1
ATI Medical-Surg Proctored Exam 2023 Advanced/Hard Level |
Nursing Students | Next Generation NCLEX (NGN) Style | 100%
Pass Guaranteed | Graded A+
1. A nurse is caring for a client who is 2 days post-operative following a total hip arthroplasty.
Which of the following findings should the nurse report to the provider immediately?
A. Pain of 4 on a 0-10 scale with movement
B. Moderate serosanguinous drainage on the dressing
C. Unilateral calf swelling and warmth
D. Temperature of 37.5°C (99.5°F)
☑ Correct Answer: C
☑ Explanation: Unilateral calf swelling and warmth are classic signs of deep vein
thrombosis (DVT), a serious post-operative complication that can lead to pulmonary embolism.
This finding requires immediate reporting. Pain with movement, moderate serosanguinous
drainage, and a low-grade fever are expected post-operative findings.
2. A nurse is assessing a client with heart failure who has been prescribed furosemide. Which
of the following assessment findings indicates that the medication is effective?
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A. Decreased urine output
B. Weight gain of 0.5 kg over 24 hours
C. Decreased peripheral edema
D. Increased dyspnea
☑ Correct Answer: C
☑ Explanation: Furosemide is a loop diuretic used to reduce fluid volume in heart failure. A
decrease in peripheral edema indicates that the medication is effectively removing excess fluid.
Decreased urine output, weight gain, and increased dyspnea would indicate worsening heart
failure or ineffective treatment.
3. A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes
mellitus. Which of the following statements by the client indicates an understanding of the
teaching?
A. "I will take my metformin only when my blood sugar is high."
B. "I should exercise for 30 minutes most days of the week."
C. "I can stop my medication once my blood sugar is normal."
D. "I should check my blood sugar once a week."
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☑ Correct Answer: B
☑ Explanation: Regular exercise (30 minutes most days) helps improve insulin sensitivity
and is a key component of diabetes management. Metformin should be taken daily as
prescribed, not PRN. Diabetes medications are typically continued even when blood sugar is
normal to maintain control. Blood glucose should be checked multiple times daily, not weekly.
4. A nurse is preparing to administer a blood transfusion to a client. Which of the following
actions should the nurse take first?
A. Obtain the client's vital signs
B. Verify the client's identity using two identifiers
C. Prime the blood tubing with 0.9% sodium chloride
D. Ask the client about previous transfusion reactions
☑ Correct Answer: B
☑ Explanation: The first step in blood transfusion administration is verifying the client's
identity using two unique identifiers (e.g., name and date of birth) to ensure the correct blood
product is given to the correct client. This is a critical safety measure to prevent transfusion
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errors. Vital signs, priming tubing, and assessing history are also important but follow
identification verification.
5. A nurse is caring for a client who has acute pancreatitis. Which of the following laboratory
values should the nurse monitor?
A. Serum amylase
B. Serum lipase
C. Serum glucose
D. All of the above
☑ Correct Answer: D
☑ Explanation: In acute pancreatitis, serum amylase and lipase are elevated (lipase is
more specific). Serum glucose may be elevated due to impaired insulin production from
pancreatic inflammation. Monitoring all three values is important for assessing the severity and
complications of pancreatitis.
6. A nurse is assessing a client with COPD who has a barrel chest. Which of the following is
the underlying cause of this finding?
ATI Medical-Surg Proctored Exam 2023 Advanced/Hard Level |
Nursing Students | Next Generation NCLEX (NGN) Style | 100%
Pass Guaranteed | Graded A+
1. A nurse is caring for a client who is 2 days post-operative following a total hip arthroplasty.
Which of the following findings should the nurse report to the provider immediately?
A. Pain of 4 on a 0-10 scale with movement
B. Moderate serosanguinous drainage on the dressing
C. Unilateral calf swelling and warmth
D. Temperature of 37.5°C (99.5°F)
☑ Correct Answer: C
☑ Explanation: Unilateral calf swelling and warmth are classic signs of deep vein
thrombosis (DVT), a serious post-operative complication that can lead to pulmonary embolism.
This finding requires immediate reporting. Pain with movement, moderate serosanguinous
drainage, and a low-grade fever are expected post-operative findings.
2. A nurse is assessing a client with heart failure who has been prescribed furosemide. Which
of the following assessment findings indicates that the medication is effective?
,2
A. Decreased urine output
B. Weight gain of 0.5 kg over 24 hours
C. Decreased peripheral edema
D. Increased dyspnea
☑ Correct Answer: C
☑ Explanation: Furosemide is a loop diuretic used to reduce fluid volume in heart failure. A
decrease in peripheral edema indicates that the medication is effectively removing excess fluid.
Decreased urine output, weight gain, and increased dyspnea would indicate worsening heart
failure or ineffective treatment.
3. A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes
mellitus. Which of the following statements by the client indicates an understanding of the
teaching?
A. "I will take my metformin only when my blood sugar is high."
B. "I should exercise for 30 minutes most days of the week."
C. "I can stop my medication once my blood sugar is normal."
D. "I should check my blood sugar once a week."
,3
☑ Correct Answer: B
☑ Explanation: Regular exercise (30 minutes most days) helps improve insulin sensitivity
and is a key component of diabetes management. Metformin should be taken daily as
prescribed, not PRN. Diabetes medications are typically continued even when blood sugar is
normal to maintain control. Blood glucose should be checked multiple times daily, not weekly.
4. A nurse is preparing to administer a blood transfusion to a client. Which of the following
actions should the nurse take first?
A. Obtain the client's vital signs
B. Verify the client's identity using two identifiers
C. Prime the blood tubing with 0.9% sodium chloride
D. Ask the client about previous transfusion reactions
☑ Correct Answer: B
☑ Explanation: The first step in blood transfusion administration is verifying the client's
identity using two unique identifiers (e.g., name and date of birth) to ensure the correct blood
product is given to the correct client. This is a critical safety measure to prevent transfusion
, 4
errors. Vital signs, priming tubing, and assessing history are also important but follow
identification verification.
5. A nurse is caring for a client who has acute pancreatitis. Which of the following laboratory
values should the nurse monitor?
A. Serum amylase
B. Serum lipase
C. Serum glucose
D. All of the above
☑ Correct Answer: D
☑ Explanation: In acute pancreatitis, serum amylase and lipase are elevated (lipase is
more specific). Serum glucose may be elevated due to impaired insulin production from
pancreatic inflammation. Monitoring all three values is important for assessing the severity and
complications of pancreatitis.
6. A nurse is assessing a client with COPD who has a barrel chest. Which of the following is
the underlying cause of this finding?
