ATI RN ADULT MEDICAL SURGICAL
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A nurse is caring for a client who is 24 hours postoperative following a thyroidectomy.
Which of the following findings should the nurse prioritize?
A. Hoarseness of the voice
B. Pain at the incision site
C. Tingling of the fingers and toes
D. Serosanguineous drainage on the dressing
Answer: C
Conceptual Explanation: Tingling of the fingers and toes (paresthesia) is a sign of
hypocalcemia, which can occur if the parathyroid glands are accidentally damaged or
removed during a thyroidectomy. This is a medical emergency requiring immediate
intervention to prevent tetany.
2. A nurse is assessing a client with a history of heart failure who is taking digoxin. Which of
the following findings is an early sign of digoxin toxicity?
A. Anorexia and nausea
,B. Yellow-green halos around lights
C. Sinus bradycardia
D. Hypokalemia
Answer: A
Conceptual Explanation: Gastrointestinal signs such as anorexia, nausea, and vomiting
are typically the earliest indicators of digoxin toxicity, whereas visual changes and
arrhythmias occur later.
3. A nurse is providing discharge teaching for a client who has a new prescription for warfarin.
Which of the following instructions should the nurse include?
A. Report any black, tarry stools immediately.
B. Use a hard-bristled toothbrush to prevent gingivitis.
C. Increase intake of dark green leafy vegetables.
D. Take aspirin for minor headaches.
Answer: A
Conceptual Explanation: Black, tarry stools indicate gastrointestinal bleeding, a serious
side effect of anticoagulant therapy. Clients should maintain a consistent, not increased,
intake of Vitamin K and avoid aspirin/NSAIDs.
, 4. A client is admitted with a suspected tension pneumothorax. Which of the following is a
hallmark finding associated with this condition?
A. Tracheal deviation to the unaffected side
B. Flattened neck veins
C. Hyperresonance on the unaffected side
D. Bradycardia
Answer: A
Conceptual Explanation: Tension pneumothorax causes air to trap in the pleural space,
leading to a mediastinal shift and tracheal deviation toward the unaffected side. It also
causes distended neck veins and tachycardia.
5. A nurse is monitoring a client receiving a blood transfusion. The client suddenly reports
chills, low back pain, and a headache. Which action should the nurse take first?
A. Notify the blood bank.
B. Obtain a urine specimen.
C. Administer diphenhydramine.
D. Stop the transfusion.
Answer: D
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A nurse is caring for a client who is 24 hours postoperative following a thyroidectomy.
Which of the following findings should the nurse prioritize?
A. Hoarseness of the voice
B. Pain at the incision site
C. Tingling of the fingers and toes
D. Serosanguineous drainage on the dressing
Answer: C
Conceptual Explanation: Tingling of the fingers and toes (paresthesia) is a sign of
hypocalcemia, which can occur if the parathyroid glands are accidentally damaged or
removed during a thyroidectomy. This is a medical emergency requiring immediate
intervention to prevent tetany.
2. A nurse is assessing a client with a history of heart failure who is taking digoxin. Which of
the following findings is an early sign of digoxin toxicity?
A. Anorexia and nausea
,B. Yellow-green halos around lights
C. Sinus bradycardia
D. Hypokalemia
Answer: A
Conceptual Explanation: Gastrointestinal signs such as anorexia, nausea, and vomiting
are typically the earliest indicators of digoxin toxicity, whereas visual changes and
arrhythmias occur later.
3. A nurse is providing discharge teaching for a client who has a new prescription for warfarin.
Which of the following instructions should the nurse include?
A. Report any black, tarry stools immediately.
B. Use a hard-bristled toothbrush to prevent gingivitis.
C. Increase intake of dark green leafy vegetables.
D. Take aspirin for minor headaches.
Answer: A
Conceptual Explanation: Black, tarry stools indicate gastrointestinal bleeding, a serious
side effect of anticoagulant therapy. Clients should maintain a consistent, not increased,
intake of Vitamin K and avoid aspirin/NSAIDs.
, 4. A client is admitted with a suspected tension pneumothorax. Which of the following is a
hallmark finding associated with this condition?
A. Tracheal deviation to the unaffected side
B. Flattened neck veins
C. Hyperresonance on the unaffected side
D. Bradycardia
Answer: A
Conceptual Explanation: Tension pneumothorax causes air to trap in the pleural space,
leading to a mediastinal shift and tracheal deviation toward the unaffected side. It also
causes distended neck veins and tachycardia.
5. A nurse is monitoring a client receiving a blood transfusion. The client suddenly reports
chills, low back pain, and a headache. Which action should the nurse take first?
A. Notify the blood bank.
B. Obtain a urine specimen.
C. Administer diphenhydramine.
D. Stop the transfusion.
Answer: D
