ATI Med Surg Proctored Exam (26 Latest Versions,
2022) / Med Surg ATI Proctored Exam / ATI Med
surge Proctored Exam / Med surge ATI Proctored
Exam |Real + Practice Exam, Q and A
Section 1: Perioperative Care & Surgical Nursing
1. A nurse is caring for a client 6 hours after abdominal surgery. Which assessment finding
requires immediate intervention?
A. Serosanguineous drainage on the dressing
B. Blood pressure 88/54 mm Hg with heart rate 122/min
C. Temperature 37.8°C (100.0°F)
D. Report of incisional pain rated 5/10
Correct Answer: B
Rationale: Hypotension with compensatory tachycardia suggests hypovolemic shock
(hemorrhage) and must be reported immediately. Serosanguineous drainage is expected, low-
grade fever is common postoperatively, and moderate pain is expected.
2. A client is scheduled for surgery and asks why they must stop eating 8 hours before the
procedure. Which response by the nurse is best?
A. "It prevents you from feeling hungry during surgery."
B. "It reduces your risk of vomiting and aspirating stomach contents."
C. "It helps your bowel recover faster after surgery."
D. "It lowers your blood sugar before anesthesia."
Correct Answer: B
Rationale: Preoperative fasting reduces gastric volume, decreasing the risk of aspiration
during induction of anesthesia. Hunger, bowel recovery, and blood glucose are secondary
considerations.
3. A nurse is teaching a client about incentive spirometry after thoracic surgery. Which
statement indicates correct understanding?
A. "I will use it once a day when I wake up."
,B. "I will inhale slowly and deeply, hold my breath, then exhale."
C. "I will exhale forcefully into the device as fast as I can."
D. "I will use it only if I feel short of breath."
Correct Answer: B
Rationale: Incentive spirometry promotes deep lung expansion. The client should inhale
slowly and deeply, hold 3–5 seconds, then exhale. It should be used 10 times per hour while
awake, not just once daily or only when symptomatic.
4. A postoperative client reports sudden shortness of breath and chest pain. Vital signs: HR
118/min, RR 30/min, SpO₂ 88% on room air. Which action should the nurse take first?
A. Administer prescribed morphine
B. Apply oxygen and raise the head of the bed
C. Encourage the client to cough and deep breathe
D. Obtain a chest x-ray
Correct Answer: B
Rationale: These findings suggest pulmonary embolism. Immediate priorities are
oxygenation and positioning (high Fowler's), then notifying the provider. Morphine is not first-
line; cough/deep breathing won't resolve a PE; x-ray is diagnostic but not the first action.
5. Which client is at greatest risk for malignant hyperthermia during surgery?
A. A client with a history of asthma
B. A client with a family history of malignant hyperthermia
C. A client taking beta blockers
D. A client with type 2 diabetes
Correct Answer: B
Rationale: Malignant hyperthermia is an autosomal dominant genetic disorder triggered
by inhaled anesthetics and succinylcholine. A positive family history is the strongest risk
factor.
6. A nurse is preparing a client for surgery. Which finding should be reported to the surgeon
before proceeding? (Select all that apply.)
A. Informed consent signed
B. Temperature 38.9°C (102°F)
,C. INR 2.8 in a client not on anticoagulants
D. Allergy to latex
E. NPO status confirmed
Correct Answers: B, C
Rationale: Fever suggests infection, and an elevated INR without anticoagulant therapy
indicates a bleeding risk — both require surgeon notification. Signed consent, latex allergy
documentation, and NPO status are expected preparations.
7. A nurse is caring for a client in the PACU. Which finding indicates the client is ready for
discharge from Phase I PACU?
A. Client is drowsy but arousable and maintaining a patent airway
B. Client's pain is 8/10
C. Client has not voided since surgery
D. Client's temperature is 35.5°C (95.9°F)
Correct Answer: A
Rationale: PACU discharge criteria include airway patency, adequate oxygenation, stable
vital signs, and return of consciousness. Uncontrolled pain, absence of voiding, and
hypothermia require continued monitoring.
8. A client is 2 days postoperative following hip replacement. Which intervention is most
important to prevent venous thromboembolism?
A. Encourage bed rest
B. Administer prescribed anticoagulants and encourage ankle pumps
C. Massage the calf muscles daily
D. Apply warm compresses to the legs
Correct Answer: B
Rationale: Anticoagulation plus early mobility/ankle exercises are key VTE prevention
strategies. Bed rest increases risk; calf massage is contraindicated (dislodges clots); warm
compresses do not prevent VTE.
9. A nurse is assessing a surgical incision. Which finding indicates a possible infection?
A. Pink, approximated wound edges
B. Serous drainage
, C. Warmth, redness, and purulent drainage
D. Mild incisional tenderness
Correct Answer: C
Rationale: Warmth, erythema, and purulent drainage are classic signs of infection. Pink
approximated edges, serous drainage, and mild tenderness are normal healing findings.
10. A client scheduled for surgery is taking warfarin. Which laboratory value should the nurse
monitor most closely?
A. Hemoglobin
B. INR
C. Platelet count
D. aPTT
Correct Answer: B
Rationale: INR monitors warfarin therapy. aPTT monitors heparin. Hemoglobin and
platelets are relevant but do not directly measure warfarin's anticoagulant effect.
Section 2: Fluid, Electrolyte & Acid-Base Balance
11. A client has a potassium level of 6.2 mEq/L. Which action should the nurse take first?
A. Administer prescribed potassium chloride
B. Place the client on continuous cardiac monitoring
C. Encourage a high-potassium diet
D. Restrict fluids
Correct Answer: B
Rationale: Hyperkalemia can cause life-threatening dysrhythmias, so cardiac monitoring is
the priority. Potassium should never be given; diet and fluid restriction don't address the
immediate risk.
12. A client with severe vomiting has a pH of 7.48, PaCO₂ of 44 mm Hg, and HCO₃⁻ of 30
mEq/L. Which acid-base imbalance is present?
A. Respiratory alkalosis
B. Metabolic alkalosis
2022) / Med Surg ATI Proctored Exam / ATI Med
surge Proctored Exam / Med surge ATI Proctored
Exam |Real + Practice Exam, Q and A
Section 1: Perioperative Care & Surgical Nursing
1. A nurse is caring for a client 6 hours after abdominal surgery. Which assessment finding
requires immediate intervention?
A. Serosanguineous drainage on the dressing
B. Blood pressure 88/54 mm Hg with heart rate 122/min
C. Temperature 37.8°C (100.0°F)
D. Report of incisional pain rated 5/10
Correct Answer: B
Rationale: Hypotension with compensatory tachycardia suggests hypovolemic shock
(hemorrhage) and must be reported immediately. Serosanguineous drainage is expected, low-
grade fever is common postoperatively, and moderate pain is expected.
2. A client is scheduled for surgery and asks why they must stop eating 8 hours before the
procedure. Which response by the nurse is best?
A. "It prevents you from feeling hungry during surgery."
B. "It reduces your risk of vomiting and aspirating stomach contents."
C. "It helps your bowel recover faster after surgery."
D. "It lowers your blood sugar before anesthesia."
Correct Answer: B
Rationale: Preoperative fasting reduces gastric volume, decreasing the risk of aspiration
during induction of anesthesia. Hunger, bowel recovery, and blood glucose are secondary
considerations.
3. A nurse is teaching a client about incentive spirometry after thoracic surgery. Which
statement indicates correct understanding?
A. "I will use it once a day when I wake up."
,B. "I will inhale slowly and deeply, hold my breath, then exhale."
C. "I will exhale forcefully into the device as fast as I can."
D. "I will use it only if I feel short of breath."
Correct Answer: B
Rationale: Incentive spirometry promotes deep lung expansion. The client should inhale
slowly and deeply, hold 3–5 seconds, then exhale. It should be used 10 times per hour while
awake, not just once daily or only when symptomatic.
4. A postoperative client reports sudden shortness of breath and chest pain. Vital signs: HR
118/min, RR 30/min, SpO₂ 88% on room air. Which action should the nurse take first?
A. Administer prescribed morphine
B. Apply oxygen and raise the head of the bed
C. Encourage the client to cough and deep breathe
D. Obtain a chest x-ray
Correct Answer: B
Rationale: These findings suggest pulmonary embolism. Immediate priorities are
oxygenation and positioning (high Fowler's), then notifying the provider. Morphine is not first-
line; cough/deep breathing won't resolve a PE; x-ray is diagnostic but not the first action.
5. Which client is at greatest risk for malignant hyperthermia during surgery?
A. A client with a history of asthma
B. A client with a family history of malignant hyperthermia
C. A client taking beta blockers
D. A client with type 2 diabetes
Correct Answer: B
Rationale: Malignant hyperthermia is an autosomal dominant genetic disorder triggered
by inhaled anesthetics and succinylcholine. A positive family history is the strongest risk
factor.
6. A nurse is preparing a client for surgery. Which finding should be reported to the surgeon
before proceeding? (Select all that apply.)
A. Informed consent signed
B. Temperature 38.9°C (102°F)
,C. INR 2.8 in a client not on anticoagulants
D. Allergy to latex
E. NPO status confirmed
Correct Answers: B, C
Rationale: Fever suggests infection, and an elevated INR without anticoagulant therapy
indicates a bleeding risk — both require surgeon notification. Signed consent, latex allergy
documentation, and NPO status are expected preparations.
7. A nurse is caring for a client in the PACU. Which finding indicates the client is ready for
discharge from Phase I PACU?
A. Client is drowsy but arousable and maintaining a patent airway
B. Client's pain is 8/10
C. Client has not voided since surgery
D. Client's temperature is 35.5°C (95.9°F)
Correct Answer: A
Rationale: PACU discharge criteria include airway patency, adequate oxygenation, stable
vital signs, and return of consciousness. Uncontrolled pain, absence of voiding, and
hypothermia require continued monitoring.
8. A client is 2 days postoperative following hip replacement. Which intervention is most
important to prevent venous thromboembolism?
A. Encourage bed rest
B. Administer prescribed anticoagulants and encourage ankle pumps
C. Massage the calf muscles daily
D. Apply warm compresses to the legs
Correct Answer: B
Rationale: Anticoagulation plus early mobility/ankle exercises are key VTE prevention
strategies. Bed rest increases risk; calf massage is contraindicated (dislodges clots); warm
compresses do not prevent VTE.
9. A nurse is assessing a surgical incision. Which finding indicates a possible infection?
A. Pink, approximated wound edges
B. Serous drainage
, C. Warmth, redness, and purulent drainage
D. Mild incisional tenderness
Correct Answer: C
Rationale: Warmth, erythema, and purulent drainage are classic signs of infection. Pink
approximated edges, serous drainage, and mild tenderness are normal healing findings.
10. A client scheduled for surgery is taking warfarin. Which laboratory value should the nurse
monitor most closely?
A. Hemoglobin
B. INR
C. Platelet count
D. aPTT
Correct Answer: B
Rationale: INR monitors warfarin therapy. aPTT monitors heparin. Hemoglobin and
platelets are relevant but do not directly measure warfarin's anticoagulant effect.
Section 2: Fluid, Electrolyte & Acid-Base Balance
11. A client has a potassium level of 6.2 mEq/L. Which action should the nurse take first?
A. Administer prescribed potassium chloride
B. Place the client on continuous cardiac monitoring
C. Encourage a high-potassium diet
D. Restrict fluids
Correct Answer: B
Rationale: Hyperkalemia can cause life-threatening dysrhythmias, so cardiac monitoring is
the priority. Potassium should never be given; diet and fluid restriction don't address the
immediate risk.
12. A client with severe vomiting has a pH of 7.48, PaCO₂ of 44 mm Hg, and HCO₃⁻ of 30
mEq/L. Which acid-base imbalance is present?
A. Respiratory alkalosis
B. Metabolic alkalosis
