ATI RN MEDICAL-SURGICAL NURSING — EXAM 1 ACTUAL EXAM QUESTIONS AND ANSWERS
ALREADY GRADED A+| 100% VERIFIED SOLUTIONS………...
Core Domains:
Cardiovascular Disorders
Respiratory Disorders
Renal and Urinary Disorders
Endocrine and Metabolic Disorders
Gastrointestinal Disorders
Neurological Disorders
Musculoskeletal and Perioperative Care
Hematologic and Oncologic Disorders
Fluid, Electrolyte, and Acid-Base Balance
Pharmacology and Patient Safety
Introduction:
,This comprehensive examination assesses the practical nurse's mastery of medical-surgical nursing
concepts essential for safe, effective adult client care. The assessment evaluates knowledge across
cardiovascular, respiratory, renal, endocrine, gastrointestinal, neurological, musculoskeletal, and
hematologic systems. Questions are structured in multiple-choice and scenario-based formats to
simulate real-world clinical situations. Emphasis is placed on clinical judgment, prioritization, and
application of evidence-based practice. Successful completion demonstrates readiness to deliver
competent, compassionate nursing care in diverse healthcare settings while adhering to
professional standards and regulatory requirements.
Section One: Questions 1–100
Question 1
A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD) and is
receiving oxygen at 2 L/min via nasal cannula. The client reports increased shortness of breath.
Which of the following actions should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min
B. Obtain a pulse oximetry reading
C. Assess the client's respiratory rate, depth, and pattern
D. Instruct the client to pursed-lip breathe
🟢 C. Assess the client's respiratory rate, depth, and pattern
,🔴 RATIONALE: The nurse should first assess the client's respiratory status before making any
changes to the oxygen therapy. Clients with COPD rely on a hypoxic drive to breathe; increasing
oxygen flow rate can suppress ventilation and cause respiratory acidosis. Assessment data guides
the appropriate intervention.
Question 2
A nurse is teaching a client who has asthma about the proper use of a metered-dose inhaler
(MDI) with a spacer. Which of the following statements by the client indicates an understanding
of the teaching?
A. "I will shake the inhaler, attach the spacer, exhale fully, then inhale slowly and deeply."
B. "I will take two quick breaths after pressing the inhaler to get the full dose."
C. "I will hold my breath for 5 seconds after inhaling the medication."
D. "I will rinse my mouth with water before using the inhaler to moisten my airway."
🟢 A. "I will shake the inhaler, attach the spacer, exhale fully, then inhale slowly and deeply."
🔴 RATIONALE: The correct technique for MDI use with a spacer includes shaking the inhaler,
attaching the spacer, exhaling fully, pressing the inhaler, and inhaling slowly and deeply over 3 to
5 seconds. The client should hold their breath for 10 seconds to allow medication deposition.
, Question 3
A nurse is reviewing the arterial blood gas (ABG) results of a client who has pneumonia: pH 7.30,
PaCO2 50 mm Hg, HCO3- 24 mEq/L. The nurse should interpret these findings as which of the
following?
A. Respiratory alkalosis with partial compensation
B. Respiratory acidosis without compensation
C. Metabolic acidosis with respiratory compensation
D. Metabolic alkalosis without compensation
🟢 B. Respiratory acidosis without compensation
🔴 RATIONALE: The ABG results show a pH of 7.30 (below normal 7.35-7.45), indicating acidosis.
The PaCO2 is elevated at 50 mm Hg (normal 35-45 mm Hg), which indicates a respiratory cause.
The HCO3- is normal at 24 mEq/L, indicating no metabolic compensation.
Question 4
A patient with acute decompensated heart failure is receiving IV furosemide. Which assessment
finding best indicates that the medication has been effective?
A. Urine output of 50 mL/hr with decreased breath sounds
B. Serum potassium increase from 3.2 to 4.0 mEq/L
ALREADY GRADED A+| 100% VERIFIED SOLUTIONS………...
Core Domains:
Cardiovascular Disorders
Respiratory Disorders
Renal and Urinary Disorders
Endocrine and Metabolic Disorders
Gastrointestinal Disorders
Neurological Disorders
Musculoskeletal and Perioperative Care
Hematologic and Oncologic Disorders
Fluid, Electrolyte, and Acid-Base Balance
Pharmacology and Patient Safety
Introduction:
,This comprehensive examination assesses the practical nurse's mastery of medical-surgical nursing
concepts essential for safe, effective adult client care. The assessment evaluates knowledge across
cardiovascular, respiratory, renal, endocrine, gastrointestinal, neurological, musculoskeletal, and
hematologic systems. Questions are structured in multiple-choice and scenario-based formats to
simulate real-world clinical situations. Emphasis is placed on clinical judgment, prioritization, and
application of evidence-based practice. Successful completion demonstrates readiness to deliver
competent, compassionate nursing care in diverse healthcare settings while adhering to
professional standards and regulatory requirements.
Section One: Questions 1–100
Question 1
A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD) and is
receiving oxygen at 2 L/min via nasal cannula. The client reports increased shortness of breath.
Which of the following actions should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min
B. Obtain a pulse oximetry reading
C. Assess the client's respiratory rate, depth, and pattern
D. Instruct the client to pursed-lip breathe
🟢 C. Assess the client's respiratory rate, depth, and pattern
,🔴 RATIONALE: The nurse should first assess the client's respiratory status before making any
changes to the oxygen therapy. Clients with COPD rely on a hypoxic drive to breathe; increasing
oxygen flow rate can suppress ventilation and cause respiratory acidosis. Assessment data guides
the appropriate intervention.
Question 2
A nurse is teaching a client who has asthma about the proper use of a metered-dose inhaler
(MDI) with a spacer. Which of the following statements by the client indicates an understanding
of the teaching?
A. "I will shake the inhaler, attach the spacer, exhale fully, then inhale slowly and deeply."
B. "I will take two quick breaths after pressing the inhaler to get the full dose."
C. "I will hold my breath for 5 seconds after inhaling the medication."
D. "I will rinse my mouth with water before using the inhaler to moisten my airway."
🟢 A. "I will shake the inhaler, attach the spacer, exhale fully, then inhale slowly and deeply."
🔴 RATIONALE: The correct technique for MDI use with a spacer includes shaking the inhaler,
attaching the spacer, exhaling fully, pressing the inhaler, and inhaling slowly and deeply over 3 to
5 seconds. The client should hold their breath for 10 seconds to allow medication deposition.
, Question 3
A nurse is reviewing the arterial blood gas (ABG) results of a client who has pneumonia: pH 7.30,
PaCO2 50 mm Hg, HCO3- 24 mEq/L. The nurse should interpret these findings as which of the
following?
A. Respiratory alkalosis with partial compensation
B. Respiratory acidosis without compensation
C. Metabolic acidosis with respiratory compensation
D. Metabolic alkalosis without compensation
🟢 B. Respiratory acidosis without compensation
🔴 RATIONALE: The ABG results show a pH of 7.30 (below normal 7.35-7.45), indicating acidosis.
The PaCO2 is elevated at 50 mm Hg (normal 35-45 mm Hg), which indicates a respiratory cause.
The HCO3- is normal at 24 mEq/L, indicating no metabolic compensation.
Question 4
A patient with acute decompensated heart failure is receiving IV furosemide. Which assessment
finding best indicates that the medication has been effective?
A. Urine output of 50 mL/hr with decreased breath sounds
B. Serum potassium increase from 3.2 to 4.0 mEq/L
