• Mental Health Care 09/15/2026
ATI RN Adult Medical-Surgical 2026 Proctored Exam
Most Tested Practice Questions with Answers &
Rationales Exam Format: 250 questions | Multiple
Choice, SATA, NGN Case Studies | Answers with detailed
rationales | Level 3 proficiency focus Content
The nurse notes that the client's drainage has decreased from 50 to 5 mL/hr 12 hours after chest tube insertion
for hemothorax. What is the best initial action for the nurse to take?
A.
Document this expected decrease in drainage.
B.
P 1
, • Mental Health Care 09/15/2026
Clamp the chest tube while assessing for air leaks.
C.
Milk the tube to remove any excessive blood clot buildup.
D.
Assess for kinks or dependent loops in the tubing. - Correct Answer :D
Rationale:The least invasive nursing action should be performed first to determine why the drainage has
diminished. Option A is completed after assessing for any problems causing the decrease in drainage. Option B is
no longer considered standard protocol because the increase in pressure may be harmful to the client. Option C
is an appropriate nursing action after the tube has been assessed for kinks or dependent loops.
A client who received a nephrotoxic drug is admitted with acute renal failure and asks the nurse if dialysis will
always be needed. Which pathophysiologic consequence should the nurse explain that supports the need for
temporary dialysis until acute tubular necrosis subsides?
A.
Azotemia
B.
Oliguria
C.
Hyperkalemia
D.
Nephron obstruction - Correct Answer :D
Rationale:CKD is characterized by progressive and irreversible destruction of nephrons, frequently caused by
hypertension and diabetes mellitus. Nephrotoxins cause acute tubular necrosis, a reversible acute renal failure,
which creates renal tubular obstruction from endothelial cells that are sloughed or become edematous. The
obstruction of urine flow will resolve with the return of an adequate glomerular filtration rate, and when it does,
dialysis will no longer be needed. Options A, B, and C are manifestations seen in the acute and chronic forms of
kidney disease.
The nurse is performing hourly neurologic checks for a client with a head injury. Which new assessment finding
warrants immediate action by the nurse?
A.
A unilateral pupil that is dilated and nonreactive to light
B.
P 2
, • Mental Health Care 09/15/2026
Client cries out when awakened by a verbal stimulus.
C.
Client demonstrates a loss of memory of the events leading up to the injury.
D.
Onset of nausea, headache, and vertigo - Correct Answer :A
Rationale:Any change in pupil size and reactivity is an indication of increasing intracranial pressure and should be
reported to the health care provider immediately. Option B is a normal response to being awakened. Options C
and D are common manifestations of head injury and are of less immediacy than option A.
A 62-year-old client who lives alone tripped on a scatter rug resulting in a fractured hip. Which predisposing
factor most likely contributed to the fracture in the proximal end of her femur?
A.
Failing eyesight resulting in an unsafe environment
B.
Renal osteodystrophy resulting from chronic kidney disease (CKD)
C.
Osteoporosis resulting from declining hormone levels
D.
Cerebral vessel changes causing transient ischemic attacks - Correct Answer :C
Rationale:The most common cause of a fractured hip in older women is osteoporosis, resulting from reduced
calcium in the bones as a result of hormonal changes in the perimenopausal years. Option A may or may not
have contributed to the accident, but eye changes were not involved in promoting the hip fracture. Option B is
not a common condition of older people but is associated with CKD. Although option D may result in transient
ischemic attacks (TIAs) or stroke, it will not result in fragility of the bones, as does osteoporosis.
A home health nurse is assessing a 70-year-old male client who is convalescing at home following a hip
replacement. The nurse is concerned that the client may develop pressure ulcers. Which physical characteristic
of aging puts the client at risk?
A.
16% increase in overall body fat
B.
Reduced melanin production
P 3
, • Mental Health Care 09/15/2026
C.
Thinning of the skin, with loss of elasticity
D.
Calcium loss in the bones - Correct Answer :C
Rationale:Thin nonelastic skin is an important factor in pressure formation. The proportion of body fat to lean
mass increases with age and might help decrease ulcer tendency. Option B causes gray hair. Option D can
contribute to broken bones, but it is probably not a factor in pressure ulcer formation.
The nurse is preparing a 45-year-old client for discharge from a cancer center following ileostomy surgery for
colon cancer. Which discharge goal should the nurse include in this client's discharge plan?
A.
Reduce the daily intake of animal fat to 10% of the diet within 6 weeks.
B.
Exhibit regular, soft-formed stool within 1 month.
C.
Demonstrate the irrigation procedure correctly within 1 week.
D.
Attend an ostomy support group within 2 weeks. - Correct Answer :D
Rationale:Attending a support group will be beneficial to the client and should be encouraged because
adaptation to the ostomy can be difficult. This goal is attainable and is measurable. Option A is not specifically
related to ileostomy care. The client with an ileostomy will not be able to accomplish option B. Option C is not
necessary.
A client is diagnosed with an acute small bowel obstruction and suddenly spikes a temperature of 102°F/38.9°C.
What other assessments should the nurse include in the client's focused assessment? (Select all that apply.)
A.
Nausea and vomiting
B.
Loss of appetite
C.
Abdominal cramping
P 4
ATI RN Adult Medical-Surgical 2026 Proctored Exam
Most Tested Practice Questions with Answers &
Rationales Exam Format: 250 questions | Multiple
Choice, SATA, NGN Case Studies | Answers with detailed
rationales | Level 3 proficiency focus Content
The nurse notes that the client's drainage has decreased from 50 to 5 mL/hr 12 hours after chest tube insertion
for hemothorax. What is the best initial action for the nurse to take?
A.
Document this expected decrease in drainage.
B.
P 1
, • Mental Health Care 09/15/2026
Clamp the chest tube while assessing for air leaks.
C.
Milk the tube to remove any excessive blood clot buildup.
D.
Assess for kinks or dependent loops in the tubing. - Correct Answer :D
Rationale:The least invasive nursing action should be performed first to determine why the drainage has
diminished. Option A is completed after assessing for any problems causing the decrease in drainage. Option B is
no longer considered standard protocol because the increase in pressure may be harmful to the client. Option C
is an appropriate nursing action after the tube has been assessed for kinks or dependent loops.
A client who received a nephrotoxic drug is admitted with acute renal failure and asks the nurse if dialysis will
always be needed. Which pathophysiologic consequence should the nurse explain that supports the need for
temporary dialysis until acute tubular necrosis subsides?
A.
Azotemia
B.
Oliguria
C.
Hyperkalemia
D.
Nephron obstruction - Correct Answer :D
Rationale:CKD is characterized by progressive and irreversible destruction of nephrons, frequently caused by
hypertension and diabetes mellitus. Nephrotoxins cause acute tubular necrosis, a reversible acute renal failure,
which creates renal tubular obstruction from endothelial cells that are sloughed or become edematous. The
obstruction of urine flow will resolve with the return of an adequate glomerular filtration rate, and when it does,
dialysis will no longer be needed. Options A, B, and C are manifestations seen in the acute and chronic forms of
kidney disease.
The nurse is performing hourly neurologic checks for a client with a head injury. Which new assessment finding
warrants immediate action by the nurse?
A.
A unilateral pupil that is dilated and nonreactive to light
B.
P 2
, • Mental Health Care 09/15/2026
Client cries out when awakened by a verbal stimulus.
C.
Client demonstrates a loss of memory of the events leading up to the injury.
D.
Onset of nausea, headache, and vertigo - Correct Answer :A
Rationale:Any change in pupil size and reactivity is an indication of increasing intracranial pressure and should be
reported to the health care provider immediately. Option B is a normal response to being awakened. Options C
and D are common manifestations of head injury and are of less immediacy than option A.
A 62-year-old client who lives alone tripped on a scatter rug resulting in a fractured hip. Which predisposing
factor most likely contributed to the fracture in the proximal end of her femur?
A.
Failing eyesight resulting in an unsafe environment
B.
Renal osteodystrophy resulting from chronic kidney disease (CKD)
C.
Osteoporosis resulting from declining hormone levels
D.
Cerebral vessel changes causing transient ischemic attacks - Correct Answer :C
Rationale:The most common cause of a fractured hip in older women is osteoporosis, resulting from reduced
calcium in the bones as a result of hormonal changes in the perimenopausal years. Option A may or may not
have contributed to the accident, but eye changes were not involved in promoting the hip fracture. Option B is
not a common condition of older people but is associated with CKD. Although option D may result in transient
ischemic attacks (TIAs) or stroke, it will not result in fragility of the bones, as does osteoporosis.
A home health nurse is assessing a 70-year-old male client who is convalescing at home following a hip
replacement. The nurse is concerned that the client may develop pressure ulcers. Which physical characteristic
of aging puts the client at risk?
A.
16% increase in overall body fat
B.
Reduced melanin production
P 3
, • Mental Health Care 09/15/2026
C.
Thinning of the skin, with loss of elasticity
D.
Calcium loss in the bones - Correct Answer :C
Rationale:Thin nonelastic skin is an important factor in pressure formation. The proportion of body fat to lean
mass increases with age and might help decrease ulcer tendency. Option B causes gray hair. Option D can
contribute to broken bones, but it is probably not a factor in pressure ulcer formation.
The nurse is preparing a 45-year-old client for discharge from a cancer center following ileostomy surgery for
colon cancer. Which discharge goal should the nurse include in this client's discharge plan?
A.
Reduce the daily intake of animal fat to 10% of the diet within 6 weeks.
B.
Exhibit regular, soft-formed stool within 1 month.
C.
Demonstrate the irrigation procedure correctly within 1 week.
D.
Attend an ostomy support group within 2 weeks. - Correct Answer :D
Rationale:Attending a support group will be beneficial to the client and should be encouraged because
adaptation to the ostomy can be difficult. This goal is attainable and is measurable. Option A is not specifically
related to ileostomy care. The client with an ileostomy will not be able to accomplish option B. Option C is not
necessary.
A client is diagnosed with an acute small bowel obstruction and suddenly spikes a temperature of 102°F/38.9°C.
What other assessments should the nurse include in the client's focused assessment? (Select all that apply.)
A.
Nausea and vomiting
B.
Loss of appetite
C.
Abdominal cramping
P 4
