ATI Medical-Surgical Exam 1 Study Guide (Adult Health) 2026
|Questions |Answers |Rationales
1. A nurse is assessing a client who has fluid volume excess. Which of the
following findings should the nurse expect?
A. Flat neck veins
B. Increased hematocrit
C. Crackles upon auscultation
D. Bradycardia
Answer: C
Rationale: Fluid volume excess often leads to pulmonary edema, which presents as
crackles during lung auscultation. Neck veins are typically distended, hematocrit decreases
due to hemodilution, and tachycardia is more common than bradycardia.
2. A nurse is caring for a client who has a potassium level of 2.8 mEq/L. Which of
the following findings should the nurse expect?
A. Hyperactive bowel sounds
B. Positive Trousseau’s sign
C. Elevated ST segment
D. Prominent U-waves on ECG
Answer: D
Rationale: Hypokalemia (potassium < 3.5 mEq/L) is associated with ECG changes such as
prominent U-waves, flattened T-waves, and ST depression. Positive Trousseau’s sign is
associated with hypocalcemia.
,3. A client is undergoing a thoracentesis. In which position should the nurse
place the client during the procedure?
A. Prone with a pillow under the abdomen
B. Supine with the head of the bed flat
C. Left side-lying with the right knee flexed
D. Sitting upright while leaning over a bedside table
Answer: D
Rationale: The upright position leaning over a bedside table widens the intercostal spaces
and allows for easier access to the pleural space.
4. A nurse is assessing a client with hypocalcemia. Which of the following
techniques should the nurse use to check for Chvostek’s sign?
A. Tap the client’s facial nerve in front of the ear
B. Apply a blood pressure cuff to the upper arm
C. Check for a positive Babinski reflex
D. Auscultate for a carotid bruit
Answer: A
Rationale: Chvostek’s sign is a clinical sign of hypocalcemia elicited by tapping the facial
nerve, which results in twitching of the facial muscles.
5. A nurse is teaching a client about a scheduled colonoscopy. Which of the
following instructions should the nurse include?
A. Eat a high-fiber diet the day before the procedure
B. Stop all medications 48 hours prior
C. Expect abdominal pain for two days after the procedure
D. Drink only clear liquids the day before the procedure
Answer: D
Rationale: Preparation for a colonoscopy requires a clear liquid diet the day before to
ensure the bowel is properly visualized during the procedure.
, 6. Which of the following ABG results indicates respiratory acidosis?
A. pH 7.50, PaCO2 30 mm Hg
B. pH 7.30, PaCO2 50 mm Hg
C. pH 7.32, HCO3 18 mEq/L
D. pH 7.48, HCO3 28 mEq/L
Answer: B
Rationale: Respiratory acidosis is characterized by a low pH (<7.35) and a high PaCO2
(>45 mm Hg).
7. A nurse is preparing to administer a blood transfusion. Which of the following
is the most important action to take first?
A. Verify the client’s identity and blood type with another nurse
B. Check the client’s temperature
C. Prime the tubing with 0.45% normal saline
D. Ensure the client has a 24-gauge IV catheter
Answer: A
Rationale: The highest priority safety action is verifying the correct client and blood
product with a second licensed nurse. Normal saline (0.9%) should be used, not 0.45%.
8. A nurse is caring for a client with a chest tube. The nurse notes continuous
bubbling in the water seal chamber. This is an indication of which of the
following?
A. Normal functioning of the system
B. An air leak in the system
C. A lung that has fully re-expanded
D. The suction pressure is too high
Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
Intermittent bubbling is normal during expiration or coughing.
|Questions |Answers |Rationales
1. A nurse is assessing a client who has fluid volume excess. Which of the
following findings should the nurse expect?
A. Flat neck veins
B. Increased hematocrit
C. Crackles upon auscultation
D. Bradycardia
Answer: C
Rationale: Fluid volume excess often leads to pulmonary edema, which presents as
crackles during lung auscultation. Neck veins are typically distended, hematocrit decreases
due to hemodilution, and tachycardia is more common than bradycardia.
2. A nurse is caring for a client who has a potassium level of 2.8 mEq/L. Which of
the following findings should the nurse expect?
A. Hyperactive bowel sounds
B. Positive Trousseau’s sign
C. Elevated ST segment
D. Prominent U-waves on ECG
Answer: D
Rationale: Hypokalemia (potassium < 3.5 mEq/L) is associated with ECG changes such as
prominent U-waves, flattened T-waves, and ST depression. Positive Trousseau’s sign is
associated with hypocalcemia.
,3. A client is undergoing a thoracentesis. In which position should the nurse
place the client during the procedure?
A. Prone with a pillow under the abdomen
B. Supine with the head of the bed flat
C. Left side-lying with the right knee flexed
D. Sitting upright while leaning over a bedside table
Answer: D
Rationale: The upright position leaning over a bedside table widens the intercostal spaces
and allows for easier access to the pleural space.
4. A nurse is assessing a client with hypocalcemia. Which of the following
techniques should the nurse use to check for Chvostek’s sign?
A. Tap the client’s facial nerve in front of the ear
B. Apply a blood pressure cuff to the upper arm
C. Check for a positive Babinski reflex
D. Auscultate for a carotid bruit
Answer: A
Rationale: Chvostek’s sign is a clinical sign of hypocalcemia elicited by tapping the facial
nerve, which results in twitching of the facial muscles.
5. A nurse is teaching a client about a scheduled colonoscopy. Which of the
following instructions should the nurse include?
A. Eat a high-fiber diet the day before the procedure
B. Stop all medications 48 hours prior
C. Expect abdominal pain for two days after the procedure
D. Drink only clear liquids the day before the procedure
Answer: D
Rationale: Preparation for a colonoscopy requires a clear liquid diet the day before to
ensure the bowel is properly visualized during the procedure.
, 6. Which of the following ABG results indicates respiratory acidosis?
A. pH 7.50, PaCO2 30 mm Hg
B. pH 7.30, PaCO2 50 mm Hg
C. pH 7.32, HCO3 18 mEq/L
D. pH 7.48, HCO3 28 mEq/L
Answer: B
Rationale: Respiratory acidosis is characterized by a low pH (<7.35) and a high PaCO2
(>45 mm Hg).
7. A nurse is preparing to administer a blood transfusion. Which of the following
is the most important action to take first?
A. Verify the client’s identity and blood type with another nurse
B. Check the client’s temperature
C. Prime the tubing with 0.45% normal saline
D. Ensure the client has a 24-gauge IV catheter
Answer: A
Rationale: The highest priority safety action is verifying the correct client and blood
product with a second licensed nurse. Normal saline (0.9%) should be used, not 0.45%.
8. A nurse is caring for a client with a chest tube. The nurse notes continuous
bubbling in the water seal chamber. This is an indication of which of the
following?
A. Normal functioning of the system
B. An air leak in the system
C. A lung that has fully re-expanded
D. The suction pressure is too high
Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
Intermittent bubbling is normal during expiration or coughing.
