ATI MED SURG
PROCTORED EXAM
(NGN-Style Questions & Case Scenario)
Actual Qs & Ans to Pass the Exam
This ATI test contains:
100 Qs & Ans
passing score Guarantee
Format Set of Multiple-choice
questions with incorporating Next Generation NCLEX
(NGN) and Case Scenario
Expert-Verified Explanations & Solutions
,### 1. A nurse is caring for a client who is postoperative. Based on the
client's signs of restlessness, tachycardia, hypotension, decreased pulses,
cool extremities, and decreased urine output, which condition is the client
most likely experiencing? What are appropriate nursing actions and
parameters for monitoring progress?
NGN-Style Question: Select the correct options to fill in the blanks:
Condition:
A. Hypervolemia
B. Hypovolemia
C. Orthostatic hypotension
D. Pulmonary embolism
Nursing Actions (Select Two):
A. Encourage oral fluid intake to offset deficit.
B. Insert a large-gauge IV and initiate a fluid challenge.
C. Administer blood products if hemoglobin is decreased.
D. Elevate the lower extremities above heart level.
Parameters to Monitor (Select Two):
A. Urine output
B. Heart sounds
C. Blood pressure
D. Skin integrity
Answer:
- Condition: B. Hypovolemia
,- Nursing Actions: B. Insert a large-gauge IV and initiate a fluid challenge,
D. Elevate the lower extremities above heart level.
- Parameters to Monitor: A. Urine output, C. Blood pressure
Explanation:
The client is most likely experiencing *hypovolemia* following surgery due
to fluid loss or inadequate replacement. Key symptoms include restlessness,
tachycardia, hypotension, and cool extremities. Management prioritizes fluid
replacement (e.g., IV fluids or a fluid challenge) and continuously monitoring
urine output and blood pressure to assess hemodynamic status and
treatment effectiveness.
---
### 2. A nurse is providing teaching to a client who has stage II cervical
cancer and is scheduled for brachytherapy. Which of the following
instructions should the nurse include?
A. "You will experience nausea and vomiting during the treatment."
B. "You will need to stay still in bed during each treatment session."
C. "You can start walking immediately after the procedure."
D. "You will need to wear a lead apron during the session."
Answer:
B. "You will need to stay still in bed during each treatment session."
Explanation:
Brachytherapy involves the insertion of radioactive material directly into or
near the tumor. Staying still during treatment ensures accurate placement of
,the implants and minimizes displacement, reducing the risk of harm to
adjacent tissues. Mobility is often restricted during the implantation period to
ensure effectiveness and safety.
---
### 3. A nurse is caring for a client who is receiving dialysis. For each
nursing intervention, determine if the action is *indicated* or *not
indicated*.
Potential Interventions:
A. Place the client in Trendelenburg position.
B. Notify the provider immediately.
C. Administer 0.9% sodium chloride 200 mL IV bolus.
D. Apply oxygen at 2 L/min via nasal cannula.
E. Obtain the client’s blood glucose level.
F. Perform a 12-lead ECG.
Indicated:
A. Place the client in Trendelenburg position (Yes/No?).
B. Notify the provider immediately (Yes/No?).
C. Administer 0.9% sodium chloride 200 mL IV bolus (Yes/No?).
D. Apply oxygen at 2 L/min via nasal cannula (Yes/No?).
Not Indicated:
E. Obtain the client’s blood glucose level (Yes/No?).
F. Perform a 12-lead ECG (Yes/No?).
Answer:
,Indicated: A. Yes, B. Yes, C. Yes, D. Yes
Not Indicated: E. No, F. No
Explanation:
When a client receiving dialysis shows signs of cardiovascular instability
(e.g., hypotension, hypoxia), immediate interventions like the Trendelenburg
position, oxygen supplementation, IV fluid boluses, and provider notification
are critical. Checking blood glucose levels or ordering ECGs is unnecessary
unless specific indications (e.g., hyperglycemia, arrhythmia) arise.
---
### 4. A nurse is assessing a client who has had a suspected stroke. What
is the nurse's *priority* finding?
A. Dysphagia
B. Facial drooping
C. Unilateral weakness
D. Slurred speech
Answer:
A. Dysphagia
Explanation:
While all options are common signs of a stroke, *dysphagia* is the priority
due to the immediate risk of aspiration, which can lead to respiratory
compromise or aspiration pneumonia. A swallowing evaluation should be
performed promptly before allowing oral intake.
,---
### 5. A nurse is caring for a client who is 12 hours postoperative following
a total hip arthroplasty. Which of the following nursing actions should the
nurse take?
A. Keep the client's hips in external rotation.
B. Position the client with a pillow between their legs.
C. Encourage the client to sit cross-legged to avoid edema.
D. Allow the client to bend at the waist as needed to sit upright.
Answer:
B. Position the client with a pillow between their legs.
Explanation:
To prevent hip dislocation, maintaining proper alignment is crucial. Placing a
pillow between the client's legs keeps the hip in abduction and reduces the
risk of injury. Avoid motions like hip flexion >90° or crossing the legs, which
can exacerbate dislocation risk.
---
### 6. A nurse is providing teaching to a client taking ginkgo biloba as an
herbal supplement. Which of the following statements should the nurse
make?
A. "Ginkgo biloba can help reduce your risk of blood clots."
B. "Ginkgo biloba may cause an increased risk of bleeding."
C. "You should take this medication only with meals."
,D. "This supplement is safe with other anticoagulants."
Answer:
B. "Ginkgo biloba may cause an increased risk of bleeding."
Explanation:
Ginkgo biloba is known to have antiplatelet effects, increasing the risk of
bleeding, especially when taken with anticoagulants or antiplatelet drugs.
Clients should notify their provider about its use before procedures or
combining it with other medications that affect coagulation.
---
### 7. A nurse is assessing a client who recently had thoracentesis.
Following the procedure, the nurse should expect improvement in which
common manifestation of advanced lung cancer?
A. Dyspnea
B. Hemoptysis
C. Chest pain
D. Fatigue
Answer:
A. Dyspnea
Explanation:
Thoracentesis involves removing pleural fluid in cases of pleural effusion,
which is often associated with advanced lung cancer. Alleviating the fluid
,buildup reduces lung compression, leading to improved respiratory function
and decreased dyspnea.
---
### 8. A nurse is assessing a client while suctioning a tracheostomy. Which
finding indicates hypoxia?
A. The client's pulse oximetry increases to 95%.
B. The client's skin appears flushed and warm.
C. The client's heart rate increases.
D. The client becomes drowsy.
Answer:
C. The client's heart rate increases.
Explanation:
An increase in heart rate is an early compensatory response to hypoxia, as
the body attempts to circulate more oxygen to meet cellular demands.
Nurses should ensure adequate oxygenation and limit suctioning to 10–15
seconds to reduce the risk of further hypoxia.
---
### 9. A nurse is assessing a client in the ED presenting with severe
abdominal pain. Which condition and diagnostic findings are likely?
NGN-Style Fill-in-the-Blank: Select One Condition and Corresponding
Diagnostic Evidence.
, Condition:
A. Appendicitis
B. Pancreatitis
C. Bowel obstruction
D. Peritonitis
Diagnostic Findings:
A. Elevated amylase and lipase levels
B. Positive Murphy's sign
C. Air-fluid levels on abdominal x-ray
D. Shifting dullness on percussion
Answer:
Condition: B. Pancreatitis
Diagnostic Findings: A. Elevated amylase and lipase levels
Explanation:
Pancreatitis involves inflammation of the pancreas, often diagnosed with
elevated serum amylase and lipase levels. Symptoms include severe
epigastric pain radiating to the back, nausea, and vomiting. Immediate
management includes NPO status, IV fluids, and pain control.
### 10. A nurse in the emergency department is caring for a client
presenting with severe epigastric pain radiating to the back. Drag and drop 1
condition and corresponding client finding to fill in each blank.
NGN-Style Fill-in-the-Blank Options:
PROCTORED EXAM
(NGN-Style Questions & Case Scenario)
Actual Qs & Ans to Pass the Exam
This ATI test contains:
100 Qs & Ans
passing score Guarantee
Format Set of Multiple-choice
questions with incorporating Next Generation NCLEX
(NGN) and Case Scenario
Expert-Verified Explanations & Solutions
,### 1. A nurse is caring for a client who is postoperative. Based on the
client's signs of restlessness, tachycardia, hypotension, decreased pulses,
cool extremities, and decreased urine output, which condition is the client
most likely experiencing? What are appropriate nursing actions and
parameters for monitoring progress?
NGN-Style Question: Select the correct options to fill in the blanks:
Condition:
A. Hypervolemia
B. Hypovolemia
C. Orthostatic hypotension
D. Pulmonary embolism
Nursing Actions (Select Two):
A. Encourage oral fluid intake to offset deficit.
B. Insert a large-gauge IV and initiate a fluid challenge.
C. Administer blood products if hemoglobin is decreased.
D. Elevate the lower extremities above heart level.
Parameters to Monitor (Select Two):
A. Urine output
B. Heart sounds
C. Blood pressure
D. Skin integrity
Answer:
- Condition: B. Hypovolemia
,- Nursing Actions: B. Insert a large-gauge IV and initiate a fluid challenge,
D. Elevate the lower extremities above heart level.
- Parameters to Monitor: A. Urine output, C. Blood pressure
Explanation:
The client is most likely experiencing *hypovolemia* following surgery due
to fluid loss or inadequate replacement. Key symptoms include restlessness,
tachycardia, hypotension, and cool extremities. Management prioritizes fluid
replacement (e.g., IV fluids or a fluid challenge) and continuously monitoring
urine output and blood pressure to assess hemodynamic status and
treatment effectiveness.
---
### 2. A nurse is providing teaching to a client who has stage II cervical
cancer and is scheduled for brachytherapy. Which of the following
instructions should the nurse include?
A. "You will experience nausea and vomiting during the treatment."
B. "You will need to stay still in bed during each treatment session."
C. "You can start walking immediately after the procedure."
D. "You will need to wear a lead apron during the session."
Answer:
B. "You will need to stay still in bed during each treatment session."
Explanation:
Brachytherapy involves the insertion of radioactive material directly into or
near the tumor. Staying still during treatment ensures accurate placement of
,the implants and minimizes displacement, reducing the risk of harm to
adjacent tissues. Mobility is often restricted during the implantation period to
ensure effectiveness and safety.
---
### 3. A nurse is caring for a client who is receiving dialysis. For each
nursing intervention, determine if the action is *indicated* or *not
indicated*.
Potential Interventions:
A. Place the client in Trendelenburg position.
B. Notify the provider immediately.
C. Administer 0.9% sodium chloride 200 mL IV bolus.
D. Apply oxygen at 2 L/min via nasal cannula.
E. Obtain the client’s blood glucose level.
F. Perform a 12-lead ECG.
Indicated:
A. Place the client in Trendelenburg position (Yes/No?).
B. Notify the provider immediately (Yes/No?).
C. Administer 0.9% sodium chloride 200 mL IV bolus (Yes/No?).
D. Apply oxygen at 2 L/min via nasal cannula (Yes/No?).
Not Indicated:
E. Obtain the client’s blood glucose level (Yes/No?).
F. Perform a 12-lead ECG (Yes/No?).
Answer:
,Indicated: A. Yes, B. Yes, C. Yes, D. Yes
Not Indicated: E. No, F. No
Explanation:
When a client receiving dialysis shows signs of cardiovascular instability
(e.g., hypotension, hypoxia), immediate interventions like the Trendelenburg
position, oxygen supplementation, IV fluid boluses, and provider notification
are critical. Checking blood glucose levels or ordering ECGs is unnecessary
unless specific indications (e.g., hyperglycemia, arrhythmia) arise.
---
### 4. A nurse is assessing a client who has had a suspected stroke. What
is the nurse's *priority* finding?
A. Dysphagia
B. Facial drooping
C. Unilateral weakness
D. Slurred speech
Answer:
A. Dysphagia
Explanation:
While all options are common signs of a stroke, *dysphagia* is the priority
due to the immediate risk of aspiration, which can lead to respiratory
compromise or aspiration pneumonia. A swallowing evaluation should be
performed promptly before allowing oral intake.
,---
### 5. A nurse is caring for a client who is 12 hours postoperative following
a total hip arthroplasty. Which of the following nursing actions should the
nurse take?
A. Keep the client's hips in external rotation.
B. Position the client with a pillow between their legs.
C. Encourage the client to sit cross-legged to avoid edema.
D. Allow the client to bend at the waist as needed to sit upright.
Answer:
B. Position the client with a pillow between their legs.
Explanation:
To prevent hip dislocation, maintaining proper alignment is crucial. Placing a
pillow between the client's legs keeps the hip in abduction and reduces the
risk of injury. Avoid motions like hip flexion >90° or crossing the legs, which
can exacerbate dislocation risk.
---
### 6. A nurse is providing teaching to a client taking ginkgo biloba as an
herbal supplement. Which of the following statements should the nurse
make?
A. "Ginkgo biloba can help reduce your risk of blood clots."
B. "Ginkgo biloba may cause an increased risk of bleeding."
C. "You should take this medication only with meals."
,D. "This supplement is safe with other anticoagulants."
Answer:
B. "Ginkgo biloba may cause an increased risk of bleeding."
Explanation:
Ginkgo biloba is known to have antiplatelet effects, increasing the risk of
bleeding, especially when taken with anticoagulants or antiplatelet drugs.
Clients should notify their provider about its use before procedures or
combining it with other medications that affect coagulation.
---
### 7. A nurse is assessing a client who recently had thoracentesis.
Following the procedure, the nurse should expect improvement in which
common manifestation of advanced lung cancer?
A. Dyspnea
B. Hemoptysis
C. Chest pain
D. Fatigue
Answer:
A. Dyspnea
Explanation:
Thoracentesis involves removing pleural fluid in cases of pleural effusion,
which is often associated with advanced lung cancer. Alleviating the fluid
,buildup reduces lung compression, leading to improved respiratory function
and decreased dyspnea.
---
### 8. A nurse is assessing a client while suctioning a tracheostomy. Which
finding indicates hypoxia?
A. The client's pulse oximetry increases to 95%.
B. The client's skin appears flushed and warm.
C. The client's heart rate increases.
D. The client becomes drowsy.
Answer:
C. The client's heart rate increases.
Explanation:
An increase in heart rate is an early compensatory response to hypoxia, as
the body attempts to circulate more oxygen to meet cellular demands.
Nurses should ensure adequate oxygenation and limit suctioning to 10–15
seconds to reduce the risk of further hypoxia.
---
### 9. A nurse is assessing a client in the ED presenting with severe
abdominal pain. Which condition and diagnostic findings are likely?
NGN-Style Fill-in-the-Blank: Select One Condition and Corresponding
Diagnostic Evidence.
, Condition:
A. Appendicitis
B. Pancreatitis
C. Bowel obstruction
D. Peritonitis
Diagnostic Findings:
A. Elevated amylase and lipase levels
B. Positive Murphy's sign
C. Air-fluid levels on abdominal x-ray
D. Shifting dullness on percussion
Answer:
Condition: B. Pancreatitis
Diagnostic Findings: A. Elevated amylase and lipase levels
Explanation:
Pancreatitis involves inflammation of the pancreas, often diagnosed with
elevated serum amylase and lipase levels. Symptoms include severe
epigastric pain radiating to the back, nausea, and vomiting. Immediate
management includes NPO status, IV fluids, and pain control.
### 10. A nurse in the emergency department is caring for a client
presenting with severe epigastric pain radiating to the back. Drag and drop 1
condition and corresponding client finding to fill in each blank.
NGN-Style Fill-in-the-Blank Options:
