ATI Med-Surg CMS Proctored Exam Practice -
2026-2027 Blueprint | 110 Item Set | Verified
Answers & Clinical-Judgment Rationales
110 Item Set
MANAGEMENT OF CARE (20-25 %) ‑ 27 ITEMS
Q1
The nurse is reviewing post-op orders for a client who had a total hip replacement 8 h
ago. Which prescription should the nurse question?
A. Enoxaparin 40 mg sub-q daily
B. Morphine 2 mg IV q2h PRN severe pain
C. Warfarin 5 mg PO daily
D. Ibuprofen 600 mg PO q6h PRN pain
Correct: D
Rationale: NSAIDs impair platelet function and may delay bone healing; they are usually
avoided in early post-op orthopedic period. Enoxaparin (A) & warfarin (C) are standard
VTE prophylaxis; morphine (B) appropriate for pain.
Q2
,A charge nurse is assigning clients on a med-surg unit. Which client should be assigned
to the float LPN who is unfamiliar with the unit?
A. New admit with rule-out MI awaiting cardiac cath
B. Post-op day-2 laparoscopy client needing discharge teaching
C. Client with chest tube after thoracotomy on continuous bubbling
D. Stable client 24 h post-op appendectomy with PCA teaching
Correct: D
Rationale: LPN scope includes stable post-op care & basic teaching under RN
supervision. Options A, B, C require RN assessment/ teaching of high-risk or unstable
clients.
Q3
The nurse is caring for a client with a new colostomy. The client states, “I’m
embarrassed—my spouse won’t look at it.” What is the nurse’s best first action?
A. Request wound-ostomy nurse to provide teaching supplies
B. Offer to bring in a former client with ostomy to talk
C. Acknowledge feelings & explore concerns privately
D. Teach the spouse stoma care during next visit
Correct: C
,Rationale: Therapeutic communication (Recognize/Analyze Cues) addresses
psychosocial priority. Acknowledging feelings builds trust; other actions premature
without understanding concerns.
Q4
A client’s family asks to see the medical record “to check labs.” What is the nurse’s best
response?
A. Provide the chart at the nurses’ station
B. Call the physician for permission
C. Explain that a written release is required
D. Print most recent lab results
Correct: C
Rationale: HIPAA requires written authorization from client or legal guardian before
releasing records to family. Nurse role is advocacy & confidentiality.
Q5
The nurse notes a verbal order for “Lasix 80 mg IV push now.” Which action follows the
ANA Code of Ethics?
A. Administer the drug immediately
B. Repeat the order to prescriber, enter in CPOE, then administer
C. Ask prescriber to enter order within 1 hr
D. Refuse to accept verbal order
, Correct: C
Rationale: Verbal orders accepted only in emergent/sterile procedures; routine settings
require prescriber to enter electronically (C) to prevent errors. A & B unsafe; D too
absolute if emergent.
Q6
During bedside report, the off-going nurse states, “The client is non-compliant.” The
on-coming nurse should:
A. Document “non-compliant” in the plan
B. Ask for specific behavior examples
C. Inform the client about the label
D. Tell the nurse manager
Correct: B
Rationale: Clarify subjective labels (Generate Solutions) to plan individualized care;
“non-compliant” is judgmental and lacks actionable data.
Q7
Which task can the nurse delegate to AP after hip replacement surgery?
A. Assess neurovascular status of operative leg
B. Transfer client from bed to chair first time
C. Measure vital signs q4h
D. Evaluate incisional pain
2026-2027 Blueprint | 110 Item Set | Verified
Answers & Clinical-Judgment Rationales
110 Item Set
MANAGEMENT OF CARE (20-25 %) ‑ 27 ITEMS
Q1
The nurse is reviewing post-op orders for a client who had a total hip replacement 8 h
ago. Which prescription should the nurse question?
A. Enoxaparin 40 mg sub-q daily
B. Morphine 2 mg IV q2h PRN severe pain
C. Warfarin 5 mg PO daily
D. Ibuprofen 600 mg PO q6h PRN pain
Correct: D
Rationale: NSAIDs impair platelet function and may delay bone healing; they are usually
avoided in early post-op orthopedic period. Enoxaparin (A) & warfarin (C) are standard
VTE prophylaxis; morphine (B) appropriate for pain.
Q2
,A charge nurse is assigning clients on a med-surg unit. Which client should be assigned
to the float LPN who is unfamiliar with the unit?
A. New admit with rule-out MI awaiting cardiac cath
B. Post-op day-2 laparoscopy client needing discharge teaching
C. Client with chest tube after thoracotomy on continuous bubbling
D. Stable client 24 h post-op appendectomy with PCA teaching
Correct: D
Rationale: LPN scope includes stable post-op care & basic teaching under RN
supervision. Options A, B, C require RN assessment/ teaching of high-risk or unstable
clients.
Q3
The nurse is caring for a client with a new colostomy. The client states, “I’m
embarrassed—my spouse won’t look at it.” What is the nurse’s best first action?
A. Request wound-ostomy nurse to provide teaching supplies
B. Offer to bring in a former client with ostomy to talk
C. Acknowledge feelings & explore concerns privately
D. Teach the spouse stoma care during next visit
Correct: C
,Rationale: Therapeutic communication (Recognize/Analyze Cues) addresses
psychosocial priority. Acknowledging feelings builds trust; other actions premature
without understanding concerns.
Q4
A client’s family asks to see the medical record “to check labs.” What is the nurse’s best
response?
A. Provide the chart at the nurses’ station
B. Call the physician for permission
C. Explain that a written release is required
D. Print most recent lab results
Correct: C
Rationale: HIPAA requires written authorization from client or legal guardian before
releasing records to family. Nurse role is advocacy & confidentiality.
Q5
The nurse notes a verbal order for “Lasix 80 mg IV push now.” Which action follows the
ANA Code of Ethics?
A. Administer the drug immediately
B. Repeat the order to prescriber, enter in CPOE, then administer
C. Ask prescriber to enter order within 1 hr
D. Refuse to accept verbal order
, Correct: C
Rationale: Verbal orders accepted only in emergent/sterile procedures; routine settings
require prescriber to enter electronically (C) to prevent errors. A & B unsafe; D too
absolute if emergent.
Q6
During bedside report, the off-going nurse states, “The client is non-compliant.” The
on-coming nurse should:
A. Document “non-compliant” in the plan
B. Ask for specific behavior examples
C. Inform the client about the label
D. Tell the nurse manager
Correct: B
Rationale: Clarify subjective labels (Generate Solutions) to plan individualized care;
“non-compliant” is judgmental and lacks actionable data.
Q7
Which task can the nurse delegate to AP after hip replacement surgery?
A. Assess neurovascular status of operative leg
B. Transfer client from bed to chair first time
C. Measure vital signs q4h
D. Evaluate incisional pain
