SURG ADVANCED FINAL
PROCTORED 2025-2026 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS
A patient with myasthenia gravis is admitted to the hospital with respiratory insufficiency
and severe weakness. When is a diagnosis of cholinergic crisis made?
a. The patient's respiration is impaired because of muscle weakness.
b. Administration of edrophonium (Tensilon) increases muscle weakness.
c. Administration of edrophonium (Tensilon) results in improved muscle contractility.
d. EMG reveals decreased response to repeated stimulation of muscles. - CORRECT
ANSWER b.
The reduction of the acetylcholine (ACh) effect in myasthenia gravis (MG) is treated with
anticholinesterase drugs, which prolong the action of ACh at the neuromuscular synapse,
but too much of these drugs will cause a cholinergic crisis with symptoms very similar to
those of MG. To determine whether the patient's manifestations are due to a deficiency of
ACh or to too much anticholinesterase drug, the anticholinesterase drug edrophonium
chloride (Tensilon) is administered. If the patient is in cholinergic crisis, the patient's
symptoms will worsen; if the patient is in a myasthenic crisis, the patient will improve.
QUESTION :During care of a patient in myasthenic crisis, maintenance of what is the
nurse's first priority for the patient?
a. Mobility
b. Nutrition
c. Respiratory function
d. Verbal communication - CORRECT ANSWER c.
The patient in myasthenic crisis has severe weakness and fatigability of all skeletal muscles,
affecting the patient's ability to breathe, swallow, talk, and move. However, the priority of
nursing care is monitoring and maintaining adequate ventilation.
2026 2027 GRADED A+
,2|Page
QUESTION :When providing care for a patient with ALS, the nurse recognizes what as
one of the most distressing problems experienced by the patient?
a. Painful spasticity of the face and extremities
b. Retention of cognitive function with total degeneration of motor function
c. Uncontrollable writhing and twisting movements of the face, limbs, and body
d. Knowledge that there is a 50% chance the disease has been passed to any offspring -
CORRECT ANSWER b.
In ALS there is gradual degeneration of motor neurons with extreme muscle wasting from
lack of stimulation and use. However, cognitive function is not impaired and patients feel
trapped in a dying body. Chorea manifested by writhing, involuntary movements is
characteristic of HD. As an autosomal dominant genetic disease, HD also has a 50% chance
of being passed to each offspring.
QUESTION :In providing care for patients with chronic, progressive neurologic disease,
what is the major goal of treatment that the nurse works toward?
a. Meet the patient's personal care needs.
b. Return the patient to normal neurologic function.
c. Maximize neurologic functioning for as long as possible.
d. Prevent the development of additional chronic diseases. - CORRECT ANSWER c.
Many chronic neurologic diseases involve progressive deterioration in physical or mental
capabilities and have no cure, with devastating results for patients and families. Health
care providers can only attempt to alleviate physical symptoms, prevent complications, and
assist patients in maximizing function and self-care abilities for as long as possible.
QUESTION :The nurse determines that teaching about management of migraine
headaches has been effective when the patient says which of the following?
2026 2027 GRADED A+
,3|Page
a. "I can take the (Topamax) as soon as a headache starts."
b. "A glass of wine might help me relax and prevent a headache."
c. "I will lie down someplace dark and quiet when the headaches begin."
d. "I should avoid taking aspirin and sumatriptan (Imitrex) at the same time." -
CORRECT ANSWER C.
It is recommended that the patient with a migraine rest in a dark, quiet area. Topiramate
(Topamax) is used to prevent migraines and must be taken for several months to determine
effectiveness. Aspirin or other nonsteroidal antiinflammatory medications can be taken
with the triptans. Alcohol may precipitate migraine headaches.
QUESTION :A patient who is having an acute exacerbation of multiple sclerosis has a
prescription for methylprednisolone (Solu-Medrol) 160 mg IV. The label on the vial reads:
methylprednisolone 125 mg in 2 mL. How many mL will the nurse administer? -
CORRECT ANSWER 2.56. With a concentration of 125 mg/2 mL, the nurse will need
to administer 2.56 mL to obtain 160 mg of methylprednisolone.
QUESTION :The nurse will assess a 67-year-old patient who is experiencing a cluster
headache for
a. nuchal rigidity.
b. unilateral ptosis.
c. projectile vomiting.
d. throbbing, bilateral facial pain. - CORRECT ANSWER B.
Unilateral eye edema, tearing, and ptosis are characteristic of cluster headaches. Nuchal
rigidity suggests meningeal irritation, such as occurs with meningitis. Although nausea and
vomiting may occur with migraine headaches, projectile vomiting is more consistent with
increased intracranial pressure (ICP). Unilateral sharp, stabbing pain, rather than
throbbing pain, is characteristic of cluster headaches.
2026 2027 GRADED A+
, 4|Page
QUESTION :While the nurse is transporting a patient on a stretcher to the radiology
department, the patient begins having a tonic-clonic seizure. Which action should the nurse
take?
a. Insert an oral airway during the seizure to maintain a patent airway.
b. Restrain the patient's arms and legs to prevent injury during the seizure.
c. Time and observe and record the details of the seizure and postictal state.
d. Avoid touching the patient to prevent further nervous system stimulation. - CORRECT
ANSWER C.
Because the diagnosis and treatment of seizures frequently are based on the description of
the seizure, recording the length and details of the seizure is important. Insertion of an oral
airway and restraining the patient during the seizure are contraindicated. The nurse may
need to move the patient to decrease the risk of injury during the seizure.
QUESTION :A high school teacher who has just been diagnosed with epilepsy after having
a generalized tonic-clonic seizure tells the nurse, "I cannot teach anymore, it will be too
upsetting if I have a seizure at work." Which response by the nurse is best?
a. "You might benefit from some psychologic counseling."
b. "Epilepsy usually can be well controlled with medications."
c. "You will want to contact the Epilepsy Foundation for assistance."
d. "The Department of Vocational Rehabilitation can help with work retraining." -
CORRECT ANSWER B.
The nurse should inform the patient that most patients with seizure disorders are
controlled with medication. The other information may be necessary if the seizures persist
after treatment with antiseizure medications is implemented.
2026 2027 GRADED A+
