1|Page
ATI RN Adult Medical-Surgical Proctored Newest
Exam Preparation With Complete Questions And
Correct Answers With Rationales Already Graded
A+Brand New Version!!
QUESTION 1
A nurse is assessing an older adult client at a health fair. Which of the
following statements by the client is the nurse's priority?
A) "I've noticed that there is a gray ring around the colored part of my
eye."
B) "I'm having more difficulty telling the difference between blues and
greens."
C) "I can't seem to get reading materials far enough away to see the
words."
D) "In the last day, I have had a severe headache and pain around my
right eye."
Correct Answer: D
,2|Page
Rationale: Severe headache and localized eye pain are classic clinical
manifestations of acute angle-closure glaucoma, which is a medical
emergency that can lead to permanent blindness if intraocular pressure
is not reduced immediately. A gray ring around the cornea (arcus
senilis), difficulty distinguishing blues and greens (cataracts or normal
aging changes), and needing to hold reading materials farther away
(presbyopia) are non-urgent findings common in older adults.
QUESTION 2
A nurse is reviewing laboratory results for a client receiving IV heparin.
The aPTT is 120 seconds, and the control is 30 seconds. Which action
should the nurse take?
A) Increase the heparin infusion rate
B) Prepare to administer protamine sulfate
C) Continue the infusion and recheck in 4 hours
D) Administer vitamin K
Correct Answer: B
Rationale: The therapeutic aPTT range for heparin is 1.5-2.5 times the
control (45-75 seconds). An aPTT of 120 seconds indicates excessive
anticoagulation with high bleeding risk. Protamine sulfate is the specific
,3|Page
antidote that reverses heparin's effects. Vitamin K reverses warfarin,
not heparin.
QUESTION 3
A nurse is planning care for a client who has a central venous access
device for intermittent infusions. Which action should the nurse include
in the plan of care?
A) Flush the catheter using a 10-mL syringe
B) Use clean technique when changing the dressing
C) Cleanse the site with povidone-iodine
D) Change the dressing every 24 hours
Correct Answer: A
Rationale: A 10-mL or larger syringe should be used to flush a central
venous access device to prevent excessive pressure that could damage
the catheter. Smaller syringes generate higher pressure and increase
the risk of catheter rupture.
QUESTION 4
, 4|Page
A patient with acute respiratory distress syndrome (ARDS) is on
volume-controlled ventilation with FiO2 0.8, PEEP 12 cm H2O, and
plateau pressure 30 cm H2O. Arterial blood gas shows pH 7.25, PaCO2
50 mm Hg, PaO2 55 mm Hg. Which intervention should the nurse
anticipate to improve oxygenation?
A) Increase PEEP to 18 cm H2O
B) Switch to pressure-controlled ventilation
C) Administer inhaled nitric oxide
D) Increase FiO2 to 1.0
Correct Answer: C
Rationale: Inhaled nitric oxide is a selective pulmonary vasodilator that
can improve oxygenation in ARDS by reducing ventilation-perfusion
mismatch. Increasing PEEP further may compromise cardiac output and
increase barotrauma risk. Pressure-controlled ventilation does not
directly address oxygenation. Increasing FiO2 to 1.0 provides only
temporary benefit and does not address the underlying V/Q mismatch.
QUESTION 5
A nurse in an emergency department is preparing to perform an ocular
irrigation for a client. Which action should the nurse plan to take?
ATI RN Adult Medical-Surgical Proctored Newest
Exam Preparation With Complete Questions And
Correct Answers With Rationales Already Graded
A+Brand New Version!!
QUESTION 1
A nurse is assessing an older adult client at a health fair. Which of the
following statements by the client is the nurse's priority?
A) "I've noticed that there is a gray ring around the colored part of my
eye."
B) "I'm having more difficulty telling the difference between blues and
greens."
C) "I can't seem to get reading materials far enough away to see the
words."
D) "In the last day, I have had a severe headache and pain around my
right eye."
Correct Answer: D
,2|Page
Rationale: Severe headache and localized eye pain are classic clinical
manifestations of acute angle-closure glaucoma, which is a medical
emergency that can lead to permanent blindness if intraocular pressure
is not reduced immediately. A gray ring around the cornea (arcus
senilis), difficulty distinguishing blues and greens (cataracts or normal
aging changes), and needing to hold reading materials farther away
(presbyopia) are non-urgent findings common in older adults.
QUESTION 2
A nurse is reviewing laboratory results for a client receiving IV heparin.
The aPTT is 120 seconds, and the control is 30 seconds. Which action
should the nurse take?
A) Increase the heparin infusion rate
B) Prepare to administer protamine sulfate
C) Continue the infusion and recheck in 4 hours
D) Administer vitamin K
Correct Answer: B
Rationale: The therapeutic aPTT range for heparin is 1.5-2.5 times the
control (45-75 seconds). An aPTT of 120 seconds indicates excessive
anticoagulation with high bleeding risk. Protamine sulfate is the specific
,3|Page
antidote that reverses heparin's effects. Vitamin K reverses warfarin,
not heparin.
QUESTION 3
A nurse is planning care for a client who has a central venous access
device for intermittent infusions. Which action should the nurse include
in the plan of care?
A) Flush the catheter using a 10-mL syringe
B) Use clean technique when changing the dressing
C) Cleanse the site with povidone-iodine
D) Change the dressing every 24 hours
Correct Answer: A
Rationale: A 10-mL or larger syringe should be used to flush a central
venous access device to prevent excessive pressure that could damage
the catheter. Smaller syringes generate higher pressure and increase
the risk of catheter rupture.
QUESTION 4
, 4|Page
A patient with acute respiratory distress syndrome (ARDS) is on
volume-controlled ventilation with FiO2 0.8, PEEP 12 cm H2O, and
plateau pressure 30 cm H2O. Arterial blood gas shows pH 7.25, PaCO2
50 mm Hg, PaO2 55 mm Hg. Which intervention should the nurse
anticipate to improve oxygenation?
A) Increase PEEP to 18 cm H2O
B) Switch to pressure-controlled ventilation
C) Administer inhaled nitric oxide
D) Increase FiO2 to 1.0
Correct Answer: C
Rationale: Inhaled nitric oxide is a selective pulmonary vasodilator that
can improve oxygenation in ARDS by reducing ventilation-perfusion
mismatch. Increasing PEEP further may compromise cardiac output and
increase barotrauma risk. Pressure-controlled ventilation does not
directly address oxygenation. Increasing FiO2 to 1.0 provides only
temporary benefit and does not address the underlying V/Q mismatch.
QUESTION 5
A nurse in an emergency department is preparing to perform an ocular
irrigation for a client. Which action should the nurse plan to take?
