ATI Medical-Surgical Proctored Exam 2026: COMPREHENSIVE FINAL PREP: VERIFIED QUESTIONS & EXPERT ANSWERS ULTIMATE EXAM PASS PACK – LATEST 2026/2027 UPDATES

A nurse is planning care for a client who has full-thickness burns on the lower extremities. Which of the following interventions should the nurse include in the plan of care? A. Limit visitation time for the client's children to 40 minutes per day. B. Clean the medical equipment in the client's room once per week. C. Provide a diet rich in raw fresh fruits and vegetables for the client. D. Apply a new pair of clean gloves when alternating between different wound care sites. Correct Answer: D Rationale: Loss of the skin barrier leaves burn patients highly susceptible to life-threatening nosocomial infections. Changing gloves between separate wound care sites prevents crosscontamination and the auto-inoculation of bacteria from one area of the body to another. Fresh fruits and vegetables are restricted (neutropenic-style precautions) because they can harbor gram-negative organisms like Pseudomonas aeruginosa. Equipment must be cleaned daily, not weekly. Question 2 A nurse is caring for a client who has cancer. The client tells the nurse, "I would prefer to try vitamins and minerals instead of undergoing chemotherapy." Which of the following responses should the nurse make? A. "I have never heard of any holistic treatment that is clinically effective." B. "You should ask your provider about your plan." C. "The best way to treat your cancer is through chemotherapy." D. "Tell me what you know about chemotherapy." Correct Answer: D Rationale: This therapeutic response uses an open-ended communication technique. It allows the nurse to assess the client's current baseline understanding, identify any potential misconceptions or fears regarding chemotherapy, and encourage autonomy without becoming defensive or dismissive of the patient's preferences. Question 3 A nurse is planning to teach a client whose provider has prescribed a low-purine diet. The nurse should plan to instruct the client that they can safely include which of the following foods in their diet? (Select all that apply.) • A. Sardines • B. Nuts • C. Apricots • D. Liver • E. Scallops Correct Answer: B, C Rationale: A low-purine diet is used to manage conditions like gout and uric acid kidney stones. Organ meats (liver), certain seafoods (sardines, scallops, anchovies), and red meats are extremely high in purines and must be avoided. High-protein plant alternatives like nuts, along with fruits like apricots, are low in purines and perfectly safe to consume. Question 4 A nurse is caring for a client following a total knee arthroplasty. The client reports a pain level of 6 on a scale of 0 to 10. Which of the following interventions should the nurse take? A. Place structural pillows directly under the client's knee. B. Gently massage the tissues immediately surrounding the client’s incision. C. Apply an ice pack to the client’s affected knee. D. Perform passive range-of-motion exercises on the client’s knee. Correct Answer: C Rationale: Localized cold therapy (cryotherapy) induces vasoconstriction, which minimizes postoperative edema, slows nerve conduction of pain signals, and reduces inflammation. Placing a pillow directly under the knee is strictly contraindicated because knee flexion promotes joint contractures. Massaging an acute surgical incision can trigger severe pain and compromise structural wound closure. Question 5 A nurse is caring for a client who has a lower extremity fracture and a new prescription for crutches. Which of the following client statements indicates that the client is adapting successfully to their role change? A. "I will need to have my partner take over shopping for groceries and cooking the meals for us." B. "It’s going to be difficult to tell my parents I can't take them to their appointments anymore." C. "I feel bad that I have to ask my partner to keep the house clean." D. "These crutches will make it completely impossible to care for my child." Correct Answer: A Rationale: Successful adaptation to a temporary or permanent role change involves problemsolving, identifying practical limitations, and constructively reallocating responsibilities (delegating tasks) to preserve functional structure. The alternative options reflect maladaptive patterns, guilt, or perceived helplessness. Question 6 A nurse is assessing a client who is preoperative and reports a severe allergy to bananas. The nurse should recognize that the client is at risk for an allergic cross-reactivity to which of the following substances? A. Adhesive tape B. Latex C. Local anesthetics D. Povidone-iodine Correct Answer: B Rationale: There is a well-documented genetic cross-reactivity known as the "latex-fruit syndrome." Individuals who are allergic to bananas, avocados, kiwis, or chestnuts share common allergenic proteins with natural rubber latex. Identifying this preoperatively is crucial to ensure a completely latex-free environment during surgery. Question 7 A nurse on a medical unit is planning care for a group of clients. Which of the following clients should the nurse attend to first? A. A client with chronic obstructive pulmonary disease (COPD) who has an oxygen saturation of 89%. B. A client who has left-sided paralysis and slurred speech from a documented stroke three months ago. C. A client who has thrombocytopenia and reports an active nosebleed. D. A client who has multiple sclerosis (MS) and reports mild ataxia and vertigo. Correct Answer: C Rationale: Thrombocytopenia represents a dangerously low platelet count. An active nosebleed (epistaxis) in a thrombocytopenic patient indicates spontaneous hemorrhage that can rapidly cascade into severe blood loss or compromise airway patency. This demands immediate intervention. An $SpO_2$ of 89% is an expected finding in chronic stable COPD, and chronic deficits from a prior stroke or MS do not take priority over acute bleeding. Question 8 A nurse is monitoring a client who is receiving two units of packed red blood cells. Which of the following manifestations indicates an acute hemolytic transfusion reaction? A. Severe lower back pain B. Acute hypertension C. Generalized chills D. Bradycardia Correct Answer: A Rationale: An acute hemolytic transfusion reaction occurs when there is an incompatibility between the donor and recipient blood, causing the destruction of RBCs. The lysis of red blood cells releases hemoglobin, which accumulates in and blocks the renal tubules. This manifests clinically as sudden, severe low back or flank pain, fever, chills, hypotension, and red/brown urine. Question 9 A nurse is teaching a client who has diabetes mellitus about routine foot care. Which of the following instructions should the nurse include? A. "Use a heating pad to keep your feet warm at night." B. "Wear loose-fitting slippers around the house at all times." C. "Wear clean cotton rather than synthetic nylon socks." D. "Wash your feet twice per day with antibacterial soap and hot water." Correct Answer: C Rationale: Cotton socks absorb moisture more efficiently than nylon, keeping the feet dry and reducing the risk of fungal or bacterial breakdown. Diabetic patients suffer from peripheral neuropathy and peripheral vascular disease; they must never use heating pads or hot water (due to profound burn risks from loss of sensation) and should wear properly fitting, supportive shoes rather than loose slippers to prevent skin shear and falls. Question 10 A nurse is providing teaching to a client who has a deep vein thrombosis (DVT). Which of the following findings should the nurse identify as a risk factor for the development of DVTs? A. Regular NSAID use B. Chronic hypertension C. Oral contraceptive use D. Hepatic cirrhosis Correct Answer: C Rationale: Oral contraceptives containing estrogen increase the hepatic synthesis of clotting factors and enhance platelet aggregation, creating a hypercoagulable state. This significantly escalates the risk of venous thromboembolism (VTE/DVT). NSAIDs can inhibit platelet function and decrease clotting risk, while cirrhosis typically causes a hypocoagulable state due to deficient clotting factor production. Question 11 A nurse is caring for a client who has a sealed radiation implant for internal brachytherapy. Which of the following actions should the nurse take? A. Remove soiled linens from the room immediately after each change. B. Give the personal dosimeter badge to the oncoming nurse at the end of the shift. C. Apply a second pair of gloves before touching the client's implant if it becomes dislodged. D. Limit family member visits to a maximum of 30 minutes per day. Correct Answer: D Rationale: To protect individuals from excessive radiation exposure based on the principles of time, distance, and shielding, visitors must be restricted to a maximum of 30 minutes per day and must maintain a distance of at least 6 feet from the patient. Soiled linens are kept inside the room in designated containers until the implant is removed. Dosimeter badges are personal tracking devices and must never be shared, and a dislodged implant must never be touched with gloved hands—it must be handled using long-handled lead forceps. Question 12 A nurse is providing teaching to a client and their partner about performing peritoneal dialysis at home. When discussing peritonitis, which of the following manifestations should the nurse identify as the earliest indication of this complication? A. Generalized abdominal pain B. Cloudy dialysate effluent C. Increased heart rate D. Fever Correct Answer: D Rationale: Fever is the earliest systemic sign of an infectious process like peritonitis within the peritoneal cavity. While cloudy or turbid dialysate effluent fluid draining from the abdomen is a classic, definitive sign of peritonitis, it occurs as white blood cells and fibrin gather in the fluid, often manifesting shortly after the initial systemic inflammatory response. Question 13 A nurse is caring for a client who is receiving a rapid blood transfusion. The nurse observes that the client has bounding peripheral pulses, acute hypertension, and distended jugular veins. The nurse should anticipate administering which of the following prescribed medications? A. Pantoprazole B. Acetaminophen C. Furosemide D. Diphenhydramine Correct Answer: C Rationale: The presentation of bounding pulses, jugular venous distention (JVD), dyspnea, and hypertension indicates Transfusion-Associated Circulatory Overload (TACO). This is a state of hypervolemia due to fluid volume infusing faster than the circulatory system can accommodate. The nurse must slow or stop the infusion and administer an IV loop diuretic like furosemide to rapidly excrete excess fluid volume. Question 14 A nurse is planning care for a client who has acute upper gastrointestinal bleeding due to a peptic ulcer. Which of the following actions should the nurse plan to take? A. Provide ketorolac for reports of abdominal pain. B. Administer nitroprusside IV titrated based on the client's weight. C. Insert a large-bore nasogastric (NG) tube. D. Ensure that the client has a 22-gauge peripheral IV line in place. Correct Answer: C Rationale: Inserting a large-bore nasogastric tube allows the nurse to decompress the stomach, perform gastric lavage to clear blood clots, monitor the rate of active bleeding, and prevent vomiting and aspiration. Ketorolac is an NSAID and is strictly contraindicated because it impairs platelet function and worsens GI bleeding. A 22-gauge IV is too small; the patient requires largebore access (18-gauge or larger) for rapid fluid and blood resuscitation. Question 15 A nurse is caring for a client who has bladder cancer and a white blood cell (WBC) count of $900/text{mm}^3$. Which of the following actions should the nurse take? A. Instruct the client to avoid eating raw fresh fruit. B. Move the client into a negative-pressure isolation room. C. Implement strict contact isolation precautions while providing care. D. Apply continuous pressure to venipuncture sites for 10 minutes. Correct Answer: A Rationale: A WBC count of $900/text{mm}^3$ indicates severe neutropenia (normal range: $5,000text{--}10,000/text{mm}^3$), which puts the patient at extreme risk for opportunistic infections. The nurse must institute neutropenic protective environments, which includes eliminating raw fruits, raw vegetables, and fresh flowers because they naturally harbor pathogenic bacteria and molds. Negative pressure is for airborne infections; this patient needs a positive-pressure, clean environment. Question 16 A nurse is caring for a patient who exhibits hypotension, cool and clammy skin, tachycardia, and tachypnea. In which of the following positions should the nurse place the client? A. Reverse Trendelenburg position B. Supine with the feet elevated C. Side-lying lateral position D. High-Fowler's position Correct Answer: B Rationale: The clinical manifestations describe hypovolemic shock. Placing the patient supine with their legs elevated (modified Trendelenburg) uses gravity to promote venous return from the lower extremities back to the heart, increasing cardiac output and enhancing perfusion to vital organs like the brain and kidneys. Question 17 A nurse is caring for a client who weighs $190text{ lb}$ and is receiving Total Parenteral Nutrition (TPN). If the Recommended Dietary Allowance (RDA) for protein is $0.8text{ g/kg}$ of body weight, how many grams of protein should the client receive daily? (Round the answer to the nearest whole number.) Correct Answer: 69 grams Rationale: To calculate the daily protein requirement, convert the weight from pounds to kilograms and multiply by the protein parameter: 1. Convert pounds to kilograms: $$text{Weight} = 190text{ lb} div 2.2text{ lb/kg} = 86.3636text{ kg}$$ 2. Calculate daily protein allowance: $$text{Protein Intake} = 86.3636text{ kg} times 0.8text{ g/kg} = 69.0909text{ g}$$ 3. Rounding to the nearest whole number yields 69 grams. Question 18 A nurse is planning care for a client who has a central venous access device (CVAD) for intermittent infusions. Which of the following actions should the nurse include in the plan of care? A. Flush the catheter lumen utilizing a 10 mL syringe. B. Use clean technique when changing the transparent dressing. C. Cleanse the insertion site using a povidone-iodine solution. D. Change the transparent dressing every 24 hours. Correct Answer: A Rationale: The nurse must always use a 10 mL syringe or larger when flushing a central line. Syringes smaller than 10 mL generate excessive, dangerous hydrostatic pressure that can rupture the catheter catheter wall or dislodge an intraluminal clot into circulation. Central line dressing changes require strict sterile (not clean) technique, and transparent dressings are typically changed every 7 days unless compromised.