ATI Medical-Surgical (Med-Surg) Proctored Exam 2026: HIGH-STAKES EXIT EXAM: UPDATED QUESTION POOL & VERIFIED KEYS ACE THE FINAL: COMPLETE 3-VERSION TEST BANK WITH 100% ACCURACY

A nurse is caring for a client who experienced a traumatic head injury and has an intraventricular catheter (ventriculostomy) for intracranial pressure (ICP) monitoring. The nurse should monitor the client for which of the following complications related to the ventriculostomy? A. Headache B. Infection C. Aphasia D. Hypertension Correct Answer: B Rationale: An intraventricular catheter creates a direct pathway from the outside environment into the ventricles of the brain, introducing a profound risk for contamination. The nurse must use strict aseptic technique during all access and fluid manipulation to avoid life-threatening infections, such as bacterial meningitis or ventriculitis. Question 2 A nurse is providing education to a client who is to undergo an electroencephalogram (EEG) the following day. Which of the following instructions should the nurse include in the teaching? A. "Do not wash your hair the morning of the procedure." B. "Try and stay awake most of the night prior to the procedure." C. "The procedure will take approximately 15 minutes." D. "You will need to lie flat for 4 hours after the procedure." Correct Answer: B Rationale: Sleep deprivation provides metabolic and cranial stress that lowers the seizure threshold, increasing the probability that abnormal electrical activity will be detected during the recording. Hair should be washed to remove oils that block electrode adhesion, the test typically takes 45–60 minutes, and no post-procedure flat positioning is required. Question 3 A nurse is caring for a client who is postprocedural following a lumbar puncture and reports a throbbing headache when sitting upright. Which of the following actions should the nurse take? (Select all that apply.) • A. Use the Glasgow Coma Scale (GCS) to assess the client. • B. Assist the client into a supine position. • C. Administer an opioid analgesic. • D. Encourage the client to increase oral fluid intake. • E. Instruct the client to perform coughing and deep breathing exercises. Correct Answer: B, D Rationale: A post-lumbar puncture headache is caused by cerebrospinal fluid (CSF) leaking from the dural puncture site, reducing intracranial pressure. Assisting the client into a flat, supine position eliminates the gravity-induced pull on the meninges, providing immediate relief. Increasing fluid intake accelerates the body's natural replenishment of CSF. Coughing increases intrathecal pressure and can worsen the leak. Question 4 A nurse is caring for a client who has continuous bladder irrigation (CBI) following a transurethral resection of the prostate (TURP). Which of the following findings should the nurse report to the provider? A. Urinary output that is equal to the volume of instilled irrigant B. Client reports of transient bladder spasms C. Viscous, bright red urinary output with large clots D. Reports of a strong, persistent urge to urinate Correct Answer: C Rationale: Viscous, thick, bright red urinary output containing large clots indicates acute arterial bleeding, which requires prompt provider notification and potential traction on the catheter. Transient bladder spasms, an equal irrigation balance, and a mild urge to urinate due to balloon pressure against the bladder sphincter are common, expected post-TURP findings. Question 5 A nurse is monitoring the ECG of a client who has hypocalcemia. Which of the following findings should the nurse expect? A. Flattened T-waves B. Prolonged QT intervals C. Shortened QT intervals D. Widened QRS complexes Correct Answer: B Rationale: Hypocalcemia slows down ventricular repolarization, which lengthens the ST segment and directly results in a prolonged QT interval. This places the client at risk for lethal ventricular dysrhythmias like Torsades de Pointes. Flattened T-waves are associated with hypokalemia. Question 6 A nurse is preparing a client who has a brain tumor for a computed tomography (CT) scan with contrast media. Which of the following factors affects the manner in which the nurse will prepare the client for the scan? A. No food or fluids consumed for 4 hours B. Difficulty recalling recent events C. Development of hives while eating shrimp D. Paresthesia in both hands Correct Answer: C Rationale: A history of hypersensitivity or hives when eating shellfish (shrimp) suggests a potential cross-sensitivity allergy to iodinated contrast dyes used during CT scans. The nurse must identify this to prevent severe hypersensitivity or anaphylactic reactions, often requiring premedication with antihistamines and corticosteroids or a non-contrast study. Question 7 A nurse is preparing an in-service program about the stages of acute kidney injury (AKI). Which of the following pieces of information should the nurse include about prerenal azotemia? A. Prerenal azotemia begins prior to the onset of symptoms. B. Interference with renal perfusion causes prerenal azotemia. C. Prerenal azotemia is irreversible, even in its early stages. D. Infections and intrarenal tumors cause prerenal azotemia. Correct Answer: B Rationale: Prerenal AKI/azotemia is caused by factors outside the kidney that decrease systemic blood flow and compromise renal perfusion, such as hypovolemia, hemorrhage, or severe heart failure. It is highly reversible if tissue perfusion is restored promptly before structural intrarenal damage occurs. Infections or tumors within the kidney describe intrarenal or postrenal etiologies. Question 8 A nurse is teaching a client who has coronary artery disease (CAD) about the difference between angina pectoris and a myocardial infarction (MI). Which of the following findings should the nurse identify as indications of an MI? (Select all that apply.) • A. Nausea and vomiting • B. Diaphoresis and dizziness • C. Chest and left arm pain that subsides completely with rest • D. Intense anxiety and feelings of impending doom • E. Bounding peripheral pulses and bradypnea Correct Answer: A, B, D Rationale: An MI triggers a massive sympathetic nervous system response, resulting in diaphoresis, dizziness, severe anxiety, and feelings of impending doom. Pain from an MI is not relieved by rest or nitroglycerin. Nausea and vomiting frequently result from severe pain and vagal stimulation, particularly in inferior wall infarctions. Question 9 A nurse is reviewing the laboratory results of a lumbar puncture for a client who has clinical manifestations of bacterial meningitis. Which of the following findings should the nurse expect in the cerebrospinal fluid (CSF)? A. Elevated glucose B. Elevated protein C. Massive presence of RBCs D. Presence of D-dimer Correct Answer: B Rationale: Bacterial meningitis causes a severe inflammatory response in the meninges, which increases the permeability of the blood-brain barrier and allows large proteins to leak into the CSF, resulting in elevated protein levels. The bacteria consume glucose, so CSF glucose levels will be decreased, not elevated. High white blood cell (WBC) counts are expected, rather than red blood cells (RBCs). Question 10 A nurse is providing teaching to a client who has a new diagnosis of myasthenia gravis (MG). Which of the following pieces of information should the nurse include? A. Use enemas regularly to treat constipation caused by daily medications. B. Take a hot bath when muscles ache to increase circulation. C. Eat a low-calorie diet to prevent weight gain. D. Set an alarm to ensure medication dosages are taken precisely on time. Correct Answer: D Rationale: Anticholinesterase medications used to treat myasthenia gravis must be taken exactly on time to maintain stable therapeutic blood levels and prevent sudden, severe muscle weakness or a myasthenic crisis. Exposure to heat (like hot baths) can exacerbate muscle weakness and should be avoided. Question 11 A nurse is teaching a client who has a new diagnosis of primary open-angle glaucoma (POAG). Which of the following pieces of information should the nurse include in the teaching? (Select all that apply.) • A. Lost vision can improve gradually with daily eye drops. • B. Administer eye drops only as needed when vision loss worsens. • C. Glasses will be necessary to correct the accompanying presbyopia. • D. Driving can be dangerous due to the loss of peripheral vision. • E. Laser surgery can help reestablish the flow of aqueous humor. Correct Answer: C, D, E Rationale: POAG causes a slow, painless loss of peripheral vision ("tunnel vision"), making driving highly hazardous. It does not alter presbyopia (normal age-related near-vision loss), so reading glasses may still be needed. Lifelong daily eye drop compliance is required to stop progression, but drops cannot reverse or improve vision loss that has already occurred. Laser trabeculoplasty can be used to improve aqueous humor drainage. Question 12 A nurse is assessing a client who has a fractured left femur and is in skeletal traction. Which of the following findings should the nurse report to the provider immediately? A. Ecchymosis of the left thigh B. Serous drainage at the pin site C. Petechiae across the chest D. Mild muscle spasms in the left leg Correct Answer: C Rationale: Long-bone fractures (such as a femur fracture) put the client at high risk for Fat Embolism Syndrome (FES), which typically develops 12–48 hours post-injury. The classic triad of FES includes respiratory distress, neurological changes, and a transient petechial rash across the chest, neck, and axillae. This is a medical emergency that can rapidly progress to acute respiratory failure. Question 13 A nurse is assessing a client who has Kaposi's sarcoma. Which of the following findings should the nurse expect? A. Nonproductive cough, fever, and shortness of breath B. Lesions on the retina that produce blurred vision C. Onset of progressive dementia D. Reddish-purple skin lesions Correct Answer: D Rationale: Kaposi's sarcoma is an opportunistic, vascular oncology condition frequently associated with advanced HIV/AIDS. It characteristically manifests as hyperpigmented, painless, reddish-purple or dark brown skin lesions that can be flat, raised, or nodular anywhere on the body or mucous membranes. Question 14 A nurse is completing an assessment for a client who has a history of unstable angina. Which of the following findings should the nurse expect? A. Chest pain is relieved soon after resting. B. Nitroglycerin completely relieves the chest pain. C. Physical exertion does not precipitate the chest pain. D. Chest pain lasts for longer than 15 minutes. Correct Answer: D Rationale: Unstable angina represents a worsening of coronary artery disease where an atherosclerotic plaque partially obstructs blood flow, causing chest pain that typically lasts longer than 15 minutes. It is unpredictable, can occur entirely at rest, and mimics or heralds an impending myocardial infarction, showing poor or minimal response to nitroglycerin. Pain relieved by rest is characteristic of stable angina. Question 15 A nurse is assessing a client with a closed head injury who has received mannitol for manifestations of increased intracranial pressure (ICP). Which of the following findings indicates that the medication is having its desired therapeutic effect? A. The client's serum osmolarity is 310 mOsm/L. B. The client's pupils are fixed and dilated. C. The client's heart rate is 56/min. D. The client is increasingly restless. Correct Answer: A Rationale: Mannitol is an osmotic diuretic that increases osmotic pressure in the intravascular space, drawing fluid out of swollen brain tissue into the vasculature to be excreted. This therapeutic shift raises serum osmolarity; a targeted range of 300–320 mOsm/L indicates that fluid is successfully being drawn from the cerebral tissues to reduce ICP. Dilated pupils, bradycardia, and restlessness indicate worsening ICP or herniation.