ADVANCED ADULT HEALTH ATI MED SURG TESTBANK QUESTIONS
AND ANSWERS 2025.
1. What nursing actions should be taken for ongoing care of a client receiving total
parenteral nutrition (TPN)?
• Check vital signs daily; change tubing weekly
• Assess vital signs every 4–8 hr, weigh daily; change tubing and solution bag every 24
hr
• Use the TPN line for other IV boluses
• Add medications to the TPN solution
Rationale: Frequent monitoring and daily tubing changes prevent sepsis; avoiding
additional IV use maintains sterility.
2. What post-procedure nursing actions and client education are required for nasogastric
decompression in gastric bleeding?
• Allow oral intake immediately; reposition daily
• Maintain NPO status; monitor vital signs, assess for absence of blood in NG tube,
perform gastric lavage
• Remove NG tube without lavage
• Ignore abdominal girth
Rationale: NPO and monitoring prevent aspiration and assess bleeding cessation; lavage
stops active bleeds.
3. What nursing considerations apply post-procedure for a client with an ostomy (ileostomy
or colostomy)?
• Empty the bag when full; ignore stoma color
• Empty the bag when one-third to one-half full; assess stoma for pink, moist
appearance
• Avoid skin barriers
• Expect solid ileostomy output
Rationale: Early emptying prevents leakage; a pink, moist stoma indicates health.
4. What are the main types of abdominal ostomies and their indications?
• Ileostomy: Drains urine; Colostomy: Drains bile
• Ileostomy: Drains liquid stool from ileum (e.g., Crohn’s); Colostomy: Drains stool
from colon (e.g., cancer)
• Ileostomy: Solid stool; Colostomy: Liquid stool
• Both for kidney drainage
Rationale: Ileostomy bypasses the colon; colostomy varies by colon segment.
5. What physical findings should a nurse expect in a client with deep vein thrombosis
(DVT)?
, • Cool skin and reduced edema
• Calf/groin pain, warmth, edema; induration over vessel
• Bilateral swelling
• No circumference change
Rationale: DVT causes localized inflammation and swelling.
6. How do osteoarthritis and rheumatoid arthritis (RA) differ in presentation?
• Osteoarthritis: Systemic autoimmune; RA: Unilateral
• Osteoarthritis: Unilateral, degenerative; RA: Symmetrical, autoimmune
• Osteoarthritis: Affects organs; RA: Joints only
• Both symmetrical and degenerative
Rationale: Osteoarthritis is wear-and-tear; RA affects multiple systems.
7. What are the expected findings in macular degeneration?
• Improved central vision
• Lack of depth perception; loss of central vision
• Enhanced peripheral vision
• No distortion
Rationale: Macular damage impairs central vision.
8. What are the manifestations of cataracts?
• Improved night vision
• Decreased visual acuity; blurred or dim vision
• Reduced light sensitivity
• Clear lens
Rationale: Lens opacity causes vision impairment.
9. What are the manifestations of acute angle-closure glaucoma?
• Mild discomfort
• Severe eye pain; halo around lights
• Improved peripheral vision
• Reactive pupils
Rationale: Pressure buildup causes pain and halos.
10. What general rule guides a nurse when multiple exam answers seem plausible?
• Choose highest vital sign
• Select low urine output (<30 mL/hr) when in doubt
• Pick respiratory rate
• Opt for longest duration
Rationale: Low urine output often indicates critical conditions.
, 11. What physical finding suggests a hematologic disorder?
• Increased leg hair
• Absence of hair on legs
• Red extremities
• Thickened skin
Rationale: Hair loss signals poor arterial circulation.
12. What is brachytherapy, and what are its nursing considerations?
• External radiation
• Internal radioactive material placement; wear lead apron, limit visitors to 30
min/day
• Non-radioactive implant
• No protection needed
Rationale: Internal radiation requires safety measures.
13. What laboratory findings indicate pancreatitis?
• Decreased lipase
• Increased serum lipase; increased glucose
• Normal WBC
• Decreased amylase
Rationale: Lipase release and reduced insulin elevate glucose.
14. What nursing interventions apply to polycythemia vera?
• Keep legs dependent
• Elevate legs; drink 3 L fluid daily
• Avoid support hose
• Use hard toothbrush
Rationale: Elevation and hydration reduce clotting risk.
15. How should a nurse instruct a client with pyelonephritis to prevent recurrence?
• Wipe back to front
• Wipe front to back after fecal elimination
• Limit fluids
• Avoid catheterization
Rationale: Prevents bacterial spread to urinary tract.
16. How can dumping syndrome be prevented post-gastric surgery?
• Encourage sugars
• Avoid simple sugars; ingest protein at every meal
• Mix fluids with meals
AND ANSWERS 2025.
1. What nursing actions should be taken for ongoing care of a client receiving total
parenteral nutrition (TPN)?
• Check vital signs daily; change tubing weekly
• Assess vital signs every 4–8 hr, weigh daily; change tubing and solution bag every 24
hr
• Use the TPN line for other IV boluses
• Add medications to the TPN solution
Rationale: Frequent monitoring and daily tubing changes prevent sepsis; avoiding
additional IV use maintains sterility.
2. What post-procedure nursing actions and client education are required for nasogastric
decompression in gastric bleeding?
• Allow oral intake immediately; reposition daily
• Maintain NPO status; monitor vital signs, assess for absence of blood in NG tube,
perform gastric lavage
• Remove NG tube without lavage
• Ignore abdominal girth
Rationale: NPO and monitoring prevent aspiration and assess bleeding cessation; lavage
stops active bleeds.
3. What nursing considerations apply post-procedure for a client with an ostomy (ileostomy
or colostomy)?
• Empty the bag when full; ignore stoma color
• Empty the bag when one-third to one-half full; assess stoma for pink, moist
appearance
• Avoid skin barriers
• Expect solid ileostomy output
Rationale: Early emptying prevents leakage; a pink, moist stoma indicates health.
4. What are the main types of abdominal ostomies and their indications?
• Ileostomy: Drains urine; Colostomy: Drains bile
• Ileostomy: Drains liquid stool from ileum (e.g., Crohn’s); Colostomy: Drains stool
from colon (e.g., cancer)
• Ileostomy: Solid stool; Colostomy: Liquid stool
• Both for kidney drainage
Rationale: Ileostomy bypasses the colon; colostomy varies by colon segment.
5. What physical findings should a nurse expect in a client with deep vein thrombosis
(DVT)?
, • Cool skin and reduced edema
• Calf/groin pain, warmth, edema; induration over vessel
• Bilateral swelling
• No circumference change
Rationale: DVT causes localized inflammation and swelling.
6. How do osteoarthritis and rheumatoid arthritis (RA) differ in presentation?
• Osteoarthritis: Systemic autoimmune; RA: Unilateral
• Osteoarthritis: Unilateral, degenerative; RA: Symmetrical, autoimmune
• Osteoarthritis: Affects organs; RA: Joints only
• Both symmetrical and degenerative
Rationale: Osteoarthritis is wear-and-tear; RA affects multiple systems.
7. What are the expected findings in macular degeneration?
• Improved central vision
• Lack of depth perception; loss of central vision
• Enhanced peripheral vision
• No distortion
Rationale: Macular damage impairs central vision.
8. What are the manifestations of cataracts?
• Improved night vision
• Decreased visual acuity; blurred or dim vision
• Reduced light sensitivity
• Clear lens
Rationale: Lens opacity causes vision impairment.
9. What are the manifestations of acute angle-closure glaucoma?
• Mild discomfort
• Severe eye pain; halo around lights
• Improved peripheral vision
• Reactive pupils
Rationale: Pressure buildup causes pain and halos.
10. What general rule guides a nurse when multiple exam answers seem plausible?
• Choose highest vital sign
• Select low urine output (<30 mL/hr) when in doubt
• Pick respiratory rate
• Opt for longest duration
Rationale: Low urine output often indicates critical conditions.
, 11. What physical finding suggests a hematologic disorder?
• Increased leg hair
• Absence of hair on legs
• Red extremities
• Thickened skin
Rationale: Hair loss signals poor arterial circulation.
12. What is brachytherapy, and what are its nursing considerations?
• External radiation
• Internal radioactive material placement; wear lead apron, limit visitors to 30
min/day
• Non-radioactive implant
• No protection needed
Rationale: Internal radiation requires safety measures.
13. What laboratory findings indicate pancreatitis?
• Decreased lipase
• Increased serum lipase; increased glucose
• Normal WBC
• Decreased amylase
Rationale: Lipase release and reduced insulin elevate glucose.
14. What nursing interventions apply to polycythemia vera?
• Keep legs dependent
• Elevate legs; drink 3 L fluid daily
• Avoid support hose
• Use hard toothbrush
Rationale: Elevation and hydration reduce clotting risk.
15. How should a nurse instruct a client with pyelonephritis to prevent recurrence?
• Wipe back to front
• Wipe front to back after fecal elimination
• Limit fluids
• Avoid catheterization
Rationale: Prevents bacterial spread to urinary tract.
16. How can dumping syndrome be prevented post-gastric surgery?
• Encourage sugars
• Avoid simple sugars; ingest protein at every meal
• Mix fluids with meals
