ATI Medical –Surgical latest
(Nursing Exam Prep 2023)
Test Bank Practice
Questions & Study Guide
verified 100% latest update
**Q1. A nurse is providing discharge teaching to a client who has a new prescription for sublingual
nitroglycerin. Which client statement indicates understanding of the teaching?**
,A. "I can keep my medications for 1 year before replacing it"
B. "I should lie down when I take this medication"
C. "I should discontinue this medication if I develop a headache"
D. "I can take up to five tablets in 15 minutes before seeking medical attention"
**Correct Answer: B**
**Rationale:** The client should lie down when taking sublingual nitroglycerin to prevent hypotension
and syncope, which are common adverse effects of vasodilation. Nitroglycerin should be replaced every
6 months, not yearly. Headache is an expected side effect and does not warrant discontinuation. The
correct protocol is one tablet every 5 minutes for up to 3 doses, then seek emergency care if pain
persists .
---
**Q2. A nurse is caring for a client who has heart failure and has been taking digoxin 0.25 mg daily. The
client refuses breakfast and reports nausea. Which action should the nurse take first?**
A. Suggest the client rest before eating
B. Request a dietary consult
C. Check the client's vital signs
D. Request an order for an antiemetic
**Correct Answer: C**
**Rationale:** Nausea is a manifestation of digoxin toxicity, along with other signs such as muscle
weakness, confusion, abdominal cramping, and vision changes. The nurse's priority is to check vital
signs, particularly the apical pulse, as digoxin toxicity can cause bradycardia and dysrhythmias. Using the
, ABC (airway, breathing, circulation) approach, the nurse should obtain vital signs before initiating other
interventions .
---
**Q3. A nurse is caring for a client who is receiving a unit of packed RBCs. Which finding indicates fluid
overload?**
A. Hypotension
B. Dyspnea
C. Fever
D. Pruritus
**Correct Answer: B**
**Rationale:** Dyspnea (shortness of breath) along with crackles, hypertension, and tachycardia are
classic signs of fluid overload/circulatory overload from a too-rapid transfusion. Hypotension, fever, and
pruritus suggest a transfusion reaction, not fluid overload.
---
### Pain Management & Oncology
**Q4. Which question asked by the nurse will give the most information about the patient's metastatic
bone cancer pain?**
A. "How long have you had this pain?"
(Nursing Exam Prep 2023)
Test Bank Practice
Questions & Study Guide
verified 100% latest update
**Q1. A nurse is providing discharge teaching to a client who has a new prescription for sublingual
nitroglycerin. Which client statement indicates understanding of the teaching?**
,A. "I can keep my medications for 1 year before replacing it"
B. "I should lie down when I take this medication"
C. "I should discontinue this medication if I develop a headache"
D. "I can take up to five tablets in 15 minutes before seeking medical attention"
**Correct Answer: B**
**Rationale:** The client should lie down when taking sublingual nitroglycerin to prevent hypotension
and syncope, which are common adverse effects of vasodilation. Nitroglycerin should be replaced every
6 months, not yearly. Headache is an expected side effect and does not warrant discontinuation. The
correct protocol is one tablet every 5 minutes for up to 3 doses, then seek emergency care if pain
persists .
---
**Q2. A nurse is caring for a client who has heart failure and has been taking digoxin 0.25 mg daily. The
client refuses breakfast and reports nausea. Which action should the nurse take first?**
A. Suggest the client rest before eating
B. Request a dietary consult
C. Check the client's vital signs
D. Request an order for an antiemetic
**Correct Answer: C**
**Rationale:** Nausea is a manifestation of digoxin toxicity, along with other signs such as muscle
weakness, confusion, abdominal cramping, and vision changes. The nurse's priority is to check vital
signs, particularly the apical pulse, as digoxin toxicity can cause bradycardia and dysrhythmias. Using the
, ABC (airway, breathing, circulation) approach, the nurse should obtain vital signs before initiating other
interventions .
---
**Q3. A nurse is caring for a client who is receiving a unit of packed RBCs. Which finding indicates fluid
overload?**
A. Hypotension
B. Dyspnea
C. Fever
D. Pruritus
**Correct Answer: B**
**Rationale:** Dyspnea (shortness of breath) along with crackles, hypertension, and tachycardia are
classic signs of fluid overload/circulatory overload from a too-rapid transfusion. Hypotension, fever, and
pruritus suggest a transfusion reaction, not fluid overload.
---
### Pain Management & Oncology
**Q4. Which question asked by the nurse will give the most information about the patient's metastatic
bone cancer pain?**
A. "How long have you had this pain?"
