ATI Medical-Surgical Exam 8: Musculoskeletal & Immune System 2026
|Questions |Answers |Rationales
1. A nurse is teaching a client who has a new prescription for methotrexate to
treat rheumatoid arthritis. Which of the following instructions should the nurse
include?
A. Expect your stools to turn black and tarry.
B. Drink 2 to 3 liters of water per day.
C. Take the medication with an antacid if GI upset occurs.
D. Take a vitamin D supplement daily.
Answer: B
Rationale: Methotrexate can cause renal toxicity; therefore, the client should maintain
adequate hydration to promote excretion of the drug. Black stools indicate GI bleeding,
which is a serious side effect, and antacids can interfere with absorption.
2. A nurse is assessing a client who is 24 hours postoperative following a total
hip arthroplasty. Which of the following findings should the nurse identify as a
possible fat embolism?
A. Pain in the calf when the foot is dorsiflexed.
B. Diminished pedal pulses in the affected extremity.
C. Petechiae on the chest and neck.
D. Serosanguineous drainage on the surgical dressing.
Answer: C
Rationale: Petechiae on the chest, neck, and axilla are a hallmark sign of fat embolism
syndrome (FES), resulting from the occlusion of small vessels by fat globules.
,3. A client with Systemic Lupus Erythematosus (SLE) is being discharged. Which
instruction is most important for the nurse to provide?
A. Increase intake of red meat to prevent anemia.
B. Use a tanning bed to maintain vitamin D levels.
C. Wear sunscreen with an SPF of at least 30 when outdoors.
D. Limit fluid intake to 1 liter per day.
Answer: C
Rationale: Photosensitivity is a common feature of SLE. Exposure to UV light can trigger a
flare-up of the disease, so high-SPF sunscreen and protective clothing are essential.
4. A nurse is providing teaching to a client who has osteoarthritis. Which of the
following statements should the nurse include?
A. Osteoarthritis is an autoimmune inflammatory disease.
B. Morning stiffness usually lasts longer than 1 hour.
C. The disease affects joints symmetrically.
D. Joint pain typically increases with activity and decreases with rest.
Answer: D
Rationale: Osteoarthritis is a degenerative joint disease where pain occurs with use and is
relieved by rest. In contrast, RA is autoimmune, symmetrical, and involves prolonged
morning stiffness.
5. A nurse is assessing a client who has a fractured left femur and is in skeletal
traction. Which of the following findings should the nurse report to the
provider?
A. The weights are hanging freely off the floor.
B. Ecchymosis is present over the fracture site.
C. The client’s left leg is in internal rotation.
D. The pin sites have a small amount of clear drainage.
Answer: C
, Rationale: Internal or external rotation of the limb in traction suggests that the alignment
is not maintained or the traction is ineffective, which should be reported. Weights should
hang freely, and ecchymosis is expected.
6. A nurse is monitoring a client who has HIV for the presence of opportunistic
infections. Which of the following findings should the nurse report?
A. A CD4 count of 450 cells/mm3.
B. A negative tuberculin skin test.
C. A weight gain of 2 kg over the last month.
D. White, cheesy patches on the tongue and oral mucosa.
Answer: D
Rationale: White patches on the tongue indicate oral candidiasis (thrush), which is a
common opportunistic fungal infection in immunocompromised clients.
7. Which of the following foods should a client with gout be instructed to avoid?
A. Whole grain bread.
B. Skim milk.
C. Organ meats such as liver.
D. Fresh strawberries.
Answer: C
Rationale: Gout is caused by hyperuricemia. The client should avoid high-purine foods,
such as organ meats, shellfish, and alcohol, which break down into uric acid.
|Questions |Answers |Rationales
1. A nurse is teaching a client who has a new prescription for methotrexate to
treat rheumatoid arthritis. Which of the following instructions should the nurse
include?
A. Expect your stools to turn black and tarry.
B. Drink 2 to 3 liters of water per day.
C. Take the medication with an antacid if GI upset occurs.
D. Take a vitamin D supplement daily.
Answer: B
Rationale: Methotrexate can cause renal toxicity; therefore, the client should maintain
adequate hydration to promote excretion of the drug. Black stools indicate GI bleeding,
which is a serious side effect, and antacids can interfere with absorption.
2. A nurse is assessing a client who is 24 hours postoperative following a total
hip arthroplasty. Which of the following findings should the nurse identify as a
possible fat embolism?
A. Pain in the calf when the foot is dorsiflexed.
B. Diminished pedal pulses in the affected extremity.
C. Petechiae on the chest and neck.
D. Serosanguineous drainage on the surgical dressing.
Answer: C
Rationale: Petechiae on the chest, neck, and axilla are a hallmark sign of fat embolism
syndrome (FES), resulting from the occlusion of small vessels by fat globules.
,3. A client with Systemic Lupus Erythematosus (SLE) is being discharged. Which
instruction is most important for the nurse to provide?
A. Increase intake of red meat to prevent anemia.
B. Use a tanning bed to maintain vitamin D levels.
C. Wear sunscreen with an SPF of at least 30 when outdoors.
D. Limit fluid intake to 1 liter per day.
Answer: C
Rationale: Photosensitivity is a common feature of SLE. Exposure to UV light can trigger a
flare-up of the disease, so high-SPF sunscreen and protective clothing are essential.
4. A nurse is providing teaching to a client who has osteoarthritis. Which of the
following statements should the nurse include?
A. Osteoarthritis is an autoimmune inflammatory disease.
B. Morning stiffness usually lasts longer than 1 hour.
C. The disease affects joints symmetrically.
D. Joint pain typically increases with activity and decreases with rest.
Answer: D
Rationale: Osteoarthritis is a degenerative joint disease where pain occurs with use and is
relieved by rest. In contrast, RA is autoimmune, symmetrical, and involves prolonged
morning stiffness.
5. A nurse is assessing a client who has a fractured left femur and is in skeletal
traction. Which of the following findings should the nurse report to the
provider?
A. The weights are hanging freely off the floor.
B. Ecchymosis is present over the fracture site.
C. The client’s left leg is in internal rotation.
D. The pin sites have a small amount of clear drainage.
Answer: C
, Rationale: Internal or external rotation of the limb in traction suggests that the alignment
is not maintained or the traction is ineffective, which should be reported. Weights should
hang freely, and ecchymosis is expected.
6. A nurse is monitoring a client who has HIV for the presence of opportunistic
infections. Which of the following findings should the nurse report?
A. A CD4 count of 450 cells/mm3.
B. A negative tuberculin skin test.
C. A weight gain of 2 kg over the last month.
D. White, cheesy patches on the tongue and oral mucosa.
Answer: D
Rationale: White patches on the tongue indicate oral candidiasis (thrush), which is a
common opportunistic fungal infection in immunocompromised clients.
7. Which of the following foods should a client with gout be instructed to avoid?
A. Whole grain bread.
B. Skim milk.
C. Organ meats such as liver.
D. Fresh strawberries.
Answer: C
Rationale: Gout is caused by hyperuricemia. The client should avoid high-purine foods,
such as organ meats, shellfish, and alcohol, which break down into uric acid.
