ATI NCLEX MEDICAL SURGICAL ASSESSMENT 1
LATEST QUESTIONS WITH CORRECT ANSWERS
A nurse is planning care for a client receiving mechanical ventilation. Which action
should the nurse include in the plan - Answer-Provide means of communication using
electronic tablet, speech generating device, alphabet board, pencil and paper, etc
/.A nurse is caring for a client receiving IV fluid replacement therapy for dehydration.
Which laboratory result indicates effectiveness of treatment - Answer-Urine specific
gravity 1.020, within expected range of 1.005-1.030
/.A nurse is monitoring lab findings for a client postoperative following total hip
arthroplasty. Which value indicates increased risk for bleeding - Answer-Platelets
80,000, range is 150,000-400,000
/.A nurse is admitting a client with a cervical spinal cord injury following a motor vehicle
crash. What intervention is the nurse's priority - Answer-Assist client with quad coughing
to ensure airway clearance
/.A nurse is caring for a client receiving a blood transfusion. Which finding indicates
transfusion-associated circulatory overload - Answer-Dyspnea, indicating possible
circulatory overload or transfusion-related lung injury
/.A nurse is assessing a client with lung cancer undergoing radiation therapy to the
chest. What indicates an adverse effect of therapy - Answer-Altered taste sensations
due to release of metabolites by dead cells
/.A nurse is preparing to administer packed RBCs to a client with anemia. Which actions
should the nurse plan to take - Answer-Obtain pre-transfusion temperature, verify
client's blood type, use 20 gauge IV needle for venous access
/.A nurse is reviewing lab findings for a dehydrated client. What BUN level should the
nurse expect - Answer-26 mg/dL, elevated levels indicate various conditions including
dehydration
/.A nurse is reviewing ECG strips for clients. Which image indicates atrial fibrillation -
Answer-Multiple irregular waves at baseline and irregular R to R intervals
/.A nurse is preparing to admit a client with a new tracheostomy. What item is the
priority to have available in the client's room upon admission - Answer-Obturator for
emergency airway maintenance in case of dislodgment or decannulation
/.A nurse is caring for a client who had a below the knee amputation due to a traumatic
injury 2 days ago. Which of the following statements should the nurse use to assess
, how the client is coping with this change in their body image - Answer-Tell me how the
changes to your leg make you feel
/.A nurse is teaching a client how to administer a medication using an inhaler with a
spacer. Which of the following instructions should the nurse include - Answer-Wait at
least 30 to 60 seconds between puffs of the medication. Wait 2-5 min between using
different medications from separate inhalers
/.A nurse in an endoscopy clinic is providing teaching to a client who is to undergo a
colonoscopy for colon cancer screening. Which of the following information should the
nurse provide - Answer-You will need someone to drive you home after your procedure
/.A nurse is monitoring a client who is receiving moderate sedation with midazolam.
Which of the following findings requires immediate intervention by the nurse - Answer-
No response to verbal stimuli
/.A nurse is reviewing the laboratory findings for a client who has heart failure and is
taking furosemide. The nurse should identify which of the following findings as an
adverse effect of the medication - Answer-Potassium 3.2 mEq/L
/.A nurse is caring for a client who is in Buck's traction. Which of the following actions
should the nurse take? (select all that apply) - Answer-Monitor peripheral pulses in the
affected extremity, Examine the skin under the traction boot, Assess the temperature of
the affected extremity
/.A nurse is reviewing safety measures with the caregiver of a client who has
Alzheimer's disease. Which of the following instructions should the nurse include in the
teaching - Answer-Lock doors leading to stairways
/.A nurse is developing a plan of care for a client who has meningitis. Which of the
following interventions should the nurse include in the plan - Answer-Keep the client's
room dark and quiet
/.A nurse is caring for a client who has a right subclavian central venous catheter. When
reconnecting a new intravenous infusion administration set, which of the following
actions should the nurse take - Answer-Use aseptic technique
/.A nurse is educating an older adult client about immunizations. Which of the following
immunizations should the nurse include in the recommendation for the client - Answer-
Recombinant herpes zoster
/.A nurse is caring for a client with continuous bladder irrigation post TURP. What
should the nurse do? - Answer-Determine accurate urinary output by subtracting
irrigation solution amount from total output
LATEST QUESTIONS WITH CORRECT ANSWERS
A nurse is planning care for a client receiving mechanical ventilation. Which action
should the nurse include in the plan - Answer-Provide means of communication using
electronic tablet, speech generating device, alphabet board, pencil and paper, etc
/.A nurse is caring for a client receiving IV fluid replacement therapy for dehydration.
Which laboratory result indicates effectiveness of treatment - Answer-Urine specific
gravity 1.020, within expected range of 1.005-1.030
/.A nurse is monitoring lab findings for a client postoperative following total hip
arthroplasty. Which value indicates increased risk for bleeding - Answer-Platelets
80,000, range is 150,000-400,000
/.A nurse is admitting a client with a cervical spinal cord injury following a motor vehicle
crash. What intervention is the nurse's priority - Answer-Assist client with quad coughing
to ensure airway clearance
/.A nurse is caring for a client receiving a blood transfusion. Which finding indicates
transfusion-associated circulatory overload - Answer-Dyspnea, indicating possible
circulatory overload or transfusion-related lung injury
/.A nurse is assessing a client with lung cancer undergoing radiation therapy to the
chest. What indicates an adverse effect of therapy - Answer-Altered taste sensations
due to release of metabolites by dead cells
/.A nurse is preparing to administer packed RBCs to a client with anemia. Which actions
should the nurse plan to take - Answer-Obtain pre-transfusion temperature, verify
client's blood type, use 20 gauge IV needle for venous access
/.A nurse is reviewing lab findings for a dehydrated client. What BUN level should the
nurse expect - Answer-26 mg/dL, elevated levels indicate various conditions including
dehydration
/.A nurse is reviewing ECG strips for clients. Which image indicates atrial fibrillation -
Answer-Multiple irregular waves at baseline and irregular R to R intervals
/.A nurse is preparing to admit a client with a new tracheostomy. What item is the
priority to have available in the client's room upon admission - Answer-Obturator for
emergency airway maintenance in case of dislodgment or decannulation
/.A nurse is caring for a client who had a below the knee amputation due to a traumatic
injury 2 days ago. Which of the following statements should the nurse use to assess
, how the client is coping with this change in their body image - Answer-Tell me how the
changes to your leg make you feel
/.A nurse is teaching a client how to administer a medication using an inhaler with a
spacer. Which of the following instructions should the nurse include - Answer-Wait at
least 30 to 60 seconds between puffs of the medication. Wait 2-5 min between using
different medications from separate inhalers
/.A nurse in an endoscopy clinic is providing teaching to a client who is to undergo a
colonoscopy for colon cancer screening. Which of the following information should the
nurse provide - Answer-You will need someone to drive you home after your procedure
/.A nurse is monitoring a client who is receiving moderate sedation with midazolam.
Which of the following findings requires immediate intervention by the nurse - Answer-
No response to verbal stimuli
/.A nurse is reviewing the laboratory findings for a client who has heart failure and is
taking furosemide. The nurse should identify which of the following findings as an
adverse effect of the medication - Answer-Potassium 3.2 mEq/L
/.A nurse is caring for a client who is in Buck's traction. Which of the following actions
should the nurse take? (select all that apply) - Answer-Monitor peripheral pulses in the
affected extremity, Examine the skin under the traction boot, Assess the temperature of
the affected extremity
/.A nurse is reviewing safety measures with the caregiver of a client who has
Alzheimer's disease. Which of the following instructions should the nurse include in the
teaching - Answer-Lock doors leading to stairways
/.A nurse is developing a plan of care for a client who has meningitis. Which of the
following interventions should the nurse include in the plan - Answer-Keep the client's
room dark and quiet
/.A nurse is caring for a client who has a right subclavian central venous catheter. When
reconnecting a new intravenous infusion administration set, which of the following
actions should the nurse take - Answer-Use aseptic technique
/.A nurse is educating an older adult client about immunizations. Which of the following
immunizations should the nurse include in the recommendation for the client - Answer-
Recombinant herpes zoster
/.A nurse is caring for a client with continuous bladder irrigation post TURP. What
should the nurse do? - Answer-Determine accurate urinary output by subtracting
irrigation solution amount from total output
