ATI MEDICAL SURGERY EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL
DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains
* Cardiovascular System Disorders
* Respiratory System and Gas Exchange
* Endocrine System and Metabolic Regulation
* Gastrointestinal and Nutritional Support
* Renal and Urologic Function
* Neurological Assessment and Management
* Integumentary and Musculoskeletal Integrity
* Immune Response and Infection Control
* Perioperative Nursing Care
Introduction
*The purpose of this examination is to evaluate the clinical proficiency and theoretical
knowledge of nursing professionals in medical-surgical environments. This assessment
measures the ability to synthesize complex data, identify nursing priorities, and implement
evidence-based interventions for patients with acute and chronic conditions. Comprised of
multiple-choice and scenario-based questions, the exam requires critical thinking and real-
world application of safety, ethics, and regulatory standards. Success on this assessment
demonstrates the mastery necessary for providing high-quality, safe, and effective patient
care in diverse healthcare settings, emphasizing clinical decision-making and optimal patient
outcomes.*
Section One: Questions 1–100
Question 1 A nurse is caring for a client with heart failure who is receiving furosemide.
Which laboratory value should the nurse monitor? A. Serum potassium B. Serum sodium C.
Blood glucose D. Serum creatinine A. Serum potassium Explanation: Furosemide is a
loop diuretic that promotes the excretion of potassium, placing the client at risk for
hypokalemia.
,Question 2 A client with type 1 diabetes mellitus is found unconscious and diaphoretic.
Which action should the nurse take first? A. Administer subcutaneous insulin B. Check the
client’s blood glucose level C. Provide a high-protein snack D. Start an intravenous infusion of
normal saline B. Check the client’s blood glucose level Explanation: Hypoglycemia is
a medical emergency; determining the blood glucose level is the immediate priority to
confirm the diagnosis and guide intervention.
Question 3 A nurse is preparing a client for an appendectomy. Which assessment finding is
most concerning? A. Rebound tenderness in the right lower quadrant B. A sudden decrease
in abdominal pain C. An oral temperature of 99.4 F D. A white blood cell count of
12,000/mm3 B. A sudden decrease in abdominal pain Explanation: A sudden
cessation of pain in the context of appendicitis often indicates rupture of the appendix,
leading to peritonitis.
Question 4 Which intervention is most effective in preventing postoperative pneumonia in a
client who underwent abdominal surgery? A. Maintaining strict bed rest B. Encouraging
frequent deep breathing and coughing C. Administering prophylactic antibiotics D.
Maintaining a NPO status for 48 hours B. Encouraging frequent deep breathing and
coughing Explanation: Deep breathing and coughing promote lung expansion and the
clearance of secretions, which are primary preventive measures against atelectasis and
pneumonia.
Question 5 A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at
2 L/min via nasal cannula. The nurse observes the client’s respiratory rate is 8 breaths/min.
What is the nurse's priority action? A. Increase the oxygen flow rate to 4 L/min B. Notify the
healthcare provider C. Reposition the client to a high-Fowler’s position D. Encourage the
client to breathe deeply B. Notify the healthcare provider Explanation: A respiratory
rate of 8 breaths/min indicates bradypnea and potential respiratory depression,
necessitating immediate medical evaluation.
Question 6 A nurse is assessing a client with hyperthyroidism. Which clinical manifestation
should the nurse expect? A. Bradycardia B. Weight gain C. Heat intolerance D. Constipation
C. Heat intolerance Explanation: Hyperthyroidism causes an increased metabolic
rate, which commonly results in heat intolerance and diaphoresis.
Question 7 A client is admitted with a suspected pulmonary embolism. Which diagnostic test
is the gold standard for confirmation? A. Chest X-ray B. Electrocardiogram C. Computed
tomography pulmonary angiography (CTPA) D. Arterial blood gas analysis C. Computed
tomography pulmonary angiography (CTPA) Explanation: CTPA is the preferred
diagnostic imaging modality for visualizing pulmonary emboli with high sensitivity and
specificity.
, Question 8 Which nursing action is essential when caring for a client with a chest tube? A.
Milking the tubing every hour B. Keeping the drainage system below the level of the chest C.
Clamping the tube when the client ambulates D. Emptying the drainage container every 4
hours B. Keeping the drainage system below the level of the chest Explanation: The
drainage system must be kept below the chest level to use gravity to facilitate drainage and
prevent the backflow of fluid into the pleural space.
Question 9 A nurse is teaching a client with hypertension about dietary modifications. Which
food selection is most appropriate? A. Canned vegetable soup B. Baked salmon with
steamed broccoli C. Deli turkey sandwich D. Fast food cheeseburger B. Baked salmon
with steamed broccoli Explanation: A diet low in sodium and high in whole foods, such
as fresh vegetables and lean protein, is recommended for managing hypertension.
Question 10 A client is diagnosed with acute kidney injury (AKI). Which laboratory result
indicates the oliguric phase? A. Polyuria B. Decreased serum creatinine C. Low urine output
D. High urine specific gravity C. Low urine output Explanation: The oliguric phase of
AKI is characterized by a significant decrease in urine output, typically less than 400 mL per
day.
Question 11 A nurse is caring for a client who has sustained a burn injury. Which assessment
is the priority during the first 24 hours? A. Assessing the wound for infection B. Monitoring
for signs of fluid volume deficit C. Evaluating the client’s pain level D. Promoting range of
motion exercises B. Monitoring for signs of fluid volume deficit Explanation: During
the emergent phase of a burn injury, massive fluid shifts occur, making the client highly
susceptible to hypovolemic shock.
Question 12 A nurse is preparing to administer packed red blood cells to a client. Which
action is the priority? A. Warming the blood to room temperature B. Verifying the blood
with another nurse at the bedside C. Initiating the infusion at a rapid rate D. Documenting
the client's skin turgor B. Verifying the blood with another nurse at the bedside
Explanation: Strict verification procedures, including checking the blood and the client's
identification by two licensed professionals, are mandatory to prevent transfusion reactions.
Question 13 A client with Parkinson’s disease is experiencing difficulty swallowing. Which
nursing intervention is most appropriate? A. Providing thin liquids for easier ingestion B.
Elevating the head of the bed during meals C. Encouraging the client to eat quickly D.
Providing a straw for drinking fluids B. Elevating the head of the bed during meals
Explanation: Elevating the head of the bed helps prevent aspiration by utilizing gravity during
the swallowing process.
Question 14 Which finding in a client with a long leg cast suggests the development of
compartment syndrome? A. Bounding pedal pulses B. Intense pain not relieved by
medication C. Increased capillary refill time D. Skin warmth distal to the cast B. Intense
DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains
* Cardiovascular System Disorders
* Respiratory System and Gas Exchange
* Endocrine System and Metabolic Regulation
* Gastrointestinal and Nutritional Support
* Renal and Urologic Function
* Neurological Assessment and Management
* Integumentary and Musculoskeletal Integrity
* Immune Response and Infection Control
* Perioperative Nursing Care
Introduction
*The purpose of this examination is to evaluate the clinical proficiency and theoretical
knowledge of nursing professionals in medical-surgical environments. This assessment
measures the ability to synthesize complex data, identify nursing priorities, and implement
evidence-based interventions for patients with acute and chronic conditions. Comprised of
multiple-choice and scenario-based questions, the exam requires critical thinking and real-
world application of safety, ethics, and regulatory standards. Success on this assessment
demonstrates the mastery necessary for providing high-quality, safe, and effective patient
care in diverse healthcare settings, emphasizing clinical decision-making and optimal patient
outcomes.*
Section One: Questions 1–100
Question 1 A nurse is caring for a client with heart failure who is receiving furosemide.
Which laboratory value should the nurse monitor? A. Serum potassium B. Serum sodium C.
Blood glucose D. Serum creatinine A. Serum potassium Explanation: Furosemide is a
loop diuretic that promotes the excretion of potassium, placing the client at risk for
hypokalemia.
,Question 2 A client with type 1 diabetes mellitus is found unconscious and diaphoretic.
Which action should the nurse take first? A. Administer subcutaneous insulin B. Check the
client’s blood glucose level C. Provide a high-protein snack D. Start an intravenous infusion of
normal saline B. Check the client’s blood glucose level Explanation: Hypoglycemia is
a medical emergency; determining the blood glucose level is the immediate priority to
confirm the diagnosis and guide intervention.
Question 3 A nurse is preparing a client for an appendectomy. Which assessment finding is
most concerning? A. Rebound tenderness in the right lower quadrant B. A sudden decrease
in abdominal pain C. An oral temperature of 99.4 F D. A white blood cell count of
12,000/mm3 B. A sudden decrease in abdominal pain Explanation: A sudden
cessation of pain in the context of appendicitis often indicates rupture of the appendix,
leading to peritonitis.
Question 4 Which intervention is most effective in preventing postoperative pneumonia in a
client who underwent abdominal surgery? A. Maintaining strict bed rest B. Encouraging
frequent deep breathing and coughing C. Administering prophylactic antibiotics D.
Maintaining a NPO status for 48 hours B. Encouraging frequent deep breathing and
coughing Explanation: Deep breathing and coughing promote lung expansion and the
clearance of secretions, which are primary preventive measures against atelectasis and
pneumonia.
Question 5 A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at
2 L/min via nasal cannula. The nurse observes the client’s respiratory rate is 8 breaths/min.
What is the nurse's priority action? A. Increase the oxygen flow rate to 4 L/min B. Notify the
healthcare provider C. Reposition the client to a high-Fowler’s position D. Encourage the
client to breathe deeply B. Notify the healthcare provider Explanation: A respiratory
rate of 8 breaths/min indicates bradypnea and potential respiratory depression,
necessitating immediate medical evaluation.
Question 6 A nurse is assessing a client with hyperthyroidism. Which clinical manifestation
should the nurse expect? A. Bradycardia B. Weight gain C. Heat intolerance D. Constipation
C. Heat intolerance Explanation: Hyperthyroidism causes an increased metabolic
rate, which commonly results in heat intolerance and diaphoresis.
Question 7 A client is admitted with a suspected pulmonary embolism. Which diagnostic test
is the gold standard for confirmation? A. Chest X-ray B. Electrocardiogram C. Computed
tomography pulmonary angiography (CTPA) D. Arterial blood gas analysis C. Computed
tomography pulmonary angiography (CTPA) Explanation: CTPA is the preferred
diagnostic imaging modality for visualizing pulmonary emboli with high sensitivity and
specificity.
, Question 8 Which nursing action is essential when caring for a client with a chest tube? A.
Milking the tubing every hour B. Keeping the drainage system below the level of the chest C.
Clamping the tube when the client ambulates D. Emptying the drainage container every 4
hours B. Keeping the drainage system below the level of the chest Explanation: The
drainage system must be kept below the chest level to use gravity to facilitate drainage and
prevent the backflow of fluid into the pleural space.
Question 9 A nurse is teaching a client with hypertension about dietary modifications. Which
food selection is most appropriate? A. Canned vegetable soup B. Baked salmon with
steamed broccoli C. Deli turkey sandwich D. Fast food cheeseburger B. Baked salmon
with steamed broccoli Explanation: A diet low in sodium and high in whole foods, such
as fresh vegetables and lean protein, is recommended for managing hypertension.
Question 10 A client is diagnosed with acute kidney injury (AKI). Which laboratory result
indicates the oliguric phase? A. Polyuria B. Decreased serum creatinine C. Low urine output
D. High urine specific gravity C. Low urine output Explanation: The oliguric phase of
AKI is characterized by a significant decrease in urine output, typically less than 400 mL per
day.
Question 11 A nurse is caring for a client who has sustained a burn injury. Which assessment
is the priority during the first 24 hours? A. Assessing the wound for infection B. Monitoring
for signs of fluid volume deficit C. Evaluating the client’s pain level D. Promoting range of
motion exercises B. Monitoring for signs of fluid volume deficit Explanation: During
the emergent phase of a burn injury, massive fluid shifts occur, making the client highly
susceptible to hypovolemic shock.
Question 12 A nurse is preparing to administer packed red blood cells to a client. Which
action is the priority? A. Warming the blood to room temperature B. Verifying the blood
with another nurse at the bedside C. Initiating the infusion at a rapid rate D. Documenting
the client's skin turgor B. Verifying the blood with another nurse at the bedside
Explanation: Strict verification procedures, including checking the blood and the client's
identification by two licensed professionals, are mandatory to prevent transfusion reactions.
Question 13 A client with Parkinson’s disease is experiencing difficulty swallowing. Which
nursing intervention is most appropriate? A. Providing thin liquids for easier ingestion B.
Elevating the head of the bed during meals C. Encouraging the client to eat quickly D.
Providing a straw for drinking fluids B. Elevating the head of the bed during meals
Explanation: Elevating the head of the bed helps prevent aspiration by utilizing gravity during
the swallowing process.
Question 14 Which finding in a client with a long leg cast suggests the development of
compartment syndrome? A. Bounding pedal pulses B. Intense pain not relieved by
medication C. Increased capillary refill time D. Skin warmth distal to the cast B. Intense
