ATI RN ADULT MEDICAL-SURGICAL PROCTORED RETAKE EXAM: THE ULTIMATE 200-QUESTION PRACTICE BANK WITH DETAILED RATIONALES

ATI RN ADULT MEDICAL-SURGICAL PROCTORED RETAKE EXAM: THE ULTIMATE 200-QUESTION PRACTICE BANK WITH DETAILED RATIONALES 1. A nurse is assessing a client who has right-sided heart failure. Which of the following findings should the nurse expect? A) Crackles in the lung bases B) Paroxysmal nocturnal dyspnea C) Jugular venous distension D) Frothy sputum Answer: C Rationale: Right-sided heart failure is characterized by fluid backup into the systemic venous system, leading to jugular venous distension, peripheral edema, and hepatomegaly. Crackles, paroxysmal nocturnal dyspnea, and frothy sputum are signs of left-sided heart failure. ________________________________________ 2. A nurse is caring for a client who has a new diagnosis of hypertension. Which of the following lifestyle modifications should the nurse recommend? A) Increase intake of red meat B) Limit alcohol consumption to two drinks per day for men C) Decrease physical activity to reduce stress D) Increase sodium intake to 3,000 mg daily Answer: B Rationale: Lifestyle modifications for hypertension include limiting alcohol to two drinks per day for men and one drink for women, following a low-sodium diet (e.g., DASH diet), and engaging in regular aerobic physical activity. ________________________________________ 3. A nurse is assessing a client who has pericarditis. Which of the following findings should the nurse expect? A) Chest pain that is relieved when lying flat B) Chest pain that worsens when leaning forward C) Friction rub auscultated at the left sternal border D) Pain that is unrelieved by sitting forward Answer: C Rationale: Pericarditis is characterized by a pericardial friction rub heard at the left sternal border. Chest pain typically worsens when lying flat and improves when leaning forward. ________________________________________ 4. A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following statements by the client indicates an understanding of the teaching? A) "I will eat more green leafy vegetables." B) "I will take ibuprofen for headaches." C) "I will use an electric razor to shave." D) "I will stop taking the medication if I notice bruising." Answer: C Rationale: Clients taking warfarin should use an electric razor to prevent bleeding from cuts. Green leafy vegetables contain vitamin K, which antagonizes warfarin; ibuprofen increases bleeding risk; and clients should not stop medications without provider guidance. ________________________________________ 5. A nurse is caring for a client who has a serum potassium level of 6.8 mEq/L. Which of the following assessments is the priority? A) Skin turgor B) Lung sounds C) Cardiac rhythm D) Deep tendon reflexes Answer: C Rationale: Hyperkalemia (potassium 5.0 mEq/L) can cause fatal cardiac dysrhythmias, including peaked T waves, widened QRS complexes, and ventricular fibrillation. ECG monitoring is the priority. ________________________________________ 6. A client who is receiving a continuous intravenous heparin infusion has an aPTT of 98 seconds. Which of the following actions should the nurse take? A) Increase the heparin infusion rate B) Decrease the heparin infusion rate C) Administer protamine sulfate D) Continue the infusion at the current rate Answer: B Rationale: The therapeutic aPTT range for heparin therapy is 1.5 to 2.5 times the normal control (approximately 60-80 seconds). An aPTT of 98 seconds indicates over-anticoagulation, and the infusion rate should be decreased. Protamine sulfate is used for severe bleeding. ________________________________________ 7. A nurse is assessing a client who has heart failure. Which of the following findings should the nurse expect? A) Decreased jugular venous pressure B) Bounding peripheral pulses C) Crackles in the lung bases D) Decreased central venous pressure Answer: C Rationale: Heart failure leads to fluid accumulation in the lungs, causing crackles upon auscultation, particularly in the lung bases. Jugular venous pressure is typically elevated, peripheral pulses may be weak, and central venous pressure is increased due to fluid overload. ________________________________________ 8. A nurse is reviewing the laboratory results of a client who is taking digoxin. Which of the following findings should indicate to the nurse that the client is at risk for digoxin toxicity? A) Serum potassium 3.2 mEq/L B) Serum calcium 10.2 mg/dL