MED SURG ATI PROCTORED WITH NGN /ATI PROCTORED
MEDICAL SURGICAL WITH NGN EXAM LATEST VERSION
2026.ACTUAL EXAM GUIDE WITH QUESTION AND ANSWERS.
QUESTION
A nurse is obtaining a urine specimen for culture and sensitivity from a client who has
manifestations of a urinary tract infection. Which of the following actions should the
nurse take?
a. Instruct the client to start urinating then pass the container into the stream.
b. Collect the first voided urine of the morning.
c. Obtain the specimen from the indwelling catheter port.
d. Have the client urinate into the container immediately upon starting the stream.
CORRECT ANS: a. Instruct the client to start urinating then pass the container into the
stream.
EXPERT RATIONALE
For a clean-catch midstream urine specimen, the client should begin to void, then pass
the sterile container into the urine stream to collect 30 to 60 mL of urine. This technique
minimizes contamination from the urethral meatus and skin flora. The first voided urine
of the morning (b) is preferred for routine urinalysis but is not the standard for culture
and sensitivity. Obtaining the specimen from the catheter port (c) requires sterile
technique but is not the method for a clean-catch specimen. Collecting the initial stream
(d) would include contaminants and is not appropriate for a culture and sensitivity.
QUESTION
A nurse is providing instructions for reducing the dietary intake of potassium to a client
who has chronic kidney disease. Which of the following client food selections indicates
an understanding of the teaching?
a. One large raw apple.
b. One medium baked potato.
c. One cup of cooked spinach.
d. One half of a cantaloupe.
CORRECT ANS: a. One large raw apple.
,EXPERT RATIONALE
Of these options, one large apple is the lowest in potassium, containing approximately
239 mg per serving. Clients with chronic kidney disease (CKD) must restrict potassium
intake to prevent hyperkalemia, which can lead to cardiac dysrhythmias. Baked potatoes
(b), cooked spinach (c), and cantaloupe (d) are all high-potassium foods that should be
limited or avoided.
QUESTION
A nurse is providing discharge teaching to a client who has chronic kidney disease (CKD).
Which of the following statements by the client indicates an understanding of the
teaching?
a. "I will decrease my intake of foods that are high in phosphorus."
b. "I will increase my intake of dairy products."
c. "I will limit my fluid intake to 3 liters per day."
d. "I will eat more bananas and oranges."
CORRECT ANS: a. "I will decrease my intake of foods that are high in phosphorus."
EXPERT RATIONALE
Clients with CKD should limit their intake of phosphorus to prevent bone
demineralization and metastatic calcification. Hyperphosphatemia is a common
complication of CKD and can lead to renal osteodystrophy. Increasing dairy (b) would
worsen phosphorus levels. Fluid restriction varies but is typically 1-2 liters, not 3 (c).
Bananas and oranges (d) are high in potassium, which is also restricted in CKD.
QUESTION
A nurse is teaching a client who has urge urinary incontinence about bladder retraining.
Which of the following instructions should the nurse include?
a. "Increase the intervals between urination by 15 minutes per day when able to remain
continent."
b. "Decrease the intervals between urination by 15 minutes per day."
c. "Wait until you have a strong urge to void before going to the bathroom."
d. "Drink at least 2 liters of fluid per day."
CORRECT ANS: a. "Increase the intervals between urination by 15 minutes per day when
able to remain continent."
, EXPERT RATIONALE
Bladder retraining involves gradually increasing the time between urinations to improve
bladder capacity and control. The client should increase the interval by 15 minutes per
day when they are able to remain continent, with a goal of 3 to 4 hours between voids.
Decreasing intervals (b) would not improve retention. Waiting until a strong urge (c) is
the opposite of retraining. Fluid intake should be adequate but not excessive (d).
QUESTION
A nurse is teaching a client who has a diagnosis of acute pyelonephritis. Which of the
following instructions should the nurse include in the teaching?
a. Avoid the use of NSAIDs for pain.
b. Increase intake of citrus fruits.
c. Limit fluid intake to prevent bladder distention.
d. Take antibiotics until symptoms resolve.
CORRECT ANS: a. Avoid the use of NSAIDs for pain.
EXPERT RATIONALE
Nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided in acute
pyelonephritis because they can further damage the kidney by causing papillary necrosis
and reducing renal blood flow. Acetaminophen is a safer alternative for pain
management. Citrus fruits (b) may irritate the bladder. Fluid intake should be increased
(c), not limited, to flush the urinary tract. Antibiotics (d) must be taken for the full
prescribed course, not just until symptoms resolve, to prevent recurrence and resistance.
QUESTION
A nurse in an emergency department is caring for a client who reports costovertebral
angle tenderness, nausea, and vomiting. Which of the following laboratory values should
the nurse report to the provider?
a. WBC count 15,000/mm³.
b. Serum sodium 138 mEq/L.
c. Serum creatinine 1.2 mg/dL.
d. Urine specific gravity 1.010.
CORRECT ANS: a. WBC count 15,000/mm³.
MEDICAL SURGICAL WITH NGN EXAM LATEST VERSION
2026.ACTUAL EXAM GUIDE WITH QUESTION AND ANSWERS.
QUESTION
A nurse is obtaining a urine specimen for culture and sensitivity from a client who has
manifestations of a urinary tract infection. Which of the following actions should the
nurse take?
a. Instruct the client to start urinating then pass the container into the stream.
b. Collect the first voided urine of the morning.
c. Obtain the specimen from the indwelling catheter port.
d. Have the client urinate into the container immediately upon starting the stream.
CORRECT ANS: a. Instruct the client to start urinating then pass the container into the
stream.
EXPERT RATIONALE
For a clean-catch midstream urine specimen, the client should begin to void, then pass
the sterile container into the urine stream to collect 30 to 60 mL of urine. This technique
minimizes contamination from the urethral meatus and skin flora. The first voided urine
of the morning (b) is preferred for routine urinalysis but is not the standard for culture
and sensitivity. Obtaining the specimen from the catheter port (c) requires sterile
technique but is not the method for a clean-catch specimen. Collecting the initial stream
(d) would include contaminants and is not appropriate for a culture and sensitivity.
QUESTION
A nurse is providing instructions for reducing the dietary intake of potassium to a client
who has chronic kidney disease. Which of the following client food selections indicates
an understanding of the teaching?
a. One large raw apple.
b. One medium baked potato.
c. One cup of cooked spinach.
d. One half of a cantaloupe.
CORRECT ANS: a. One large raw apple.
,EXPERT RATIONALE
Of these options, one large apple is the lowest in potassium, containing approximately
239 mg per serving. Clients with chronic kidney disease (CKD) must restrict potassium
intake to prevent hyperkalemia, which can lead to cardiac dysrhythmias. Baked potatoes
(b), cooked spinach (c), and cantaloupe (d) are all high-potassium foods that should be
limited or avoided.
QUESTION
A nurse is providing discharge teaching to a client who has chronic kidney disease (CKD).
Which of the following statements by the client indicates an understanding of the
teaching?
a. "I will decrease my intake of foods that are high in phosphorus."
b. "I will increase my intake of dairy products."
c. "I will limit my fluid intake to 3 liters per day."
d. "I will eat more bananas and oranges."
CORRECT ANS: a. "I will decrease my intake of foods that are high in phosphorus."
EXPERT RATIONALE
Clients with CKD should limit their intake of phosphorus to prevent bone
demineralization and metastatic calcification. Hyperphosphatemia is a common
complication of CKD and can lead to renal osteodystrophy. Increasing dairy (b) would
worsen phosphorus levels. Fluid restriction varies but is typically 1-2 liters, not 3 (c).
Bananas and oranges (d) are high in potassium, which is also restricted in CKD.
QUESTION
A nurse is teaching a client who has urge urinary incontinence about bladder retraining.
Which of the following instructions should the nurse include?
a. "Increase the intervals between urination by 15 minutes per day when able to remain
continent."
b. "Decrease the intervals between urination by 15 minutes per day."
c. "Wait until you have a strong urge to void before going to the bathroom."
d. "Drink at least 2 liters of fluid per day."
CORRECT ANS: a. "Increase the intervals between urination by 15 minutes per day when
able to remain continent."
, EXPERT RATIONALE
Bladder retraining involves gradually increasing the time between urinations to improve
bladder capacity and control. The client should increase the interval by 15 minutes per
day when they are able to remain continent, with a goal of 3 to 4 hours between voids.
Decreasing intervals (b) would not improve retention. Waiting until a strong urge (c) is
the opposite of retraining. Fluid intake should be adequate but not excessive (d).
QUESTION
A nurse is teaching a client who has a diagnosis of acute pyelonephritis. Which of the
following instructions should the nurse include in the teaching?
a. Avoid the use of NSAIDs for pain.
b. Increase intake of citrus fruits.
c. Limit fluid intake to prevent bladder distention.
d. Take antibiotics until symptoms resolve.
CORRECT ANS: a. Avoid the use of NSAIDs for pain.
EXPERT RATIONALE
Nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided in acute
pyelonephritis because they can further damage the kidney by causing papillary necrosis
and reducing renal blood flow. Acetaminophen is a safer alternative for pain
management. Citrus fruits (b) may irritate the bladder. Fluid intake should be increased
(c), not limited, to flush the urinary tract. Antibiotics (d) must be taken for the full
prescribed course, not just until symptoms resolve, to prevent recurrence and resistance.
QUESTION
A nurse in an emergency department is caring for a client who reports costovertebral
angle tenderness, nausea, and vomiting. Which of the following laboratory values should
the nurse report to the provider?
a. WBC count 15,000/mm³.
b. Serum sodium 138 mEq/L.
c. Serum creatinine 1.2 mg/dL.
d. Urine specific gravity 1.010.
CORRECT ANS: a. WBC count 15,000/mm³.
