ATI ADULT MEDICAL SURGICAL
QUESTIONS AND ANSWERS |
COMPREHENSIVE NCLEX STYLE STUDY
GUIDE 2026 | GRADED A+ |
GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep and Comprehensive Rationales Included
,Infection control: Appropriate room assignment Standard Precautions:
1. applies to all patients
2. Hand washing
a. alcohol based preferred unless hands visually soiled
3. Gloves - when touching anything that has the potential to contaminate.
4. Masks, eye protection & face shields when care may cause splashing or
spraying of body fluids
Droplet:
1. private room or with someone with same illness
2. masks
Airborne:
1. private room
2. masks or respiratory protection devices
a. use an N95 respirator for tuberculosis
3. Negative pressure airflow
4. full face protection if splashing or spraying is possible
Contact:
1. private room or room with same illness
2. gloves & gowns
3. disposal of infections dressing materials into a single, nonporous bag without
touching the outside of the bag
TB: Priority action for a client in the emergency -Wear an N95 or HEPA respirator
department (249) -Place client in negative airflow room and implement airborne precautions
-use barrier protection when the risk of hand or clothing contamination exists
Immunizations: Recommended vaccinations for older Adults age 50 or older:
adult clients (943) -Pneumococcal Vaccine (PPSV)
- Influenza vaccine
- Herpes Zoster Vaccine
-Hepatitis A
- Hepatitis B
- Meningococcal Vaccine
,Pulmonary Embolism: Risk factors for DVT (258) -Long term immobility
- Oral contraceptives
- Pregnancy
- Tobacco use
- Hypercoagulabilty
- Obesity
- Surgery
- Heart failure or chronic A-Fib
- Autoimmune hemolytic anemia (sickle cell)
-Long bone fractures
-Advanced age
Disorders of the male reproductive system: -Urethral trauma
Complications of continuous irrigation following Trans- -Urinary retention
urethral Resection (743) - Bleeding
- Infection
Stroke: Caring for a client who has left sided hemiplegia - Observe extremities for injury
(155) - Apply an arm sling if client is unable to care for the affected extremity
- Ensure foot rest is on wheel chair and ankle brace is on the affected foot
- Instruct client to dress the affected side first
Fractures and immobilization devices: Prevent -Assess neurovascular status of the affected body part for every hour for 24 hours
complications (787) and Q4 hours after that
- Maintain body alignment
- avoid lifting or removing weights
-Monitor pain level
- Monitor for signs of infection
- Support nutrition
Pain Management: use of non pharmacological methods - Cutaneous (skin) stimulation- TENS, heat, cold, therapeutic touch and massage
of pain relief - Distraction (deep breathing, ambulation, visitors, TV and music)
- Relaxation (meditation, yoga and progressive muscle relaxation
-Imagery (focus on pleasant thoughts)
- Elevation of extremities to promote venous return
Acute Kidney injury and chronic kidney disease: -Restrict dietary intake of potassium, phosphate and magnesium during oliguric
Evaluating teaching about nutrition phase
-K and Na is regulated according to stage of kidney injury
- high protein diet to replace the high rate of protein breakdown due to the stress
from the illness. Possible TPN
Heart failure and pulmonary edema: Dietary teaching Maintain fluid and sodium restriction
about sodium restriction Increase dietary intake of potassium
, Pulmonary Embolism: Planning care for a client who is -Assess for contraindications (active bleeding, peptic ulcer disease, history of
receiving enoxaparin stroke, recent trauma)
-Monitor bleeding times (PT, aPTT and INR)
-Monitor for side effects such as thrombocytopenia, anemia and hemmorhage
Rheumatoid Arthritis: Reviewing Laboratory Values -Positive Anti- cyclic citrullinated peptide
-RF Antibody (Diagnostic level for RA is 1:40-1:60) expected reference range 1:20
- Elevated ESR
20-40 mild inflammation
40-70 moderate
70-150 severe
- Positive C-reactive protein
- Positive ANA titier
- Elevated WBC's
Medications affecting coagulation: Heparin Avoid NSAIDS while on heparin
Contraindications
Antibiotics affecting protein synthesis: Adverse effects of -Ototoxicity: cochlear damage (hearing loss) and vestibular damage (loss of
gentamicin balance).
-Nephrotoxicity (proteinuria, elevated BUN, creatinine levels).
-Hypersensitivity ( rash, pruritis, parathesia of hands and feet, and urticaria).
Electrolyte imbalance: manifestations of hypokalemia Weak, irregular pulse, hypotension, respiratory distress
Premature ventricular contractions, bradycardia, inverted T waves, ST depression
Decreased GI motility, abdominal distension, constipation, n/v, anorexia, polyuria
Decreased K (<3.5)
ABG: Metabolic alkalosis (pH > 7.45)
Electrolyte imbalance: Priority assessment for Assessing for a patent and open airway
hypokalemia
Blood and blood product transfusions: Administering Initiate a large bore IV access: 20 gauge needle
Fresh Frozen Plasma Complete transfusion withing 2-4 hours time frame
If reaction occurs:
-Stop transfusion immediately
- Initiate 0.9% NaCl in a separate line
- Save blood bag and blood tubing
Cardiovascular Diagnostic and Therapeutic Procedures: -Assessing site every 8 hours. Note redness, swelling, drainage, tenderness and
Caring for a client who has a PICC condition of dressing
-Change tube and positive pressure cap per facility protocol
-Using 10mL or larger syringe to flush the line
-Cleanse with alcohol for 3 seconds before accessing it
-Use transparent dressing
QUESTIONS AND ANSWERS |
COMPREHENSIVE NCLEX STYLE STUDY
GUIDE 2026 | GRADED A+ |
GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep and Comprehensive Rationales Included
,Infection control: Appropriate room assignment Standard Precautions:
1. applies to all patients
2. Hand washing
a. alcohol based preferred unless hands visually soiled
3. Gloves - when touching anything that has the potential to contaminate.
4. Masks, eye protection & face shields when care may cause splashing or
spraying of body fluids
Droplet:
1. private room or with someone with same illness
2. masks
Airborne:
1. private room
2. masks or respiratory protection devices
a. use an N95 respirator for tuberculosis
3. Negative pressure airflow
4. full face protection if splashing or spraying is possible
Contact:
1. private room or room with same illness
2. gloves & gowns
3. disposal of infections dressing materials into a single, nonporous bag without
touching the outside of the bag
TB: Priority action for a client in the emergency -Wear an N95 or HEPA respirator
department (249) -Place client in negative airflow room and implement airborne precautions
-use barrier protection when the risk of hand or clothing contamination exists
Immunizations: Recommended vaccinations for older Adults age 50 or older:
adult clients (943) -Pneumococcal Vaccine (PPSV)
- Influenza vaccine
- Herpes Zoster Vaccine
-Hepatitis A
- Hepatitis B
- Meningococcal Vaccine
,Pulmonary Embolism: Risk factors for DVT (258) -Long term immobility
- Oral contraceptives
- Pregnancy
- Tobacco use
- Hypercoagulabilty
- Obesity
- Surgery
- Heart failure or chronic A-Fib
- Autoimmune hemolytic anemia (sickle cell)
-Long bone fractures
-Advanced age
Disorders of the male reproductive system: -Urethral trauma
Complications of continuous irrigation following Trans- -Urinary retention
urethral Resection (743) - Bleeding
- Infection
Stroke: Caring for a client who has left sided hemiplegia - Observe extremities for injury
(155) - Apply an arm sling if client is unable to care for the affected extremity
- Ensure foot rest is on wheel chair and ankle brace is on the affected foot
- Instruct client to dress the affected side first
Fractures and immobilization devices: Prevent -Assess neurovascular status of the affected body part for every hour for 24 hours
complications (787) and Q4 hours after that
- Maintain body alignment
- avoid lifting or removing weights
-Monitor pain level
- Monitor for signs of infection
- Support nutrition
Pain Management: use of non pharmacological methods - Cutaneous (skin) stimulation- TENS, heat, cold, therapeutic touch and massage
of pain relief - Distraction (deep breathing, ambulation, visitors, TV and music)
- Relaxation (meditation, yoga and progressive muscle relaxation
-Imagery (focus on pleasant thoughts)
- Elevation of extremities to promote venous return
Acute Kidney injury and chronic kidney disease: -Restrict dietary intake of potassium, phosphate and magnesium during oliguric
Evaluating teaching about nutrition phase
-K and Na is regulated according to stage of kidney injury
- high protein diet to replace the high rate of protein breakdown due to the stress
from the illness. Possible TPN
Heart failure and pulmonary edema: Dietary teaching Maintain fluid and sodium restriction
about sodium restriction Increase dietary intake of potassium
, Pulmonary Embolism: Planning care for a client who is -Assess for contraindications (active bleeding, peptic ulcer disease, history of
receiving enoxaparin stroke, recent trauma)
-Monitor bleeding times (PT, aPTT and INR)
-Monitor for side effects such as thrombocytopenia, anemia and hemmorhage
Rheumatoid Arthritis: Reviewing Laboratory Values -Positive Anti- cyclic citrullinated peptide
-RF Antibody (Diagnostic level for RA is 1:40-1:60) expected reference range 1:20
- Elevated ESR
20-40 mild inflammation
40-70 moderate
70-150 severe
- Positive C-reactive protein
- Positive ANA titier
- Elevated WBC's
Medications affecting coagulation: Heparin Avoid NSAIDS while on heparin
Contraindications
Antibiotics affecting protein synthesis: Adverse effects of -Ototoxicity: cochlear damage (hearing loss) and vestibular damage (loss of
gentamicin balance).
-Nephrotoxicity (proteinuria, elevated BUN, creatinine levels).
-Hypersensitivity ( rash, pruritis, parathesia of hands and feet, and urticaria).
Electrolyte imbalance: manifestations of hypokalemia Weak, irregular pulse, hypotension, respiratory distress
Premature ventricular contractions, bradycardia, inverted T waves, ST depression
Decreased GI motility, abdominal distension, constipation, n/v, anorexia, polyuria
Decreased K (<3.5)
ABG: Metabolic alkalosis (pH > 7.45)
Electrolyte imbalance: Priority assessment for Assessing for a patent and open airway
hypokalemia
Blood and blood product transfusions: Administering Initiate a large bore IV access: 20 gauge needle
Fresh Frozen Plasma Complete transfusion withing 2-4 hours time frame
If reaction occurs:
-Stop transfusion immediately
- Initiate 0.9% NaCl in a separate line
- Save blood bag and blood tubing
Cardiovascular Diagnostic and Therapeutic Procedures: -Assessing site every 8 hours. Note redness, swelling, drainage, tenderness and
Caring for a client who has a PICC condition of dressing
-Change tube and positive pressure cap per facility protocol
-Using 10mL or larger syringe to flush the line
-Cleanse with alcohol for 3 seconds before accessing it
-Use transparent dressing
