ATI RN MEDICAL-SURGICAL PROCTORED EXAM 2019 RETAKE
ATI RN MEDICAL-SURGICAL
PROCTORED EXAM 2019 RETAKE
VERIFIED QUESTIONS AND ANSWERS
WITH RATIONALES
1|Page
,ATI RN MEDICAL-SURGICAL PROCTORED EXAM 2019 RETAKE
A nurse is caring for a client with heart failure who has new onset crackles
and dyspnea. Which action should the nurse take first?
A. Administer prescribed furosemide
B. Place the client in high-Fowler’s position
C. Restrict oral fluids
D. Notify the provider
Correct Answer: B. Place the client in high-Fowler’s position
Rationale:
Airway and breathing take priority. Positioning the client upright immediately
improves lung expansion and reduces venous return to the heart, decreasing
pulmonary congestion. Medication administration follows after stabilization.
A client with type 1 diabetes reports feeling shaky and diaphoretic. Blood
glucose is 52 mg/dL. What is the nurse’s priority action?
A. Administer 1 mg glucagon IM
B. Give 15 g of fast-acting carbohydrates
C. Start IV dextrose 50%
D. Recheck glucose in 30 minutes
Correct Answer: B. Give 15 g of fast-acting carbohydrates
Rationale:
The client is conscious and symptomatic. The 15-15 rule applies: give 15 g of rapid
carbohydrate (juice, glucose tablets), then recheck in 15 minutes.
Which finding requires immediate intervention in a client receiving heparin
therapy?
A. aPTT of 68 seconds
B. Bruising at injection site
C. Hematuria
D. Platelet count of 220,000/mm³
2|Page
,ATI RN MEDICAL-SURGICAL PROCTORED EXAM 2019 RETAKE
Correct Answer: C. Hematuria
Rationale:
Hematuria indicates possible internal bleeding. Therapeutic aPTT is typically 60–
80 seconds. Mild bruising is common. Normal platelets rule out HIT.
A nurse is caring for a client 24 hours after a thyroidectomy. Which finding
requires immediate reporting?
A. Hoarseness
B. Calcium level 8.5 mg/dL
C. Tingling around the mouth
D. Pain rating 6/10
Correct Answer: C. Tingling around the mouth
Rationale:
Perioral tingling suggests hypocalcemia due to parathyroid damage. This can
progress to tetany and airway compromise.
A client with COPD is prescribed oxygen at 6 L/min via nasal cannula. Which
action is appropriate?
A. Increase oxygen to 10 L
B. Apply humidification
C. Switch to non-rebreather mask
D. Maintain low-flow oxygen per prescription
Correct Answer: D. Maintain low-flow oxygen per prescription
Rationale:
COPD clients rely on hypoxic drive. High oxygen levels can suppress respiratory
drive. Low-flow oxygen is appropriate.
Which assessment finding indicates fluid volume overload?
3|Page
, ATI RN MEDICAL-SURGICAL PROCTORED EXAM 2019 RETAKE
A. Flat neck veins
B. Hypotension
C. Bounding pulse
D. Dry mucous membranes
Correct Answer: C. Bounding pulse
Rationale:
Fluid overload presents with hypertension, bounding pulses, edema, and distended
neck veins.
A client with pancreatitis reports severe abdominal pain. Which lab value
supports this diagnosis?
A. Decreased amylase
B. Elevated lipase
C. Low calcium
D. High hemoglobin
Correct Answer: B. Elevated lipase
Rationale:
Lipase is more specific for pancreatitis and remains elevated longer than amylase.
A nurse is teaching a client with warfarin therapy. Which statement indicates
understanding?
A. “I will increase green leafy vegetables.”
B. “I will use a soft toothbrush.”
C. “I can take ibuprofen for headaches.”
D. “I will skip doses if I bruise.”
Correct Answer: B. “I will use a soft toothbrush.”
Rationale:
Soft toothbrush reduces bleeding risk. Vitamin K foods should remain consistent.
NSAIDs increase bleeding risk.
4|Page
ATI RN MEDICAL-SURGICAL
PROCTORED EXAM 2019 RETAKE
VERIFIED QUESTIONS AND ANSWERS
WITH RATIONALES
1|Page
,ATI RN MEDICAL-SURGICAL PROCTORED EXAM 2019 RETAKE
A nurse is caring for a client with heart failure who has new onset crackles
and dyspnea. Which action should the nurse take first?
A. Administer prescribed furosemide
B. Place the client in high-Fowler’s position
C. Restrict oral fluids
D. Notify the provider
Correct Answer: B. Place the client in high-Fowler’s position
Rationale:
Airway and breathing take priority. Positioning the client upright immediately
improves lung expansion and reduces venous return to the heart, decreasing
pulmonary congestion. Medication administration follows after stabilization.
A client with type 1 diabetes reports feeling shaky and diaphoretic. Blood
glucose is 52 mg/dL. What is the nurse’s priority action?
A. Administer 1 mg glucagon IM
B. Give 15 g of fast-acting carbohydrates
C. Start IV dextrose 50%
D. Recheck glucose in 30 minutes
Correct Answer: B. Give 15 g of fast-acting carbohydrates
Rationale:
The client is conscious and symptomatic. The 15-15 rule applies: give 15 g of rapid
carbohydrate (juice, glucose tablets), then recheck in 15 minutes.
Which finding requires immediate intervention in a client receiving heparin
therapy?
A. aPTT of 68 seconds
B. Bruising at injection site
C. Hematuria
D. Platelet count of 220,000/mm³
2|Page
,ATI RN MEDICAL-SURGICAL PROCTORED EXAM 2019 RETAKE
Correct Answer: C. Hematuria
Rationale:
Hematuria indicates possible internal bleeding. Therapeutic aPTT is typically 60–
80 seconds. Mild bruising is common. Normal platelets rule out HIT.
A nurse is caring for a client 24 hours after a thyroidectomy. Which finding
requires immediate reporting?
A. Hoarseness
B. Calcium level 8.5 mg/dL
C. Tingling around the mouth
D. Pain rating 6/10
Correct Answer: C. Tingling around the mouth
Rationale:
Perioral tingling suggests hypocalcemia due to parathyroid damage. This can
progress to tetany and airway compromise.
A client with COPD is prescribed oxygen at 6 L/min via nasal cannula. Which
action is appropriate?
A. Increase oxygen to 10 L
B. Apply humidification
C. Switch to non-rebreather mask
D. Maintain low-flow oxygen per prescription
Correct Answer: D. Maintain low-flow oxygen per prescription
Rationale:
COPD clients rely on hypoxic drive. High oxygen levels can suppress respiratory
drive. Low-flow oxygen is appropriate.
Which assessment finding indicates fluid volume overload?
3|Page
, ATI RN MEDICAL-SURGICAL PROCTORED EXAM 2019 RETAKE
A. Flat neck veins
B. Hypotension
C. Bounding pulse
D. Dry mucous membranes
Correct Answer: C. Bounding pulse
Rationale:
Fluid overload presents with hypertension, bounding pulses, edema, and distended
neck veins.
A client with pancreatitis reports severe abdominal pain. Which lab value
supports this diagnosis?
A. Decreased amylase
B. Elevated lipase
C. Low calcium
D. High hemoglobin
Correct Answer: B. Elevated lipase
Rationale:
Lipase is more specific for pancreatitis and remains elevated longer than amylase.
A nurse is teaching a client with warfarin therapy. Which statement indicates
understanding?
A. “I will increase green leafy vegetables.”
B. “I will use a soft toothbrush.”
C. “I can take ibuprofen for headaches.”
D. “I will skip doses if I bruise.”
Correct Answer: B. “I will use a soft toothbrush.”
Rationale:
Soft toothbrush reduces bleeding risk. Vitamin K foods should remain consistent.
NSAIDs increase bleeding risk.
4|Page
