ATI Medical-Surgical Proctored Exam 2026: COMPREHENSIVE FINAL PREP: VERIFIED QUESTIONS & EXPERT ANSWERS ULTIMATE EXAM PASS PACK – LATEST 2026/2027 UPDATES

Question 1 A nurse is teaching a client who asks about taking a glucosamine supplement for osteoarthritis. Which of the following information should the nurse include in the teaching? A. Avoid using glucosamine in combination with chondroitin. B. Glucosamine can cause degradation of joint cartilage when used over a long period. C. Avoid taking glucosamine if you have a documented shellfish allergy. D. You can safely take glucosamine concurrently with an anticoagulant medication. Correct Answer: C Rationale: Glucosamine is commercially manufactured by deriving compounds from the exoskeletons of shellfish. Therefore, clients with a known shellfish allergy must avoid this supplement due to the high risk of a severe hypersensitivity or anaphylactic reaction. Glucosamine can also increase the risk of bleeding, making it dangerous to take alongside anticoagulants like warfarin. Question 2 A nurse is caring for a client who has severe visual loss. Which of the following actions should the nurse implement? A. Remove all personal objects from the client's bedside table. B. Instruct the client to open all packaged items on their food tray independently. C. Walk approximately one step behind the client when assisting with ambulation. D. Count steps to the bathroom out loud with the client. Correct Answer: D Rationale: Counting the steps to frequently used locations (like the bathroom) helps mentally map and orient the client to their physical environment, which minimizes fall risks and fosters autonomy. When assisting with ambulation, the nurse should use the "sighted guide" technique, walking one step ahead of the client while allowing the client to hold the nurse's elbow. Objects on the bedside table should be left within reach and described using the clock-face method rather than removed entirely. Question 3 A nurse is discussing activity modification with a client who had a right total hip arthroplasty. Which of the following statements should the nurse include in the information? A. Plan to sit in a low, comfortable, soft-backed sofa when out of bed. B. Place an abduction pillow between your legs when lying in bed. C. You can safely cross your legs at the ankles when sitting. D. You should bend at the waist when tying your shoes. Correct Answer: B Rationale: Following a total hip arthroplasty, placing an abduction pillow or a wedge between the legs prevents hip adduction. Keeping the operative leg abducted is critical to prevent the femoral head from slipping out of the acetabular cup (dislocation). Bending at the waist (flexion $90^circ$), sitting in low chairs, and crossing the legs are all strictly contraindicated hip-flexion violations. Question 4 A nurse is teaching a newly licensed nurse about preventing a catheter-associated urinary tract infection (CAUTI) for a client who has an indwelling urinary catheter. Which of the following instructions should the nurse include? A. Ensure the urinary catheter tubing is completely free of kinks. B. Rest the catheter collection bag flat on the floor when the client sits in a chair. C. Cleanse the periurethral area with a strong antiseptic solution daily. D. Empty the catheter collection bag for the client exactly every 12 hours. Correct Answer: A Rationale: Ensuring that catheter tubing is completely free of kinks or dependent loops maintains a continuous downward flow of urine. This prevents urinary stasis, backflow, and bladder distention, which are primary drivers of bacterial colonization and CAUTIs. The collection bag must never touch the floor, the perineal area should be cleaned with mild soap and water (antiseptics can irritate and damage tissue), and the bag should be emptied when it is half-full or at least every 8 hours. Question 5 A nurse is planning wound management for a client who has a Stage 3 pressure injury. Which of the following interventions should the nurse include in the plan? A. Measure the depth of the wound using a sterile cotton-tipped applicator. B. Measure the wound using a reusable plastic tape measure. C. Cover the open wound bed entirely with dry gauze dressings. D. Cleanse the open wound bed with antibacterial soap and water. Correct Answer: A Rationale: A Stage 3 pressure injury involves full-thickness tissue loss where subcutaneous fat may be visible. To safely and accurately measure the depth, tunneling, or undermining, the nurse should gently insert a sterile, cotton-tipped applicator into the deepest part of the wound bed, mark it at the margin, and measure it against a disposable metric ruler. Reusable tape measures pose a severe cross-contamination risk, dry gauze adheres to and damages new granulation tissue, and harsh soaps dry out the wound bed. Question 6 A nurse is planning care for four clients following a change-of-shift report. Which of the following clients is the nurse's priority? A. A client who had an ischemic stroke and exhibits expressive aphasia. B. A client who has a hemoglobin level of $11text{ g/dL}$ and requires 1 unit of packed RBCs. C. A client who has acute asthma and a peak expiratory flow rate (PEFR) in the green zone. D. A client who has peptic ulcer disease (PUD) and exhibits a rigid, board-like abdomen. Correct Answer: D Rationale: A rigid, board-like abdomen accompanied by severe pain is a classic, definitive indicator of a perforated peptic ulcer. Perforation allows gastric contents to spill directly into the peritoneal cavity, triggering acute chemical peritonitis, systemic sepsis, and hypovolemic shock. This is a surgical emergency. The other clients are stable or presenting with expected findings for their diagnoses. Question 7 A nurse is planning care for four clients following a change-of-shift report. Which of the following clients should the nurse see first? A. A client who is receiving propranolol and has a heart rate of 55/min. B. A client who is receiving warfarin and has an INR of 2.5. C. A client who has a newly implanted permanent pacemaker and has persistent, uncontrollable hiccuping. D. A client who has acute cholecystitis and reports localized rebound tenderness. Correct Answer: C Rationale: Persistent hiccuping in a patient with a newly implanted permanent pacemaker is a red flag that indicates lead wire displacement. The dislodged pacing wire can stimulate the phrenic nerve or diaphragm directly, causing hiccups. This signifies that the pacemaker may not be capturing or pacing the myocardium correctly, putting the client at risk for severe bradycardia or lethal arrhythmias. A heart rate of 55/min on a beta-blocker and an INR of 2.5 on warfarin are stable, therapeutic findings. Question 8 A nurse is reviewing the laboratory data of a client who is taking the herbal supplement feverfew to reduce the frequency of migraine headaches. The nurse should identify which of the following findings as a contraindication to taking this supplement? A. Potassium level $3.5text{ mEq/L}$ B. Platelet count $100,000/text{mm}^3$ C. Total cholesterol level $250text{ mg/dL}$ D. Urine bilirubin level $0.2text{ mg/dL}$ Correct Answer: B Rationale: Feverfew impairs platelet aggregation and can prolong bleeding times. A platelet count of $100,000/text{mm}^3$ indicates thrombocytopenia (normal range: $150,000text{-}400,000/text{mm}^3$). Taking feverfew with a pre-existing low platelet count severely exaggerates the patient's risk for spontaneous, dangerous bleeding episodes. Question 9 A nurse is caring for a postoperative client with a history of chronic heart failure who reports slight dyspnea when ambulating. Which of the following findings should the nurse expect during a localized skin assessment? A. Tiny, pinpoint petechiae scattered over the client's chest and abdomen. B. Severe tenting of the skin on the client's forearm. C. Taut, shiny skin areas on the client's ankles and feet. D. Dry, flaky, scaling skin on the client's arms and hands. Correct Answer: C Rationale: Right-sided heart failure causes venous congestion and fluid retention, which manifests as dependent peripheral edema. This fluid accumulation causes the skin overlying the lower extremities (ankles and feet) to stretch tightly, appearing distinctly taut and shiny. Petechiae point to capillary micro-hemorrhages, while skin tenting reflects severe dehydration (fluid volume deficit). Question 10 A hospice nurse is planning end-of-life comfort care for a client. Which of the following interventions should the nurse include in the plan? A. Cover the client with an electric blanket if their extremities become cold and mottled. B. Provide frequent, high-calorie liquid feedings throughout the day. C. Position the client on their side (lateral position) to improve breathing patterns. D. Remove all visitors from the room immediately if the client becomes restless. Correct Answer: C Rationale: Turning the client into a lateral or side-lying position helps keep the airway clear, prevents tongue obstruction, and allows oral secretions to drain naturally. This minimizes the "death rattle" and reduces the risk of aspiration or severe dyspnea during the actively dying phase. Feeding should not be forced, as the GI tract slows down, and electric blankets can easily burn fragile, poorly perfused mottled skin. Question 11 A nurse is teaching a client who has a new prescription for continuous ambulatory peritoneal dialysis (CAPD). Which of the following instructions should the nurse include? A. Eat a low-fiber diet to optimize and maintain dialysate outflow. B. Warm the refrigerated dialysate bags in the microwave before instillation. C. Expect the initial dialysate outflow to appear slightly cloudy. D. Allow the dialysate fluid to dwell for 4 hours during each prescribed exchange. Correct Answer: D Rationale: In CAPD, a metabolic dwell time of approximately 4 to 8 hours is required to allow solutes and fluids to pass through the peritoneal membrane via diffusion and osmosis. Constipation can impede dialysate outflow by compressing the catheter, so a high-fiber diet is recommended. Warming dialysate must be done using specialized warming pads, never a microwave (which creates uneven hot spots that burn the peritoneum). Outflow fluid must always be clear and pale yellow; cloudy fluid is a primary indicator of peritonitis. Question 12 A nurse is providing hydrotherapy for a client who has full-thickness burns on the lower leg. Which of the following actions should the nurse take? A. Schedule and perform the hydrotherapy sessions three times per week. B. Gently wash the client's burn wounds using a mild soap and water. C. Rinse the client's burn wounds thoroughly with cold sterile water. D. Fully immerse the client's entire lower body in a standard whirlpool tub. Correct Answer: B Rationale: Debridement and cleaning via hydrotherapy utilize mild soap and warm water to remove loose, dead tissue, exudate, and topical medications. This promotes wound healing and minimizes bacterial load. Prolonged full body immersion in a whirlpool tub is avoided because it carries a massive risk of cross-contamination from pseudomonal pathogens and causes rapid electrolyte shifts. Cold water is avoided because it triggers severe vasoconstriction and rapid hypothermia in burn patients. Question 13 A nurse is assessing a client who is receiving external beam radiation therapy to the head and neck to treat esophageal cancer. The nurse should identify which of the following findings as an expected localized adverse effect of this treatment? A. The development of a productive, hacking cough. B. New-onset peripheral neuropathy in the lower extremities. C. A persistent report of dry mouth (xerostomia). D. Severe, watery diarrhea. Correct Answer: C Rationale: Radiation therapy to the head and neck inevitably damages the endothelial cells of the salivary glands located within the radiation field. This results in xerostomia (severe dry mouth), which causes difficulty swallowing, altered taste, and a high risk for rapid tooth decay. Systemic issues like lower-extremity peripheral neuropathy or diarrhea are not expected side effects of localized neck radiation. Question 14 A nurse is assessing a client who has an endotracheal tube (ETT) and is receiving mechanical ventilation. The client is acutely agitated and appears to be in respiratory distress. Which of the following actions should the nurse take first? A. Disconnect the ETT and manually ventilate the client using a bag-valve-mask device attached to high-flow oxygen. B. Perform deep endotracheal suctioning through the client's tube. C. Contact the respiratory therapist immediately to troubleshoot the mechanical ventilator parameters. D. Draw a blood sample for immediate arterial blood gas (ABG) analysis. Correct Answer: A Rationale: Following the Airway, Breathing, Circulation (ABC) emergency framework, if a mechanically ventilated patient develops sudden, unexplained respiratory distress and agitation, the immediate priority is ensuring adequate oxygenation. If the underlying cause is not immediately obvious (e.g., a visibly kinked tube), the nurse must quickly disconnect the patient from the ventilator circuit and manually ventilate them with a bag-valve device. This rules out a mechanical ventilator failure and stabilizes ventilation while further troubleshooting occurs.