ATI Med Surg Proctored Exam Review 2025:
Comprehensive Study Guide, 100 Practice
Questions, and Key Strategies for Success
1. A nurse is assessing a client who is near the end of life following a head injury.
The client has alternating periods of rapid breathing and apnea. What respiratory
pattern should the nurse document?
• a. Biot's respirations
• b. Hypoventilatory respirations
• c. Kussmaul respirations
• ✅ d. Cheyne-Stokes respirations
Rationale: Cheyne-Stokes respirations are marked by a cyclical pattern of increased
rate and depth followed by a period of apnea. This often occurs with increased
intracranial pressure or at the end of life.
2. A nurse is administering a unit of packed RBCs and notes several small clots in
the IV bag. What should the nurse do?
• a. Inject 5,000 units of heparin into the unit
• b. Place the unit in a warming device for 5 min
• ✅ c. Return the unit to the blood bank
• d. Dilute the unit with lactated Ringer's
Rationale: The presence of clots indicates the unit is compromised and unsafe. It must
be returned to the blood bank to prevent harm.
3. A nurse is teaching a client about GERD self-management. Which instruction is
appropriate?
• a. Eat a light meal 1 hour before bedtime
• b. Lie down for 30 minutes after meals
• c. Increase caloric intake by 250 calories/day
, • ✅ d. Sleep with the head of the bed elevated 6 inches
Rationale: Elevating the head of the bed reduces nighttime reflux. Clients should also
avoid meals 2-3 hours before bedtime.
4. During peritoneal dialysis teaching, which finding should the nurse identify as
the earliest sign of peritonitis?
• a. Generalized abdominal pain
• b. Cloudy effluent
• ✅ c. Fever
• d. Increased heart rate
Rationale: Fever is typically the first systemic sign of peritonitis. Cloudy dialysate often
follows but is not the earliest.
5. A client is receiving enteral nutrition. Which action helps prevent aspiration?
• a. Check gastric pH after feedings
• b. Place the client in supine position
• c. Instruct to do the Valsalva maneuver after feedings
• ✅ d. Measure residual volume prior to feedings
Rationale: Measuring residual volume helps evaluate gastric emptying. Clients should
also be upright during and after feedings.
A nurse is teaching a client about the use of an incentive spirometer. Which of the
following instructions should the nurse include in the teaching?
1.Place hands on the upper abdomen during inhalation.
2. Exhale slowly through pursed lips.
3.Hold breath about 3 to 5 seconds before exhaling. (ATI page 138)
4.Position the mouthpiece 2.5 cm (1 in) from the mouth - - correct ans- -3.Hold breath
about 3 to 5 seconds before exhaling. (ATI page 138)
, A nurse is assessing a client who is 12 hr. postoperative following a colon resection.
Which of the following findings should the nurse report to the surgeon?
1.Heart rate 90/mm
2.Hgb 8.2 g/dL
3.Gastric ph of 3.0
4.Absent bowel sounds - - correct ans- -4.Absent bowel sounds
A nurse is caring for a client who has diabetes insipidus. Which of the following
medications should the nurse plan to administer?
1.Regular Insulin
2.Furosemide
3.Desmopressin
4.Lithium Carbonate - - correct ans- -3.Desmopressin
A nurse is admitting a client who has arthritic pain and reports taking ibuprofen several
times daily for 3 years. Which of the following test should the nurse monitor? 1.Stool
occult blood
2.Urine for white blood cells
3.Fasting blood glucose
4.Serum calcium - - correct ans- -1.Stool occult blood
A nurse in the emergency department is assessing a client. Which of the following
actions should the nurse take first? (Click on the "Exhibit" button for additional
information about the client. There are three tabs that contain separate categories of
data.)
1.Obtain a sputum sample for culture.
2.Prepare the client for a chest x-ray.
3.Initiate airborne precautions 4.Administer ondansetron - - correct ans- -3.Initiate
airborne precautions
Comprehensive Study Guide, 100 Practice
Questions, and Key Strategies for Success
1. A nurse is assessing a client who is near the end of life following a head injury.
The client has alternating periods of rapid breathing and apnea. What respiratory
pattern should the nurse document?
• a. Biot's respirations
• b. Hypoventilatory respirations
• c. Kussmaul respirations
• ✅ d. Cheyne-Stokes respirations
Rationale: Cheyne-Stokes respirations are marked by a cyclical pattern of increased
rate and depth followed by a period of apnea. This often occurs with increased
intracranial pressure or at the end of life.
2. A nurse is administering a unit of packed RBCs and notes several small clots in
the IV bag. What should the nurse do?
• a. Inject 5,000 units of heparin into the unit
• b. Place the unit in a warming device for 5 min
• ✅ c. Return the unit to the blood bank
• d. Dilute the unit with lactated Ringer's
Rationale: The presence of clots indicates the unit is compromised and unsafe. It must
be returned to the blood bank to prevent harm.
3. A nurse is teaching a client about GERD self-management. Which instruction is
appropriate?
• a. Eat a light meal 1 hour before bedtime
• b. Lie down for 30 minutes after meals
• c. Increase caloric intake by 250 calories/day
, • ✅ d. Sleep with the head of the bed elevated 6 inches
Rationale: Elevating the head of the bed reduces nighttime reflux. Clients should also
avoid meals 2-3 hours before bedtime.
4. During peritoneal dialysis teaching, which finding should the nurse identify as
the earliest sign of peritonitis?
• a. Generalized abdominal pain
• b. Cloudy effluent
• ✅ c. Fever
• d. Increased heart rate
Rationale: Fever is typically the first systemic sign of peritonitis. Cloudy dialysate often
follows but is not the earliest.
5. A client is receiving enteral nutrition. Which action helps prevent aspiration?
• a. Check gastric pH after feedings
• b. Place the client in supine position
• c. Instruct to do the Valsalva maneuver after feedings
• ✅ d. Measure residual volume prior to feedings
Rationale: Measuring residual volume helps evaluate gastric emptying. Clients should
also be upright during and after feedings.
A nurse is teaching a client about the use of an incentive spirometer. Which of the
following instructions should the nurse include in the teaching?
1.Place hands on the upper abdomen during inhalation.
2. Exhale slowly through pursed lips.
3.Hold breath about 3 to 5 seconds before exhaling. (ATI page 138)
4.Position the mouthpiece 2.5 cm (1 in) from the mouth - - correct ans- -3.Hold breath
about 3 to 5 seconds before exhaling. (ATI page 138)
, A nurse is assessing a client who is 12 hr. postoperative following a colon resection.
Which of the following findings should the nurse report to the surgeon?
1.Heart rate 90/mm
2.Hgb 8.2 g/dL
3.Gastric ph of 3.0
4.Absent bowel sounds - - correct ans- -4.Absent bowel sounds
A nurse is caring for a client who has diabetes insipidus. Which of the following
medications should the nurse plan to administer?
1.Regular Insulin
2.Furosemide
3.Desmopressin
4.Lithium Carbonate - - correct ans- -3.Desmopressin
A nurse is admitting a client who has arthritic pain and reports taking ibuprofen several
times daily for 3 years. Which of the following test should the nurse monitor? 1.Stool
occult blood
2.Urine for white blood cells
3.Fasting blood glucose
4.Serum calcium - - correct ans- -1.Stool occult blood
A nurse in the emergency department is assessing a client. Which of the following
actions should the nurse take first? (Click on the "Exhibit" button for additional
information about the client. There are three tabs that contain separate categories of
data.)
1.Obtain a sputum sample for culture.
2.Prepare the client for a chest x-ray.
3.Initiate airborne precautions 4.Administer ondansetron - - correct ans- -3.Initiate
airborne precautions
