ATI COMPREHENSIVE MEDICAL-SURGICAL NURSING MIDTERM EXAM
ATI
NURSING
QUESTIONS & ANSWERS WITH
RATIONALES
,ATI COMPREHENSIVE MEDICAL-SURGICAL NURSING MIDTERM EXAM
1. A client with acute pulmonary edema is severely dyspneic and coughing pink, frothy
sputum. Which action should the nurse take first?
A. Place the client in high-Fowler position.
B. Encourage oral fluids.
C. Obtain a routine weight.
D. Place the client supine.
Answer: A
Rationale: High-Fowler positioning improves lung expansion and decreases venous return, helping relieve acute
pulmonary edema. Oxygen and prescribed emergency therapies should follow immediately.
2. A client with chronic obstructive pulmonary disease is receiving oxygen. Which finding
requires the nurse's most immediate attention?
A. Oxygen saturation of 90% with the prescribed target range.
B. New confusion and increasing drowsiness.
C. Respiratory rate of 20/min.
D. Barrel-shaped chest.
Answer: B
Rationale: New confusion and drowsiness can indicate worsening hypoxemia or carbon dioxide retention and
require prompt assessment and intervention.
3. A client with suspected myocardial infarction reports crushing chest pain. Which
prescribed medication should the nurse anticipate administering first if not
contraindicated?
,ATI COMPREHENSIVE MEDICAL-SURGICAL NURSING MIDTERM EXAM
A. Aspirin.
B. Warfarin.
C. Furosemide.
D. Digoxin.
Answer: A
Rationale: Chewed aspirin reduces platelet aggregation and is an early evidence-based intervention for suspected
acute coronary syndrome when contraindications are absent.
4. A client receiving IV heparin has a platelet count that falls substantially from
baseline. Which complication should the nurse suspect?
A. Heparin-induced thrombocytopenia.
B. Disseminated intravascular coagulation from dehydration.
C. Iron-deficiency anemia.
D. Vitamin K toxicity.
Answer: A
Rationale: A significant platelet fall during heparin therapy can indicate HIT, a potentially life-threatening
prothrombotic reaction requiring immediate evaluation.
5. A client with heart failure has gained 2 kg (4.4 lb) in 48 hours. What is the most
appropriate nursing response?
A. Notify the provider and assess for fluid overload.
B. Reassure the client that this is expected.
C. Increase oral sodium intake.
D. Hold all prescribed diuretics.
, ATI COMPREHENSIVE MEDICAL-SURGICAL NURSING MIDTERM EXAM
Answer: A
Rationale: Rapid weight gain commonly reflects fluid retention in heart failure and warrants assessment and timely
intervention.
ATI
NURSING
QUESTIONS & ANSWERS WITH
RATIONALES
,ATI COMPREHENSIVE MEDICAL-SURGICAL NURSING MIDTERM EXAM
1. A client with acute pulmonary edema is severely dyspneic and coughing pink, frothy
sputum. Which action should the nurse take first?
A. Place the client in high-Fowler position.
B. Encourage oral fluids.
C. Obtain a routine weight.
D. Place the client supine.
Answer: A
Rationale: High-Fowler positioning improves lung expansion and decreases venous return, helping relieve acute
pulmonary edema. Oxygen and prescribed emergency therapies should follow immediately.
2. A client with chronic obstructive pulmonary disease is receiving oxygen. Which finding
requires the nurse's most immediate attention?
A. Oxygen saturation of 90% with the prescribed target range.
B. New confusion and increasing drowsiness.
C. Respiratory rate of 20/min.
D. Barrel-shaped chest.
Answer: B
Rationale: New confusion and drowsiness can indicate worsening hypoxemia or carbon dioxide retention and
require prompt assessment and intervention.
3. A client with suspected myocardial infarction reports crushing chest pain. Which
prescribed medication should the nurse anticipate administering first if not
contraindicated?
,ATI COMPREHENSIVE MEDICAL-SURGICAL NURSING MIDTERM EXAM
A. Aspirin.
B. Warfarin.
C. Furosemide.
D. Digoxin.
Answer: A
Rationale: Chewed aspirin reduces platelet aggregation and is an early evidence-based intervention for suspected
acute coronary syndrome when contraindications are absent.
4. A client receiving IV heparin has a platelet count that falls substantially from
baseline. Which complication should the nurse suspect?
A. Heparin-induced thrombocytopenia.
B. Disseminated intravascular coagulation from dehydration.
C. Iron-deficiency anemia.
D. Vitamin K toxicity.
Answer: A
Rationale: A significant platelet fall during heparin therapy can indicate HIT, a potentially life-threatening
prothrombotic reaction requiring immediate evaluation.
5. A client with heart failure has gained 2 kg (4.4 lb) in 48 hours. What is the most
appropriate nursing response?
A. Notify the provider and assess for fluid overload.
B. Reassure the client that this is expected.
C. Increase oral sodium intake.
D. Hold all prescribed diuretics.
, ATI COMPREHENSIVE MEDICAL-SURGICAL NURSING MIDTERM EXAM
Answer: A
Rationale: Rapid weight gain commonly reflects fluid retention in heart failure and warrants assessment and timely
intervention.
