ATI ADULT MED SURG 100 QUESTION FINAL PREP MASTER
EXAM GUIDE WITH RATIONALES A+ GRADED
1. A nurse is reinforcing teaching with a client who has a new prescription for
transdermal nitroglycerin patches to treat angina pectoris. Which of the following
instructions should the nurse include?
A. Apply a new patch to the same skin site every day.
B. Leave the patch in place for 24 hours before replacing it.
C. Remove the patch for 10 to 12 hours each day.
D. Place the patch on the distal part of an extremity.
CORRECT ANSWER: C
RATiONAlE: To prevent the development of nitrate tolerance, the client should
have a nitrate-free period of 10 to 12 hours every 24 hours. The patch should be applied to a
clean, hairless, intact area of skin on the torso or upper arms, and sites should be rotated
daily to prevent skin irritation.
2. A nurse is caring for a client who is 24 hours postoperative following an abdominal
cholecystectomy. The client reports severe pain in the right shoulder. Which of the
following actions should the nurse take?
A. Assist the client into a prone position.
B. Apply a cold compress to the shoulder area.
C. Administer the prescribed PRN opioid analgesic.
D. Encourage the client to ambulate in the hallway.
CORRECT ANSWER: D
RATiONAlE: Shoulder pain following laparoscopic or abdominal surgery is often
caused by carbon dioxide gas or diaphragmatic irritation trapped in the abdominal cavity.
Ambulation stimulates peristalsis and helps facilitate the absorption and passage of the
trapped gas, providing more effective relief than opioid analgesics alone.
3. A nurse is collecting data from a client who has advanced cirrhosis. Which of the
following findings should the nurse recognize as an indication of hepatic
encephalopathy?
A. Asterixis
B. Splenomegaly
, C. Palmar erythema
D. Spider angiomas
CORRECT ANSWER: A
RATiONAlE: Asterixis, also known as a flapping tremor of the hands, is a classic
clinical manifestation of hepatic encephalopathy caused by elevated blood ammonia
levels. Splenomegaly, palmar erythema, and spider angiomas are manifestations of portal
hypertension and structural changes in liver disease but do not directly reflect neurological
encephalopathy.
4. A nurse is monitoring a client who has a prescription for furosemide 40 mg IV bolus.
Which of the following laboratory values should the nurse check prior to
administering the medication?
A. Serum sodium 140 mEq/L
B. Serum potassium 3.2 mEq/L
C. Serum creatinine 0.9 mg/dL
D. Blood urea nitrogen (BUN) 15 mg/dL
CORRECT ANSWER: B
RATiONAlE: Furosemide is a loop diuretic that promotes the excretion of water,
sodium, and potassium. Administering furosemide to a client who is already hypokalemic
(potassium less than 3.5 mEq/L) can cause severe, life-threatening cardiac dysrhythmias.
The other laboratory values fall within expected reference ranges.
5. A nurse is reinforcing discharge teaching with a client who has a new diagnosis of
type 1 diabetes mellitus. Which of the following instructions should the nurse
include regarding alcohol consumption?
A. Consume alcohol only on an empty stomach.
B. Drink alcohol with food to prevent hypoglycemia.
C. Expect blood glucose levels to rise sharply hours after drinking.
D. Replace daily carbohydrate choices with alcoholic beverages.
CORRECT ANSWER: B
RATiONAlE: Alcohol inhibits glucose production by the liver (gluconeogenesis),
increasing the risk of delayed severe hypoglycemia. To minimize this risk, clients with type 1
,diabetes should consume alcohol only with or immediately after eating carbohydrates.
Alcohol should never be consumed on an empty stomach or used to replace food choices.
6. A nurse is reinforcing teaching about infection control measures with a client who
has human immunodeficiency virus (HIV) and a low CD4+ T-cell count. Which of the
following home care instructions should the nurse reinforce?
A. Wash dishes used by the client in warm water without soap.
B. Clean the cat's litter box daily using disposable gloves.
C. Avoid consuming raw or undercooked meats and seafood.
D. Store left-over beverages at room temperature for up to 4 hours.
CORRECT ANSWER: C
RATiONAlE: Clients who are immunocompromised are at high risk for
opportunistic infections and foodborne illnesses. They should strictly avoid raw or
undercooked meats, seafood, and eggs. Immunocompromised individuals should avoid
cleaning animal litter boxes entirely due to the risk of toxoplasmosis. Leftover beverages
should not sit out at room temperature.
7. A nurse is reviewing the arterial blood gas (ABG) results of a client who has chronic
obstructive pulmonary disease (COPD): pH 7.31, PaCO2 52 mm Hg, HCO3- 25
mEq/L, PaO2 75 mm Hg. The nurse should interpret these findings as which of the
following acid-base imbalances?
A. Uncompensated metabolic acidosis
B. Compensated respiratory acidosis
C. Uncompensated respiratory acidosis
D. Compensated metabolic alkalosis
CORRECT ANSWER: C
RATiONAlE: A pH below 7.35 indicates acidosis. The PaCO2 is elevated above the
normal range of 35 to 45 mm Hg, indicating a respiratory origin. The HCO3- is within the
normal range of 22 to 26 mEq/L, which demonstrates that the kidneys have not yet
compensated for the respiratory imbalance, making it uncompensated.
8. A nurse is reinforcing care instructions for a client who has an active deep vein
thrombosis (DVT) in the right calf. Which of the following interventions should the
nurse include in the plan of care?
A. Massage the affected calf twice daily to stimulate circulation.
, B. Elevate the right leg above the level of the heart when resting.
C. Apply ice packs to the right calf for 20 minutes every 4 hours.
D. Maintain the client on strict bed rest without leg movement.
CORRECT ANSWER: B
RATiONAlE: Elevating the affected extremity above the heart promotes venous
return and reduces localized edema. Massaging the leg is strictly contraindicated because
it can dislodge the thrombus, causing a pulmonary embolism. Warm, moist heat is
preferred over cold compresses to relieve discomfort, and early ambulation is generally
encouraged once therapeutic anticoagulation is established.
9. A nurse is reinforcing teaching with a client who has chronic renal failure and a new
prescription for epoetin alfa. Which of the following therapeutic outcomes should
the nurse tell the client to expect?
A. Increased white blood cell count
B. Decreased serum potassium levels
C. Increased hematocrit and hemoglobin
D. Decreased blood urea nitrogen (BUN)
CORRECT ANSWER: C
RATiONAlE: Epoetin alfa is a synthetic form of erythropoietin that stimulates the
bone marrow to produce red blood cells. It is used to treat anemia associated with chronic
renal failure. The therapeutic effect is measured by an increase in hemoglobin and
hematocrit levels.
10. A nurse is checking a client's surgical incision 48 hours postoperative following an
open cholecystectomy. Which of the following findings should the nurse report to
the charge nurse immediately?
A. Serosanguineous drainage on the dressing
B. Purulent drainage accompanied by localized warmth
C. Moderate tenderness immediately surrounding the incision
D. Incisional edges that are well-approximated with staples
CORRECT ANSWER: B
RATiONAlE: Purulent drainage and localized warmth are classic manifestations of
EXAM GUIDE WITH RATIONALES A+ GRADED
1. A nurse is reinforcing teaching with a client who has a new prescription for
transdermal nitroglycerin patches to treat angina pectoris. Which of the following
instructions should the nurse include?
A. Apply a new patch to the same skin site every day.
B. Leave the patch in place for 24 hours before replacing it.
C. Remove the patch for 10 to 12 hours each day.
D. Place the patch on the distal part of an extremity.
CORRECT ANSWER: C
RATiONAlE: To prevent the development of nitrate tolerance, the client should
have a nitrate-free period of 10 to 12 hours every 24 hours. The patch should be applied to a
clean, hairless, intact area of skin on the torso or upper arms, and sites should be rotated
daily to prevent skin irritation.
2. A nurse is caring for a client who is 24 hours postoperative following an abdominal
cholecystectomy. The client reports severe pain in the right shoulder. Which of the
following actions should the nurse take?
A. Assist the client into a prone position.
B. Apply a cold compress to the shoulder area.
C. Administer the prescribed PRN opioid analgesic.
D. Encourage the client to ambulate in the hallway.
CORRECT ANSWER: D
RATiONAlE: Shoulder pain following laparoscopic or abdominal surgery is often
caused by carbon dioxide gas or diaphragmatic irritation trapped in the abdominal cavity.
Ambulation stimulates peristalsis and helps facilitate the absorption and passage of the
trapped gas, providing more effective relief than opioid analgesics alone.
3. A nurse is collecting data from a client who has advanced cirrhosis. Which of the
following findings should the nurse recognize as an indication of hepatic
encephalopathy?
A. Asterixis
B. Splenomegaly
, C. Palmar erythema
D. Spider angiomas
CORRECT ANSWER: A
RATiONAlE: Asterixis, also known as a flapping tremor of the hands, is a classic
clinical manifestation of hepatic encephalopathy caused by elevated blood ammonia
levels. Splenomegaly, palmar erythema, and spider angiomas are manifestations of portal
hypertension and structural changes in liver disease but do not directly reflect neurological
encephalopathy.
4. A nurse is monitoring a client who has a prescription for furosemide 40 mg IV bolus.
Which of the following laboratory values should the nurse check prior to
administering the medication?
A. Serum sodium 140 mEq/L
B. Serum potassium 3.2 mEq/L
C. Serum creatinine 0.9 mg/dL
D. Blood urea nitrogen (BUN) 15 mg/dL
CORRECT ANSWER: B
RATiONAlE: Furosemide is a loop diuretic that promotes the excretion of water,
sodium, and potassium. Administering furosemide to a client who is already hypokalemic
(potassium less than 3.5 mEq/L) can cause severe, life-threatening cardiac dysrhythmias.
The other laboratory values fall within expected reference ranges.
5. A nurse is reinforcing discharge teaching with a client who has a new diagnosis of
type 1 diabetes mellitus. Which of the following instructions should the nurse
include regarding alcohol consumption?
A. Consume alcohol only on an empty stomach.
B. Drink alcohol with food to prevent hypoglycemia.
C. Expect blood glucose levels to rise sharply hours after drinking.
D. Replace daily carbohydrate choices with alcoholic beverages.
CORRECT ANSWER: B
RATiONAlE: Alcohol inhibits glucose production by the liver (gluconeogenesis),
increasing the risk of delayed severe hypoglycemia. To minimize this risk, clients with type 1
,diabetes should consume alcohol only with or immediately after eating carbohydrates.
Alcohol should never be consumed on an empty stomach or used to replace food choices.
6. A nurse is reinforcing teaching about infection control measures with a client who
has human immunodeficiency virus (HIV) and a low CD4+ T-cell count. Which of the
following home care instructions should the nurse reinforce?
A. Wash dishes used by the client in warm water without soap.
B. Clean the cat's litter box daily using disposable gloves.
C. Avoid consuming raw or undercooked meats and seafood.
D. Store left-over beverages at room temperature for up to 4 hours.
CORRECT ANSWER: C
RATiONAlE: Clients who are immunocompromised are at high risk for
opportunistic infections and foodborne illnesses. They should strictly avoid raw or
undercooked meats, seafood, and eggs. Immunocompromised individuals should avoid
cleaning animal litter boxes entirely due to the risk of toxoplasmosis. Leftover beverages
should not sit out at room temperature.
7. A nurse is reviewing the arterial blood gas (ABG) results of a client who has chronic
obstructive pulmonary disease (COPD): pH 7.31, PaCO2 52 mm Hg, HCO3- 25
mEq/L, PaO2 75 mm Hg. The nurse should interpret these findings as which of the
following acid-base imbalances?
A. Uncompensated metabolic acidosis
B. Compensated respiratory acidosis
C. Uncompensated respiratory acidosis
D. Compensated metabolic alkalosis
CORRECT ANSWER: C
RATiONAlE: A pH below 7.35 indicates acidosis. The PaCO2 is elevated above the
normal range of 35 to 45 mm Hg, indicating a respiratory origin. The HCO3- is within the
normal range of 22 to 26 mEq/L, which demonstrates that the kidneys have not yet
compensated for the respiratory imbalance, making it uncompensated.
8. A nurse is reinforcing care instructions for a client who has an active deep vein
thrombosis (DVT) in the right calf. Which of the following interventions should the
nurse include in the plan of care?
A. Massage the affected calf twice daily to stimulate circulation.
, B. Elevate the right leg above the level of the heart when resting.
C. Apply ice packs to the right calf for 20 minutes every 4 hours.
D. Maintain the client on strict bed rest without leg movement.
CORRECT ANSWER: B
RATiONAlE: Elevating the affected extremity above the heart promotes venous
return and reduces localized edema. Massaging the leg is strictly contraindicated because
it can dislodge the thrombus, causing a pulmonary embolism. Warm, moist heat is
preferred over cold compresses to relieve discomfort, and early ambulation is generally
encouraged once therapeutic anticoagulation is established.
9. A nurse is reinforcing teaching with a client who has chronic renal failure and a new
prescription for epoetin alfa. Which of the following therapeutic outcomes should
the nurse tell the client to expect?
A. Increased white blood cell count
B. Decreased serum potassium levels
C. Increased hematocrit and hemoglobin
D. Decreased blood urea nitrogen (BUN)
CORRECT ANSWER: C
RATiONAlE: Epoetin alfa is a synthetic form of erythropoietin that stimulates the
bone marrow to produce red blood cells. It is used to treat anemia associated with chronic
renal failure. The therapeutic effect is measured by an increase in hemoglobin and
hematocrit levels.
10. A nurse is checking a client's surgical incision 48 hours postoperative following an
open cholecystectomy. Which of the following findings should the nurse report to
the charge nurse immediately?
A. Serosanguineous drainage on the dressing
B. Purulent drainage accompanied by localized warmth
C. Moderate tenderness immediately surrounding the incision
D. Incisional edges that are well-approximated with staples
CORRECT ANSWER: B
RATiONAlE: Purulent drainage and localized warmth are classic manifestations of
