MED SURG ATI FINAL EXAM V1 (90 Correct Questions
and Answers)
SECTION 1: ENDOCRINE & METABOLIC DISORDERS
1. A nurse is reinforcing teaching with a client who has osteoporosis and a new
prescription for calcitonin. Which statement should the nurse include to
describe the effect of calcitonin in treating osteoporosis?
• A) "Calcitonin will help your body absorb more calcium from your diet."
• B) "Calcitonin will slow the breakdown of bone in your body."
• C) "Calcitonin will replace the estrogen your body is no longer producing."
• D) "Calcitonin will increase the number of bone-forming cells."
Correct Answer: B
Rationale: Calcitonin is a hormone that inhibits osteoclast activity, thereby slowing
bone resorption and reducing the rate of bone breakdown. It does not directly
increase calcium absorption (vitamin D does that), replace estrogen, or stimulate
bone-forming cells.
2. A nurse is reviewing laboratory results for a client with diabetic ketoacidosis
(DKA). Results: blood glucose 468 mg/dL, pH 7.30, potassium 5.5 mEq/L,
creatinine 1.7 mg/dL, and urine ketones positive. The client is at risk for
developing which complications? (Select all that apply)
• A) Cerebral edema
• B) Cardiac arrhythmias
• C) Renal failure
• D) Hypoglycemia
, • E) Respiratory alkalosis
Correct Answer: A, B, C
Rationale: DKA complications include cerebral edema (from rapid correction of
hyperglycemia), cardiac arrhythmias (from electrolyte shifts, particularly
potassium), and renal failure (from dehydration and reduced perfusion).
Hypoglycemia can occur with treatment but is not an inherent risk of DKA itself.
Respiratory acidosis (not alkalosis) can occur in severe DKA.
3. A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus
about glycosylated hemoglobin (HbA1c) testing. Which information should the
nurse include?
• A) "HbA1c testing should be done every month."
• B) "HbA1c results measure glucose control for the prior 3 months."
• C) "HbA1c testing replaces the need for daily blood glucose monitoring."
• D) "HbA1c results show your blood sugar level at the time of the test."
Correct Answer: B
Rationale: HbA1c reflects average blood glucose levels over the previous 2–3
months (the lifespan of red blood cells). It is typically measured every 3–6 months
and is used to assess long-term glycemic control, not daily fluctuations.
4. A newly diabetic patient will receive instructions from the nurse. Which
action should the nurse take FIRST?
• A) Provide the patient with brochures for making smart food choices.
• B) Ask the patient what they know about diabetes.
• C) Instruct the patient on exercise or activities to increase metabolism.
• D) Teach the patient how to use a glucometer.
,Correct Answer: B
Rationale: Before providing education, the nurse should assess the patient's
baseline knowledge. This allows the nurse to tailor teaching to the patient's needs
and correct any misconceptions. This is an assessment-first approach.
5. A nurse is caring for a client who has laboratory findings of serum Na+ 133
mEq/L and K+ 3.4 mEq/L. Which treatment can result in these findings?
• A) Three tap water enemas
• B) 0.9% sodium chloride solution IV at 50 mL/hr
• C) 5% dextrose in water solution with 20 mEq of K+ IV at 80 mL/hr
• D) Administration of glucocorticoids
Correct Answer: A
Rationale: Tap water enemas can cause hyponatremia and hypokalemia because
tap water is hypotonic. Gastrointestinal losses are isotonic, and the absorption of
free water dilutes serum electrolytes. This leads to decreased serum sodium and
potassium.
6. A nurse is caring for a client with diabetic ketoacidosis (DKA). Which finding
indicates the client's condition is improving?
• A) Glucose 272 mg/dL
• B) Sodium 132 mEq/L
• C) Potassium 6.0 mEq/L
• D) Bicarbonate 15 mmol/L
Correct Answer: A
Rationale: A glucose level moving toward the target range (typically <250 mg/dL)
indicates resolution of hyperglycemia. Sodium, potassium, and bicarbonate levels
require correction but are not definitive markers of improvement.
, 7. A nurse is reinforcing teaching with a client who has a new prescription for
regular and NPH insulin. Which instruction on preparing the insulin should the
nurse include?
• A) "Draw up the NPH insulin first, then the regular insulin."
• B) "Draw up the regular insulin first, then the NPH insulin."
• C) "Mix the insulins in a separate vial before drawing up."
• D) "Do not mix these insulins; administer them separately."
Correct Answer: B
Rationale: When mixing regular (clear) and NPH (cloudy) insulin, draw the regular
insulin first to prevent contamination of the regular vial with NPH. The mnemonic
"clear to cloudy" helps recall this sequence.
8. A patient with type 2 diabetes is prescribed carvedilol (Coreg) for
hypertension. The nurse should monitor for:
• A) Hypoglycemia
• B) Hyperglycemia
• C) Hypocalcemia
• D) Hypercalcemia
Correct Answer: A
Rationale: Carvedilol (a non-selective beta-blocker) can mask the symptoms of
hypoglycemia (such as tachycardia) by blocking the adrenergic response. It may
also increase the effects of hypoglycemic drugs. Patients with diabetes should be
monitored closely for hypoglycemia.
and Answers)
SECTION 1: ENDOCRINE & METABOLIC DISORDERS
1. A nurse is reinforcing teaching with a client who has osteoporosis and a new
prescription for calcitonin. Which statement should the nurse include to
describe the effect of calcitonin in treating osteoporosis?
• A) "Calcitonin will help your body absorb more calcium from your diet."
• B) "Calcitonin will slow the breakdown of bone in your body."
• C) "Calcitonin will replace the estrogen your body is no longer producing."
• D) "Calcitonin will increase the number of bone-forming cells."
Correct Answer: B
Rationale: Calcitonin is a hormone that inhibits osteoclast activity, thereby slowing
bone resorption and reducing the rate of bone breakdown. It does not directly
increase calcium absorption (vitamin D does that), replace estrogen, or stimulate
bone-forming cells.
2. A nurse is reviewing laboratory results for a client with diabetic ketoacidosis
(DKA). Results: blood glucose 468 mg/dL, pH 7.30, potassium 5.5 mEq/L,
creatinine 1.7 mg/dL, and urine ketones positive. The client is at risk for
developing which complications? (Select all that apply)
• A) Cerebral edema
• B) Cardiac arrhythmias
• C) Renal failure
• D) Hypoglycemia
, • E) Respiratory alkalosis
Correct Answer: A, B, C
Rationale: DKA complications include cerebral edema (from rapid correction of
hyperglycemia), cardiac arrhythmias (from electrolyte shifts, particularly
potassium), and renal failure (from dehydration and reduced perfusion).
Hypoglycemia can occur with treatment but is not an inherent risk of DKA itself.
Respiratory acidosis (not alkalosis) can occur in severe DKA.
3. A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus
about glycosylated hemoglobin (HbA1c) testing. Which information should the
nurse include?
• A) "HbA1c testing should be done every month."
• B) "HbA1c results measure glucose control for the prior 3 months."
• C) "HbA1c testing replaces the need for daily blood glucose monitoring."
• D) "HbA1c results show your blood sugar level at the time of the test."
Correct Answer: B
Rationale: HbA1c reflects average blood glucose levels over the previous 2–3
months (the lifespan of red blood cells). It is typically measured every 3–6 months
and is used to assess long-term glycemic control, not daily fluctuations.
4. A newly diabetic patient will receive instructions from the nurse. Which
action should the nurse take FIRST?
• A) Provide the patient with brochures for making smart food choices.
• B) Ask the patient what they know about diabetes.
• C) Instruct the patient on exercise or activities to increase metabolism.
• D) Teach the patient how to use a glucometer.
,Correct Answer: B
Rationale: Before providing education, the nurse should assess the patient's
baseline knowledge. This allows the nurse to tailor teaching to the patient's needs
and correct any misconceptions. This is an assessment-first approach.
5. A nurse is caring for a client who has laboratory findings of serum Na+ 133
mEq/L and K+ 3.4 mEq/L. Which treatment can result in these findings?
• A) Three tap water enemas
• B) 0.9% sodium chloride solution IV at 50 mL/hr
• C) 5% dextrose in water solution with 20 mEq of K+ IV at 80 mL/hr
• D) Administration of glucocorticoids
Correct Answer: A
Rationale: Tap water enemas can cause hyponatremia and hypokalemia because
tap water is hypotonic. Gastrointestinal losses are isotonic, and the absorption of
free water dilutes serum electrolytes. This leads to decreased serum sodium and
potassium.
6. A nurse is caring for a client with diabetic ketoacidosis (DKA). Which finding
indicates the client's condition is improving?
• A) Glucose 272 mg/dL
• B) Sodium 132 mEq/L
• C) Potassium 6.0 mEq/L
• D) Bicarbonate 15 mmol/L
Correct Answer: A
Rationale: A glucose level moving toward the target range (typically <250 mg/dL)
indicates resolution of hyperglycemia. Sodium, potassium, and bicarbonate levels
require correction but are not definitive markers of improvement.
, 7. A nurse is reinforcing teaching with a client who has a new prescription for
regular and NPH insulin. Which instruction on preparing the insulin should the
nurse include?
• A) "Draw up the NPH insulin first, then the regular insulin."
• B) "Draw up the regular insulin first, then the NPH insulin."
• C) "Mix the insulins in a separate vial before drawing up."
• D) "Do not mix these insulins; administer them separately."
Correct Answer: B
Rationale: When mixing regular (clear) and NPH (cloudy) insulin, draw the regular
insulin first to prevent contamination of the regular vial with NPH. The mnemonic
"clear to cloudy" helps recall this sequence.
8. A patient with type 2 diabetes is prescribed carvedilol (Coreg) for
hypertension. The nurse should monitor for:
• A) Hypoglycemia
• B) Hyperglycemia
• C) Hypocalcemia
• D) Hypercalcemia
Correct Answer: A
Rationale: Carvedilol (a non-selective beta-blocker) can mask the symptoms of
hypoglycemia (such as tachycardia) by blocking the adrenergic response. It may
also increase the effects of hypoglycemic drugs. Patients with diabetes should be
monitored closely for hypoglycemia.
