ATI CAPSTONE MEDICAL SURGICAL ASSESSMENT 1 & 2
2026 PRACTICE TEST Q@A
1 A nurse is planning care for a client who is receiving mechanical
ventilation. Which of the following actions should the nurse
include in the plan?
A. Administer sedation every 4 hours
B. Provide the client with a means of communication
C. Keep the bed in flat position
D. Restrict fluid intake to 1 L/day
Correct Answer: B
Explanation: Clients on mechanical ventilation cannot speak due
to the endotracheal tube. Providing a communication method
(e.g., alphabet board, writing pad, or electronic device) is
essential for meeting their needs and reducing anxiety. Sedation
should be individualized, not given routinely every 4 hours. The
bed should be elevated 30-45 degrees to prevent VAP, and fluid
restriction is not standard unless indicated.
2 A nurse is caring for a client who is receiving IV fluid
replacement therapy for dehydration. Which of the following
laboratory results indicates effectiveness of the treatment?
A. BUN 28 mg/dL
B. Hematocrit 48%
C. Sodium 149 mEq/L
D. BUN 14 mg/dL
Correct Answer: D
Explanation: A BUN of 14 mg/dL (normal range 10-20 mg/dL)
indicates resolution of dehydration. Elevated BUN (28 mg/dL),
elevated hematocrit (48%), and elevated sodium (149 mEq/L) all
,indicate ongoing dehydration. Effective fluid replacement
normalizes these values.
3 A nurse is preparing to administer a unit of packed RBCs to a
client who has anemia. Which of the following actions should the
nurse plan to take? (Select all that apply)
A. Use a 18-gauge IV needle for venous access
B. Verify the client's blood type with a second nurse
C. Obtain pre-transfusion temperature
D. Infuse the blood within 4 hours
Correct Answer: B
Explanation: Verifying the client's blood type with a second
nurse is a mandatory safety step to prevent transfusion
reactions. While obtaining pre-transfusion temperature (C) is
also important, the question asks for the primary action. A 20-
gauge (not 18-gauge) IV is recommended, and blood should be
infused within 4 hours but this is not the priority verification
step.
4 A nurse is reviewing the laboratory findings for a client who is
dehydrated. Which of the following BUN levels should the nurse
expect?
A. 8 mg/dL
B. 15 mg/dL
C. 26 mg/dL
D. 3 mg/dL
Correct Answer: C
Explanation: A BUN of 26 mg/dL is elevated above the normal
range (10-20 mg/dL), indicating dehydration. Elevated BUN
,occurs in dehydration, renal disease, shock, and GI bleeding.
Low BUN levels (8, 3 mg/dL) indicate malnutrition or fluid
overload, while 15 mg/dL is normal.
5 A nurse is reviewing ECG strips for several clients. Which of the
following images should the nurse identify as A-Fib?
A. Regular P waves with regular QRS complexes
B. Flat baseline with no QRS complexes
C. Multiple irregular and variable waves at the baseline and
irregular R to R intervals
D. Narrow QRS complexes with regular rhythm
Correct Answer: C
Explanation: Atrial fibrillation (A-Fib) presents with multiple
irregular, variable baseline waves (fibrillatory waves) and
irregular R-to-R intervals due to disorganized atrial activity.
Regular P waves with regular QRS (A) indicate normal sinus
rhythm. Flat baseline without QRS (B) indicates asystole.
Narrow QRS with regular rhythm (D) suggests normal rhythm
or sinus tachycardia.
6 A nurse is preparing to admit a client who has a new
tracheostomy from the operating room. Which of the following
items is the priority for the nurse to have available in the client's
room upon admission?
A. Suction catheter
B. Obturator
C. Oxygen tank
D. Nebulizer
Correct Answer: B
, Explanation: The obturator is the priority item because it can be
inserted into the stoma in case of tracheostomy tube dislodgment
or decannulation to maintain an airway until a new tube can be
placed. For the first 72 hours post-tracheostomy, dislodgment is
an emergency. Suction (A) is important but not the priority for
emergency reinsertion.
7 A nurse is caring for a client who had a below-the-knee
amputation due to a traumatic injury 2 days ago. Which of the
following statements should the nurse use to assess how the client
is coping with this change in their body image?
A. "Do you feel sad about your leg?"
B. "Tell me how the changes to your leg make you feel"
C. "When will you be ready to walk again?"
D. "Have you thought about getting a prosthetic?"
Correct Answer: B
Explanation: "Tell me how the changes to your leg make you
feel" is an open-ended question that allows the client to express
emotions about body image changes without leading or judging.
Option A is too specific and may limit expression. Options C and
D focus on future mobility rather than current emotional coping.
8 A nurse is teaching a client how to administer a medication
using an inhaler with a spacer. Which of the following instructions
should the nurse include?
A. "Hold your breath for 30 seconds after inhaling"
B. "Shake the inhaler vigorously prior to use"
C. "Inhale slowly over 10 seconds"
D. "Rinse your mouth before using the inhaler"
2026 PRACTICE TEST Q@A
1 A nurse is planning care for a client who is receiving mechanical
ventilation. Which of the following actions should the nurse
include in the plan?
A. Administer sedation every 4 hours
B. Provide the client with a means of communication
C. Keep the bed in flat position
D. Restrict fluid intake to 1 L/day
Correct Answer: B
Explanation: Clients on mechanical ventilation cannot speak due
to the endotracheal tube. Providing a communication method
(e.g., alphabet board, writing pad, or electronic device) is
essential for meeting their needs and reducing anxiety. Sedation
should be individualized, not given routinely every 4 hours. The
bed should be elevated 30-45 degrees to prevent VAP, and fluid
restriction is not standard unless indicated.
2 A nurse is caring for a client who is receiving IV fluid
replacement therapy for dehydration. Which of the following
laboratory results indicates effectiveness of the treatment?
A. BUN 28 mg/dL
B. Hematocrit 48%
C. Sodium 149 mEq/L
D. BUN 14 mg/dL
Correct Answer: D
Explanation: A BUN of 14 mg/dL (normal range 10-20 mg/dL)
indicates resolution of dehydration. Elevated BUN (28 mg/dL),
elevated hematocrit (48%), and elevated sodium (149 mEq/L) all
,indicate ongoing dehydration. Effective fluid replacement
normalizes these values.
3 A nurse is preparing to administer a unit of packed RBCs to a
client who has anemia. Which of the following actions should the
nurse plan to take? (Select all that apply)
A. Use a 18-gauge IV needle for venous access
B. Verify the client's blood type with a second nurse
C. Obtain pre-transfusion temperature
D. Infuse the blood within 4 hours
Correct Answer: B
Explanation: Verifying the client's blood type with a second
nurse is a mandatory safety step to prevent transfusion
reactions. While obtaining pre-transfusion temperature (C) is
also important, the question asks for the primary action. A 20-
gauge (not 18-gauge) IV is recommended, and blood should be
infused within 4 hours but this is not the priority verification
step.
4 A nurse is reviewing the laboratory findings for a client who is
dehydrated. Which of the following BUN levels should the nurse
expect?
A. 8 mg/dL
B. 15 mg/dL
C. 26 mg/dL
D. 3 mg/dL
Correct Answer: C
Explanation: A BUN of 26 mg/dL is elevated above the normal
range (10-20 mg/dL), indicating dehydration. Elevated BUN
,occurs in dehydration, renal disease, shock, and GI bleeding.
Low BUN levels (8, 3 mg/dL) indicate malnutrition or fluid
overload, while 15 mg/dL is normal.
5 A nurse is reviewing ECG strips for several clients. Which of the
following images should the nurse identify as A-Fib?
A. Regular P waves with regular QRS complexes
B. Flat baseline with no QRS complexes
C. Multiple irregular and variable waves at the baseline and
irregular R to R intervals
D. Narrow QRS complexes with regular rhythm
Correct Answer: C
Explanation: Atrial fibrillation (A-Fib) presents with multiple
irregular, variable baseline waves (fibrillatory waves) and
irregular R-to-R intervals due to disorganized atrial activity.
Regular P waves with regular QRS (A) indicate normal sinus
rhythm. Flat baseline without QRS (B) indicates asystole.
Narrow QRS with regular rhythm (D) suggests normal rhythm
or sinus tachycardia.
6 A nurse is preparing to admit a client who has a new
tracheostomy from the operating room. Which of the following
items is the priority for the nurse to have available in the client's
room upon admission?
A. Suction catheter
B. Obturator
C. Oxygen tank
D. Nebulizer
Correct Answer: B
, Explanation: The obturator is the priority item because it can be
inserted into the stoma in case of tracheostomy tube dislodgment
or decannulation to maintain an airway until a new tube can be
placed. For the first 72 hours post-tracheostomy, dislodgment is
an emergency. Suction (A) is important but not the priority for
emergency reinsertion.
7 A nurse is caring for a client who had a below-the-knee
amputation due to a traumatic injury 2 days ago. Which of the
following statements should the nurse use to assess how the client
is coping with this change in their body image?
A. "Do you feel sad about your leg?"
B. "Tell me how the changes to your leg make you feel"
C. "When will you be ready to walk again?"
D. "Have you thought about getting a prosthetic?"
Correct Answer: B
Explanation: "Tell me how the changes to your leg make you
feel" is an open-ended question that allows the client to express
emotions about body image changes without leading or judging.
Option A is too specific and may limit expression. Options C and
D focus on future mobility rather than current emotional coping.
8 A nurse is teaching a client how to administer a medication
using an inhaler with a spacer. Which of the following instructions
should the nurse include?
A. "Hold your breath for 30 seconds after inhaling"
B. "Shake the inhaler vigorously prior to use"
C. "Inhale slowly over 10 seconds"
D. "Rinse your mouth before using the inhaler"
