ATI MED SURG Test Bank (LATEST-
2021, Verified And Answers)
Perioperative Care & Surgical Nursing (Q1–10)
1. A client is scheduled for surgery in 2 hours. Which preoperative assessment finding should
the nurse report to the surgeon immediately?
A. Blood pressure 138/86 mm Hg
B. Temperature 101.8°F (38.8°C)
C. Heart rate 88 beats/min
D. Serum potassium 4.2 mEq/L
Correct Answer: B. Temperature 101.8°F (38.8°C)
Rationale: An elevated temperature may indicate an active infection, which can increase
surgical risk and warrant postponement of surgery. The other values are within normal limits
and do not require immediate notification.
2. A postoperative client who had abdominal surgery reports sudden shortness of breath and
chest pain. The nurse notes a heart rate of 122 beats/min and oxygen saturation of 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 12-lead ECG
Correct Answer: B. Apply oxygen and raise the head of the bed
Rationale: The client shows signs of possible pulmonary embolism. The priority is to
improve oxygenation by applying oxygen and positioning the client upright. ECG and morphine
may follow, but oxygenation is the immediate priority.
3. Which findings are expected in a client experiencing malignant hyperthermia during surgery?
(SATA)
,A. Muscle rigidity
B. Hypercarbia
C. Tachycardia
D. Hypothermia
E. Decreased serum potassium
Correct Answers: A, B, C
Rationale: Malignant hyperthermia causes muscle rigidity, increased end-tidal CO₂
(hypercarbia), tachycardia, hyperthermia, and hyperkalemia. Hypothermia and hypokalemia are
not expected.
4. A nurse is teaching a client about preoperative leg exercises. Which statement indicates
correct understanding?
A. "I should point my toes down and hold for 10 seconds."
B. "I will flex my feet toward my head and then point them away."
C. "I should only exercise the leg that will be operated on."
D. "These exercises should be avoided after surgery."
Correct Answer: B. "I will flex my feet toward my head and then point them away."
Rationale: Dorsiflexion and plantar flexion promote venous return and prevent thrombus
formation. Both legs should be exercised, and the exercises should continue postoperatively.
5. A client is 24 hours postoperative following a total hip replacement. Which action should the
nurse include in the plan of care?
A. Place a pillow under the knees to flex the hips
B. Keep the affected leg adducted
C. Use an abductor pillow between the legs
D. Encourage crossing the legs when turning
Correct Answer: C. Use an abductor pillow between the legs
Rationale: An abductor pillow prevents adduction and dislocation of the new hip. Pillows
under the knees and crossing the legs promote flexion and adduction, which are
contraindicated.
,6. Which client is at greatest risk for postoperative wound dehiscence?
A. A client who is 30 years old and had a hernia repair
B. A client who is obese and had abdominal surgery
C. A client who is 25 years old and had arthroscopic knee surgery
D. A client who had a tooth extraction
Correct Answer: B. A client who is obese and had abdominal surgery
Rationale: Obesity, abdominal surgery, poor nutrition, and increased intra-abdominal
pressure increase the risk for dehiscence. The other clients have lower risk.
7. A nurse is preparing a client for surgery and notes the client signed the consent form but has
questions about the procedure. Which action should the nurse take?
A. Answer the client's questions in detail
B. Have the client sign the form again
C. Notify the surgeon to address the client's questions
D. Proceed with surgery as scheduled
Correct Answer: C. Notify the surgeon to address the client's questions
Rationale: Informed consent requires that the provider performing the procedure explain it
and answer questions. The nurse can witness the signature but should not provide detailed
procedural explanations.
8. Which assessment findings indicate that a postoperative client may be experiencing a
paralytic ileus? (SATA)
A. Absent bowel sounds
B. Abdominal distention
C. Passage of flatus
D. Nausea and vomiting
E. Hyperactive bowel sounds
Correct Answers: A, B, D
Rationale: Paralytic ileus presents with absent bowel sounds, distention, nausea, vomiting,
and inability to pass flatus. Hyperactive bowel sounds and passage of flatus suggest normal or
increased motility.
, 9. A client is receiving conscious sedation for a procedure. Which parameter is most important
for the nurse to monitor?
A. Urine output
B. Respiratory status
C. Blood glucose
D. Skin color
Correct Answer: B. Respiratory status
Rationale: Conscious sedation can depress the respiratory drive. Continuous monitoring of
respiratory rate, depth, and oxygen saturation is the priority.
10. A nurse is caring for a client with a Jackson-Pratt drain after surgery. Which action is correct?
A. Irrigate the drain with sterile saline daily
B. Compress the bulb to maintain suction
C. Keep the drain above the incision site
D. Clamp the drain for 8 hours each shift
Correct Answer: B. Compress the bulb to maintain suction
Rationale: The JP drain works by negative pressure created when the bulb is compressed. It
should be kept below the incision, not irrigated routinely, and not clamped for extended
periods.
Fluids, Electrolytes & Acid-Base (Q11–20)
11. A client has a serum potassium level of 2.9 mEq/L. Which finding should the nurse expect?
A. Muscle weakness and leg cramps
B. Cardiac dysrhythmias and peaked T waves
C. Hyperactive reflexes and tetany
D. Hypertension and bradycardia
Correct Answer: A. Muscle weakness and leg cramps
Rationale: Hypokalemia causes muscle weakness, leg cramps, fatigue, and dysrhythmias.
Peaked T waves are associated with hyperkalemia.
2021, Verified And Answers)
Perioperative Care & Surgical Nursing (Q1–10)
1. A client is scheduled for surgery in 2 hours. Which preoperative assessment finding should
the nurse report to the surgeon immediately?
A. Blood pressure 138/86 mm Hg
B. Temperature 101.8°F (38.8°C)
C. Heart rate 88 beats/min
D. Serum potassium 4.2 mEq/L
Correct Answer: B. Temperature 101.8°F (38.8°C)
Rationale: An elevated temperature may indicate an active infection, which can increase
surgical risk and warrant postponement of surgery. The other values are within normal limits
and do not require immediate notification.
2. A postoperative client who had abdominal surgery reports sudden shortness of breath and
chest pain. The nurse notes a heart rate of 122 beats/min and oxygen saturation of 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 12-lead ECG
Correct Answer: B. Apply oxygen and raise the head of the bed
Rationale: The client shows signs of possible pulmonary embolism. The priority is to
improve oxygenation by applying oxygen and positioning the client upright. ECG and morphine
may follow, but oxygenation is the immediate priority.
3. Which findings are expected in a client experiencing malignant hyperthermia during surgery?
(SATA)
,A. Muscle rigidity
B. Hypercarbia
C. Tachycardia
D. Hypothermia
E. Decreased serum potassium
Correct Answers: A, B, C
Rationale: Malignant hyperthermia causes muscle rigidity, increased end-tidal CO₂
(hypercarbia), tachycardia, hyperthermia, and hyperkalemia. Hypothermia and hypokalemia are
not expected.
4. A nurse is teaching a client about preoperative leg exercises. Which statement indicates
correct understanding?
A. "I should point my toes down and hold for 10 seconds."
B. "I will flex my feet toward my head and then point them away."
C. "I should only exercise the leg that will be operated on."
D. "These exercises should be avoided after surgery."
Correct Answer: B. "I will flex my feet toward my head and then point them away."
Rationale: Dorsiflexion and plantar flexion promote venous return and prevent thrombus
formation. Both legs should be exercised, and the exercises should continue postoperatively.
5. A client is 24 hours postoperative following a total hip replacement. Which action should the
nurse include in the plan of care?
A. Place a pillow under the knees to flex the hips
B. Keep the affected leg adducted
C. Use an abductor pillow between the legs
D. Encourage crossing the legs when turning
Correct Answer: C. Use an abductor pillow between the legs
Rationale: An abductor pillow prevents adduction and dislocation of the new hip. Pillows
under the knees and crossing the legs promote flexion and adduction, which are
contraindicated.
,6. Which client is at greatest risk for postoperative wound dehiscence?
A. A client who is 30 years old and had a hernia repair
B. A client who is obese and had abdominal surgery
C. A client who is 25 years old and had arthroscopic knee surgery
D. A client who had a tooth extraction
Correct Answer: B. A client who is obese and had abdominal surgery
Rationale: Obesity, abdominal surgery, poor nutrition, and increased intra-abdominal
pressure increase the risk for dehiscence. The other clients have lower risk.
7. A nurse is preparing a client for surgery and notes the client signed the consent form but has
questions about the procedure. Which action should the nurse take?
A. Answer the client's questions in detail
B. Have the client sign the form again
C. Notify the surgeon to address the client's questions
D. Proceed with surgery as scheduled
Correct Answer: C. Notify the surgeon to address the client's questions
Rationale: Informed consent requires that the provider performing the procedure explain it
and answer questions. The nurse can witness the signature but should not provide detailed
procedural explanations.
8. Which assessment findings indicate that a postoperative client may be experiencing a
paralytic ileus? (SATA)
A. Absent bowel sounds
B. Abdominal distention
C. Passage of flatus
D. Nausea and vomiting
E. Hyperactive bowel sounds
Correct Answers: A, B, D
Rationale: Paralytic ileus presents with absent bowel sounds, distention, nausea, vomiting,
and inability to pass flatus. Hyperactive bowel sounds and passage of flatus suggest normal or
increased motility.
, 9. A client is receiving conscious sedation for a procedure. Which parameter is most important
for the nurse to monitor?
A. Urine output
B. Respiratory status
C. Blood glucose
D. Skin color
Correct Answer: B. Respiratory status
Rationale: Conscious sedation can depress the respiratory drive. Continuous monitoring of
respiratory rate, depth, and oxygen saturation is the priority.
10. A nurse is caring for a client with a Jackson-Pratt drain after surgery. Which action is correct?
A. Irrigate the drain with sterile saline daily
B. Compress the bulb to maintain suction
C. Keep the drain above the incision site
D. Clamp the drain for 8 hours each shift
Correct Answer: B. Compress the bulb to maintain suction
Rationale: The JP drain works by negative pressure created when the bulb is compressed. It
should be kept below the incision, not irrigated routinely, and not clamped for extended
periods.
Fluids, Electrolytes & Acid-Base (Q11–20)
11. A client has a serum potassium level of 2.9 mEq/L. Which finding should the nurse expect?
A. Muscle weakness and leg cramps
B. Cardiac dysrhythmias and peaked T waves
C. Hyperactive reflexes and tetany
D. Hypertension and bradycardia
Correct Answer: A. Muscle weakness and leg cramps
Rationale: Hypokalemia causes muscle weakness, leg cramps, fatigue, and dysrhythmias.
Peaked T waves are associated with hyperkalemia.
