ATI RN Med Surg Proctored Exam Study Guide |
Complete Actual Exam Questions with Verified
Correct Answers and Detailed Rationales | Latest
Update 2026/2027 | Already Graded A+
Question 1
A nurse in a burn treatment center is caring for a client who is admitted with severe burns
to both lower extremities and is pending an escharotomy. The client's spouse asks the
nurse what the procedure entails. Which of the following nursing statements is
appropriate?
A. "A piece of skin will be removed and grafted over the burned area."
B. "I can call the doctor back here if you want me to."
C. "Large incisions will be made in the eschar to improve circulation."
D. "Dead tissue will be surgically removed."
Answer: C
Rationale: An escharotomy involves making incisions through the eschar (dead skin) to
relieve pressure and improve circulation in burned extremities. This procedure is
necessary when edema beneath the eschar compromises blood flow. Skin grafting (A) is a
separate procedure. Option B is not therapeutic communication.
Question 2
A nurse is monitoring the fluid replacement of a client who has sustained burns. Which of
the following fluids is used in the first 24 hours following a burn injury?
A. 5% dextrose in water
B. 5% dextrose in normal saline
C. Normal saline
D. Lactated Ringer's
Answer: D
Rationale: Lactated Ringer's is the preferred fluid for resuscitation in burn patients
during the first 24 hours because it most closely resembles plasma electrolyte
composition. Normal saline can cause hyperchloremic metabolic acidosis. Dextrose
solutions are not used for fluid resuscitation.
pg. 1
,Question 3
A nurse is assessing the depth and extent of a client who has severe burns to the face,
neck, and upper extremities. Which of the following factors is the first priority when
assessing the severity of the burn?
A. Age of the client
B. Associated medical history
C. Location of the burn
D. Cause of the burn
Answer: C
Rationale: The location of the burn is the priority assessment factor. Burns to the face,
neck, and upper extremities indicate potential airway compromise and respiratory injury,
which are immediately life-threatening. The ABCs (Airway, Breathing, Circulation)
always take priority.
Question 4
A client arrives at the emergency department following an explosion at a chemical plant.
He has deep partial and full-thickness chemical burns over more than 25% of his body
surface area. What is the nurse's priority intervention?
A. Initiate fluid resuscitation
B. Medication for pain
C. Administer antibiotics
D. Maintain a patent airway
Answer: D
Rationale: Airway maintenance is always the priority intervention in any emergency
situation. Chemical burns and explosion injuries can cause inhalation injury, airway
edema, and respiratory compromise. The ABCs take precedence over fluid resuscitation,
pain management, and antibiotics.
Question 5
A nurse is caring for a client who came to the emergency department reporting chest
pain. The provider suspects a myocardial infarction. While waiting for the laboratory to
report the client's troponin levels, the client asks what this blood test will show. The nurse
should explain that troponin is:
pg. 2
,A. An enzyme that indicates damage to brain, heart, and skeletal muscle tissues
B. A protein whose levels reflect the risk for coronary artery disease
C. A heart muscle protein that appears in the bloodstream when there is damage to the
heart
D. A protein that helps transport oxygen throughout the body
Answer: C
Rationale: Troponin is a cardiac muscle protein that is released into the bloodstream
when myocardial damage occurs. It is the most specific and sensitive biomarker for
myocardial infarction. Unlike creatine kinase, troponin is not found in skeletal muscle,
making it highly specific for cardiac injury.
Question 6
A nurse is assessing a client who has disseminated intravascular coagulation (DIC).
Which of the following should the nurse expect in the findings?
A. Excessive thrombosis and bleeding
B. Progressive increase in platelet production
C. Immediate sodium and fluid retention
D. Increased clotting factors
Answer: A
Rationale: DIC is characterized by widespread activation of coagulation, leading to
microvascular thrombosis and consumption of clotting factors and platelets. This results
in a paradoxical combination of excessive thrombosis and bleeding. Platelet production is
not increased.
Question 7
A nurse is about to administer warfarin (Coumadin) to a client who has atrial fibrillation.
When the client asks what this medication will do, which of the following is an
appropriate nursing response?
A. It helps convert atrial fibrillation to sinus rhythm
B. It dissolves clots in the bloodstream
C. It slows the response of the ventricles to the fast atrial impulses
D. It prevents strokes in clients who have atrial fibrillation
Answer: D
Rationale: Warfarin is an anticoagulant that prevents thromboembolic events, including
pg. 3
, strokes, in clients with atrial fibrillation. It does not convert atrial fibrillation to sinus
rhythm, dissolve existing clots, or slow ventricular response. Rate control medications
include beta-blockers and calcium channel blockers.
Question 8
A nurse in a cardiac care unit is caring for a client with acute heart failure. Which of the
following findings should the nurse expect?
A. Decreased brain natriuretic peptide (BNP)
B. Elevated central venous pressure (CVP)
C. Decreased pulmonary pressure
D. Increased urinary output
Answer: B
Rationale: Heart failure leads to fluid overload and increased venous pressures. Elevated
CVP is a hallmark finding in right-sided heart failure and indicates fluid volume
overload. BNP is typically elevated, not decreased, in heart failure. Pulmonary pressures
are increased, and urinary output is decreased.
Question 9
A client comes into the ED reporting nausea and vomiting that worsens when lying down
and without relief from antacids. The provider suspects acute pancreatitis. Which of the
following lab test results should the nurse expect to see if the client has acute
pancreatitis?
A. Decreased WBC
B. Increased serum amylase
C. Decreased serum lipase
D. Increased serum calcium
Answer: B
Rationale: In acute pancreatitis, serum amylase and lipase levels are elevated due to
release from damaged pancreatic cells. Lipase is more specific than amylase. WBC is
typically increased, calcium is often decreased due to saponification, and lipase is
increased, not decreased.
Question 10
A nurse in the ICU is caring for a client who has acute respiratory distress syndrome
pg. 4
Complete Actual Exam Questions with Verified
Correct Answers and Detailed Rationales | Latest
Update 2026/2027 | Already Graded A+
Question 1
A nurse in a burn treatment center is caring for a client who is admitted with severe burns
to both lower extremities and is pending an escharotomy. The client's spouse asks the
nurse what the procedure entails. Which of the following nursing statements is
appropriate?
A. "A piece of skin will be removed and grafted over the burned area."
B. "I can call the doctor back here if you want me to."
C. "Large incisions will be made in the eschar to improve circulation."
D. "Dead tissue will be surgically removed."
Answer: C
Rationale: An escharotomy involves making incisions through the eschar (dead skin) to
relieve pressure and improve circulation in burned extremities. This procedure is
necessary when edema beneath the eschar compromises blood flow. Skin grafting (A) is a
separate procedure. Option B is not therapeutic communication.
Question 2
A nurse is monitoring the fluid replacement of a client who has sustained burns. Which of
the following fluids is used in the first 24 hours following a burn injury?
A. 5% dextrose in water
B. 5% dextrose in normal saline
C. Normal saline
D. Lactated Ringer's
Answer: D
Rationale: Lactated Ringer's is the preferred fluid for resuscitation in burn patients
during the first 24 hours because it most closely resembles plasma electrolyte
composition. Normal saline can cause hyperchloremic metabolic acidosis. Dextrose
solutions are not used for fluid resuscitation.
pg. 1
,Question 3
A nurse is assessing the depth and extent of a client who has severe burns to the face,
neck, and upper extremities. Which of the following factors is the first priority when
assessing the severity of the burn?
A. Age of the client
B. Associated medical history
C. Location of the burn
D. Cause of the burn
Answer: C
Rationale: The location of the burn is the priority assessment factor. Burns to the face,
neck, and upper extremities indicate potential airway compromise and respiratory injury,
which are immediately life-threatening. The ABCs (Airway, Breathing, Circulation)
always take priority.
Question 4
A client arrives at the emergency department following an explosion at a chemical plant.
He has deep partial and full-thickness chemical burns over more than 25% of his body
surface area. What is the nurse's priority intervention?
A. Initiate fluid resuscitation
B. Medication for pain
C. Administer antibiotics
D. Maintain a patent airway
Answer: D
Rationale: Airway maintenance is always the priority intervention in any emergency
situation. Chemical burns and explosion injuries can cause inhalation injury, airway
edema, and respiratory compromise. The ABCs take precedence over fluid resuscitation,
pain management, and antibiotics.
Question 5
A nurse is caring for a client who came to the emergency department reporting chest
pain. The provider suspects a myocardial infarction. While waiting for the laboratory to
report the client's troponin levels, the client asks what this blood test will show. The nurse
should explain that troponin is:
pg. 2
,A. An enzyme that indicates damage to brain, heart, and skeletal muscle tissues
B. A protein whose levels reflect the risk for coronary artery disease
C. A heart muscle protein that appears in the bloodstream when there is damage to the
heart
D. A protein that helps transport oxygen throughout the body
Answer: C
Rationale: Troponin is a cardiac muscle protein that is released into the bloodstream
when myocardial damage occurs. It is the most specific and sensitive biomarker for
myocardial infarction. Unlike creatine kinase, troponin is not found in skeletal muscle,
making it highly specific for cardiac injury.
Question 6
A nurse is assessing a client who has disseminated intravascular coagulation (DIC).
Which of the following should the nurse expect in the findings?
A. Excessive thrombosis and bleeding
B. Progressive increase in platelet production
C. Immediate sodium and fluid retention
D. Increased clotting factors
Answer: A
Rationale: DIC is characterized by widespread activation of coagulation, leading to
microvascular thrombosis and consumption of clotting factors and platelets. This results
in a paradoxical combination of excessive thrombosis and bleeding. Platelet production is
not increased.
Question 7
A nurse is about to administer warfarin (Coumadin) to a client who has atrial fibrillation.
When the client asks what this medication will do, which of the following is an
appropriate nursing response?
A. It helps convert atrial fibrillation to sinus rhythm
B. It dissolves clots in the bloodstream
C. It slows the response of the ventricles to the fast atrial impulses
D. It prevents strokes in clients who have atrial fibrillation
Answer: D
Rationale: Warfarin is an anticoagulant that prevents thromboembolic events, including
pg. 3
, strokes, in clients with atrial fibrillation. It does not convert atrial fibrillation to sinus
rhythm, dissolve existing clots, or slow ventricular response. Rate control medications
include beta-blockers and calcium channel blockers.
Question 8
A nurse in a cardiac care unit is caring for a client with acute heart failure. Which of the
following findings should the nurse expect?
A. Decreased brain natriuretic peptide (BNP)
B. Elevated central venous pressure (CVP)
C. Decreased pulmonary pressure
D. Increased urinary output
Answer: B
Rationale: Heart failure leads to fluid overload and increased venous pressures. Elevated
CVP is a hallmark finding in right-sided heart failure and indicates fluid volume
overload. BNP is typically elevated, not decreased, in heart failure. Pulmonary pressures
are increased, and urinary output is decreased.
Question 9
A client comes into the ED reporting nausea and vomiting that worsens when lying down
and without relief from antacids. The provider suspects acute pancreatitis. Which of the
following lab test results should the nurse expect to see if the client has acute
pancreatitis?
A. Decreased WBC
B. Increased serum amylase
C. Decreased serum lipase
D. Increased serum calcium
Answer: B
Rationale: In acute pancreatitis, serum amylase and lipase levels are elevated due to
release from damaged pancreatic cells. Lipase is more specific than amylase. WBC is
typically increased, calcium is often decreased due to saponification, and lipase is
increased, not decreased.
Question 10
A nurse in the ICU is caring for a client who has acute respiratory distress syndrome
pg. 4
