ATI RN MEDICAL SURGICAL /MED SURG ATI PROCTORED EXAM
100 EXPECTED QUESTION AND ANSWERS WITH
RATIONALES LATEST 2026-2027.
A nurse is teaching a client who has ovarian cancer about skin care following
radiation treatment. Which of the following instructions should the nurse
include?
A) Pat the skin on the radiation site to dry it
B) Apply over-the-counter moisturizer to the radiation site
C) Cover the radiation site loosely with a gauze wrap before dressing
D) Use a soft washcloth to clean the area around the radiation site
Correct Answer: A
Rationale
After radiation therapy, the skin in the treatment area becomes sensitive and
prone to irritation. The client should pat the skin dry rather than rubbing it to
prevent trauma and further irritation. Option B is incorrect because over-the-
counter moisturizers should not be applied to the radiation site without the
provider's approval; they may contain ingredients that could irritate the skin.
Option C is incorrect because the radiation site should not be covered with
gauze wraps unless specifically prescribed; loose, soft cotton clothing is
recommended. Option D is incorrect because the area around the radiation site
should be cleansed gently with lukewarm water and mild soap, but the
radiation site itself should be handled with extreme care. The nurse should also
instruct the client to avoid exposing the area to direct sunlight and to wear
loose, soft clothing.
A nurse is caring for a client who has diabetes insipidus. Which of the
following medications should the nurse plan to administer?
A) Desmopressin
B) Regular insulin
C) Furosemide
D) Lithium carbonate
Correct Answer: A
Rationale
Diabetes insipidus is characterized by a deficiency of antidiuretic hormone
(ADH), leading to excessive urination and thirst. Desmopressin (DDAVP) is a
synthetic analog of ADH that is administered to replace ADH and reduce urine
,output. Option B, regular insulin, is used to treat hyperglycemia. Option C,
furosemide, is a diuretic that would worsen the condition. Option D, lithium
carbonate, is used to treat bipolar disorder and can actually cause nephrogenic
diabetes insipidus as a side effect. The nurse should monitor the client's urine
output, specific gravity, and electrolyte levels.
A nurse is admitting a client who has arthritic pain and reports taking ibuprofen
several times daily for 3 years. Which of the following tests should the nurse
monitor?
A) Fasting blood glucose
B) Stool for occult blood
C) Urine for white blood cells
D) Serum calcium
Correct Answer: B
Rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause
gastrointestinal bleeding. The nurse should monitor the client's stool for occult
blood and assess for signs of GI bleeding (bloody or tarry stools, abdominal
pain, hematemesis). Option A, fasting blood glucose, is not directly affected by
ibuprofen. Option C, urine for WBCs, is not related to ibuprofen use. Option
D, serum calcium, is not affected by ibuprofen. Long-term NSAID use also
increases the risk of renal impairment, so renal function should be monitored.
A nurse is contacting the provider for a client who has cancer and is
experiencing breakthrough pain. Which of the following prescriptions should
the nurse anticipate?
A) Transmucosal fentanyl
B) Intramuscular meperidine
C) Oral acetaminophen
D) Intravenous dexamethasone
Correct Answer: A
Rationale
Transmucosal fentanyl (Actiq) is a rapid-acting opioid used for breakthrough
pain in clients with cancer who are already receiving around-the-clock opioids.
Option B, intramuscular meperidine, is not recommended for chronic pain due
to the accumulation of the toxic metabolite normeperidine. Option C, oral
acetaminophen, is not sufficient for breakthrough cancer pain. Option D,
,intravenous dexamethasone, is a corticosteroid used for pain related to
inflammation or edema, not breakthrough pain. The nurse should also assess
the client's pain level and response to treatment.
A nurse is admitting a client who reports chest pain and has been placed on a
telemetry monitor. Which of the following should the nurse analyze to
determine whether the client is experiencing a myocardial infarction?
A) PR interval
B) QRS duration
C) T wave
D) ST segment
Correct Answer: D
Rationale
ST segment elevation indicates myocardial infarction (STEMI). ST segment
depression indicates ischemia. Option A, PR interval, is used to assess heart
block. Option B, QRS duration, is used to assess ventricular conduction.
Option C, T wave changes, may indicate ischemia or electrolyte imbalances.
The nurse should also assess the client's symptoms and cardiac enzymes.
A nurse is assessing a client who is 12 hours postoperative following a colon
resection. Which of the following findings should the nurse report to the
surgeon?
A) Heart rate 90/min
B) Absent bowel sounds
C) Hemoglobin 8.2 g/dL
D) Gastric pH of 3.0
Correct Answer: C
Rationale
A hemoglobin level of 8.2 g/dL is significantly below the normal range (13-18
g/dL for males, 12-16 g/dL for females) and may indicate possible
hemorrhaging following surgery. Option A, heart rate 90/min, is within the
normal range (60-100/min). Option B, absent bowel sounds, is an expected
finding after major bowel surgery; bowel sounds typically return within several
days. Option D, gastric pH of 3.0, is within the normal range for gastric acid
(pH 1-4). The nurse should monitor the client's vital signs and assess for signs
of bleeding, including hypotension, tachycardia, and decreased urine output.
, A nurse is caring for a client who is receiving a blood transfusion. The nurse
observes that the client has bounding peripheral pulses, hypertension, and
distended jugular veins. The nurse should anticipate administering which of the
following prescribed medications?
A) Diphenhydramine
B) Acetaminophen
C) Pantoprazole
D) Furosemide
Correct Answer: D
Rationale
Bounding peripheral pulses, hypertension, and distended jugular veins are
signs of fluid overload (transfusion-associated circulatory overload or TACO).
The nurse should anticipate administering a diuretic such as furosemide to
reduce fluid volume. Option A, diphenhydramine, is an antihistamine used for
allergic reactions. Option B, acetaminophen, is used for fever. Option C,
pantoprazole, is a proton pump inhibitor used for gastrointestinal bleeding
prevention. The nurse should slow or stop the transfusion and notify the
provider.
A nurse is assessing a client who is receiving magnesium sulfate IV for the
treatment of hypomagnesemia. Which of the following findings indicates
effectiveness of the medication?
A) Lungs clear
B) Apical pulse 82/min
C) Hyperactive bowel sounds
D) Blood pressure 90/50 mm Hg
Correct Answer: C
Rationale
Hypomagnesemia is characterized by hypoactive bowel sounds, constipation,
and paralytic ileus. Effectiveness of magnesium replacement is indicated by the
return of normal bowel function, including hyperactive or normal bowel
sounds. Option A, clear lungs, is not specific to magnesium therapy. Option B,
apical pulse 82/min, is a normal finding but does not specifically indicate
magnesium effectiveness. Option D, blood pressure 90/50 mm Hg, is
hypotension, which may indicate magnesium toxicity or other issues. The
nurse should also monitor deep tendon reflexes and serum magnesium levels.
100 EXPECTED QUESTION AND ANSWERS WITH
RATIONALES LATEST 2026-2027.
A nurse is teaching a client who has ovarian cancer about skin care following
radiation treatment. Which of the following instructions should the nurse
include?
A) Pat the skin on the radiation site to dry it
B) Apply over-the-counter moisturizer to the radiation site
C) Cover the radiation site loosely with a gauze wrap before dressing
D) Use a soft washcloth to clean the area around the radiation site
Correct Answer: A
Rationale
After radiation therapy, the skin in the treatment area becomes sensitive and
prone to irritation. The client should pat the skin dry rather than rubbing it to
prevent trauma and further irritation. Option B is incorrect because over-the-
counter moisturizers should not be applied to the radiation site without the
provider's approval; they may contain ingredients that could irritate the skin.
Option C is incorrect because the radiation site should not be covered with
gauze wraps unless specifically prescribed; loose, soft cotton clothing is
recommended. Option D is incorrect because the area around the radiation site
should be cleansed gently with lukewarm water and mild soap, but the
radiation site itself should be handled with extreme care. The nurse should also
instruct the client to avoid exposing the area to direct sunlight and to wear
loose, soft clothing.
A nurse is caring for a client who has diabetes insipidus. Which of the
following medications should the nurse plan to administer?
A) Desmopressin
B) Regular insulin
C) Furosemide
D) Lithium carbonate
Correct Answer: A
Rationale
Diabetes insipidus is characterized by a deficiency of antidiuretic hormone
(ADH), leading to excessive urination and thirst. Desmopressin (DDAVP) is a
synthetic analog of ADH that is administered to replace ADH and reduce urine
,output. Option B, regular insulin, is used to treat hyperglycemia. Option C,
furosemide, is a diuretic that would worsen the condition. Option D, lithium
carbonate, is used to treat bipolar disorder and can actually cause nephrogenic
diabetes insipidus as a side effect. The nurse should monitor the client's urine
output, specific gravity, and electrolyte levels.
A nurse is admitting a client who has arthritic pain and reports taking ibuprofen
several times daily for 3 years. Which of the following tests should the nurse
monitor?
A) Fasting blood glucose
B) Stool for occult blood
C) Urine for white blood cells
D) Serum calcium
Correct Answer: B
Rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause
gastrointestinal bleeding. The nurse should monitor the client's stool for occult
blood and assess for signs of GI bleeding (bloody or tarry stools, abdominal
pain, hematemesis). Option A, fasting blood glucose, is not directly affected by
ibuprofen. Option C, urine for WBCs, is not related to ibuprofen use. Option
D, serum calcium, is not affected by ibuprofen. Long-term NSAID use also
increases the risk of renal impairment, so renal function should be monitored.
A nurse is contacting the provider for a client who has cancer and is
experiencing breakthrough pain. Which of the following prescriptions should
the nurse anticipate?
A) Transmucosal fentanyl
B) Intramuscular meperidine
C) Oral acetaminophen
D) Intravenous dexamethasone
Correct Answer: A
Rationale
Transmucosal fentanyl (Actiq) is a rapid-acting opioid used for breakthrough
pain in clients with cancer who are already receiving around-the-clock opioids.
Option B, intramuscular meperidine, is not recommended for chronic pain due
to the accumulation of the toxic metabolite normeperidine. Option C, oral
acetaminophen, is not sufficient for breakthrough cancer pain. Option D,
,intravenous dexamethasone, is a corticosteroid used for pain related to
inflammation or edema, not breakthrough pain. The nurse should also assess
the client's pain level and response to treatment.
A nurse is admitting a client who reports chest pain and has been placed on a
telemetry monitor. Which of the following should the nurse analyze to
determine whether the client is experiencing a myocardial infarction?
A) PR interval
B) QRS duration
C) T wave
D) ST segment
Correct Answer: D
Rationale
ST segment elevation indicates myocardial infarction (STEMI). ST segment
depression indicates ischemia. Option A, PR interval, is used to assess heart
block. Option B, QRS duration, is used to assess ventricular conduction.
Option C, T wave changes, may indicate ischemia or electrolyte imbalances.
The nurse should also assess the client's symptoms and cardiac enzymes.
A nurse is assessing a client who is 12 hours postoperative following a colon
resection. Which of the following findings should the nurse report to the
surgeon?
A) Heart rate 90/min
B) Absent bowel sounds
C) Hemoglobin 8.2 g/dL
D) Gastric pH of 3.0
Correct Answer: C
Rationale
A hemoglobin level of 8.2 g/dL is significantly below the normal range (13-18
g/dL for males, 12-16 g/dL for females) and may indicate possible
hemorrhaging following surgery. Option A, heart rate 90/min, is within the
normal range (60-100/min). Option B, absent bowel sounds, is an expected
finding after major bowel surgery; bowel sounds typically return within several
days. Option D, gastric pH of 3.0, is within the normal range for gastric acid
(pH 1-4). The nurse should monitor the client's vital signs and assess for signs
of bleeding, including hypotension, tachycardia, and decreased urine output.
, A nurse is caring for a client who is receiving a blood transfusion. The nurse
observes that the client has bounding peripheral pulses, hypertension, and
distended jugular veins. The nurse should anticipate administering which of the
following prescribed medications?
A) Diphenhydramine
B) Acetaminophen
C) Pantoprazole
D) Furosemide
Correct Answer: D
Rationale
Bounding peripheral pulses, hypertension, and distended jugular veins are
signs of fluid overload (transfusion-associated circulatory overload or TACO).
The nurse should anticipate administering a diuretic such as furosemide to
reduce fluid volume. Option A, diphenhydramine, is an antihistamine used for
allergic reactions. Option B, acetaminophen, is used for fever. Option C,
pantoprazole, is a proton pump inhibitor used for gastrointestinal bleeding
prevention. The nurse should slow or stop the transfusion and notify the
provider.
A nurse is assessing a client who is receiving magnesium sulfate IV for the
treatment of hypomagnesemia. Which of the following findings indicates
effectiveness of the medication?
A) Lungs clear
B) Apical pulse 82/min
C) Hyperactive bowel sounds
D) Blood pressure 90/50 mm Hg
Correct Answer: C
Rationale
Hypomagnesemia is characterized by hypoactive bowel sounds, constipation,
and paralytic ileus. Effectiveness of magnesium replacement is indicated by the
return of normal bowel function, including hyperactive or normal bowel
sounds. Option A, clear lungs, is not specific to magnesium therapy. Option B,
apical pulse 82/min, is a normal finding but does not specifically indicate
magnesium effectiveness. Option D, blood pressure 90/50 mm Hg, is
hypotension, which may indicate magnesium toxicity or other issues. The
nurse should also monitor deep tendon reflexes and serum magnesium levels.
