ATI MED-SURG PROCTORED EXAM TEST BANK COMPREHENSIVE QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
*Core Domains:*
* *Fluid, Electrolyte, and Acid-Base Imbalances*
* *Perioperative Care and Anesthesia*
* *Advanced Cardiovascular and Hematologic Disorders*
* *Advanced Respiratory Care and Ventilation*
* *Neurological and Senses Management*
* *Gastrointestinal, Hepatic, and Pancreatic Disorders*
* *Endocrine and Metabolic Dysfunctions*
* *Renal and Urological Care*
* *Musculoskeletal and Integumentary Interventions*
* *Immunological, Infectious, and Oncological Management*
*Introduction*
*The purpose of this comprehensive test bank is to evaluate advanced nursing students' knowledge
Section One: Questions 1–100
Question 1
,A nurse is caring for a client who is 24 hours postoperative following a total thyroidectomy. Which of the
following findings is the priority for the nurse to report to the provider?
A. Hoarseness when speaking
B. Pain rating of 6 on a 0 to 10 scale
C. Muscle twitching and tingling around the mouth
D. Serosanguineous drainage on the dressing
🟢 C. Muscle twitching and tingling around the mouth
🔴 RATIONALE: Muscle twitching, positive Chvostek's or Trousseau's signs, and perioral numbness
indicate hypocalcemia, a major complication of thyroidectomy if the parathyroid glands are accidentally
damaged or removed. This can progress quickly to laryngospasm and seizures, making it the highest
priority finding.
Question 2
A nurse is assessing a client who has a chest tube connected to a water-seal drainage system. The nurse
notes continuous bubbling in the water-seal chamber. Which of the following actions should the nurse
take?
A. Check the system for an air leak
B. Decrease the suction wall pressure
C. Document this as an expected finding
D. Strip the chest tube drainage tubing
🟢 A. Check the system for an air leak
🔴 RATIONALE: Continuous bubbling in the water-seal chamber indicates an air leak within the drainage
system or at the insertion site. Intermittent bubbling is expected with expiration or coughing, but
continuous bubbling requires immediate systematic checking of connections to isolate and repair the leak.
Question 3
A nurse is reviewing the laboratory results of a client who is receiving mechanical ventilation and has a
prescription for respiratory adjustments. The client's ABG results are: pH 7.21, PaCO2 62 mm Hg, HCO3-
,25 mEq/L. The nurse should interpret these results as indicating which of the following acid-base
imbalances?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
🟢 C. Respiratory acidosis
🔴 RATIONALE: A pH of 7.21 indicates acidosis (normal 7.35–7.45). The PaCO2 of 62 mm Hg is
elevated (normal 35–45 mm Hg), which aligns with the acidic pH. The HCO3- is within the normal range
(22–26 mEq/L), indicating an uncompensated respiratory acidosis.
Question 4
A nurse is planning care for a client who is scheduled for an esophagogastroduodenoscopy (EGD). Which
of the following pre-procedural interventions should the nurse include?
A. Maintain the client NPO for at least 6 to 8 hours
B. Administer an oral bowel prep solution the night before
C. Inform the client they will be awake and alert during the test
D. Position the client in a right lateral position
🟢 A. Maintain the client NPO for at least 6 to 8 hours
🔴 RATIONALE: To prevent aspiration and allow full visualization of the gastric mucosa, the client must
be kept NPO for 6 to 8 hours before an EGD. Bowel preps are used for colonoscopies, not EGDs, and
moderate sedation is typically used.
Question 5
A nurse is assessing a client who is 12 hours postoperative following an open cholecystectomy. Which of
the following findings should the nurse identify as an indication of a surgical complication?
A. Bile-stained drainage on the abdominal dressing
B. Pain at the surgical incision site during coughing
C. Hypoactive bowel sounds in all four quadrants
, D. Urinary output of 35 mL/hr for the past 2 hours
🟢 A. Bile-stained drainage on the abdominal dressing
🔴 RATIONALE: Bile-stained drainage on the surgical dressing or outside of a designated drain after a
cholecystectomy may indicate a biliary leak or injury to the bile duct. Incisional pain with coughing,
transient hypoactive bowel sounds, and a urine output above 30 mL/hr are expected findings within the
early postoperative period.
Question 6
A nurse is reviewing the medical record of a client who has acute pancreatitis. Which of the following
laboratory findings should the nurse expect?
A. Decreased serum amylase
B. Increased serum calcium
C. Increased serum lipase
D. Decreased white blood cell count
🟢 C. Increased serum lipase
🔴 RATIONALE: Acute pancreatitis results in the auto-digestion of pancreatic tissue, leading to sharp
elevations in pancreatic enzymes, specifically serum amylase and lipase. Serum calcium levels typically
decrease due to fat necrosis and saponification.
Question 7
A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of the
following instructions should the nurse include?
A. Increase intake of dark green leafy vegetables
B. Use a soft-bristled toothbrush for oral care
C. Take aspirin for mild headaches or body aches
D. Schedule a weekly appointment to measure partial thromboplastin time (PTT)
🟢 B. Use a soft-bristled toothbrush for oral care
🔴 RATIONALE: Warfarin increases the risk of bleeding. Using a soft-bristled toothbrush helps minimize
the risk of gingival trauma and bleeding. Dark green leafy vegetables are high in Vitamin K and can
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
*Core Domains:*
* *Fluid, Electrolyte, and Acid-Base Imbalances*
* *Perioperative Care and Anesthesia*
* *Advanced Cardiovascular and Hematologic Disorders*
* *Advanced Respiratory Care and Ventilation*
* *Neurological and Senses Management*
* *Gastrointestinal, Hepatic, and Pancreatic Disorders*
* *Endocrine and Metabolic Dysfunctions*
* *Renal and Urological Care*
* *Musculoskeletal and Integumentary Interventions*
* *Immunological, Infectious, and Oncological Management*
*Introduction*
*The purpose of this comprehensive test bank is to evaluate advanced nursing students' knowledge
Section One: Questions 1–100
Question 1
,A nurse is caring for a client who is 24 hours postoperative following a total thyroidectomy. Which of the
following findings is the priority for the nurse to report to the provider?
A. Hoarseness when speaking
B. Pain rating of 6 on a 0 to 10 scale
C. Muscle twitching and tingling around the mouth
D. Serosanguineous drainage on the dressing
🟢 C. Muscle twitching and tingling around the mouth
🔴 RATIONALE: Muscle twitching, positive Chvostek's or Trousseau's signs, and perioral numbness
indicate hypocalcemia, a major complication of thyroidectomy if the parathyroid glands are accidentally
damaged or removed. This can progress quickly to laryngospasm and seizures, making it the highest
priority finding.
Question 2
A nurse is assessing a client who has a chest tube connected to a water-seal drainage system. The nurse
notes continuous bubbling in the water-seal chamber. Which of the following actions should the nurse
take?
A. Check the system for an air leak
B. Decrease the suction wall pressure
C. Document this as an expected finding
D. Strip the chest tube drainage tubing
🟢 A. Check the system for an air leak
🔴 RATIONALE: Continuous bubbling in the water-seal chamber indicates an air leak within the drainage
system or at the insertion site. Intermittent bubbling is expected with expiration or coughing, but
continuous bubbling requires immediate systematic checking of connections to isolate and repair the leak.
Question 3
A nurse is reviewing the laboratory results of a client who is receiving mechanical ventilation and has a
prescription for respiratory adjustments. The client's ABG results are: pH 7.21, PaCO2 62 mm Hg, HCO3-
,25 mEq/L. The nurse should interpret these results as indicating which of the following acid-base
imbalances?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
🟢 C. Respiratory acidosis
🔴 RATIONALE: A pH of 7.21 indicates acidosis (normal 7.35–7.45). The PaCO2 of 62 mm Hg is
elevated (normal 35–45 mm Hg), which aligns with the acidic pH. The HCO3- is within the normal range
(22–26 mEq/L), indicating an uncompensated respiratory acidosis.
Question 4
A nurse is planning care for a client who is scheduled for an esophagogastroduodenoscopy (EGD). Which
of the following pre-procedural interventions should the nurse include?
A. Maintain the client NPO for at least 6 to 8 hours
B. Administer an oral bowel prep solution the night before
C. Inform the client they will be awake and alert during the test
D. Position the client in a right lateral position
🟢 A. Maintain the client NPO for at least 6 to 8 hours
🔴 RATIONALE: To prevent aspiration and allow full visualization of the gastric mucosa, the client must
be kept NPO for 6 to 8 hours before an EGD. Bowel preps are used for colonoscopies, not EGDs, and
moderate sedation is typically used.
Question 5
A nurse is assessing a client who is 12 hours postoperative following an open cholecystectomy. Which of
the following findings should the nurse identify as an indication of a surgical complication?
A. Bile-stained drainage on the abdominal dressing
B. Pain at the surgical incision site during coughing
C. Hypoactive bowel sounds in all four quadrants
, D. Urinary output of 35 mL/hr for the past 2 hours
🟢 A. Bile-stained drainage on the abdominal dressing
🔴 RATIONALE: Bile-stained drainage on the surgical dressing or outside of a designated drain after a
cholecystectomy may indicate a biliary leak or injury to the bile duct. Incisional pain with coughing,
transient hypoactive bowel sounds, and a urine output above 30 mL/hr are expected findings within the
early postoperative period.
Question 6
A nurse is reviewing the medical record of a client who has acute pancreatitis. Which of the following
laboratory findings should the nurse expect?
A. Decreased serum amylase
B. Increased serum calcium
C. Increased serum lipase
D. Decreased white blood cell count
🟢 C. Increased serum lipase
🔴 RATIONALE: Acute pancreatitis results in the auto-digestion of pancreatic tissue, leading to sharp
elevations in pancreatic enzymes, specifically serum amylase and lipase. Serum calcium levels typically
decrease due to fat necrosis and saponification.
Question 7
A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of the
following instructions should the nurse include?
A. Increase intake of dark green leafy vegetables
B. Use a soft-bristled toothbrush for oral care
C. Take aspirin for mild headaches or body aches
D. Schedule a weekly appointment to measure partial thromboplastin time (PTT)
🟢 B. Use a soft-bristled toothbrush for oral care
🔴 RATIONALE: Warfarin increases the risk of bleeding. Using a soft-bristled toothbrush helps minimize
the risk of gingival trauma and bleeding. Dark green leafy vegetables are high in Vitamin K and can
