ATI RN ADULT MEDICAL SURGICAL 2023
ACTUAL and RETAKE EXAM PREP 150
CORE QUESTIONS WITH DETAILED
CORRECT ANSWERS and RATIONALES
CORRECT VERIFIED ANSWERS GRADE
A+ STUDY GUIDE | 100% PASS
GUARANTEE | INSTANT DOWNLOAD
ATI RN Adult Medical Surgical 2023 Mock Exam
(Questions 1–150)
Section I: Fluid, Electrolyte, and Acid-Base Imbalances
1. A nurse is caring for a client who has a serum potassium
level of 6.2 mED/L. Which of the following prescription
interventions should the nurse anticipate executing first to
protect the client's cardiac conduction system?
A. Administer oral sodium polystyrene sulfonate.
B. Administer intravenous 10% calcium gluconate.
C. Initiate a continuous intravenous infusion of regular
insulin with dextrose.
D. Obtain a 24-hour urine collection for creatinine
clearance.
Correct Answer: B. Rationale: Intravenous
calcium gluconate does not lower potassium levels but
immediately stabilizes the myocardial cell membrane to
prevent lethal dysrhythmias caused by severe
hyperkalemia. [1]
2. A nurse is reviewing the arterial blood gas (ABG) results of
a client who has a history of severe chronic obstructive
pulmonary disease (COPD). The results indicate: pH 7.31,
PaCO2 52 mm Hg, and HCO3 28 mEq/L. Which of the
, following acid-base imbalances is this client experiencing?
A. Uncompensated metabolic acidosis.
B. Partially compensated respiratory acidosis.
C. Fully compensated metabolic alkalosis.
D. Uncompensated respiratory alkalosis.
Correct Answer: B. Rationale: A pH below 7.35
indicates acidosis. The elevated PaCO2 confirms a
respiratory origin, while the elevated HCO3 shows the
kidneys have begun retaining bicarbonate to compensate,
making it partially compensated. [1, 2]
3. A nurse is assessing a client who has severe hypocalcemia
secondary to hypoparathyroidism. Which of the following
clinical findings should the nurse expect to observe?
A. Hypoactive deep tendon reflexes and severe
constipation.
B. Flaccid paralysis and a shortened QT interval on an
electrocardiogram.
C. Positive Chvostek's sign consisting of facial
muscle twitching when tapped.
D. Polyuria and bounding peripheral pulses.
Correct Answer: C. Rationale: Hypocalcemia
increases neuromuscular irritability. A positive
Chvostek's sign (facial twitching) and Trousseau's sign
(carpal spasm) are classic indicators of low serum
calcium levels. [1]
4. A nurse is planning care for a client who is receiving a
continuous intravenous infusion of 3% sodium chloride for
severe hyponatremia. Which of the following assessments
is the highest priority for the nurse to monitor?
B. Neurological status and signs of central pontine
myelinolysis.
C. Hourly urinary output via an indwelling catheter.
D. Skin turgor over the sternum and mucous membrane
moisture.
, Correct Answer: B. Rationale: Hypertonic
solutions (3% NaCl) pull fluid into the vascular space.
Rapid shifts or correction can cause devastating
neurological complications; the nurse must monitor for
altered consciousness, seizures, and hypernatremia. [1]
5. A nurse is evaluating a client who has metabolic alkalosis
secondary to persistent nasogastric tube suctioning. Which
of the following laboratory changes should the nurse
monitor closely as a consequence of this imbalance?
A. Serum sodium level of 142 mEq/L.
B. Serum potassium level of 3.2 mEq/L.
C. Serum calcium level of 10.5 mg/dL.
D. Blood urea nitrogen (BUN) level of 15 mg/dL.
Correct Answer: B. Rationale: In metabolic
alkalosis, hydrogen ions move out of the cells into the
extracellular fluid to correct pH, forcing potassium ions
to shift into the cells, resulting in hypokalemia.
Section II: Gastrointestinal and Nutritional Care
6. A nurse is providing discharge teaching to a client who is
recovering from a total gastrectomy secondary to gastric
cancer. Which of the following nutritional supplements
should the nurse emphasize will be required for the rest of
the client's life?
A. Oral iron sulfate capsules.
B. Folic acid tablets.
C. Intramuscular vitamin B12 injections.
D. Calcium carbonate chewable tablets.
Correct Answer: C. Rationale: A total
gastrectomy removes the parietal cells responsible for
secreting intrinsic factor. Without intrinsic factor, the
body cannot absorb vitamin B12 in the ileum, requiring
lifelong injections to prevent pernicious anemia. [1]
, 7. A nurse is assessing a client who is 4 hours postoperative
following a laparoscopic cholecystectomy. The client
reports severe pain radiating to the right shoulder. Which
of the following actions should the nurse take?
A. Assist the client into a left lateral Sims' position
or encourage early ambulation.
B. Irrigate the surgical drain with 30 mL of sterile normal
saline.
C. Apply a tight abdominal binder over the laparoscopic
port sites.
D. Place the client in a Trendelenburg position to improve
venous return.
Correct Answer: A. Rationale: Right shoulder
pain after a laparoscopic procedure is caused by carbon
dioxide gas irritating the phrenic nerve. Ambulation and
a left lateral position help move the gas pocket away
from the diaphragm.
8. A nurse is managing a client who is receiving continuous
total parenteral nutrition (TPN) through a central venous
access device. The current bag of TPN is empty, and the
next bag from the pharmacy has been delayed by 1 hour.
Which of the following solutions should the nurse infuse
until the next TPN bag arrives?
A. 0.9% sodium chloride infusion.
B. 10% dextrose in water infusion.
C. Lactated Ringer's solution.
D. 5% dextrose in 0.45% sodium chloride.
Correct Answer: B. Rationale: TPN contains high
concentrations of glucose. Abruptly stopping it can cause
severe rebound hypoglycemia; infusing 10% dextrose in
water (D10W) maintains blood glucose levels until the
new TPN bag is hung. [1, 2, 3, 4]
9. A nurse is caring for a client who has advanced cirrhosis
and is exhibiting asterixis, confusion, and a serum
ACTUAL and RETAKE EXAM PREP 150
CORE QUESTIONS WITH DETAILED
CORRECT ANSWERS and RATIONALES
CORRECT VERIFIED ANSWERS GRADE
A+ STUDY GUIDE | 100% PASS
GUARANTEE | INSTANT DOWNLOAD
ATI RN Adult Medical Surgical 2023 Mock Exam
(Questions 1–150)
Section I: Fluid, Electrolyte, and Acid-Base Imbalances
1. A nurse is caring for a client who has a serum potassium
level of 6.2 mED/L. Which of the following prescription
interventions should the nurse anticipate executing first to
protect the client's cardiac conduction system?
A. Administer oral sodium polystyrene sulfonate.
B. Administer intravenous 10% calcium gluconate.
C. Initiate a continuous intravenous infusion of regular
insulin with dextrose.
D. Obtain a 24-hour urine collection for creatinine
clearance.
Correct Answer: B. Rationale: Intravenous
calcium gluconate does not lower potassium levels but
immediately stabilizes the myocardial cell membrane to
prevent lethal dysrhythmias caused by severe
hyperkalemia. [1]
2. A nurse is reviewing the arterial blood gas (ABG) results of
a client who has a history of severe chronic obstructive
pulmonary disease (COPD). The results indicate: pH 7.31,
PaCO2 52 mm Hg, and HCO3 28 mEq/L. Which of the
, following acid-base imbalances is this client experiencing?
A. Uncompensated metabolic acidosis.
B. Partially compensated respiratory acidosis.
C. Fully compensated metabolic alkalosis.
D. Uncompensated respiratory alkalosis.
Correct Answer: B. Rationale: A pH below 7.35
indicates acidosis. The elevated PaCO2 confirms a
respiratory origin, while the elevated HCO3 shows the
kidneys have begun retaining bicarbonate to compensate,
making it partially compensated. [1, 2]
3. A nurse is assessing a client who has severe hypocalcemia
secondary to hypoparathyroidism. Which of the following
clinical findings should the nurse expect to observe?
A. Hypoactive deep tendon reflexes and severe
constipation.
B. Flaccid paralysis and a shortened QT interval on an
electrocardiogram.
C. Positive Chvostek's sign consisting of facial
muscle twitching when tapped.
D. Polyuria and bounding peripheral pulses.
Correct Answer: C. Rationale: Hypocalcemia
increases neuromuscular irritability. A positive
Chvostek's sign (facial twitching) and Trousseau's sign
(carpal spasm) are classic indicators of low serum
calcium levels. [1]
4. A nurse is planning care for a client who is receiving a
continuous intravenous infusion of 3% sodium chloride for
severe hyponatremia. Which of the following assessments
is the highest priority for the nurse to monitor?
B. Neurological status and signs of central pontine
myelinolysis.
C. Hourly urinary output via an indwelling catheter.
D. Skin turgor over the sternum and mucous membrane
moisture.
, Correct Answer: B. Rationale: Hypertonic
solutions (3% NaCl) pull fluid into the vascular space.
Rapid shifts or correction can cause devastating
neurological complications; the nurse must monitor for
altered consciousness, seizures, and hypernatremia. [1]
5. A nurse is evaluating a client who has metabolic alkalosis
secondary to persistent nasogastric tube suctioning. Which
of the following laboratory changes should the nurse
monitor closely as a consequence of this imbalance?
A. Serum sodium level of 142 mEq/L.
B. Serum potassium level of 3.2 mEq/L.
C. Serum calcium level of 10.5 mg/dL.
D. Blood urea nitrogen (BUN) level of 15 mg/dL.
Correct Answer: B. Rationale: In metabolic
alkalosis, hydrogen ions move out of the cells into the
extracellular fluid to correct pH, forcing potassium ions
to shift into the cells, resulting in hypokalemia.
Section II: Gastrointestinal and Nutritional Care
6. A nurse is providing discharge teaching to a client who is
recovering from a total gastrectomy secondary to gastric
cancer. Which of the following nutritional supplements
should the nurse emphasize will be required for the rest of
the client's life?
A. Oral iron sulfate capsules.
B. Folic acid tablets.
C. Intramuscular vitamin B12 injections.
D. Calcium carbonate chewable tablets.
Correct Answer: C. Rationale: A total
gastrectomy removes the parietal cells responsible for
secreting intrinsic factor. Without intrinsic factor, the
body cannot absorb vitamin B12 in the ileum, requiring
lifelong injections to prevent pernicious anemia. [1]
, 7. A nurse is assessing a client who is 4 hours postoperative
following a laparoscopic cholecystectomy. The client
reports severe pain radiating to the right shoulder. Which
of the following actions should the nurse take?
A. Assist the client into a left lateral Sims' position
or encourage early ambulation.
B. Irrigate the surgical drain with 30 mL of sterile normal
saline.
C. Apply a tight abdominal binder over the laparoscopic
port sites.
D. Place the client in a Trendelenburg position to improve
venous return.
Correct Answer: A. Rationale: Right shoulder
pain after a laparoscopic procedure is caused by carbon
dioxide gas irritating the phrenic nerve. Ambulation and
a left lateral position help move the gas pocket away
from the diaphragm.
8. A nurse is managing a client who is receiving continuous
total parenteral nutrition (TPN) through a central venous
access device. The current bag of TPN is empty, and the
next bag from the pharmacy has been delayed by 1 hour.
Which of the following solutions should the nurse infuse
until the next TPN bag arrives?
A. 0.9% sodium chloride infusion.
B. 10% dextrose in water infusion.
C. Lactated Ringer's solution.
D. 5% dextrose in 0.45% sodium chloride.
Correct Answer: B. Rationale: TPN contains high
concentrations of glucose. Abruptly stopping it can cause
severe rebound hypoglycemia; infusing 10% dextrose in
water (D10W) maintains blood glucose levels until the
new TPN bag is hung. [1, 2, 3, 4]
9. A nurse is caring for a client who has advanced cirrhosis
and is exhibiting asterixis, confusion, and a serum
