ATI Med-Surg Proctored Exam 2025: With 100
Ultimate Study Guide with Real Practice
Questions, Rationales, and Test-Taking Strategies
for Guaranteed Success
1. Dehydration in Gastroenteritis
Question:
A nurse is caring for a client who has gastroenteritis. Which of the following assessment
findings should the nurse recognize as an indication that the client is experiencing
dehydration?
Options: a. Pitting, dependent edema
b. Distended jugular veins
c. Increased BP
d. Decreased BP ✅
Rationale:
Dehydration leads to a reduced circulating blood volume, which results in hypotension
(low blood pressure). This is a classic indicator, especially in patients with fluid loss
such as from vomiting or diarrhea due to gastroenteritis.
2. IV Medication for Diabetes Insipidus
Question:
A nurse is caring for a client who has a contusion of the brainstem and reports thirst.
The client's urinary output was 4,000 ml over the past 24 hours. The nurse should
anticipate a prescription for which of the following IV medications?
Options: a. Desmopressin ✅
b. Epinephrine
c. Furosemide
d. Nitroprusside
Rationale:
High urine output and excessive thirst are signs of diabetes insipidus, commonly
associated with brain injuries. Desmopressin is a synthetic form of antidiuretic
hormone (ADH) and is used to treat this condition by reducing urine production.
,3. ACE Inhibitor Cough
Question:
A nurse in a clinic receives a phone call from a client who recently started therapy with
an ACE inhibitor and reports a nagging dry cough. Which of the following responses by
the nurse is appropriate?
Options: a. "Your cough may require that you stop or change your medication." ✅
b. "Increasing your daily fluid intake may eliminate your cough."
c. "Sucking on lozenge may reduce the frequency of your cough."
d. "Your cough should go away in time."
Rationale:
A persistent dry cough is a common side effect of ACE inhibitors due to the
accumulation of bradykinin. This may warrant discontinuing or switching to another
class of medication like ARBs.
4. Trigger for Raynaud's Disease
Question:
A nurse is taking an admission history from a client who reports Raynaud's disease.
Which of the following assessment findings should the nurse identify as a potential
trigger for exacerbations?
Options: a. Eating a strict vegetarian diet
b. A history of herpes zoster
c. Taking amiodipine for hypertension
d. Using a nicotine transdermal patch ✅
Rationale:
Nicotine is a vasoconstrictor and can significantly worsen the vasospastic episodes
seen in Raynaud's disease. Even nicotine patches can provoke attacks.
5. Spironolactone and Electrolyte Imbalance
Question:
A nurse is providing discharge teaching to a client who has a prescription for
spironolactone. Which of the following statements by the client indicates an
understanding of the teaching?
Options: a. “I will use a salt substitute instead of regular salt.”
b. “I will eat foods that are high in potassium.”
, c. “I will report a high potassium level to my provider.” ✅
d. “I will use a diuretic with this medication.”
Rationale:
Spironolactone is a potassium-sparing diuretic. Clients taking it are at risk for
hyperkalemia and should avoid potassium-rich foods and salt substitutes containing
potassium. Reporting high potassium levels is crucial to avoid complications like
cardiac arrhythmias.
6. Allopurinol and Gout
Question:
A nurse is reviewing the medication record of a client who has gout and a new
prescription for allopurinol. The nurse should recognize that which of the following
medications interacts adversely with allopurinol?
Options: a. Ibuprofen
b. Warfarin ✅
c. Metoprolol
d. Furosemide
Rationale:
Allopurinol can increase the effects of warfarin, raising the risk for bleeding. Clients on
both medications should be monitored closely, and warfarin dosage may need
adjustment.
7. Discharge Teaching: Metronidazole
Question:
A nurse is providing discharge teaching to a client who has a prescription for
metronidazole. Which of the following statements by the client indicates an
understanding of the teaching?
Options: a. “I can have a glass of wine with dinner.”
b. “I will avoid drinking alcohol while taking this medication.” ✅
c. “I will take the medication on an empty stomach.”
d. “I may stop the medication once I feel better.”
Rationale:
Alcohol should be avoided while taking metronidazole and for at least 48 hours after
discontinuation due to the risk of a disulfiram-like reaction (flushing, nausea, vomiting,
hypotension).
Ultimate Study Guide with Real Practice
Questions, Rationales, and Test-Taking Strategies
for Guaranteed Success
1. Dehydration in Gastroenteritis
Question:
A nurse is caring for a client who has gastroenteritis. Which of the following assessment
findings should the nurse recognize as an indication that the client is experiencing
dehydration?
Options: a. Pitting, dependent edema
b. Distended jugular veins
c. Increased BP
d. Decreased BP ✅
Rationale:
Dehydration leads to a reduced circulating blood volume, which results in hypotension
(low blood pressure). This is a classic indicator, especially in patients with fluid loss
such as from vomiting or diarrhea due to gastroenteritis.
2. IV Medication for Diabetes Insipidus
Question:
A nurse is caring for a client who has a contusion of the brainstem and reports thirst.
The client's urinary output was 4,000 ml over the past 24 hours. The nurse should
anticipate a prescription for which of the following IV medications?
Options: a. Desmopressin ✅
b. Epinephrine
c. Furosemide
d. Nitroprusside
Rationale:
High urine output and excessive thirst are signs of diabetes insipidus, commonly
associated with brain injuries. Desmopressin is a synthetic form of antidiuretic
hormone (ADH) and is used to treat this condition by reducing urine production.
,3. ACE Inhibitor Cough
Question:
A nurse in a clinic receives a phone call from a client who recently started therapy with
an ACE inhibitor and reports a nagging dry cough. Which of the following responses by
the nurse is appropriate?
Options: a. "Your cough may require that you stop or change your medication." ✅
b. "Increasing your daily fluid intake may eliminate your cough."
c. "Sucking on lozenge may reduce the frequency of your cough."
d. "Your cough should go away in time."
Rationale:
A persistent dry cough is a common side effect of ACE inhibitors due to the
accumulation of bradykinin. This may warrant discontinuing or switching to another
class of medication like ARBs.
4. Trigger for Raynaud's Disease
Question:
A nurse is taking an admission history from a client who reports Raynaud's disease.
Which of the following assessment findings should the nurse identify as a potential
trigger for exacerbations?
Options: a. Eating a strict vegetarian diet
b. A history of herpes zoster
c. Taking amiodipine for hypertension
d. Using a nicotine transdermal patch ✅
Rationale:
Nicotine is a vasoconstrictor and can significantly worsen the vasospastic episodes
seen in Raynaud's disease. Even nicotine patches can provoke attacks.
5. Spironolactone and Electrolyte Imbalance
Question:
A nurse is providing discharge teaching to a client who has a prescription for
spironolactone. Which of the following statements by the client indicates an
understanding of the teaching?
Options: a. “I will use a salt substitute instead of regular salt.”
b. “I will eat foods that are high in potassium.”
, c. “I will report a high potassium level to my provider.” ✅
d. “I will use a diuretic with this medication.”
Rationale:
Spironolactone is a potassium-sparing diuretic. Clients taking it are at risk for
hyperkalemia and should avoid potassium-rich foods and salt substitutes containing
potassium. Reporting high potassium levels is crucial to avoid complications like
cardiac arrhythmias.
6. Allopurinol and Gout
Question:
A nurse is reviewing the medication record of a client who has gout and a new
prescription for allopurinol. The nurse should recognize that which of the following
medications interacts adversely with allopurinol?
Options: a. Ibuprofen
b. Warfarin ✅
c. Metoprolol
d. Furosemide
Rationale:
Allopurinol can increase the effects of warfarin, raising the risk for bleeding. Clients on
both medications should be monitored closely, and warfarin dosage may need
adjustment.
7. Discharge Teaching: Metronidazole
Question:
A nurse is providing discharge teaching to a client who has a prescription for
metronidazole. Which of the following statements by the client indicates an
understanding of the teaching?
Options: a. “I can have a glass of wine with dinner.”
b. “I will avoid drinking alcohol while taking this medication.” ✅
c. “I will take the medication on an empty stomach.”
d. “I may stop the medication once I feel better.”
Rationale:
Alcohol should be avoided while taking metronidazole and for at least 48 hours after
discontinuation due to the risk of a disulfiram-like reaction (flushing, nausea, vomiting,
hypotension).
