ATI Med-Surg Exam Practice Questions with Verified Answers
1. A nurse is caring for a client with heart failure who has developed pulmonary edema.
Which of the following findings should the nurse expect?
A) Frothy, pink-tinged sputum
B) Decreased respiratory rate
C) Weight loss
D) Bradycardia
Answer: A) Frothy, pink-tinged sputum
Rationale: Pulmonary edema results from fluid accumulation in the alveoli, leading to frothy,
pink-tinged sputum. Respiratory rate typically increases (tachypnea), not decreases. Weight gain
occurs due to fluid retention, and tachycardia is more common than bradycardia.
2. A client with COPD is prescribed oxygen therapy. Which oxygen delivery method is most
appropriate for this client?
A) Non-rebreather mask at 15 L/min
B) Nasal cannula at 2 L/min
C) Simple face mask at 8 L/min
D) Venturi mask at 10 L/min
Answer: B) Nasal cannula at 2 L/min
Rationale: Clients with COPD often have chronic carbon dioxide retention and rely on hypoxic
drive to stimulate breathing. High-flow oxygen can suppress this drive, leading to respiratory
depression. A nasal cannula at 1-3 L/min is preferred to maintain oxygen saturation without
eliminating the hypoxic drive.
3. A nurse is assessing a client with diabetic ketoacidosis (DKA). Which laboratory finding is
most indicative of this condition?
A) Serum pH 7.35
B) Serum bicarbonate 18 mEq/L
C) Serum glucose 250 mg/dL
D) Serum potassium 3.8 mEq/L
Answer: B) Serum bicarbonate 18 mEq/L
Rationale: DKA is characterized by metabolic acidosis with a low serum bicarbonate level
(typically <15 mEq/L). Serum glucose is usually >250 mg/dL, often much higher. Serum pH is
decreased (<7.30), and potassium may be normal or elevated initially.
4. A client with cirrhosis is exhibiting signs of hepatic encephalopathy. Which dietary
modification should the nurse anticipate?
A) High-protein diet
,B) Low-sodium diet
C) Low-protein diet
D) High-carbohydrate diet
Answer: C) Low-protein diet
Rationale: Hepatic encephalopathy results from the liver's inability to metabolize ammonia, a
byproduct of protein breakdown. A low-protein diet helps reduce ammonia production. Sodium
restriction is used for ascites, not specifically for encephalopathy.
5. A nurse is caring for a client with acute kidney injury (AKI) in the oliguric phase. Which
finding requires immediate intervention?
A) Serum potassium 6.2 mEq/L
B) Serum creatinine 3.5 mg/dL
C) Blood urea nitrogen (BUN) 45 mg/dL
D) Urine output 300 mL in 24 hours
Answer: A) Serum potassium 6.2 mEq/L
Rationale: Hyperkalemia (serum potassium >5.5 mEq/L) is a life-threatening complication of AKI
that can cause cardiac arrhythmias. This finding requires immediate intervention, such as
administering calcium gluconate, insulin with glucose, or Kayexalate.
6. A client is diagnosed with pheochromocytoma. Which assessment finding is most
consistent with this diagnosis?
A) Hypotension
B) Bradycardia
C) Severe hypertension
D) Hypoglycemia
Answer: C) Severe hypertension
Rationale: Pheochromocytoma is a tumor of the adrenal medulla that secretes excessive
catecholamines, leading to severe, episodic hypertension. Tachycardia, not bradycardia, is
common. Hyperglycemia may also occur.
7. A nurse is providing education to a client with GERD. Which instruction should be included?
A) Lie down immediately after eating
B) Avoid eating 3 hours before bedtime
C) Increase intake of spicy foods
D) Drink large amounts of fluid with meals
Answer: B) Avoid eating 3 hours before bedtime
Rationale: Clients with GERD should avoid lying down for at least 2-3 hours after meals to
prevent reflux. Spicy foods and large fluid volumes with meals can worsen symptoms.
,8. A client with appendicitis is scheduled for surgery. Which finding indicates a possible
rupture?
A) Sudden relief of pain
B) Increased bowel sounds
C) Decreased temperature
D) Bradycardia
Answer: A) Sudden relief of pain
Rationale: Sudden relief of pain in appendicitis may indicate perforation of the appendix.
Perforation releases pressure and allows purulent material to escape, temporarily relieving pain,
but this is a medical emergency.
9. A nurse is caring for a client with tuberculosis who is taking isoniazid. Which adverse effect
should the nurse monitor?
A) Peripheral neuropathy
B) Hyperglycemia
C) Tinnitus
D) Nephrotoxicity
Answer: A) Peripheral neuropathy
Rationale: Isoniazid can cause peripheral neuropathy due to pyridoxine (vitamin B6) deficiency.
Patients often receive supplemental vitamin B6 to prevent this. Hepatotoxicity is another
concern.
10. A client with a head injury has an intracranial pressure (ICP) of 20 mm Hg. Which
intervention should the nurse implement?
A) Keep the head of bed flat
B) Administer prescribed mannitol
C) Increase IV fluids
D) Suction the airway frequently
Answer: B) Administer prescribed mannitol
Rationale: Normal ICP is 5-15 mm Hg. An ICP of 20 mm Hg is elevated. Mannitol is an osmotic
diuretic that reduces cerebral edema and ICP. The head of the bed should be elevated (30-45
degrees) to promote venous drainage.
11. A client is receiving warfarin therapy for atrial fibrillation. Which laboratory value should
the nurse monitor most closely?
A) Prothrombin time (PT) and INR
B) Activated partial thromboplastin time (aPTT)
C) Platelet count
D) Hemoglobin
, Answer: A) Prothrombin time (PT) and INR
Rationale: Warfarin affects the extrinsic pathway of coagulation, so PT and INR are used to
monitor therapeutic levels. The target INR for atrial fibrillation is typically 2.0-3.0. aPTT is used
to monitor heparin therapy.
12. A nurse is assessing a client who has just returned from a thyroidectomy. Which finding is
most concerning?
A) Hoarseness
B) Pain at the incision site
C) Stridor
D) Difficulty swallowing
Answer: C) Stridor
Rationale: Stridor is a high-pitched respiratory sound indicating airway obstruction. This is a sign
of laryngeal edema or hematoma compressing the trachea, which is a life-threatening
complication following thyroidectomy requiring immediate intervention.
13. A client with a history of seizures is prescribed phenytoin. Which nursing action is most
important?
A) Monitor blood glucose levels
B) Assess for gingival hyperplasia
C) Check for bradycardia
D) Monitor for hyperkalemia
Answer: B) Assess for gingival hyperplasia
Rationale: Phenytoin is known to cause gingival hyperplasia (overgrowth of gum tissue). Regular
dental hygiene and monitoring are essential. It also causes nystagmus and ataxia.
14. A client with chronic kidney disease is advised to follow a renal diet. Which food should
the client avoid?
A) Bananas
B) Apples
C) Grapes
D) Cabbage
Answer: A) Bananas
Rationale: Bananas are high in potassium, which can accumulate in renal failure and cause
hyperkalemia, a life-threatening condition. Apples, grapes, and cabbage are lower-potassium
choices.
15. A nurse is caring for a client with acute pancreatitis. Which position should the nurse
encourage to reduce pain?
A) Prone position
B) Supine position
1. A nurse is caring for a client with heart failure who has developed pulmonary edema.
Which of the following findings should the nurse expect?
A) Frothy, pink-tinged sputum
B) Decreased respiratory rate
C) Weight loss
D) Bradycardia
Answer: A) Frothy, pink-tinged sputum
Rationale: Pulmonary edema results from fluid accumulation in the alveoli, leading to frothy,
pink-tinged sputum. Respiratory rate typically increases (tachypnea), not decreases. Weight gain
occurs due to fluid retention, and tachycardia is more common than bradycardia.
2. A client with COPD is prescribed oxygen therapy. Which oxygen delivery method is most
appropriate for this client?
A) Non-rebreather mask at 15 L/min
B) Nasal cannula at 2 L/min
C) Simple face mask at 8 L/min
D) Venturi mask at 10 L/min
Answer: B) Nasal cannula at 2 L/min
Rationale: Clients with COPD often have chronic carbon dioxide retention and rely on hypoxic
drive to stimulate breathing. High-flow oxygen can suppress this drive, leading to respiratory
depression. A nasal cannula at 1-3 L/min is preferred to maintain oxygen saturation without
eliminating the hypoxic drive.
3. A nurse is assessing a client with diabetic ketoacidosis (DKA). Which laboratory finding is
most indicative of this condition?
A) Serum pH 7.35
B) Serum bicarbonate 18 mEq/L
C) Serum glucose 250 mg/dL
D) Serum potassium 3.8 mEq/L
Answer: B) Serum bicarbonate 18 mEq/L
Rationale: DKA is characterized by metabolic acidosis with a low serum bicarbonate level
(typically <15 mEq/L). Serum glucose is usually >250 mg/dL, often much higher. Serum pH is
decreased (<7.30), and potassium may be normal or elevated initially.
4. A client with cirrhosis is exhibiting signs of hepatic encephalopathy. Which dietary
modification should the nurse anticipate?
A) High-protein diet
,B) Low-sodium diet
C) Low-protein diet
D) High-carbohydrate diet
Answer: C) Low-protein diet
Rationale: Hepatic encephalopathy results from the liver's inability to metabolize ammonia, a
byproduct of protein breakdown. A low-protein diet helps reduce ammonia production. Sodium
restriction is used for ascites, not specifically for encephalopathy.
5. A nurse is caring for a client with acute kidney injury (AKI) in the oliguric phase. Which
finding requires immediate intervention?
A) Serum potassium 6.2 mEq/L
B) Serum creatinine 3.5 mg/dL
C) Blood urea nitrogen (BUN) 45 mg/dL
D) Urine output 300 mL in 24 hours
Answer: A) Serum potassium 6.2 mEq/L
Rationale: Hyperkalemia (serum potassium >5.5 mEq/L) is a life-threatening complication of AKI
that can cause cardiac arrhythmias. This finding requires immediate intervention, such as
administering calcium gluconate, insulin with glucose, or Kayexalate.
6. A client is diagnosed with pheochromocytoma. Which assessment finding is most
consistent with this diagnosis?
A) Hypotension
B) Bradycardia
C) Severe hypertension
D) Hypoglycemia
Answer: C) Severe hypertension
Rationale: Pheochromocytoma is a tumor of the adrenal medulla that secretes excessive
catecholamines, leading to severe, episodic hypertension. Tachycardia, not bradycardia, is
common. Hyperglycemia may also occur.
7. A nurse is providing education to a client with GERD. Which instruction should be included?
A) Lie down immediately after eating
B) Avoid eating 3 hours before bedtime
C) Increase intake of spicy foods
D) Drink large amounts of fluid with meals
Answer: B) Avoid eating 3 hours before bedtime
Rationale: Clients with GERD should avoid lying down for at least 2-3 hours after meals to
prevent reflux. Spicy foods and large fluid volumes with meals can worsen symptoms.
,8. A client with appendicitis is scheduled for surgery. Which finding indicates a possible
rupture?
A) Sudden relief of pain
B) Increased bowel sounds
C) Decreased temperature
D) Bradycardia
Answer: A) Sudden relief of pain
Rationale: Sudden relief of pain in appendicitis may indicate perforation of the appendix.
Perforation releases pressure and allows purulent material to escape, temporarily relieving pain,
but this is a medical emergency.
9. A nurse is caring for a client with tuberculosis who is taking isoniazid. Which adverse effect
should the nurse monitor?
A) Peripheral neuropathy
B) Hyperglycemia
C) Tinnitus
D) Nephrotoxicity
Answer: A) Peripheral neuropathy
Rationale: Isoniazid can cause peripheral neuropathy due to pyridoxine (vitamin B6) deficiency.
Patients often receive supplemental vitamin B6 to prevent this. Hepatotoxicity is another
concern.
10. A client with a head injury has an intracranial pressure (ICP) of 20 mm Hg. Which
intervention should the nurse implement?
A) Keep the head of bed flat
B) Administer prescribed mannitol
C) Increase IV fluids
D) Suction the airway frequently
Answer: B) Administer prescribed mannitol
Rationale: Normal ICP is 5-15 mm Hg. An ICP of 20 mm Hg is elevated. Mannitol is an osmotic
diuretic that reduces cerebral edema and ICP. The head of the bed should be elevated (30-45
degrees) to promote venous drainage.
11. A client is receiving warfarin therapy for atrial fibrillation. Which laboratory value should
the nurse monitor most closely?
A) Prothrombin time (PT) and INR
B) Activated partial thromboplastin time (aPTT)
C) Platelet count
D) Hemoglobin
, Answer: A) Prothrombin time (PT) and INR
Rationale: Warfarin affects the extrinsic pathway of coagulation, so PT and INR are used to
monitor therapeutic levels. The target INR for atrial fibrillation is typically 2.0-3.0. aPTT is used
to monitor heparin therapy.
12. A nurse is assessing a client who has just returned from a thyroidectomy. Which finding is
most concerning?
A) Hoarseness
B) Pain at the incision site
C) Stridor
D) Difficulty swallowing
Answer: C) Stridor
Rationale: Stridor is a high-pitched respiratory sound indicating airway obstruction. This is a sign
of laryngeal edema or hematoma compressing the trachea, which is a life-threatening
complication following thyroidectomy requiring immediate intervention.
13. A client with a history of seizures is prescribed phenytoin. Which nursing action is most
important?
A) Monitor blood glucose levels
B) Assess for gingival hyperplasia
C) Check for bradycardia
D) Monitor for hyperkalemia
Answer: B) Assess for gingival hyperplasia
Rationale: Phenytoin is known to cause gingival hyperplasia (overgrowth of gum tissue). Regular
dental hygiene and monitoring are essential. It also causes nystagmus and ataxia.
14. A client with chronic kidney disease is advised to follow a renal diet. Which food should
the client avoid?
A) Bananas
B) Apples
C) Grapes
D) Cabbage
Answer: A) Bananas
Rationale: Bananas are high in potassium, which can accumulate in renal failure and cause
hyperkalemia, a life-threatening condition. Apples, grapes, and cabbage are lower-potassium
choices.
15. A nurse is caring for a client with acute pancreatitis. Which position should the nurse
encourage to reduce pain?
A) Prone position
B) Supine position
