ATI RN Adult Medical Surgical Latest
2024 Complete Exam/ Comprehensive
Questions with Answers
Cardiovascular & Respiratory
1. A nurse is preparing to administer thrombolytic therapy to a client who had
an ischemic stroke. Which of the following is an appropriate nursing action?
A) Start the therapy within 8 hours
B) Insert an indwelling urinary catheter after therapy begins
C) Monitor blood pressure every 30 minutes during the infusion
D) Elevate the head of bed between 25 and 30 degrees
Correct Answer: C – Monitor blood pressure every 30 minutes during infusion
Rationale: Thrombolytic therapy carries a significant risk of bleeding, including
intracranial hemorrhage. Frequent blood pressure monitoring is essential to
detect hypertension that could increase bleeding risk. Thrombolytics should be
administered within 3-4.5 hours of stroke onset, not 8 hours. Indwelling catheters
should be placed before therapy begins to minimize trauma. HOB elevation of 25-
30 degrees is appropriate for stroke patients but is not specific to thrombolytic
administration.
2. A nurse is caring for a client who is receiving a blood transfusion. The nurse
observes bounding peripheral pulses, hypertension, and distended jugular
veins. The nurse should anticipate administering which prescribed medication?
A) Acetaminophen
B) Furosemide
C) Diphenhydramine
D) Pantoprazole
,Correct Answer: B – Furosemide
Rationale: These findings indicate fluid volume overload (circulatory overload), a
complication of rapid blood transfusion. Furosemide is a loop diuretic that will
reduce preload and relieve fluid overload symptoms. Acetaminophen treats fever,
diphenhydramine treats allergic reactions, and pantoprazole treats GI bleeding
prophylaxis.
3. A nurse is caring for a client who is postoperative following coronary artery
bypass surgery and reports shortness of breath. The nurse administers oxygen
at 3 L/min and obtains arterial blood gases 60 minutes later. Which laboratory
finding indicates a positive response to oxygen therapy?
A) PaO2 70 mm Hg
B) PaO2 80 mm Hg
C) PaO2 90 mm Hg
D) PaO2 100 mm Hg
Correct Answer: C – PaO2 90 mm Hg
Rationale: A PaO2 of 90 mm Hg indicates adequate oxygenation and a positive
response to supplemental oxygen. Normal PaO2 range is 80-100 mm Hg. Values
below this indicate continued hypoxemia requiring further intervention.
4. A nurse is admitting a client who reports chest pain and has been placed on a
telemetry monitor. Which of the following should the nurse analyze to
determine whether the client is experiencing a myocardial infarction?
A) QRS duration
B) ST segment
C) T wave
D) PR interval
Correct Answer: B – ST segment
Rationale: ST segment elevation or depression is the primary ECG change
indicating myocardial ischemia or infarction. ST elevation (STEMI) indicates
,transmural infarction requiring immediate intervention. QRS duration indicates
bundle branch blocks, T wave changes indicate ischemia or electrolyte
disturbances, and PR interval indicates AV conduction delays.
5. A nurse is caring for a client who has COPD. Which assessment finding
requires immediate follow-up?
A) Productive cough with yellow mucus
B) Oxygen saturation 87% on room air
C) Wheezes and crackles upon auscultation
D) Restlessness
Correct Answer: B – Oxygen saturation 87% on room air
Rationale: An SpO2 of 87% indicates significant hypoxemia and is the priority
finding requiring immediate intervention. Restlessness is also a sign of hypoxia.
The other findings are expected in COPD exacerbation but do not represent the
most urgent threat.
6. A nurse is teaching a client about the use of an incentive spirometer. Which
instruction should the nurse include?
A) Place hands on the upper abdomen during inhalation
B) Exhale slowly through pursed lips
C) Hold breaths about 3 to 5 seconds before exhaling
D) Position the mouthpiece 2.5 cm from the mouth
Correct Answer: C – Hold breaths about 3 to 5 seconds before exhaling
Rationale: Holding the breath for 3-5 seconds after inhalation allows for maximal
alveolar expansion and prevents atelectasis. The client should sit upright, seal lips
around the mouthpiece, inhale slowly and deeply, then hold. Hand placement is
not typically needed, and mouthpiece should be sealed, not positioned away.
7. A nurse is reviewing ECG strips for several clients. Which rhythm should the
nurse identify as atrial fibrillation?
, A) Absent P waves with irregularly irregular QRS complexes
B) Prolonged PR intervals
C) Wide QRS complexes
D) Sawtooth flutter waves
Correct Answer: A – Absent P waves with irregularly irregular QRS complexes
Rationale: Atrial fibrillation is characterized by absent P waves and an irregularly
irregular ventricular response due to chaotic atrial depolarization. Prolonged PR
interval is first-degree heart block, wide QRS indicates ventricular conduction
delay, and sawtooth waves are atrial flutter.
8. A nurse is caring for a client who is experiencing an exacerbation of heart
failure. Which finding indicates potential worsening of the condition?
A) Weight loss
B) Clear lung sounds
C) Shortness of breath with exertion
D) Decreased peripheral edema
Correct Answer: C – Shortness of breath with exertion
Rationale: Dyspnea on exertion indicates worsening heart failure due to increased
pulmonary congestion. Weight gain (not loss), worsening edema, and crackles
would also indicate deterioration. Improvement would be shown by weight loss,
clear lung sounds, and decreased edema.
9. A nurse is providing dietary instructions to a client who has cardiovascular
disease. Which statement indicates understanding of the teaching?
A) "I will use butter when cooking vegetables"
B) "I will use canola oil when making salad dressing"
C) "I will eat red meat at least 5 times per week"
D) "I will avoid all types of fish"
Correct Answer: B – "I will use canola oil when making salad dressing"
2024 Complete Exam/ Comprehensive
Questions with Answers
Cardiovascular & Respiratory
1. A nurse is preparing to administer thrombolytic therapy to a client who had
an ischemic stroke. Which of the following is an appropriate nursing action?
A) Start the therapy within 8 hours
B) Insert an indwelling urinary catheter after therapy begins
C) Monitor blood pressure every 30 minutes during the infusion
D) Elevate the head of bed between 25 and 30 degrees
Correct Answer: C – Monitor blood pressure every 30 minutes during infusion
Rationale: Thrombolytic therapy carries a significant risk of bleeding, including
intracranial hemorrhage. Frequent blood pressure monitoring is essential to
detect hypertension that could increase bleeding risk. Thrombolytics should be
administered within 3-4.5 hours of stroke onset, not 8 hours. Indwelling catheters
should be placed before therapy begins to minimize trauma. HOB elevation of 25-
30 degrees is appropriate for stroke patients but is not specific to thrombolytic
administration.
2. A nurse is caring for a client who is receiving a blood transfusion. The nurse
observes bounding peripheral pulses, hypertension, and distended jugular
veins. The nurse should anticipate administering which prescribed medication?
A) Acetaminophen
B) Furosemide
C) Diphenhydramine
D) Pantoprazole
,Correct Answer: B – Furosemide
Rationale: These findings indicate fluid volume overload (circulatory overload), a
complication of rapid blood transfusion. Furosemide is a loop diuretic that will
reduce preload and relieve fluid overload symptoms. Acetaminophen treats fever,
diphenhydramine treats allergic reactions, and pantoprazole treats GI bleeding
prophylaxis.
3. A nurse is caring for a client who is postoperative following coronary artery
bypass surgery and reports shortness of breath. The nurse administers oxygen
at 3 L/min and obtains arterial blood gases 60 minutes later. Which laboratory
finding indicates a positive response to oxygen therapy?
A) PaO2 70 mm Hg
B) PaO2 80 mm Hg
C) PaO2 90 mm Hg
D) PaO2 100 mm Hg
Correct Answer: C – PaO2 90 mm Hg
Rationale: A PaO2 of 90 mm Hg indicates adequate oxygenation and a positive
response to supplemental oxygen. Normal PaO2 range is 80-100 mm Hg. Values
below this indicate continued hypoxemia requiring further intervention.
4. A nurse is admitting a client who reports chest pain and has been placed on a
telemetry monitor. Which of the following should the nurse analyze to
determine whether the client is experiencing a myocardial infarction?
A) QRS duration
B) ST segment
C) T wave
D) PR interval
Correct Answer: B – ST segment
Rationale: ST segment elevation or depression is the primary ECG change
indicating myocardial ischemia or infarction. ST elevation (STEMI) indicates
,transmural infarction requiring immediate intervention. QRS duration indicates
bundle branch blocks, T wave changes indicate ischemia or electrolyte
disturbances, and PR interval indicates AV conduction delays.
5. A nurse is caring for a client who has COPD. Which assessment finding
requires immediate follow-up?
A) Productive cough with yellow mucus
B) Oxygen saturation 87% on room air
C) Wheezes and crackles upon auscultation
D) Restlessness
Correct Answer: B – Oxygen saturation 87% on room air
Rationale: An SpO2 of 87% indicates significant hypoxemia and is the priority
finding requiring immediate intervention. Restlessness is also a sign of hypoxia.
The other findings are expected in COPD exacerbation but do not represent the
most urgent threat.
6. A nurse is teaching a client about the use of an incentive spirometer. Which
instruction should the nurse include?
A) Place hands on the upper abdomen during inhalation
B) Exhale slowly through pursed lips
C) Hold breaths about 3 to 5 seconds before exhaling
D) Position the mouthpiece 2.5 cm from the mouth
Correct Answer: C – Hold breaths about 3 to 5 seconds before exhaling
Rationale: Holding the breath for 3-5 seconds after inhalation allows for maximal
alveolar expansion and prevents atelectasis. The client should sit upright, seal lips
around the mouthpiece, inhale slowly and deeply, then hold. Hand placement is
not typically needed, and mouthpiece should be sealed, not positioned away.
7. A nurse is reviewing ECG strips for several clients. Which rhythm should the
nurse identify as atrial fibrillation?
, A) Absent P waves with irregularly irregular QRS complexes
B) Prolonged PR intervals
C) Wide QRS complexes
D) Sawtooth flutter waves
Correct Answer: A – Absent P waves with irregularly irregular QRS complexes
Rationale: Atrial fibrillation is characterized by absent P waves and an irregularly
irregular ventricular response due to chaotic atrial depolarization. Prolonged PR
interval is first-degree heart block, wide QRS indicates ventricular conduction
delay, and sawtooth waves are atrial flutter.
8. A nurse is caring for a client who is experiencing an exacerbation of heart
failure. Which finding indicates potential worsening of the condition?
A) Weight loss
B) Clear lung sounds
C) Shortness of breath with exertion
D) Decreased peripheral edema
Correct Answer: C – Shortness of breath with exertion
Rationale: Dyspnea on exertion indicates worsening heart failure due to increased
pulmonary congestion. Weight gain (not loss), worsening edema, and crackles
would also indicate deterioration. Improvement would be shown by weight loss,
clear lung sounds, and decreased edema.
9. A nurse is providing dietary instructions to a client who has cardiovascular
disease. Which statement indicates understanding of the teaching?
A) "I will use butter when cooking vegetables"
B) "I will use canola oil when making salad dressing"
C) "I will eat red meat at least 5 times per week"
D) "I will avoid all types of fish"
Correct Answer: B – "I will use canola oil when making salad dressing"
