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ATI Medical Surgical 2025/2026
Proctored Exam – 2 Versions (A & B) |
200 Verified Questions and Correct
Answers | Graded A+
Version A (100 Questions)
Respiratory (20 Questions)
1. A client with chronic obstructive pulmonary disease (COPD) is experiencing dyspnea.
Which position should the nurse place the client in to improve breathing?
A. Supine with head elevated.
B. High Fowler’s position.
C. Trendelenburg position.
D. Prone position.
Rationale: High Fowler’s position (sitting upright at 60-90 degrees) promotes lung
expansion and reduces dyspnea in COPD by facilitating diaphragmatic movement.
2. A client with pneumonia develops a fever of 102.8°F. Which action should the nurse take
first?
A. Administer antibiotics as prescribed.
B. Administer acetaminophen as prescribed.
C. Apply a cooling blanket.
D. Increase fluid intake.
Rationale: Acetaminophen is the first-line treatment to reduce fever and improve client
comfort while addressing the underlying infection with antibiotics.
3. A client with a chest tube reports sudden shortness of breath and no drainage in the
system. What should the nurse suspect?
A. Pneumothorax resolution.
B. Chest tube occlusion.
C. Normal post-procedure response.
D. Pulmonary edema.
Rationale: Sudden shortness of breath and lack of drainage suggest chest tube occlusion,
which can lead to tension pneumothorax if not addressed.
, 2
4. A client with asthma is prescribed albuterol via nebulizer. Which side effect should the
nurse monitor for?
A. Bradycardia.
B. Tremors.
C. Hypotension.
D. Constipation.
Rationale: Albuterol, a beta-agonist, can cause tremors due to nervous system
stimulation.
5. A client with a history of tuberculosis is prescribed isoniazid. Which vitamin supplement
should the nurse recommend?
A. Vitamin C.
B. Vitamin B6.
C. Vitamin D.
D. Vitamin A.
Rationale: Isoniazid can cause peripheral neuropathy due to vitamin B6 deficiency, so
supplementation is recommended.
6. A client with acute respiratory distress syndrome (ARDS) is on mechanical ventilation.
Which arterial blood gas result indicates respiratory acidosis?
A. pH 7.45, PaCO2 35 mmHg.
B. pH 7.30, PaCO2 50 mmHg.
C. pH 7.50, PaCO2 30 mmHg.
D. pH 7.40, PaCO2 40 mmHg.
Rationale: Respiratory acidosis is indicated by a low pH (<7.35) and elevated PaCO2
(>45 mmHg), reflecting CO2 retention.
7. A client with a tracheostomy is at risk for aspiration during feeding. Which action should
the nurse take?
A. Deflate the tracheostomy cuff.
B. Keep the tracheostomy cuff inflated.
C. Remove the tracheostomy tube.
D. Position the client supine.
Rationale: Keeping the tracheostomy cuff inflated during feeding prevents aspiration by
blocking the airway from food particles.
8. A client with COPD is prescribed oxygen at 2 L/min via nasal cannula. Which instruction
should the nurse provide?
A. Use oxygen only during activity.
B. Keep oxygen on at all times.
C. Remove oxygen during meals.
D. Increase flow rate if short of breath.
, 3
Rationale: Continuous oxygen therapy is prescribed for COPD to maintain adequate
oxygenation, especially during rest.
9. A client with a pulmonary embolism is receiving heparin. Which laboratory value should
the nurse monitor?
A. International normalized ratio (INR).
B. Activated partial thromboplastin time (aPTT).
C. Prothrombin time (PT).
D. Platelet count.
Rationale: Heparin’s anticoagulant effect is monitored using aPTT to ensure therapeutic
levels and prevent complications.
10. A client with a history of asthma reports wheezing. Which action should the nurse take
first?
A. Administer oral steroids.
B. Administer albuterol via nebulizer.
C. Encourage deep breathing exercises.
D. Apply oxygen at 4 L/min.
Rationale: Albuterol is the first-line treatment for acute asthma exacerbations to relieve
bronchospasm.
11. A client with pneumonia is prescribed levofloxacin. Which instruction should the nurse
include?
A. Take with dairy products.
B. Avoid sun exposure.
C. Take at bedtime only.
D. Double the dose if missed.
Rationale: Levofloxacin can cause photosensitivity, so clients should avoid sun exposure
to prevent skin reactions.
12. A client with a history of lung cancer reports hemoptysis. What should the nurse do first?
A. Administer oxygen.
B. Assess airway patency.
C. Prepare for intubation.
D. Notify the family.
Rationale: Hemoptysis can compromise the airway, so assessing patency is the priority
to ensure adequate oxygenation.
13. A client with a history of COPD reports increased sputum production. Which action
should the nurse take?
A. Restrict fluid intake.
B. Assess sputum color and consistency.
, 4
C. Administer antihistamines.
D. Encourage bed rest.
Rationale: Sputum color and consistency can indicate infection or exacerbation,
requiring further evaluation.
14. A client with a pneumothorax has a chest tube inserted. Which finding indicates the
pneumothorax is resolving?
A. Continuous bubbling in the water seal chamber.
B. Decreased bubbling in the water seal chamber.
C. Increased drainage in the collection chamber.
D. Fluctuation in the suction chamber.
Rationale: Decreased bubbling in the water seal chamber indicates resolving air leak as
the pneumothorax improves.
15. A client with a history of sleep apnea is prescribed continuous positive airway pressure
(CPAP). Which instruction should the nurse include?
A. Use only during daytime naps.
B. Use during sleep every night.
C. Remove the mask if discomfort occurs.
D. Increase pressure if snoring persists.
Rationale: CPAP is most effective when used consistently during sleep to maintain
airway patency.
16. A client with a history of bronchitis is prescribed guaifenesin. Which instruction should
the nurse provide?
A. Take with food to prevent nausea.
B. Increase fluid intake.
C. Take at bedtime only.
D. Avoid caffeine.
Rationale: Guaifenesin is an expectorant, and increased fluid intake helps thin mucus for
easier expectoration.
17. A client with a history of pulmonary hypertension is prescribed sildenafil. Which side
effect should the nurse monitor for?
A. Hyperglycemia.
B. Hypotension.
C. Weight gain.
D. Insomnia.
Rationale: Sildenafil, a vasodilator, can cause hypotension, requiring careful
monitoring.
ATI Medical Surgical 2025/2026
Proctored Exam – 2 Versions (A & B) |
200 Verified Questions and Correct
Answers | Graded A+
Version A (100 Questions)
Respiratory (20 Questions)
1. A client with chronic obstructive pulmonary disease (COPD) is experiencing dyspnea.
Which position should the nurse place the client in to improve breathing?
A. Supine with head elevated.
B. High Fowler’s position.
C. Trendelenburg position.
D. Prone position.
Rationale: High Fowler’s position (sitting upright at 60-90 degrees) promotes lung
expansion and reduces dyspnea in COPD by facilitating diaphragmatic movement.
2. A client with pneumonia develops a fever of 102.8°F. Which action should the nurse take
first?
A. Administer antibiotics as prescribed.
B. Administer acetaminophen as prescribed.
C. Apply a cooling blanket.
D. Increase fluid intake.
Rationale: Acetaminophen is the first-line treatment to reduce fever and improve client
comfort while addressing the underlying infection with antibiotics.
3. A client with a chest tube reports sudden shortness of breath and no drainage in the
system. What should the nurse suspect?
A. Pneumothorax resolution.
B. Chest tube occlusion.
C. Normal post-procedure response.
D. Pulmonary edema.
Rationale: Sudden shortness of breath and lack of drainage suggest chest tube occlusion,
which can lead to tension pneumothorax if not addressed.
, 2
4. A client with asthma is prescribed albuterol via nebulizer. Which side effect should the
nurse monitor for?
A. Bradycardia.
B. Tremors.
C. Hypotension.
D. Constipation.
Rationale: Albuterol, a beta-agonist, can cause tremors due to nervous system
stimulation.
5. A client with a history of tuberculosis is prescribed isoniazid. Which vitamin supplement
should the nurse recommend?
A. Vitamin C.
B. Vitamin B6.
C. Vitamin D.
D. Vitamin A.
Rationale: Isoniazid can cause peripheral neuropathy due to vitamin B6 deficiency, so
supplementation is recommended.
6. A client with acute respiratory distress syndrome (ARDS) is on mechanical ventilation.
Which arterial blood gas result indicates respiratory acidosis?
A. pH 7.45, PaCO2 35 mmHg.
B. pH 7.30, PaCO2 50 mmHg.
C. pH 7.50, PaCO2 30 mmHg.
D. pH 7.40, PaCO2 40 mmHg.
Rationale: Respiratory acidosis is indicated by a low pH (<7.35) and elevated PaCO2
(>45 mmHg), reflecting CO2 retention.
7. A client with a tracheostomy is at risk for aspiration during feeding. Which action should
the nurse take?
A. Deflate the tracheostomy cuff.
B. Keep the tracheostomy cuff inflated.
C. Remove the tracheostomy tube.
D. Position the client supine.
Rationale: Keeping the tracheostomy cuff inflated during feeding prevents aspiration by
blocking the airway from food particles.
8. A client with COPD is prescribed oxygen at 2 L/min via nasal cannula. Which instruction
should the nurse provide?
A. Use oxygen only during activity.
B. Keep oxygen on at all times.
C. Remove oxygen during meals.
D. Increase flow rate if short of breath.
, 3
Rationale: Continuous oxygen therapy is prescribed for COPD to maintain adequate
oxygenation, especially during rest.
9. A client with a pulmonary embolism is receiving heparin. Which laboratory value should
the nurse monitor?
A. International normalized ratio (INR).
B. Activated partial thromboplastin time (aPTT).
C. Prothrombin time (PT).
D. Platelet count.
Rationale: Heparin’s anticoagulant effect is monitored using aPTT to ensure therapeutic
levels and prevent complications.
10. A client with a history of asthma reports wheezing. Which action should the nurse take
first?
A. Administer oral steroids.
B. Administer albuterol via nebulizer.
C. Encourage deep breathing exercises.
D. Apply oxygen at 4 L/min.
Rationale: Albuterol is the first-line treatment for acute asthma exacerbations to relieve
bronchospasm.
11. A client with pneumonia is prescribed levofloxacin. Which instruction should the nurse
include?
A. Take with dairy products.
B. Avoid sun exposure.
C. Take at bedtime only.
D. Double the dose if missed.
Rationale: Levofloxacin can cause photosensitivity, so clients should avoid sun exposure
to prevent skin reactions.
12. A client with a history of lung cancer reports hemoptysis. What should the nurse do first?
A. Administer oxygen.
B. Assess airway patency.
C. Prepare for intubation.
D. Notify the family.
Rationale: Hemoptysis can compromise the airway, so assessing patency is the priority
to ensure adequate oxygenation.
13. A client with a history of COPD reports increased sputum production. Which action
should the nurse take?
A. Restrict fluid intake.
B. Assess sputum color and consistency.
, 4
C. Administer antihistamines.
D. Encourage bed rest.
Rationale: Sputum color and consistency can indicate infection or exacerbation,
requiring further evaluation.
14. A client with a pneumothorax has a chest tube inserted. Which finding indicates the
pneumothorax is resolving?
A. Continuous bubbling in the water seal chamber.
B. Decreased bubbling in the water seal chamber.
C. Increased drainage in the collection chamber.
D. Fluctuation in the suction chamber.
Rationale: Decreased bubbling in the water seal chamber indicates resolving air leak as
the pneumothorax improves.
15. A client with a history of sleep apnea is prescribed continuous positive airway pressure
(CPAP). Which instruction should the nurse include?
A. Use only during daytime naps.
B. Use during sleep every night.
C. Remove the mask if discomfort occurs.
D. Increase pressure if snoring persists.
Rationale: CPAP is most effective when used consistently during sleep to maintain
airway patency.
16. A client with a history of bronchitis is prescribed guaifenesin. Which instruction should
the nurse provide?
A. Take with food to prevent nausea.
B. Increase fluid intake.
C. Take at bedtime only.
D. Avoid caffeine.
Rationale: Guaifenesin is an expectorant, and increased fluid intake helps thin mucus for
easier expectoration.
17. A client with a history of pulmonary hypertension is prescribed sildenafil. Which side
effect should the nurse monitor for?
A. Hyperglycemia.
B. Hypotension.
C. Weight gain.
D. Insomnia.
Rationale: Sildenafil, a vasodilator, can cause hypotension, requiring careful
monitoring.
