RN 2023 ADULT CMS
MEDICAL SURGICAL
ATI PROCTORED
LATEST 2025!!!
A nurse is caring for a client who is experiencing anxiety as well as numbness and tingling of the lips
and fingers. The client's ABGs are: pH 7.48, PCO2 30 mm Hg, HCO3- 24 mEq/L, PaO2 85 mm Hg.
Which of the following acid-base imbalances should the nurse identify that the client is
experiencing?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
A. Respiratory alkalosis
This pH is alkaline (increased) and the PCO2 is decreased, representing alveolar
hyperventilation and resultant respiratory alkalosis.
A nurse is assessing a client who has Cushing's syndrome. Which of the following findings should
the nurse expect?
A. Vitiligo
B. Osteoporosis
C. Myxedema
D. Heat intolerance
B. Osteoporosis
Osteoporosis is a common finding with Cushing's syndrome. Bones become thinner as a
result of mineral loss and nitrogen depletion, and the risk for fractures increases.
A nurse is inspecting the skin of a client who has basal cell carcinoma. The nurse should identify
which of the following lesion characteristics on the client's skin?
A. A pearly, waxy nodule
,RN 2023 ADULT CMS
MEDICAL SURGICAL
ATI PROCTORED
LATEST 2025!!!
B. An irregular border on a variegated-colored lesion
C. A firm, nodular, crusty, or ulcerated lesion
D. A weeping vesicle
A. A pearly, waxy nodule
A client who has basal cell carcinoma has a nodular lesion with well-defined borders and a
pearly or waxy appearance, resulting from overexposure to the sun, especially on the face,
head, and neck.
A nurse is caring for a client who has atopic dermatitis and a prescription for triamcinolone
ointment. The nurse should assess the client to monitor for which of the following adverse effects?
A. Increased pigmentation
B. Localized hair loss
C. Thinning of the skin
D. Increased sensitivity to the sun
C. Thinning of the skin
Thinning of the skin and delayed healing are adverse effects of topical glucocorticoid
preparations. The client should only apply the ointment to dry patches of the skin because
topical steroids can cause atrophy of the dermis and epidermis, which can result in thinning
of the skin.
A nurse is assessing a client who has left-sided heart failure. Which of the following findings should
the nurse identify as a manifestation of left-sided heart failure?
A. Dependent edema
B. Jugular distention
C. Weight gain
D. Frothy sputum
D. Frothy sputum
,RN 2023 ADULT CMS
MEDICAL SURGICAL
ATI PROCTORED
LATEST 2025!!!
The nurse should identify that frothy sputum, dyspnea, and wheezing are manifestations of
left-sided heart failure. Treatment includes fluid restriction and diuretics to decrease
preload and reduce pulmonary congestion. Pink-tinged frothy sputum can be an early indication of
pulmonary edema and can be life-threatening. Therefore, the nurse should
notify the provider immediately.
A nurse is assessing a client who has hypocalcemia. In which of the following areas should the nurse
tap on the client's face to detect the presence of Chvostek's sign?
A is correct.
The nurse should tap the client's cheek just in front of the ear and below the zygomatic arch. The
client who has hypocalcemia will display a Ckvostek's sign, which is a
twitching of the facial muscle.
A nurse in an emergency department is assessing a client who is overusing prescribed diuretics and
has a sodium level of 127 mEq/L. Which of the following laboratory findings should the
nurse expect?
A. High lipase
B. Low urine specific gravity
C. Low hemoglobin
D. High creatine kinase-MB (CK-MB)
B. Low urine specific gravity
A client who has hyponatremia as a result of diuretic overuse has a low urine specific
gravity. The increased excretion of water alters the ratio of particulate matter, which
affects the specific gravity.
A home health nurse is assisting a client with planning care for a family member who has
Alzheimer's disease. Which of the following instructions should the nurse include?
, RN 2023 ADULT CMS
MEDICAL SURGICAL
ATI PROCTORED
LATEST 2025!!!
A. Remove clutter from rooms and hallways.
B. Place a monthly calendar in the client's room.
C. Use confrontation to manage the client's behavior.
D. Review the daily schedule with the client every morning.
A. Remove clutter from rooms and hallways.
The nurse should instruct the family member to remove clutter from rooms and hallways so the
client is able to walk without the risk of falling or tripping over objects. Later in the disease, the
client can experience seizures, so cluttered areas could be a risk to the client.
A nurse is caring for a client who has developed acute respiratory distress syndrome (ARDS). Which
of the following findings should the nurse identify as a manifestation of this syndrome?
A. An audible pleural friction rub
B. Tracheal deviation from the midline
C. Refractory hypoxemia
D. Bloody expectorant when coughing
C. Refractory hypoxemia
ARDS is a systemic inflammatory response to trauma, sepsis, burns, pancreatitis, and blood
transfusions, when excess lung fluid dilutes surfactant activity in the lungs. A client who
has ARDS has refractory hypoxemia, which is hypoxemia that does not improve with
oxygen therapy. Extensive pulmonary edema evident on a chest x-ray is a manifestation of
ARDS.
An emergency room nurse is assessing a client who has asthma and difficulty breathing. Which of
the following findings should indicate to the nurse that the client is experiencing status
asthmaticus?
A. Coughing
MEDICAL SURGICAL
ATI PROCTORED
LATEST 2025!!!
A nurse is caring for a client who is experiencing anxiety as well as numbness and tingling of the lips
and fingers. The client's ABGs are: pH 7.48, PCO2 30 mm Hg, HCO3- 24 mEq/L, PaO2 85 mm Hg.
Which of the following acid-base imbalances should the nurse identify that the client is
experiencing?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
A. Respiratory alkalosis
This pH is alkaline (increased) and the PCO2 is decreased, representing alveolar
hyperventilation and resultant respiratory alkalosis.
A nurse is assessing a client who has Cushing's syndrome. Which of the following findings should
the nurse expect?
A. Vitiligo
B. Osteoporosis
C. Myxedema
D. Heat intolerance
B. Osteoporosis
Osteoporosis is a common finding with Cushing's syndrome. Bones become thinner as a
result of mineral loss and nitrogen depletion, and the risk for fractures increases.
A nurse is inspecting the skin of a client who has basal cell carcinoma. The nurse should identify
which of the following lesion characteristics on the client's skin?
A. A pearly, waxy nodule
,RN 2023 ADULT CMS
MEDICAL SURGICAL
ATI PROCTORED
LATEST 2025!!!
B. An irregular border on a variegated-colored lesion
C. A firm, nodular, crusty, or ulcerated lesion
D. A weeping vesicle
A. A pearly, waxy nodule
A client who has basal cell carcinoma has a nodular lesion with well-defined borders and a
pearly or waxy appearance, resulting from overexposure to the sun, especially on the face,
head, and neck.
A nurse is caring for a client who has atopic dermatitis and a prescription for triamcinolone
ointment. The nurse should assess the client to monitor for which of the following adverse effects?
A. Increased pigmentation
B. Localized hair loss
C. Thinning of the skin
D. Increased sensitivity to the sun
C. Thinning of the skin
Thinning of the skin and delayed healing are adverse effects of topical glucocorticoid
preparations. The client should only apply the ointment to dry patches of the skin because
topical steroids can cause atrophy of the dermis and epidermis, which can result in thinning
of the skin.
A nurse is assessing a client who has left-sided heart failure. Which of the following findings should
the nurse identify as a manifestation of left-sided heart failure?
A. Dependent edema
B. Jugular distention
C. Weight gain
D. Frothy sputum
D. Frothy sputum
,RN 2023 ADULT CMS
MEDICAL SURGICAL
ATI PROCTORED
LATEST 2025!!!
The nurse should identify that frothy sputum, dyspnea, and wheezing are manifestations of
left-sided heart failure. Treatment includes fluid restriction and diuretics to decrease
preload and reduce pulmonary congestion. Pink-tinged frothy sputum can be an early indication of
pulmonary edema and can be life-threatening. Therefore, the nurse should
notify the provider immediately.
A nurse is assessing a client who has hypocalcemia. In which of the following areas should the nurse
tap on the client's face to detect the presence of Chvostek's sign?
A is correct.
The nurse should tap the client's cheek just in front of the ear and below the zygomatic arch. The
client who has hypocalcemia will display a Ckvostek's sign, which is a
twitching of the facial muscle.
A nurse in an emergency department is assessing a client who is overusing prescribed diuretics and
has a sodium level of 127 mEq/L. Which of the following laboratory findings should the
nurse expect?
A. High lipase
B. Low urine specific gravity
C. Low hemoglobin
D. High creatine kinase-MB (CK-MB)
B. Low urine specific gravity
A client who has hyponatremia as a result of diuretic overuse has a low urine specific
gravity. The increased excretion of water alters the ratio of particulate matter, which
affects the specific gravity.
A home health nurse is assisting a client with planning care for a family member who has
Alzheimer's disease. Which of the following instructions should the nurse include?
, RN 2023 ADULT CMS
MEDICAL SURGICAL
ATI PROCTORED
LATEST 2025!!!
A. Remove clutter from rooms and hallways.
B. Place a monthly calendar in the client's room.
C. Use confrontation to manage the client's behavior.
D. Review the daily schedule with the client every morning.
A. Remove clutter from rooms and hallways.
The nurse should instruct the family member to remove clutter from rooms and hallways so the
client is able to walk without the risk of falling or tripping over objects. Later in the disease, the
client can experience seizures, so cluttered areas could be a risk to the client.
A nurse is caring for a client who has developed acute respiratory distress syndrome (ARDS). Which
of the following findings should the nurse identify as a manifestation of this syndrome?
A. An audible pleural friction rub
B. Tracheal deviation from the midline
C. Refractory hypoxemia
D. Bloody expectorant when coughing
C. Refractory hypoxemia
ARDS is a systemic inflammatory response to trauma, sepsis, burns, pancreatitis, and blood
transfusions, when excess lung fluid dilutes surfactant activity in the lungs. A client who
has ARDS has refractory hypoxemia, which is hypoxemia that does not improve with
oxygen therapy. Extensive pulmonary edema evident on a chest x-ray is a manifestation of
ARDS.
An emergency room nurse is assessing a client who has asthma and difficulty breathing. Which of
the following findings should indicate to the nurse that the client is experiencing status
asthmaticus?
A. Coughing
