ATI PROCTORED MEDICAL SURGICAL
MID-TERM EXAM QUESTIONS AND
VERIFIED ANSWERS 2024-2025
A nurse practitioner is assessing a patient who has manifestations of acromegaly. Which
of the following findings should the nurse practitioner expect?
A. Thinning of skeletal bone structure
B. Concave chest wall
C. High-pitched voice
D. Increased head size - CORRECT ANSWER-Correct
CORRECT: D. Increased head size
A patient who has acromegaly will present with an enlarged head size due to the
excessive production of growth hormones after closing of the epiphyses (the "growth
plate" at the ends of the long bones) by the pituitary gland. This results in the gradual
enlargement of the patient's body tissues such as the bones of the face, jaw, hands,
feet, and skull.
Incorrect Answers: A. A patient who has acromegaly will have skeletal thickening due to
the increased growth hormones secreted by the pituitary gland.
B. A patient who has acromegaly will have a barrel-shaped chest due to the increased
growth hormones that enlarge the skeletal system.
C. A patient who has acromegaly will have vocal deepening due to hypertrophy of the
vocal cords from the increased growth hormones secreted by the pituitary gland.
A nurse practitioner is providing teaching to a patient who has cervical cancer and is
scheduled to receive brachytherapy in an ambulatory care clinic. Which of the following
statements by the patient indicates an understanding of the teaching?
A. "I need to lie still in bed during my brachytherapy treatment."
B. "I will have an implant placed once a month during my brachytherapy treatment."
C. "I must stay at least 3 feet away from others between brachytherapy treatments."
,D. "I should expect some blood in my urine after each brachytherapy treatment." -
CORRECT ANSWER-Correct CORRECT: A.
"I need to lie still in bed during my brachytherapy treatment."
The nurse practitioner should confirm that the patient understands the need to remain
on bed rest with limited movement while the radioactive implant is in place to prevent
dislodgment.
Incorrect Answers: B. The nurse practitioner should explain that the provider often
prescribes brachytherapy treatments 1 to 2 times per week.
C. The nurse practitioner should explain that the patient does not emit any radiation
between treatments; therefore, there are no restrictions regarding contact with others.
D. The nurse practitioner should explain that blood in the urine is not expected after
brachytherapy treatment. The patient should notify the provider immediately if she
develops this manifestation.
A nurse practitioner is planning care for a patient who has AIDS and has developed
stomatitis. Which of the following interventions should the nurse practitioner include in
the plan of care?
A. Rinse the mouth with chlorhexidine solution every 2 hr
B. Limit fluid intake with meals
C. Provide oral hygiene with a firm-bristled toothbrush after each meal
D. Avoid salty foods - CORRECT ANSWER-Correct CORRECT:
D. Avoid salty foods
Stomatitis is an inflammation of the mucosa of the mouth, usually with ulcerations.
Foods that are spicy, acidic, or salty should be avoided to prevent further irritation and
damage to the oral mucosa.
Incorrect Answers: A. Chlorhexidine is an antiseptic that could cause further irritation to
the oral mucosa. The nurse practitioner should provide the patient with 0.9% sodium
chloride solution or baking soda to mix with water and use as a rinse aid.
B. The nurse practitioner should plan to provide moist foods and liquids with meals to
decrease the patient's discomfort and to promote nutritional intake.
C. The patient's oral care should be provided with a soft-bristled toothbrush to avoid
further irritation and damage to the oral mucosa.
A charge nurse practitioner receives notification of the admission of a patient who is
coughing frequently and whose sputum is pink, frothy, and copious. The patient has a
history of night sweats, anorexia, and weight loss. Which of the following actions should
the nurse practitioner take? (Select all that apply.)
A. Assign the patient to a private room with negative-pressure airflow.
,B. Add contact precautions to the patient's plan of care.
C. Wear an N95 respirator when entering the patient's room.
D. Ensure the patient's environment provides 4 exchanges of fresh air per minute.
E. Institute protective environment precautions as soon as the patient arrives on the unit.
- CORRECT ANSWER-Correct Answers: A.
Assign the patient to a private room with negative-pressure airflow.
C.
Wear an N95 respirator when entering the patient's room.
This patient's history and present status suggest tuberculosis, a communicable infection
that mandates a private room with negative-pressure airflow. Airborne precautions will
be required, including wearing an N95 respirator when entering the patient's room.
Incorrect Answers:B. Tuberculosis is a communicable infection that mandates a
different type of transmission-based precautions in addition to standard precautions.
D. Tuberculosis mandates the provision of a well-ventilated room with 6-12 exchanges
of fresh air per minute.
E. Protective environment precautions are for immunocompromised patients who are at
high risk of infection (e.g. patients who had chemotherapy).
A nurse practitioner is preparing a 24-hr urine specimen for a patient who is suspected
to have pheochromocytoma. Which of the following laboratory tests from the 24-hr urine
specimen should the nurse practitioner use to determine the patient's condition?
A. Creatinine clearance
B. Vanillylmandelic acid (VMA)
C. 17-hydroxycorticosteroids (17-OHCS)
D. Protein - CORRECT ANSWER-Correct CORRECT: B.
Vanillylmandelic acid (VMA)
The VMA test is used to determine if the patient has pheochromocytoma, which
measures the level of catecholamine metabolites in a 24-hour urine sample.
Pheochromocytoma is a tumor of the adrenal gland that causes excess release of the
catecholamines epinephrine and norepinephrine, which are hormones that regulate
blood pressure and heart rate.
Incorrect Answers:A. A 24-hour urine specimen for creatinine clearance is used to
evaluate the patient's renal function by calculating the glomerular filtration rate of the
kidneys.
C. A 24-hour urine specimen for 17-OHCS is used to determine if the patient is producing
an adequate amount of cortisol. An increase of cortisol in the specimen can indicate
Cushing's disease.
D. A 24-hr urine specimen for protein is used to evaluate the patient's renal function.
, A nurse practitioner is teaching a female patient with a new diagnosis of systemic lupus
erythematosus (SLE) about factors that can trigger an exacerbation of SLE. The nurse
practitioner should determine that the patient requires further teaching if she identifies
which of the following as an exacerbation factor?
A. Exercise
B. Pregnancy
C. Infection
D. Sunlight - CORRECT ANSWER-Correct CORRECT: A.
Exercise
SLE is a chronic autoimmune disease that develops when the immune system becomes
hyperactive and attacks healthy body tissue. This attack results in generalized
inflammation and creates manifestations associated with the specific involved tissues.
Most patients who have SLE can follow an exercise program to increase their cellular
aerobic capacity and improve immune function, and the patient should follow a
program with her provider's assistance. This patient needs additional teaching about
the importance of exercise to keep her muscles and joints active.
Incorrect Answers:B. Due to hormonal changes, pregnancy can exacerbate SLE. The
nurse practitioner should advise the patient of the risks. If the patient becomes
pregnant, she should be monitored closely for renal and cardiovascular effects.
C. Infections, especially streptococcal or viral infections, stress the body and can trigger
an exacerbation of SLE. In addition, many patients who have SLE take steroids, placing
them at higher risk of infection.
D. Exposure to sunlight and artificial ultraviolet light is the leading cause of SLE
exacerbations, especially the characteristic skin lesions and butterfly rash. Patients
should use a sunscreen with a high sun protection factor (SPF) and cover their skin with
appropriate clothing and hats when exposed to sunlight.
A nurse practitioner is caring for patient who has human immunodeficiency virus (HIV).
Which of the following types of isolation should the nurse practitioner implement to
prevent the transmission of HIV?
A. Protective isolation
B. Droplet precautions
C. Standard precautions
D. Airborne precautions - CORRECT ANSWER-Correct CORRECT: C.
Standard precautions
Standard precautions should be implemented with every patient to prevent the spread of
infection transmitted by direct or indirect contact with infectious blood or body fluids.
Because HIV is spread through blood and bodily fluids, standard precautions are
appropriate.
Incorrect Answers:A. Protective isolation keeps a patient who is immunocompromised
from acquiring communicable infections that are prevalent in the hospital setting, but it
does not prevent the transmission of HIV.
MID-TERM EXAM QUESTIONS AND
VERIFIED ANSWERS 2024-2025
A nurse practitioner is assessing a patient who has manifestations of acromegaly. Which
of the following findings should the nurse practitioner expect?
A. Thinning of skeletal bone structure
B. Concave chest wall
C. High-pitched voice
D. Increased head size - CORRECT ANSWER-Correct
CORRECT: D. Increased head size
A patient who has acromegaly will present with an enlarged head size due to the
excessive production of growth hormones after closing of the epiphyses (the "growth
plate" at the ends of the long bones) by the pituitary gland. This results in the gradual
enlargement of the patient's body tissues such as the bones of the face, jaw, hands,
feet, and skull.
Incorrect Answers: A. A patient who has acromegaly will have skeletal thickening due to
the increased growth hormones secreted by the pituitary gland.
B. A patient who has acromegaly will have a barrel-shaped chest due to the increased
growth hormones that enlarge the skeletal system.
C. A patient who has acromegaly will have vocal deepening due to hypertrophy of the
vocal cords from the increased growth hormones secreted by the pituitary gland.
A nurse practitioner is providing teaching to a patient who has cervical cancer and is
scheduled to receive brachytherapy in an ambulatory care clinic. Which of the following
statements by the patient indicates an understanding of the teaching?
A. "I need to lie still in bed during my brachytherapy treatment."
B. "I will have an implant placed once a month during my brachytherapy treatment."
C. "I must stay at least 3 feet away from others between brachytherapy treatments."
,D. "I should expect some blood in my urine after each brachytherapy treatment." -
CORRECT ANSWER-Correct CORRECT: A.
"I need to lie still in bed during my brachytherapy treatment."
The nurse practitioner should confirm that the patient understands the need to remain
on bed rest with limited movement while the radioactive implant is in place to prevent
dislodgment.
Incorrect Answers: B. The nurse practitioner should explain that the provider often
prescribes brachytherapy treatments 1 to 2 times per week.
C. The nurse practitioner should explain that the patient does not emit any radiation
between treatments; therefore, there are no restrictions regarding contact with others.
D. The nurse practitioner should explain that blood in the urine is not expected after
brachytherapy treatment. The patient should notify the provider immediately if she
develops this manifestation.
A nurse practitioner is planning care for a patient who has AIDS and has developed
stomatitis. Which of the following interventions should the nurse practitioner include in
the plan of care?
A. Rinse the mouth with chlorhexidine solution every 2 hr
B. Limit fluid intake with meals
C. Provide oral hygiene with a firm-bristled toothbrush after each meal
D. Avoid salty foods - CORRECT ANSWER-Correct CORRECT:
D. Avoid salty foods
Stomatitis is an inflammation of the mucosa of the mouth, usually with ulcerations.
Foods that are spicy, acidic, or salty should be avoided to prevent further irritation and
damage to the oral mucosa.
Incorrect Answers: A. Chlorhexidine is an antiseptic that could cause further irritation to
the oral mucosa. The nurse practitioner should provide the patient with 0.9% sodium
chloride solution or baking soda to mix with water and use as a rinse aid.
B. The nurse practitioner should plan to provide moist foods and liquids with meals to
decrease the patient's discomfort and to promote nutritional intake.
C. The patient's oral care should be provided with a soft-bristled toothbrush to avoid
further irritation and damage to the oral mucosa.
A charge nurse practitioner receives notification of the admission of a patient who is
coughing frequently and whose sputum is pink, frothy, and copious. The patient has a
history of night sweats, anorexia, and weight loss. Which of the following actions should
the nurse practitioner take? (Select all that apply.)
A. Assign the patient to a private room with negative-pressure airflow.
,B. Add contact precautions to the patient's plan of care.
C. Wear an N95 respirator when entering the patient's room.
D. Ensure the patient's environment provides 4 exchanges of fresh air per minute.
E. Institute protective environment precautions as soon as the patient arrives on the unit.
- CORRECT ANSWER-Correct Answers: A.
Assign the patient to a private room with negative-pressure airflow.
C.
Wear an N95 respirator when entering the patient's room.
This patient's history and present status suggest tuberculosis, a communicable infection
that mandates a private room with negative-pressure airflow. Airborne precautions will
be required, including wearing an N95 respirator when entering the patient's room.
Incorrect Answers:B. Tuberculosis is a communicable infection that mandates a
different type of transmission-based precautions in addition to standard precautions.
D. Tuberculosis mandates the provision of a well-ventilated room with 6-12 exchanges
of fresh air per minute.
E. Protective environment precautions are for immunocompromised patients who are at
high risk of infection (e.g. patients who had chemotherapy).
A nurse practitioner is preparing a 24-hr urine specimen for a patient who is suspected
to have pheochromocytoma. Which of the following laboratory tests from the 24-hr urine
specimen should the nurse practitioner use to determine the patient's condition?
A. Creatinine clearance
B. Vanillylmandelic acid (VMA)
C. 17-hydroxycorticosteroids (17-OHCS)
D. Protein - CORRECT ANSWER-Correct CORRECT: B.
Vanillylmandelic acid (VMA)
The VMA test is used to determine if the patient has pheochromocytoma, which
measures the level of catecholamine metabolites in a 24-hour urine sample.
Pheochromocytoma is a tumor of the adrenal gland that causes excess release of the
catecholamines epinephrine and norepinephrine, which are hormones that regulate
blood pressure and heart rate.
Incorrect Answers:A. A 24-hour urine specimen for creatinine clearance is used to
evaluate the patient's renal function by calculating the glomerular filtration rate of the
kidneys.
C. A 24-hour urine specimen for 17-OHCS is used to determine if the patient is producing
an adequate amount of cortisol. An increase of cortisol in the specimen can indicate
Cushing's disease.
D. A 24-hr urine specimen for protein is used to evaluate the patient's renal function.
, A nurse practitioner is teaching a female patient with a new diagnosis of systemic lupus
erythematosus (SLE) about factors that can trigger an exacerbation of SLE. The nurse
practitioner should determine that the patient requires further teaching if she identifies
which of the following as an exacerbation factor?
A. Exercise
B. Pregnancy
C. Infection
D. Sunlight - CORRECT ANSWER-Correct CORRECT: A.
Exercise
SLE is a chronic autoimmune disease that develops when the immune system becomes
hyperactive and attacks healthy body tissue. This attack results in generalized
inflammation and creates manifestations associated with the specific involved tissues.
Most patients who have SLE can follow an exercise program to increase their cellular
aerobic capacity and improve immune function, and the patient should follow a
program with her provider's assistance. This patient needs additional teaching about
the importance of exercise to keep her muscles and joints active.
Incorrect Answers:B. Due to hormonal changes, pregnancy can exacerbate SLE. The
nurse practitioner should advise the patient of the risks. If the patient becomes
pregnant, she should be monitored closely for renal and cardiovascular effects.
C. Infections, especially streptococcal or viral infections, stress the body and can trigger
an exacerbation of SLE. In addition, many patients who have SLE take steroids, placing
them at higher risk of infection.
D. Exposure to sunlight and artificial ultraviolet light is the leading cause of SLE
exacerbations, especially the characteristic skin lesions and butterfly rash. Patients
should use a sunscreen with a high sun protection factor (SPF) and cover their skin with
appropriate clothing and hats when exposed to sunlight.
A nurse practitioner is caring for patient who has human immunodeficiency virus (HIV).
Which of the following types of isolation should the nurse practitioner implement to
prevent the transmission of HIV?
A. Protective isolation
B. Droplet precautions
C. Standard precautions
D. Airborne precautions - CORRECT ANSWER-Correct CORRECT: C.
Standard precautions
Standard precautions should be implemented with every patient to prevent the spread of
infection transmitted by direct or indirect contact with infectious blood or body fluids.
Because HIV is spread through blood and bodily fluids, standard precautions are
appropriate.
Incorrect Answers:A. Protective isolation keeps a patient who is immunocompromised
from acquiring communicable infections that are prevalent in the hospital setting, but it
does not prevent the transmission of HIV.
