ATI Medical-Surgical 2026/2027 Study Guide |
ACTUAL-Style ATI Medical-Surgical Nursing
Practice Questions & Answers, RN Medical-Surgical
Exam Prep, Verified Answers, Detailed Rationales,
Adult Medical-Surgical Nursing, Cardiovascular,
Respiratory, Neurologic, Gastrointestinal, Renal,
Endocrine, Musculoskeletal, Hematologic,
Oncology, Infection Control, Perioperative Nursing,
Emergency Care, Prioritization, Delegation &
Comprehensive Nursing Review
Question 1: A nurse is assessing a client who has been admitted
with acute exacerbation of heart failure. Which of the following
findings should the nurse expect?
A. Dry, hacking cough
B. Bibasilar crackles
C. Bradycardia
D. Hypertension
CORRECT ANSWER: B. Bibasilar crackles
Rationale: In acute heart failure, fluid backs up into the pulmonary
circulation, leading to pulmonary congestion. Bibasilar crackles are a classic
auscultatory finding due to fluid accumulation in the alveoli. A dry cough
and bradycardia are not typical; tachycardia is more common.
Hypertension can occur but is not a direct expected finding of fluid
overload.
Question 2: A nurse is caring for a client who is receiving heparin
therapy. Which of the following laboratory values should the nurse
monitor to evaluate the effectiveness of the therapy?
A. Prothrombin time (PT)
B. International normalized ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Bleeding time
CORRECT ANSWER: C. Activated partial thromboplastin time
(aPTT)
Rationale: Heparin therapy is monitored using the aPTT, which measures
the intrinsic pathway of coagulation. The therapeutic range is typically 1.5
,to 2.5 times the control value. PT and INR are used to monitor warfarin
therapy. Bleeding time is not used for heparin monitoring.
Question 3: A nurse is teaching a client who has a new prescription
for metformin. Which of the following instructions should the
nurse include?
A. "Take this medication with meals to reduce gastrointestinal upset."
B. "You should expect to gain weight while taking this medication."
C. "Stop taking the medication if you experience a metallic taste."
D. "This medication can cause hypoglycemia, so carry glucose tablets."
CORRECT ANSWER: A. "Take this medication with meals to reduce
gastrointestinal upset."
Rationale: Metformin is an oral antidiabetic agent that commonly causes
gastrointestinal side effects such as nausea, diarrhea, and abdominal
discomfort. Taking it with meals helps minimize these effects. Weight loss,
not gain, is often associated with metformin. A metallic taste may occur but
does not require stopping the medication. Metformin alone rarely causes
hypoglycemia.
Question 4: A nurse is assessing a client who has been diagnosed
with a peptic ulcer. Which of the following findings is the priority
for the nurse to report?
A. Nausea after eating
B. Dull, gnawing pain in the epigastric area
C. Board-like abdominal rigidity
D. Belching and bloating
CORRECT ANSWER: C. Board-like abdominal rigidity
Rationale: Board-like abdominal rigidity is a sign of peritonitis, which can
occur if a peptic ulcer perforates. This is a medical emergency requiring
immediate intervention. Nausea, dull pain, and belching are common
symptoms of peptic ulcer disease but are not immediately life-threatening.
Question 5: A nurse is caring for a client who is postoperative
following a total hip arthroplasty. Which of the following positions
should the nurse avoid for this client?
A. Supine with a pillow between the legs
B. Side-lying with a pillow between the legs
,C. Flexing the hip greater than 90 degrees
D. Using an abduction pillow
CORRECT ANSWER: C. Flexing the hip greater than 90 degrees
Rationale: After total hip arthroplasty, hip flexion greater than 90 degrees
can cause dislocation of the prosthesis. The nurse should instruct the client
to avoid bending the hip excessively, crossing the legs, and turning the toes
inward. Abduction pillows and pillows between the legs help maintain
proper alignment.
Question 6: A nurse is reviewing the laboratory results of a client
who has chronic kidney disease. Which of the following findings
should the nurse expect?
A. Increased glomerular filtration rate (GFR)
B. Decreased serum creatinine
C. Increased blood urea nitrogen (BUN)
D. Increased serum calcium
CORRECT ANSWER: C. Increased blood urea nitrogen (BUN)
Rationale: In chronic kidney disease, the kidneys are unable to effectively
filter waste products, leading to an accumulation of BUN and creatinine.
GFR decreases, not increases. Serum calcium typically decreases due to
impaired activation of vitamin D and hyperphosphatemia.
Question 7: A nurse is providing discharge teaching to a client who
has a new colostomy. Which of the following statements by the
client indicates understanding of the teaching?
A. "I should expect my stoma to be pale and dry."
B. "I can irrigate my colostomy every day to control output."
C. "I should avoid eating foods that cause gas."
D. "I will change my ostomy pouch every day."
CORRECT ANSWER: C. "I should avoid eating foods that cause
gas."
Rationale: Clients with a colostomy should avoid gas-producing foods such
as beans, broccoli, and carbonated beverages to reduce discomfort and
pouch distention. A healthy stoma should be pink and moist, not pale and
dry. Irrigation is not appropriate for all colostomies and should be done
, only if prescribed. The pouch should be changed every 3 to 7 days, not
daily.
Question 8: A nurse is caring for a client who is experiencing a
tonic-clonic seizure. Which of the following actions should the
nurse take first?
A. Insert a padded tongue blade into the client's mouth.
B. Restrain the client's extremities.
C. Protect the client's head from injury.
D. Administer intravenous diazepam.
CORRECT ANSWER: C. Protect the client's head from injury.
Rationale: During a tonic-clonic seizure, the priority is to ensure safety by
protecting the client's head from injury and maintaining a patent airway.
Inserting objects into the mouth or restraining the client can cause injury.
Diazepam may be administered after the seizure or if it is prolonged, but
immediate safety measures come first.
Question 9: A nurse is teaching a client who has asthma about
using a peak flow meter. Which of the following instructions should
the nurse include?
A. "Use the peak flow meter only when you are experiencing an asthma
attack."
B. "Take a deep breath and blow out as hard and fast as you can."
C. "Record the highest of three attempts."
D. "Use the meter after using your rescue inhaler."
CORRECT ANSWER: B. "Take a deep breath and blow out as hard
and fast as you can."
Rationale: To use a peak flow meter correctly, the client should stand, take
a deep breath, and blow out as hard and fast as possible. The meter should
be used daily to monitor asthma control, not just during attacks. The
highest of three attempts is recorded, but the instruction to blow hard and
fast is the key technique. It should be used before using a rescue inhaler.
Question 10: A nurse is assessing a client who has a suspected
fracture of the right femur. Which of the following findings should
the nurse expect?
ACTUAL-Style ATI Medical-Surgical Nursing
Practice Questions & Answers, RN Medical-Surgical
Exam Prep, Verified Answers, Detailed Rationales,
Adult Medical-Surgical Nursing, Cardiovascular,
Respiratory, Neurologic, Gastrointestinal, Renal,
Endocrine, Musculoskeletal, Hematologic,
Oncology, Infection Control, Perioperative Nursing,
Emergency Care, Prioritization, Delegation &
Comprehensive Nursing Review
Question 1: A nurse is assessing a client who has been admitted
with acute exacerbation of heart failure. Which of the following
findings should the nurse expect?
A. Dry, hacking cough
B. Bibasilar crackles
C. Bradycardia
D. Hypertension
CORRECT ANSWER: B. Bibasilar crackles
Rationale: In acute heart failure, fluid backs up into the pulmonary
circulation, leading to pulmonary congestion. Bibasilar crackles are a classic
auscultatory finding due to fluid accumulation in the alveoli. A dry cough
and bradycardia are not typical; tachycardia is more common.
Hypertension can occur but is not a direct expected finding of fluid
overload.
Question 2: A nurse is caring for a client who is receiving heparin
therapy. Which of the following laboratory values should the nurse
monitor to evaluate the effectiveness of the therapy?
A. Prothrombin time (PT)
B. International normalized ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Bleeding time
CORRECT ANSWER: C. Activated partial thromboplastin time
(aPTT)
Rationale: Heparin therapy is monitored using the aPTT, which measures
the intrinsic pathway of coagulation. The therapeutic range is typically 1.5
,to 2.5 times the control value. PT and INR are used to monitor warfarin
therapy. Bleeding time is not used for heparin monitoring.
Question 3: A nurse is teaching a client who has a new prescription
for metformin. Which of the following instructions should the
nurse include?
A. "Take this medication with meals to reduce gastrointestinal upset."
B. "You should expect to gain weight while taking this medication."
C. "Stop taking the medication if you experience a metallic taste."
D. "This medication can cause hypoglycemia, so carry glucose tablets."
CORRECT ANSWER: A. "Take this medication with meals to reduce
gastrointestinal upset."
Rationale: Metformin is an oral antidiabetic agent that commonly causes
gastrointestinal side effects such as nausea, diarrhea, and abdominal
discomfort. Taking it with meals helps minimize these effects. Weight loss,
not gain, is often associated with metformin. A metallic taste may occur but
does not require stopping the medication. Metformin alone rarely causes
hypoglycemia.
Question 4: A nurse is assessing a client who has been diagnosed
with a peptic ulcer. Which of the following findings is the priority
for the nurse to report?
A. Nausea after eating
B. Dull, gnawing pain in the epigastric area
C. Board-like abdominal rigidity
D. Belching and bloating
CORRECT ANSWER: C. Board-like abdominal rigidity
Rationale: Board-like abdominal rigidity is a sign of peritonitis, which can
occur if a peptic ulcer perforates. This is a medical emergency requiring
immediate intervention. Nausea, dull pain, and belching are common
symptoms of peptic ulcer disease but are not immediately life-threatening.
Question 5: A nurse is caring for a client who is postoperative
following a total hip arthroplasty. Which of the following positions
should the nurse avoid for this client?
A. Supine with a pillow between the legs
B. Side-lying with a pillow between the legs
,C. Flexing the hip greater than 90 degrees
D. Using an abduction pillow
CORRECT ANSWER: C. Flexing the hip greater than 90 degrees
Rationale: After total hip arthroplasty, hip flexion greater than 90 degrees
can cause dislocation of the prosthesis. The nurse should instruct the client
to avoid bending the hip excessively, crossing the legs, and turning the toes
inward. Abduction pillows and pillows between the legs help maintain
proper alignment.
Question 6: A nurse is reviewing the laboratory results of a client
who has chronic kidney disease. Which of the following findings
should the nurse expect?
A. Increased glomerular filtration rate (GFR)
B. Decreased serum creatinine
C. Increased blood urea nitrogen (BUN)
D. Increased serum calcium
CORRECT ANSWER: C. Increased blood urea nitrogen (BUN)
Rationale: In chronic kidney disease, the kidneys are unable to effectively
filter waste products, leading to an accumulation of BUN and creatinine.
GFR decreases, not increases. Serum calcium typically decreases due to
impaired activation of vitamin D and hyperphosphatemia.
Question 7: A nurse is providing discharge teaching to a client who
has a new colostomy. Which of the following statements by the
client indicates understanding of the teaching?
A. "I should expect my stoma to be pale and dry."
B. "I can irrigate my colostomy every day to control output."
C. "I should avoid eating foods that cause gas."
D. "I will change my ostomy pouch every day."
CORRECT ANSWER: C. "I should avoid eating foods that cause
gas."
Rationale: Clients with a colostomy should avoid gas-producing foods such
as beans, broccoli, and carbonated beverages to reduce discomfort and
pouch distention. A healthy stoma should be pink and moist, not pale and
dry. Irrigation is not appropriate for all colostomies and should be done
, only if prescribed. The pouch should be changed every 3 to 7 days, not
daily.
Question 8: A nurse is caring for a client who is experiencing a
tonic-clonic seizure. Which of the following actions should the
nurse take first?
A. Insert a padded tongue blade into the client's mouth.
B. Restrain the client's extremities.
C. Protect the client's head from injury.
D. Administer intravenous diazepam.
CORRECT ANSWER: C. Protect the client's head from injury.
Rationale: During a tonic-clonic seizure, the priority is to ensure safety by
protecting the client's head from injury and maintaining a patent airway.
Inserting objects into the mouth or restraining the client can cause injury.
Diazepam may be administered after the seizure or if it is prolonged, but
immediate safety measures come first.
Question 9: A nurse is teaching a client who has asthma about
using a peak flow meter. Which of the following instructions should
the nurse include?
A. "Use the peak flow meter only when you are experiencing an asthma
attack."
B. "Take a deep breath and blow out as hard and fast as you can."
C. "Record the highest of three attempts."
D. "Use the meter after using your rescue inhaler."
CORRECT ANSWER: B. "Take a deep breath and blow out as hard
and fast as you can."
Rationale: To use a peak flow meter correctly, the client should stand, take
a deep breath, and blow out as hard and fast as possible. The meter should
be used daily to monitor asthma control, not just during attacks. The
highest of three attempts is recorded, but the instruction to blow hard and
fast is the key technique. It should be used before using a rescue inhaler.
Question 10: A nurse is assessing a client who has a suspected
fracture of the right femur. Which of the following findings should
the nurse expect?
