ATI Medical-Surgical Proctored Exam Retake:
Verified Correct Answers & Full Solution Guide
Instructions
This proctored exam retake contains 80 multiple-choice questions designed to
test your knowledge in medical-surgical nursing, covering conditions across ma-
jor body systems (cardiovascular, neurological, gastrointestinal, renal, endocrine,
etc.). Each question includes four answer choices (A–D), with one correct an-
swer, followed by a rationale. An answer key is provided at the end.
Questions
Question 1: A nurse is caring for a client with acute myocardial infarction. Which find-
ing is most concerning?
A) Chest pain radiating to the jaw
B) Blood pressure of 140/90 mmHg
C) New-onset atrial fibrillation
D) Elevated troponin levels
Correct Answer: C) New-onset atrial fibrillation
Rationale: New-onset atrial fibrillation is concerning in myocardial in-
farction as it can reduce cardiac output and increase the risk of throm-
boembolism, requiring immediate intervention. Chest pain and elevated
troponin are expected, and the blood pressure is elevated but less critical.
Question 2: A client with a stroke presents with hemiplegia. What is the nurse’s priority
action?
A) Administer thrombolytics
B) Position the client to prevent contractures
C) Monitor for seizures
D) Encourage ambulation
Correct Answer: B) Position the client to prevent contractures
Rationale: Hemiplegia increases the risk of contractures, so proper po-
sitioning is the priority to maintain joint mobility. Thrombolytics have a
narrow time window, seizures are monitored later, and ambulation is pre-
mature in acute stroke.
Question 3: A client with peptic ulcer disease reports epigastric pain. Which medica-
tion should the nurse administer?
A) Ibuprofen
B) Omeprazole
1
, C) Metoclopramide
D) Loperamide
Correct Answer: B) Omeprazole
Rationale: Omeprazole, a proton pump inhibitor, reduces acid production
to promote ulcer healing. Ibuprofen worsens ulcers, metoclopramide af-
fects motility, and loperamide treats diarrhea, not ulcers.
Question 4: A client with acute kidney injury has a potassium level of 6.5 mEq/L. What
is the priority intervention?
A) Administer furosemide
B) Prepare for dialysis
C) Give potassium chloride
D) Increase fluid intake
Correct Answer: B) Prepare for dialysis
Rationale: A potassium level of 6.5 mEq/L indicates hyperkalemia, a life-
threatening condition requiring dialysis in acute kidney injury to remove
excess potassium. Furosemide may help but is slower, potassium chloride
worsens hyperkalemia, and fluids are not the priority.
Question 5: A client with type 1 diabetes presents with confusion and fruity breath.
What is the likely diagnosis?
A) Hypoglycemia
B) Diabetic ketoacidosis
C) Hyperosmolar hyperglycemic state
D) Insulin overdose
Correct Answer: B) Diabetic ketoacidosis
Rationale: Confusion and fruity breath are hallmark signs of diabetic ke-
toacidosis, caused by insulin deficiency and ketone production in type 1 di-
abetes. Hypoglycemia causes sweating and shakiness, hyperosmolar state
is more common in type 2, and insulin overdose causes hypoglycemia.
Question 6: A client with heart failure is prescribed furosemide. Which electrolyte
should the nurse monitor closely?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Correct Answer: B) Potassium
Rationale: Furosemide, a loop diuretic, causes potassium loss, increasing
the risk of hypokalemia, which can lead to arrhythmias in heart failure
clients. Other electrolytes are monitored but are less critical.
2
, Question 7: A client with a seizure disorder is unresponsive after a tonic-clonic seizure.
What is the nurse’s priority action?
A) Administer lorazepam
B) Place a tongue depressor
C) Ensure airway patency
D) Restrain the client
Correct Answer: C) Ensure airway patency
Rationale: Post-seizure, ensuring airway patency is the priority to prevent
hypoxia. Lorazepam is given during active seizures, tongue depressors are
unsafe, and restraint is inappropriate.
Question 8: A client with cirrhosis reports hematemesis. What is the nurse’s priority
action?
A) Administer vitamin K
B) Prepare for endoscopy
C) Give antacids
D) Monitor vital signs
Correct Answer: B) Prepare for endoscopy
Rationale: Hematemesis in cirrhosis suggests esophageal varices, requir-
ing urgent endoscopy for diagnosis and treatment. Vitamin K and antacids
are not immediate priorities, and monitoring is secondary.
Question 9: A client with chronic kidney disease is on hemodialysis. Which dietary re-
striction is most important?
A) Low-protein diet
B) Low-potassium diet
C) Low-carbohydrate diet
D) Low-fat diet
Correct Answer: B) Low-potassium diet
Rationale: Chronic kidney disease impairs potassium excretion, risking
hyperkalemia. A low-potassium diet is critical to prevent arrhythmias. Pro-
tein is restricted but less urgent, and carbohydrate or fat restrictions are
not typically prioritized.
Question 10: A client with hyperthyroidism reports palpitations. Which medication should
the nurse expect to administer?
A) Levothyroxine
B) Methimazole
C) Insulin
D) Metformin
3
Verified Correct Answers & Full Solution Guide
Instructions
This proctored exam retake contains 80 multiple-choice questions designed to
test your knowledge in medical-surgical nursing, covering conditions across ma-
jor body systems (cardiovascular, neurological, gastrointestinal, renal, endocrine,
etc.). Each question includes four answer choices (A–D), with one correct an-
swer, followed by a rationale. An answer key is provided at the end.
Questions
Question 1: A nurse is caring for a client with acute myocardial infarction. Which find-
ing is most concerning?
A) Chest pain radiating to the jaw
B) Blood pressure of 140/90 mmHg
C) New-onset atrial fibrillation
D) Elevated troponin levels
Correct Answer: C) New-onset atrial fibrillation
Rationale: New-onset atrial fibrillation is concerning in myocardial in-
farction as it can reduce cardiac output and increase the risk of throm-
boembolism, requiring immediate intervention. Chest pain and elevated
troponin are expected, and the blood pressure is elevated but less critical.
Question 2: A client with a stroke presents with hemiplegia. What is the nurse’s priority
action?
A) Administer thrombolytics
B) Position the client to prevent contractures
C) Monitor for seizures
D) Encourage ambulation
Correct Answer: B) Position the client to prevent contractures
Rationale: Hemiplegia increases the risk of contractures, so proper po-
sitioning is the priority to maintain joint mobility. Thrombolytics have a
narrow time window, seizures are monitored later, and ambulation is pre-
mature in acute stroke.
Question 3: A client with peptic ulcer disease reports epigastric pain. Which medica-
tion should the nurse administer?
A) Ibuprofen
B) Omeprazole
1
, C) Metoclopramide
D) Loperamide
Correct Answer: B) Omeprazole
Rationale: Omeprazole, a proton pump inhibitor, reduces acid production
to promote ulcer healing. Ibuprofen worsens ulcers, metoclopramide af-
fects motility, and loperamide treats diarrhea, not ulcers.
Question 4: A client with acute kidney injury has a potassium level of 6.5 mEq/L. What
is the priority intervention?
A) Administer furosemide
B) Prepare for dialysis
C) Give potassium chloride
D) Increase fluid intake
Correct Answer: B) Prepare for dialysis
Rationale: A potassium level of 6.5 mEq/L indicates hyperkalemia, a life-
threatening condition requiring dialysis in acute kidney injury to remove
excess potassium. Furosemide may help but is slower, potassium chloride
worsens hyperkalemia, and fluids are not the priority.
Question 5: A client with type 1 diabetes presents with confusion and fruity breath.
What is the likely diagnosis?
A) Hypoglycemia
B) Diabetic ketoacidosis
C) Hyperosmolar hyperglycemic state
D) Insulin overdose
Correct Answer: B) Diabetic ketoacidosis
Rationale: Confusion and fruity breath are hallmark signs of diabetic ke-
toacidosis, caused by insulin deficiency and ketone production in type 1 di-
abetes. Hypoglycemia causes sweating and shakiness, hyperosmolar state
is more common in type 2, and insulin overdose causes hypoglycemia.
Question 6: A client with heart failure is prescribed furosemide. Which electrolyte
should the nurse monitor closely?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Correct Answer: B) Potassium
Rationale: Furosemide, a loop diuretic, causes potassium loss, increasing
the risk of hypokalemia, which can lead to arrhythmias in heart failure
clients. Other electrolytes are monitored but are less critical.
2
, Question 7: A client with a seizure disorder is unresponsive after a tonic-clonic seizure.
What is the nurse’s priority action?
A) Administer lorazepam
B) Place a tongue depressor
C) Ensure airway patency
D) Restrain the client
Correct Answer: C) Ensure airway patency
Rationale: Post-seizure, ensuring airway patency is the priority to prevent
hypoxia. Lorazepam is given during active seizures, tongue depressors are
unsafe, and restraint is inappropriate.
Question 8: A client with cirrhosis reports hematemesis. What is the nurse’s priority
action?
A) Administer vitamin K
B) Prepare for endoscopy
C) Give antacids
D) Monitor vital signs
Correct Answer: B) Prepare for endoscopy
Rationale: Hematemesis in cirrhosis suggests esophageal varices, requir-
ing urgent endoscopy for diagnosis and treatment. Vitamin K and antacids
are not immediate priorities, and monitoring is secondary.
Question 9: A client with chronic kidney disease is on hemodialysis. Which dietary re-
striction is most important?
A) Low-protein diet
B) Low-potassium diet
C) Low-carbohydrate diet
D) Low-fat diet
Correct Answer: B) Low-potassium diet
Rationale: Chronic kidney disease impairs potassium excretion, risking
hyperkalemia. A low-potassium diet is critical to prevent arrhythmias. Pro-
tein is restricted but less urgent, and carbohydrate or fat restrictions are
not typically prioritized.
Question 10: A client with hyperthyroidism reports palpitations. Which medication should
the nurse expect to administer?
A) Levothyroxine
B) Methimazole
C) Insulin
D) Metformin
3
