The Ultimate ATI Medical-Surgical Nursing Comprehensive Study Guide and Test
Bank: 250+ Critical Questions & Expert Answers for NCLEX and Clinical Mastery
Q1: A nurse is caring for a client who is experiencing supraventricular tachycardia. Upon
assessing the client, the nurse observes the following findings: heart rate 200/min, blood
pressure 78/40 mm Hg, and respiratory rate 30/min. Which of the following actions should the
nurse take?
a. Defibrillate the client's heart.
b. Perform synchronized cardioversion.
c. Begin cardiopulmonary resuscitation.
d. Administer lidocaine IV bolus.
Answer: b. Perform synchronized cardioversion.
Rationale: Synchronized cardioversion is the treatment of choice for a client with unstable
supraventricular tachycardia.
Q2: What rhythms are shockable with defibrillation?
Answer: Ventricular fibrillation and pulseless ventricular tachycardia.
Q3: What dysrhythmias are amiodarone and lidocaine indicated for?
Answer: Ventricular arrhythmias.
Q4: The nurse should initiate cardiopulmonary resuscitation (CPR) for a client who is:
Answer: Pulseless or not breathing.
Q5: A nurse is preparing a client who has supraventricular tachycardia for elective cardioversion.
Which medication should the nurse instruct the client to withhold for 48 hours prior to
cardioversion?
a. Enoxaparin
b. Metformin
c. Diazepam
d. Digoxin
Answer: d. Digoxin
Rationale: Digoxin is withheld prior to cardioversion because it can increase ventricular
irritability, increasing risk for ventricular fibrillation after cardioversion.
,Q6: What medications are usually given prior to cardioversion to reduce anxiety and
discomfort?
Answer: Sedatives like diazepam.
Q7: Metformin should be held before which types of procedures? Why?
Answer: Metformin is held before procedures involving contrast dye (e.g., cardiac
catheterization) to prevent kidney damage.
Q8: What medications prevent blood clots that may be released into circulation after
cardioversion?
Answer: Anticoagulants like enoxaparin.
Q9: What types of drugs are withheld prior to cardioversion?
Answer: Cardiac glycosides such as digoxin.
Q10: Define exophthalmos.
Answer: Condition produced by hyperthyroidism where eyeballs protrude beyond their normal
orbit due to tissue swelling behind the eyes.
Q11: Define entropion.
Answer: Inversion (turning inward) of the edge of an eyelid.
Q12: Define ectropion.
Answer: Eversion (turning outward) of the edge of an eyelid.
Q13: Define ptosis.
Answer: Drooping of the upper eyelid.
Q14: A nurse caring for a client with emphysema on mechanical ventilation observes anxiety,
restlessness, and hears the high-pressure alarm. What is the first action?
a. Obtain ABGs
b. Administer propofol
c. Instruct client to allow the machine to breathe for them
d. Disconnect machine and manually ventilate
Answer: c. Instruct client to allow the machine to breathe for them.
Rationale: The least restrictive intervention is first; encouraging cooperation helps reduce
anxiety and fighting the ventilator.
, Q15: A client has a potassium level of 3 mEq/L. What assessment finding should the nurse
expect?
a. Positive Trousseau's sign
b. 4+ deep tendon reflexes
c. Deep respirations
d. Hypoactive bowel sounds
Answer: d. Hypoactive bowel sounds.
Rationale: Hypokalemia decreases smooth muscle contractions causing slow bowel motility.
Q16: Deep tendon reflexes are used to monitor which electrolyte level?
Answer: Magnesium.
Q17: What type of respirations occur with hypokalemia, and why?
Answer: Shallow respirations due to respiratory muscle weakness.
Q18: What electrolyte imbalances does Trousseau's sign evaluate for?
Answer: Hypocalcemia and hypomagnesemia.
Q19: What is hypokalemia's effect on the gastrointestinal system?
Answer: Decreased smooth muscle contraction leading to hypoactive bowel sounds and
decreased peristalsis.
Q20: How do deep tendon reflexes change in hypomagnesemia and hypermagnesemia?
Answer: Increased reflexes in hypomagnesemia (e.g., 4+), decreased or absent reflexes in
hypermagnesemia.
Q21: A nurse is caring for a client experiencing hyperkalemia. Which ECG changes should the
nurse expect?
a. Flattened T waves
b. Peaked T waves
c. Prolonged PR interval
d. ST-segment depression
Answer: b. Peaked T waves.
Rationale: Peaked T waves are typical in hyperkalemia.
Q22: What is the normal potassium range in adults?
Answer: 3.5 to 5.0 mEq/L.
Bank: 250+ Critical Questions & Expert Answers for NCLEX and Clinical Mastery
Q1: A nurse is caring for a client who is experiencing supraventricular tachycardia. Upon
assessing the client, the nurse observes the following findings: heart rate 200/min, blood
pressure 78/40 mm Hg, and respiratory rate 30/min. Which of the following actions should the
nurse take?
a. Defibrillate the client's heart.
b. Perform synchronized cardioversion.
c. Begin cardiopulmonary resuscitation.
d. Administer lidocaine IV bolus.
Answer: b. Perform synchronized cardioversion.
Rationale: Synchronized cardioversion is the treatment of choice for a client with unstable
supraventricular tachycardia.
Q2: What rhythms are shockable with defibrillation?
Answer: Ventricular fibrillation and pulseless ventricular tachycardia.
Q3: What dysrhythmias are amiodarone and lidocaine indicated for?
Answer: Ventricular arrhythmias.
Q4: The nurse should initiate cardiopulmonary resuscitation (CPR) for a client who is:
Answer: Pulseless or not breathing.
Q5: A nurse is preparing a client who has supraventricular tachycardia for elective cardioversion.
Which medication should the nurse instruct the client to withhold for 48 hours prior to
cardioversion?
a. Enoxaparin
b. Metformin
c. Diazepam
d. Digoxin
Answer: d. Digoxin
Rationale: Digoxin is withheld prior to cardioversion because it can increase ventricular
irritability, increasing risk for ventricular fibrillation after cardioversion.
,Q6: What medications are usually given prior to cardioversion to reduce anxiety and
discomfort?
Answer: Sedatives like diazepam.
Q7: Metformin should be held before which types of procedures? Why?
Answer: Metformin is held before procedures involving contrast dye (e.g., cardiac
catheterization) to prevent kidney damage.
Q8: What medications prevent blood clots that may be released into circulation after
cardioversion?
Answer: Anticoagulants like enoxaparin.
Q9: What types of drugs are withheld prior to cardioversion?
Answer: Cardiac glycosides such as digoxin.
Q10: Define exophthalmos.
Answer: Condition produced by hyperthyroidism where eyeballs protrude beyond their normal
orbit due to tissue swelling behind the eyes.
Q11: Define entropion.
Answer: Inversion (turning inward) of the edge of an eyelid.
Q12: Define ectropion.
Answer: Eversion (turning outward) of the edge of an eyelid.
Q13: Define ptosis.
Answer: Drooping of the upper eyelid.
Q14: A nurse caring for a client with emphysema on mechanical ventilation observes anxiety,
restlessness, and hears the high-pressure alarm. What is the first action?
a. Obtain ABGs
b. Administer propofol
c. Instruct client to allow the machine to breathe for them
d. Disconnect machine and manually ventilate
Answer: c. Instruct client to allow the machine to breathe for them.
Rationale: The least restrictive intervention is first; encouraging cooperation helps reduce
anxiety and fighting the ventilator.
, Q15: A client has a potassium level of 3 mEq/L. What assessment finding should the nurse
expect?
a. Positive Trousseau's sign
b. 4+ deep tendon reflexes
c. Deep respirations
d. Hypoactive bowel sounds
Answer: d. Hypoactive bowel sounds.
Rationale: Hypokalemia decreases smooth muscle contractions causing slow bowel motility.
Q16: Deep tendon reflexes are used to monitor which electrolyte level?
Answer: Magnesium.
Q17: What type of respirations occur with hypokalemia, and why?
Answer: Shallow respirations due to respiratory muscle weakness.
Q18: What electrolyte imbalances does Trousseau's sign evaluate for?
Answer: Hypocalcemia and hypomagnesemia.
Q19: What is hypokalemia's effect on the gastrointestinal system?
Answer: Decreased smooth muscle contraction leading to hypoactive bowel sounds and
decreased peristalsis.
Q20: How do deep tendon reflexes change in hypomagnesemia and hypermagnesemia?
Answer: Increased reflexes in hypomagnesemia (e.g., 4+), decreased or absent reflexes in
hypermagnesemia.
Q21: A nurse is caring for a client experiencing hyperkalemia. Which ECG changes should the
nurse expect?
a. Flattened T waves
b. Peaked T waves
c. Prolonged PR interval
d. ST-segment depression
Answer: b. Peaked T waves.
Rationale: Peaked T waves are typical in hyperkalemia.
Q22: What is the normal potassium range in adults?
Answer: 3.5 to 5.0 mEq/L.
