Page 1 of 87
ATI ADVANCED MEDICAL-SURGICAL FINAL EXAM LATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
ATI ADVANCED MEDICAL-SURGICAL FINAL EXAM: 250 PRACTICE QUESTIONS
SECTION 1: CRITICAL CARE & EMERGENCY (Questions 1-25)
1. A nurse is caring for a client with burns covering 40% of the total body surface
area. Which assessment finding indicates that fluid resuscitation has been
adequate?
A) Urine output of 35 mL/hr
B) Heart rate of 130 beats/min
C) Decreased blood pressure
D) Increasing hematocrit level
Rationale: Urine output is the best indicator of adequate perfusion during burn
resuscitation; the goal is 30–50 mL/hr. Tachycardia (B), hypotension (C), and rising
hematocrit (D) indicate inadequate circulating volume and require intervention .
2. A client is admitted with extensive full-thickness burns covering 75% of the body.
Which method is most appropriate to accurately monitor the cardiovascular
system in this client?
A) Central venous pressure (CVP) monitoring
B) Noninvasive blood pressure cuff
C) Peripheral pulse palpation
D) Capillary refill assessment
Rationale: CVP monitoring provides accurate hemodynamic assessment in clients with
massive burns where peripheral pulses may be unreliable due to edema and tissue
, Page 2 of 87
damage. CVP reflects right ventricular preload and guides fluid resuscitation.
Noninvasive methods may be inaccurate in extensive burns .
3. A nurse is preparing a client with deep partial-thickness and full-thickness
chemical burns covering more than 25% of the body. Which intervention should the
nurse prioritize?
A) Fluid resuscitation
B) Administer IV antibiotics
C) Apply topical antimicrobials
D) Prepare for skin grafting
Rationale: Fluid resuscitation is the priority intervention for a client with significant
burns to maintain perfusion and prevent shock. Antibiotics (B), topical antimicrobials
(C), and skin grafting (D) are important but secondary to fluid management .
4. A client with a diagnosis of disseminated intravascular coagulation (DIC) is being
monitored by the nurse. Which finding is consistent with this condition?
A) Excessive thrombosis and bleeding
B) Isolated thrombocytopenia
C) Prolonged PT and normal PTT
D) Elevated fibrinogen levels
Rationale: DIC is characterized by both excessive thrombosis and bleeding due to
consumption of clotting factors and platelets. Isolated thrombocytopenia (B) is not
specific to DIC. PT and PTT are both prolonged (C). Fibrinogen levels are decreased, not
elevated (D) .
5. A client in the intensive care unit with ARDS is being considered for extubation.
Which criterion should the nurse prioritize in the decision-making process?
A) Endotracheal tube size and placement
B) Client's ability to follow commands
C) Weaning parameters and respiratory function
D) Presence of an air leak around the endotracheal tube
, Page 3 of 87
Rationale: Assessing weaning parameters and respiratory function is the primary
criterion for extubation readiness. An air leak around the tube indicates the airway is not
protected. While tube placement (A), the client's ability to follow commands (B), and
checking for an air leak around the tube (D) are important, evaluating respiratory
function is the priority .
6. A client undergoing a CT scan with IV contrast suddenly develops shortness of
breath, hypotension, and hives. What is the nurse's priority response?
A) Stop the contrast infusion and administer epinephrine
B) Continue the scan and monitor vital signs
C) Administer diphenhydramine and monitor
D) Notify the radiologist after the scan is complete
Rationale: These findings indicate an anaphylactic reaction to the contrast dye. The
nurse must stop the infusion immediately and administer epinephrine as ordered.
Continuing the scan (B) is unsafe. Diphenhydramine (C) is a secondary treatment.
Notifying after the scan (D) delays critical intervention .
7. A client with a traumatic brain injury has an intraventricular catheter placed.
Which findings indicate increased ICP? (Select all that apply)
A) Sleepiness or difficulty arousing the client
B) A Glasgow Coma Scale score of 15
C) Widening pulse pressure
D) Decerebrate posturing
E) Flat jugular veins
Rationale: Increased ICP signs include sleepiness or difficulty arousing (A), widening
pulse pressure (C), and decerebrate or decorticate posturing (D). A GCS of 15 (B)
indicates no impairment. Distended jugular veins, not flat (E), are seen with increased
ICP .
8. A client with a spinal cord injury develops autonomic dysreflexia. Which action
should the nurse take first?
A) Place the client in a sitting position
B) Administer an antihypertensive medication
, Page 4 of 87
C) Assess for bladder distention
D) Apply oxygen therapy
Rationale: Autonomic dysreflexia causes severe hypertension. Sitting the client upright
lowers blood pressure immediately by promoting venous pooling. The nurse should
then identify and remove the triggering stimulus, commonly bladder or bowel
distention .
9. A nurse is caring for a client receiving chemotherapy who has neutropenia.
Which action is most appropriate?
A) Place the client on protective precautions
B) Allow fresh flowers in the room
C) Encourage raw fruits and vegetables
D) Limit oral hygiene practices
Rationale: Neutropenic clients are at high risk for infection and require protective
precautions. Fresh flowers and raw foods may contain microorganisms. Oral hygiene
should be maintained to prevent infection .
10. The nurse is performing an escharotomy procedure. What is the purpose of this
intervention?
A) To release constricting eschar and improve circulation
B) To debride necrotic tissue from the wound bed
C) To obtain a tissue sample for biopsy
D) To apply a skin graft to the burned area
Rationale: Escharotomy is a surgical procedure performed to release constricting
eschar (dead tissue) to improve circulation. Escharotomy is performed to prevent
compartment syndrome and restore blood flow to affected extremities .
11. A client with a spinal cord injury at the T4 level is admitted to the rehabilitation
center. The client exhibits marked perspiration, flushing, and a pounding
headache. The nurse should assess for:
ATI ADVANCED MEDICAL-SURGICAL FINAL EXAM LATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
ATI ADVANCED MEDICAL-SURGICAL FINAL EXAM: 250 PRACTICE QUESTIONS
SECTION 1: CRITICAL CARE & EMERGENCY (Questions 1-25)
1. A nurse is caring for a client with burns covering 40% of the total body surface
area. Which assessment finding indicates that fluid resuscitation has been
adequate?
A) Urine output of 35 mL/hr
B) Heart rate of 130 beats/min
C) Decreased blood pressure
D) Increasing hematocrit level
Rationale: Urine output is the best indicator of adequate perfusion during burn
resuscitation; the goal is 30–50 mL/hr. Tachycardia (B), hypotension (C), and rising
hematocrit (D) indicate inadequate circulating volume and require intervention .
2. A client is admitted with extensive full-thickness burns covering 75% of the body.
Which method is most appropriate to accurately monitor the cardiovascular
system in this client?
A) Central venous pressure (CVP) monitoring
B) Noninvasive blood pressure cuff
C) Peripheral pulse palpation
D) Capillary refill assessment
Rationale: CVP monitoring provides accurate hemodynamic assessment in clients with
massive burns where peripheral pulses may be unreliable due to edema and tissue
, Page 2 of 87
damage. CVP reflects right ventricular preload and guides fluid resuscitation.
Noninvasive methods may be inaccurate in extensive burns .
3. A nurse is preparing a client with deep partial-thickness and full-thickness
chemical burns covering more than 25% of the body. Which intervention should the
nurse prioritize?
A) Fluid resuscitation
B) Administer IV antibiotics
C) Apply topical antimicrobials
D) Prepare for skin grafting
Rationale: Fluid resuscitation is the priority intervention for a client with significant
burns to maintain perfusion and prevent shock. Antibiotics (B), topical antimicrobials
(C), and skin grafting (D) are important but secondary to fluid management .
4. A client with a diagnosis of disseminated intravascular coagulation (DIC) is being
monitored by the nurse. Which finding is consistent with this condition?
A) Excessive thrombosis and bleeding
B) Isolated thrombocytopenia
C) Prolonged PT and normal PTT
D) Elevated fibrinogen levels
Rationale: DIC is characterized by both excessive thrombosis and bleeding due to
consumption of clotting factors and platelets. Isolated thrombocytopenia (B) is not
specific to DIC. PT and PTT are both prolonged (C). Fibrinogen levels are decreased, not
elevated (D) .
5. A client in the intensive care unit with ARDS is being considered for extubation.
Which criterion should the nurse prioritize in the decision-making process?
A) Endotracheal tube size and placement
B) Client's ability to follow commands
C) Weaning parameters and respiratory function
D) Presence of an air leak around the endotracheal tube
, Page 3 of 87
Rationale: Assessing weaning parameters and respiratory function is the primary
criterion for extubation readiness. An air leak around the tube indicates the airway is not
protected. While tube placement (A), the client's ability to follow commands (B), and
checking for an air leak around the tube (D) are important, evaluating respiratory
function is the priority .
6. A client undergoing a CT scan with IV contrast suddenly develops shortness of
breath, hypotension, and hives. What is the nurse's priority response?
A) Stop the contrast infusion and administer epinephrine
B) Continue the scan and monitor vital signs
C) Administer diphenhydramine and monitor
D) Notify the radiologist after the scan is complete
Rationale: These findings indicate an anaphylactic reaction to the contrast dye. The
nurse must stop the infusion immediately and administer epinephrine as ordered.
Continuing the scan (B) is unsafe. Diphenhydramine (C) is a secondary treatment.
Notifying after the scan (D) delays critical intervention .
7. A client with a traumatic brain injury has an intraventricular catheter placed.
Which findings indicate increased ICP? (Select all that apply)
A) Sleepiness or difficulty arousing the client
B) A Glasgow Coma Scale score of 15
C) Widening pulse pressure
D) Decerebrate posturing
E) Flat jugular veins
Rationale: Increased ICP signs include sleepiness or difficulty arousing (A), widening
pulse pressure (C), and decerebrate or decorticate posturing (D). A GCS of 15 (B)
indicates no impairment. Distended jugular veins, not flat (E), are seen with increased
ICP .
8. A client with a spinal cord injury develops autonomic dysreflexia. Which action
should the nurse take first?
A) Place the client in a sitting position
B) Administer an antihypertensive medication
, Page 4 of 87
C) Assess for bladder distention
D) Apply oxygen therapy
Rationale: Autonomic dysreflexia causes severe hypertension. Sitting the client upright
lowers blood pressure immediately by promoting venous pooling. The nurse should
then identify and remove the triggering stimulus, commonly bladder or bowel
distention .
9. A nurse is caring for a client receiving chemotherapy who has neutropenia.
Which action is most appropriate?
A) Place the client on protective precautions
B) Allow fresh flowers in the room
C) Encourage raw fruits and vegetables
D) Limit oral hygiene practices
Rationale: Neutropenic clients are at high risk for infection and require protective
precautions. Fresh flowers and raw foods may contain microorganisms. Oral hygiene
should be maintained to prevent infection .
10. The nurse is performing an escharotomy procedure. What is the purpose of this
intervention?
A) To release constricting eschar and improve circulation
B) To debride necrotic tissue from the wound bed
C) To obtain a tissue sample for biopsy
D) To apply a skin graft to the burned area
Rationale: Escharotomy is a surgical procedure performed to release constricting
eschar (dead tissue) to improve circulation. Escharotomy is performed to prevent
compartment syndrome and restore blood flow to affected extremities .
11. A client with a spinal cord injury at the T4 level is admitted to the rehabilitation
center. The client exhibits marked perspiration, flushing, and a pounding
headache. The nurse should assess for:
