ATI CAPSTONE MED SURG (VERSION 1 & VERSION 2)
COMPREHENSIVE EXAM PREPARATION
200 QUESTIONS WITH CORRECT ANSWERS AND RATIONALES
1. A nurse is assessing a client who has a sodium level of 122 mEq/L.
Which of the following findings should the nurse expect?
A Hyperactive deep-tendon reflexes
B Increased urine output
C Decreased deep-tendon reflexes
D Elevated blood pressure
Correct Answer: C
Rationale: Hyponatremia (sodium < 135 mEq/L) causes neurological
manifestations including confusion, lethargy, muscle weakness, and
decreased deep-tendon reflexes. The low sodium level affects nerve
impulse transmission and muscle contraction.
2. A nurse is caring for a client following a bronchoscopy. Which of the
following actions is the nurse's priority?
A Monitor for hemoptysis
B Assess the client's gag reflex
C Check oxygen saturation
D Encourage deep breathing exercises
Correct Answer: B
,Rationale: Following a bronchoscopy, the priority is to assess the return
of the gag reflex before allowing the client to take anything by mouth.
This prevents aspiration, which is the greatest risk. Local anesthesia
used during the procedure numbs the throat and airway.
3. A nurse is providing discharge teaching to a client who had a
colposcopy with cervical biopsy. Which of the following instructions
should the nurse include?
A Resume sexual activity immediately
B Use tampons for bleeding control
C Avoid douching for 1 week
D Take a sitz bath twice daily
Correct Answer: C
Rationale: After a cervical biopsy, the client should avoid douching,
tampon use, and sexual intercourse for 1 week to prevent infection and
allow healing of the biopsy site. The client may experience some
spotting which is normal.
4. A nurse is caring for a client who has a prescription for a 24-hour
urine collection. Which of the following actions should the nurse take?
A Discard the first voiding of the collection period
B Keep the urine container at room temperature
C Collect all urine for a 12-hour period
D Place the client on strict bed rest during collection
Correct Answer: A
,Rationale: The first voiding at the start of a 24-hour urine collection is
discarded. The collection begins after that void, and all subsequent
urine is collected for the next 24 hours. The container should be
refrigerated or kept on ice during collection.
5. A nurse is assessing a client who has hypokalemia. Which of the
following ECG changes should the nurse expect?
A Peaked T-waves
B Prolonged PR interval
C Tall U-waves
D Widened QRS complex
Correct Answer: C
Rationale: Tall U-waves are a classic ECG finding in hypokalemia. Other
findings include flattened T-waves and ST segment depression. Peaked
T-waves are associated with hyperkalemia. Prolonged PR interval and
widened QRS are seen with hyperkalemia.
6. A nurse is caring for a client who has a chest tube in place following
a thoracotomy. Which of the following findings should indicate to the
nurse that the chest tube system is functioning properly?
A Continuous bubbling in the water seal chamber
B Intermittent bubbling in the suction control chamber
C No fluctuation in the water seal chamber with respiration
D Constant bubbling in the water seal chamber
Correct Answer: B
, Rationale: Intermittent bubbling in the suction control chamber
indicates that suction is being applied correctly. Continuous bubbling in
the water seal chamber indicates an air leak. Fluctuations (tidaling) in
the water seal chamber with respiration are expected and indicate that
the chest tube is patent.
7. A nurse is providing teaching to a client who has a new diagnosis of
type 2 diabetes mellitus. Which of the following statements should
the nurse include about foot care?
A Soak your feet in hot water daily
B Apply lotion between your toes
C Wear shoes that are tight-fitting
D Inspect your feet daily for blisters and redness
Correct Answer: D
Rationale: Daily foot inspection is essential for clients with diabetes to
identify any wounds, blisters, or signs of infection early. Feet should be
washed with warm (not hot) water, lotion should not be applied
between toes, and shoes should fit properly not tight.
8. A nurse is caring for a client who has a nasogastric tube attached to
low intermittent suction. Which of the following findings indicates
that the tube has become occluded?
A The client reports nausea
B The gastric aspirate has a bloody appearance
COMPREHENSIVE EXAM PREPARATION
200 QUESTIONS WITH CORRECT ANSWERS AND RATIONALES
1. A nurse is assessing a client who has a sodium level of 122 mEq/L.
Which of the following findings should the nurse expect?
A Hyperactive deep-tendon reflexes
B Increased urine output
C Decreased deep-tendon reflexes
D Elevated blood pressure
Correct Answer: C
Rationale: Hyponatremia (sodium < 135 mEq/L) causes neurological
manifestations including confusion, lethargy, muscle weakness, and
decreased deep-tendon reflexes. The low sodium level affects nerve
impulse transmission and muscle contraction.
2. A nurse is caring for a client following a bronchoscopy. Which of the
following actions is the nurse's priority?
A Monitor for hemoptysis
B Assess the client's gag reflex
C Check oxygen saturation
D Encourage deep breathing exercises
Correct Answer: B
,Rationale: Following a bronchoscopy, the priority is to assess the return
of the gag reflex before allowing the client to take anything by mouth.
This prevents aspiration, which is the greatest risk. Local anesthesia
used during the procedure numbs the throat and airway.
3. A nurse is providing discharge teaching to a client who had a
colposcopy with cervical biopsy. Which of the following instructions
should the nurse include?
A Resume sexual activity immediately
B Use tampons for bleeding control
C Avoid douching for 1 week
D Take a sitz bath twice daily
Correct Answer: C
Rationale: After a cervical biopsy, the client should avoid douching,
tampon use, and sexual intercourse for 1 week to prevent infection and
allow healing of the biopsy site. The client may experience some
spotting which is normal.
4. A nurse is caring for a client who has a prescription for a 24-hour
urine collection. Which of the following actions should the nurse take?
A Discard the first voiding of the collection period
B Keep the urine container at room temperature
C Collect all urine for a 12-hour period
D Place the client on strict bed rest during collection
Correct Answer: A
,Rationale: The first voiding at the start of a 24-hour urine collection is
discarded. The collection begins after that void, and all subsequent
urine is collected for the next 24 hours. The container should be
refrigerated or kept on ice during collection.
5. A nurse is assessing a client who has hypokalemia. Which of the
following ECG changes should the nurse expect?
A Peaked T-waves
B Prolonged PR interval
C Tall U-waves
D Widened QRS complex
Correct Answer: C
Rationale: Tall U-waves are a classic ECG finding in hypokalemia. Other
findings include flattened T-waves and ST segment depression. Peaked
T-waves are associated with hyperkalemia. Prolonged PR interval and
widened QRS are seen with hyperkalemia.
6. A nurse is caring for a client who has a chest tube in place following
a thoracotomy. Which of the following findings should indicate to the
nurse that the chest tube system is functioning properly?
A Continuous bubbling in the water seal chamber
B Intermittent bubbling in the suction control chamber
C No fluctuation in the water seal chamber with respiration
D Constant bubbling in the water seal chamber
Correct Answer: B
, Rationale: Intermittent bubbling in the suction control chamber
indicates that suction is being applied correctly. Continuous bubbling in
the water seal chamber indicates an air leak. Fluctuations (tidaling) in
the water seal chamber with respiration are expected and indicate that
the chest tube is patent.
7. A nurse is providing teaching to a client who has a new diagnosis of
type 2 diabetes mellitus. Which of the following statements should
the nurse include about foot care?
A Soak your feet in hot water daily
B Apply lotion between your toes
C Wear shoes that are tight-fitting
D Inspect your feet daily for blisters and redness
Correct Answer: D
Rationale: Daily foot inspection is essential for clients with diabetes to
identify any wounds, blisters, or signs of infection early. Feet should be
washed with warm (not hot) water, lotion should not be applied
between toes, and shoes should fit properly not tight.
8. A nurse is caring for a client who has a nasogastric tube attached to
low intermittent suction. Which of the following findings indicates
that the tube has become occluded?
A The client reports nausea
B The gastric aspirate has a bloody appearance
