MED SURG ATI ADVANCED FINAL
EXAM /ATI MED SURG ADVANCED
FINAL PROCTORED 2026/2027
ACTUAL EXAM 350 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. - ANSb.
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.
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 - ANSc.
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.
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 -
ANSb.
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.
In providing care for patients with chronic, progressive neurologic disease, what is the major
goal of treatment that the nurse works toward?
,MED SURG ATI ADVANCED FINAL
EXAM /ATI MED SURG ADVANCED
FINAL PROCTORED 2026/2027
ACTUAL EXAM 350 QUESTIONS AND
CORRECT DETAILED ANSWERS.
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. - ANSc.
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.
The nurse determines that teaching about management of migraine headaches has been
effective when the patient says which of the following?
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." - ANSC.
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.
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? - ANS2.56.
With a concentration of 125 mg/2 mL, the nurse will need to administer 2.56 mL to obtain
160 mg of methylprednisolone.
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. - ANSB.
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.
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?
,MED SURG ATI ADVANCED FINAL
EXAM /ATI MED SURG ADVANCED
FINAL PROCTORED 2026/2027
ACTUAL EXAM 350 QUESTIONS AND
CORRECT DETAILED ANSWERS.
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. - ANSC.
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.
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." - ANSB.
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.
A patient has been taking phenytoin (Dilantin) for 2 years. Which action will the nurse take
when evaluating for adverse effects of the medication?
a. Inspect the oral mucosa.
b. Listen to the lung sounds.
c. Auscultate the bowel tones.
d. Check pupil reaction to light. - ANSA.
Phenytoin can cause gingival hyperplasia, but does not affect bowel tones, lung sounds, or
pupil reaction to light.
A patient reports feeling numbness and tingling of the left arm before experiencing a tonic-
clonic seizure. The nurse determines that this history is consistent with what type of seizure?
a. Focal
b. Atonic
c. Absence
d. Myoclonic - ANSA.
The initial symptoms of a focal seizure involve clinical manifestations that are localized to a
particular part of the body or brain. Symptoms of an absence seizure are staring and a brief
loss of consciousness. In an atonic seizure, the patient loses muscle tone and (typically) falls
, MED SURG ATI ADVANCED FINAL
EXAM /ATI MED SURG ADVANCED
FINAL PROCTORED 2026/2027
ACTUAL EXAM 350 QUESTIONS AND
CORRECT DETAILED ANSWERS.
to the ground. Myoclonic seizures are characterized by a sudden jerk of the body or
extremities.
When obtaining a health history and physical assessment for a 36-year-old female patient
with possible multiple sclerosis (MS), the nurse should
a. assess for the presence of chest pain.
b. inquire about urinary tract problems.
c. inspect the skin for rashes or discoloration.
d. ask the patient about any increase in libido. - ANSB.
Urinary tract problems with incontinence or retention are common symptoms of MS. Chest
pain and skin rashes are not symptoms of MS. A decrease in libido is common with MS.
A 31-year-old woman who has multiple sclerosis (MS) asks the nurse about risks associated
with pregnancy. Which response by the nurse is accurate?
a. "MS symptoms may be worse after the pregnancy."
b. "Women with MS frequently have premature labor."
c. "MS is associated with an increased risk for congenital defects."
d. "Symptoms of MS are likely to become worse during pregnancy." - ANSA.
During the postpartum period, women with MS are at greater risk for exacerbation of
symptoms. There is no increased risk for congenital defects in infants born of mothers with
MS. Symptoms of MS may improve during pregnancy. Onset of labor is not affected by MS.
A 49-year-old patient with multiple sclerosis (MS) is to begin treatment with glatiramer
acetate (Copaxone). Which information will the nurse include in patient teaching?
a. Recommendation to drink at least 4 L of fluid daily
b. Need to avoid driving or operating heavy machinery
c. How to draw up and administer injections of the medication
d. Use of contraceptive methods other than oral contraceptives - ANSC.
Copaxone is administered by self-injection. Oral contraceptives are an appropriate choice for
birth control. There is no need to avoid driving or drink large fluid volumes when taking
glatiramer.
Which information about a 60-year-old patient with MS indicates that the nurse should
consult with the health care provider before giving the prescribed dose of dalfampridine
(Ampyra)?
a. The patient has relapsing-remitting MS.
b. The patient walks a mile a day for exercise.
c. The patient complains of pain with neck flexion.
d. The patient has an increased serum creatinine level. - ANSD.
EXAM /ATI MED SURG ADVANCED
FINAL PROCTORED 2026/2027
ACTUAL EXAM 350 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. - ANSb.
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.
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 - ANSc.
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.
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 -
ANSb.
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.
In providing care for patients with chronic, progressive neurologic disease, what is the major
goal of treatment that the nurse works toward?
,MED SURG ATI ADVANCED FINAL
EXAM /ATI MED SURG ADVANCED
FINAL PROCTORED 2026/2027
ACTUAL EXAM 350 QUESTIONS AND
CORRECT DETAILED ANSWERS.
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. - ANSc.
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.
The nurse determines that teaching about management of migraine headaches has been
effective when the patient says which of the following?
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." - ANSC.
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.
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? - ANS2.56.
With a concentration of 125 mg/2 mL, the nurse will need to administer 2.56 mL to obtain
160 mg of methylprednisolone.
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. - ANSB.
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.
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?
,MED SURG ATI ADVANCED FINAL
EXAM /ATI MED SURG ADVANCED
FINAL PROCTORED 2026/2027
ACTUAL EXAM 350 QUESTIONS AND
CORRECT DETAILED ANSWERS.
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. - ANSC.
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.
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." - ANSB.
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.
A patient has been taking phenytoin (Dilantin) for 2 years. Which action will the nurse take
when evaluating for adverse effects of the medication?
a. Inspect the oral mucosa.
b. Listen to the lung sounds.
c. Auscultate the bowel tones.
d. Check pupil reaction to light. - ANSA.
Phenytoin can cause gingival hyperplasia, but does not affect bowel tones, lung sounds, or
pupil reaction to light.
A patient reports feeling numbness and tingling of the left arm before experiencing a tonic-
clonic seizure. The nurse determines that this history is consistent with what type of seizure?
a. Focal
b. Atonic
c. Absence
d. Myoclonic - ANSA.
The initial symptoms of a focal seizure involve clinical manifestations that are localized to a
particular part of the body or brain. Symptoms of an absence seizure are staring and a brief
loss of consciousness. In an atonic seizure, the patient loses muscle tone and (typically) falls
, MED SURG ATI ADVANCED FINAL
EXAM /ATI MED SURG ADVANCED
FINAL PROCTORED 2026/2027
ACTUAL EXAM 350 QUESTIONS AND
CORRECT DETAILED ANSWERS.
to the ground. Myoclonic seizures are characterized by a sudden jerk of the body or
extremities.
When obtaining a health history and physical assessment for a 36-year-old female patient
with possible multiple sclerosis (MS), the nurse should
a. assess for the presence of chest pain.
b. inquire about urinary tract problems.
c. inspect the skin for rashes or discoloration.
d. ask the patient about any increase in libido. - ANSB.
Urinary tract problems with incontinence or retention are common symptoms of MS. Chest
pain and skin rashes are not symptoms of MS. A decrease in libido is common with MS.
A 31-year-old woman who has multiple sclerosis (MS) asks the nurse about risks associated
with pregnancy. Which response by the nurse is accurate?
a. "MS symptoms may be worse after the pregnancy."
b. "Women with MS frequently have premature labor."
c. "MS is associated with an increased risk for congenital defects."
d. "Symptoms of MS are likely to become worse during pregnancy." - ANSA.
During the postpartum period, women with MS are at greater risk for exacerbation of
symptoms. There is no increased risk for congenital defects in infants born of mothers with
MS. Symptoms of MS may improve during pregnancy. Onset of labor is not affected by MS.
A 49-year-old patient with multiple sclerosis (MS) is to begin treatment with glatiramer
acetate (Copaxone). Which information will the nurse include in patient teaching?
a. Recommendation to drink at least 4 L of fluid daily
b. Need to avoid driving or operating heavy machinery
c. How to draw up and administer injections of the medication
d. Use of contraceptive methods other than oral contraceptives - ANSC.
Copaxone is administered by self-injection. Oral contraceptives are an appropriate choice for
birth control. There is no need to avoid driving or drink large fluid volumes when taking
glatiramer.
Which information about a 60-year-old patient with MS indicates that the nurse should
consult with the health care provider before giving the prescribed dose of dalfampridine
(Ampyra)?
a. The patient has relapsing-remitting MS.
b. The patient walks a mile a day for exercise.
c. The patient complains of pain with neck flexion.
d. The patient has an increased serum creatinine level. - ANSD.
