ATI RN Medical-Surgical Proctored
Exam 2019 Correct questions and
answers
Section 1: Cardiovascular Disorders (Questions 1–25)
Question 1
A nurse is caring for a client who is receiving a blood transfusion. The client becomes restless,
dyspneic, and has crackles noted at the lung bases. Which of the following actions should the
nurse anticipate taking first?
A. Administer an antihistamine
B. Slow the infusion rate
C. Give the client a corticosteroid
D. Elevate the client's lower extremities
Correct Answer: B. Slow the infusion rate
Rationale: Dyspnea, restlessness, and crackles during a blood transfusion are manifestations
of circulatory overload. The nurse should slow or stop the infusion to improve the client's ability
to breathe, place the client in an upright position, and notify the provider. The provider might
prescribe a diuretic to alleviate the fluid overload .
Question 2
A nurse is assessing a client who has a diagnosis of rheumatoid arthritis. Which of the following
nonpharmacological interventions should the nurse suggest to the client to reduce pain?
A. Increase intake of foods containing calcium
B. Alternate application of heat and cold to the affected joints
C. Keep the affected extremities elevated
D. Limit movement of the affected joints
Correct Answer: B. Alternate application of heat and cold to the affected joints
, Rationale: The nurse should instruct the client to alternate heat and cold applications to
decrease joint inflammation and pain. Cold application can relieve joint swelling, and heat
application can decrease joint stiffness and pain .
Question 3
A nurse is caring for a client who has heart failure and respiratory arrest. Which of the following
actions should the nurse take first?
A. Administer oxygen
B. Feel for a carotid pulse
C. Begin chest compressions
D. Establish IV access
Correct Answer: B. Feel for a carotid pulse
Rationale: The first action the nurse should take when a client is in respiratory arrest is to
assess for a pulse. If the client is pulseless, the nurse should begin CPR immediately. Checking
for a carotid pulse determines whether the client requires chest compressions or rescue
breathing .
Question 4
A nurse is reviewing the laboratory findings of a client who developed chest pain 6 hours ago.
The nurse should identify which of the following findings as an indication of a myocardial
infarction?
A. Troponin I 0.2 ng/mL
B. CK-MB 4 ng/mL
C. Myoglobin 50 mcg/L
D. Troponin T 0.8 ng/mL
Correct Answer: D. Troponin T 0.8 ng/mL
Rationale: Troponin T levels greater than 0.1 ng/mL are indicative of myocardial damage.
Troponin I levels greater than 0.5 ng/mL are also indicative of MI. The other values listed are
within normal limits .
Question 5
,A nurse is preparing to administer thrombolytic therapy to a client who had an ischemic stroke.
Which of the following is an appropriate nursing action?
A. Start the therapy within 8 hours of symptom onset
B. Insert an indwelling urinary catheter after therapy begins
C. Monitor blood pressure every 30 minutes during the infusion
D. Elevate the head of the bed between 25 and 30 degrees
Correct Answer: C. Monitor blood pressure every 30 minutes during the infusion
Rationale: The nurse should monitor the client's blood pressure every 30 minutes during
thrombolytic therapy to detect hypotension or hypertension, which can indicate complications.
Thrombolytic therapy should be started within 3 to 4.5 hours of symptom onset. Invasive
procedures should be avoided during therapy .
Question 6
A nurse is caring for a client who has a new prescription for sublingual nitroglycerin. Which of
the following client statements indicates an understanding of the teaching?
A. "I can keep my medications for 1 year before replacing them."
B. "I should lie down when I take this medication."
C. "I should discontinue this medication if I develop a headache."
D. "I can take up to five tablets in 15 minutes before seeking medical attention."
Correct Answer: B. "I should lie down when I take this medication."
Rationale: The client should lie down or sit when taking sublingual nitroglycerin due to the
risk of hypotension and syncope. Sublingual nitroglycerin should be replaced every 3 to 6
months. Headache is a common adverse effect that can be treated with acetaminophen. The
client should take one tablet every 5 minutes for up to three doses .
Question 7
A nurse is planning care for a client following a cardiac catheterization. Which of the following
actions should the nurse take?
A. Keep the client on bed rest for 24 hours
B. Limit the client's fluid intake to 1 liter per day
, C. Maintain the client's affected extremity in extension
D. Change the client's dressing every 8 hours
Correct Answer: C. Maintain the client's affected extremity in extension
Rationale: After a cardiac catheterization, the affected extremity should be maintained in
extension to prevent bleeding at the insertion site. The client should remain on bed rest for 2 to
6 hours. Fluid intake should be encouraged to promote excretion of the contrast dye .
Question 8
A nurse is reviewing the medication administration record of a client who has osteoarthritis.
Which of the following analgesic prescriptions should the nurse expect to administer when the
client reports pain?
A. Methotrexate
B. Acetaminophen
C. Gabapentin
D. Etanercept
Correct Answer: B. Acetaminophen
Rationale: Acetaminophen is the recommended initial analgesic for clients who have
osteoarthritis. Methotrexate, gabapentin, and etanercept are used for other conditions such as
rheumatoid arthritis and neuropathic pain .
Question 9
A nurse is reviewing the medical record of a client who is to undergo open heart surgery. Which
of the following findings should the nurse report to the provider as a contraindication to
receiving heparin?
A. Thalassemia
B. Rheumatoid arthritis
C. COPD
D. Thrombocytopenia
Correct Answer: D. Thrombocytopenia
Exam 2019 Correct questions and
answers
Section 1: Cardiovascular Disorders (Questions 1–25)
Question 1
A nurse is caring for a client who is receiving a blood transfusion. The client becomes restless,
dyspneic, and has crackles noted at the lung bases. Which of the following actions should the
nurse anticipate taking first?
A. Administer an antihistamine
B. Slow the infusion rate
C. Give the client a corticosteroid
D. Elevate the client's lower extremities
Correct Answer: B. Slow the infusion rate
Rationale: Dyspnea, restlessness, and crackles during a blood transfusion are manifestations
of circulatory overload. The nurse should slow or stop the infusion to improve the client's ability
to breathe, place the client in an upright position, and notify the provider. The provider might
prescribe a diuretic to alleviate the fluid overload .
Question 2
A nurse is assessing a client who has a diagnosis of rheumatoid arthritis. Which of the following
nonpharmacological interventions should the nurse suggest to the client to reduce pain?
A. Increase intake of foods containing calcium
B. Alternate application of heat and cold to the affected joints
C. Keep the affected extremities elevated
D. Limit movement of the affected joints
Correct Answer: B. Alternate application of heat and cold to the affected joints
, Rationale: The nurse should instruct the client to alternate heat and cold applications to
decrease joint inflammation and pain. Cold application can relieve joint swelling, and heat
application can decrease joint stiffness and pain .
Question 3
A nurse is caring for a client who has heart failure and respiratory arrest. Which of the following
actions should the nurse take first?
A. Administer oxygen
B. Feel for a carotid pulse
C. Begin chest compressions
D. Establish IV access
Correct Answer: B. Feel for a carotid pulse
Rationale: The first action the nurse should take when a client is in respiratory arrest is to
assess for a pulse. If the client is pulseless, the nurse should begin CPR immediately. Checking
for a carotid pulse determines whether the client requires chest compressions or rescue
breathing .
Question 4
A nurse is reviewing the laboratory findings of a client who developed chest pain 6 hours ago.
The nurse should identify which of the following findings as an indication of a myocardial
infarction?
A. Troponin I 0.2 ng/mL
B. CK-MB 4 ng/mL
C. Myoglobin 50 mcg/L
D. Troponin T 0.8 ng/mL
Correct Answer: D. Troponin T 0.8 ng/mL
Rationale: Troponin T levels greater than 0.1 ng/mL are indicative of myocardial damage.
Troponin I levels greater than 0.5 ng/mL are also indicative of MI. The other values listed are
within normal limits .
Question 5
,A nurse is preparing to administer thrombolytic therapy to a client who had an ischemic stroke.
Which of the following is an appropriate nursing action?
A. Start the therapy within 8 hours of symptom onset
B. Insert an indwelling urinary catheter after therapy begins
C. Monitor blood pressure every 30 minutes during the infusion
D. Elevate the head of the bed between 25 and 30 degrees
Correct Answer: C. Monitor blood pressure every 30 minutes during the infusion
Rationale: The nurse should monitor the client's blood pressure every 30 minutes during
thrombolytic therapy to detect hypotension or hypertension, which can indicate complications.
Thrombolytic therapy should be started within 3 to 4.5 hours of symptom onset. Invasive
procedures should be avoided during therapy .
Question 6
A nurse is caring for a client who has a new prescription for sublingual nitroglycerin. Which of
the following client statements indicates an understanding of the teaching?
A. "I can keep my medications for 1 year before replacing them."
B. "I should lie down when I take this medication."
C. "I should discontinue this medication if I develop a headache."
D. "I can take up to five tablets in 15 minutes before seeking medical attention."
Correct Answer: B. "I should lie down when I take this medication."
Rationale: The client should lie down or sit when taking sublingual nitroglycerin due to the
risk of hypotension and syncope. Sublingual nitroglycerin should be replaced every 3 to 6
months. Headache is a common adverse effect that can be treated with acetaminophen. The
client should take one tablet every 5 minutes for up to three doses .
Question 7
A nurse is planning care for a client following a cardiac catheterization. Which of the following
actions should the nurse take?
A. Keep the client on bed rest for 24 hours
B. Limit the client's fluid intake to 1 liter per day
, C. Maintain the client's affected extremity in extension
D. Change the client's dressing every 8 hours
Correct Answer: C. Maintain the client's affected extremity in extension
Rationale: After a cardiac catheterization, the affected extremity should be maintained in
extension to prevent bleeding at the insertion site. The client should remain on bed rest for 2 to
6 hours. Fluid intake should be encouraged to promote excretion of the contrast dye .
Question 8
A nurse is reviewing the medication administration record of a client who has osteoarthritis.
Which of the following analgesic prescriptions should the nurse expect to administer when the
client reports pain?
A. Methotrexate
B. Acetaminophen
C. Gabapentin
D. Etanercept
Correct Answer: B. Acetaminophen
Rationale: Acetaminophen is the recommended initial analgesic for clients who have
osteoarthritis. Methotrexate, gabapentin, and etanercept are used for other conditions such as
rheumatoid arthritis and neuropathic pain .
Question 9
A nurse is reviewing the medical record of a client who is to undergo open heart surgery. Which
of the following findings should the nurse report to the provider as a contraindication to
receiving heparin?
A. Thalassemia
B. Rheumatoid arthritis
C. COPD
D. Thrombocytopenia
Correct Answer: D. Thrombocytopenia
