ATI RN ADULT MEDICAL-SURGICAL
PROCTORED ASSESSMENT – QUESTIONS AND
ANSWERS | 2026/2027 LATEST UPDATE
SECTION 1: Foundations, Assessment, Safety, and Perioperative Nursing
Questions 1–10
1. Which assessment finding requires the nurse to obtain additional information when
completing an admission assessment for an adult client?
A) Blood pressure of 128/76 mm Hg
B) New onset confusion reported by the client's family
C) Oral temperature of 37.0°C (98.6°F)
D) Respiratory rate of 16/min
Correct Answer: New onset confusion reported by the client's family
Rationale: Acute confusion is not an expected finding and can indicate hypoxia, infection,
metabolic disturbance, medication effects, or another acute condition. The other findings are
within expected adult ranges and do not independently indicate immediate deterioration. A
change from baseline mental status is particularly important because it can be an early sign
of physiologic instability.
2. A nurse is implementing a client's plan of care. Which action represents the
implementation phase of the nursing process?
A) Reviewing the client's serum potassium level
B) Identifying acute pain as a nursing diagnosis
C) Administering the prescribed analgesic
D) Determining whether the client's pain goal was achieved
Correct Answer: Administering the prescribed analgesic
Rationale: Implementation is the phase in which the nurse carries out interventions
established during planning. Reviewing laboratory data is assessment, identifying a nursing
diagnosis is diagnosis, and determining whether goals were achieved is evaluation. Correctly
distinguishing the five nursing-process phases helps the nurse organize care and document
interventions accurately.
, 3. A client is scheduled for elective abdominal surgery. Which intervention should the
nurse teach to reduce the risk of postoperative pulmonary complications?
A) Restricting oral fluids after surgery
B) Remaining in bed for the first 24 hr
C) Using an incentive spirometer regularly
D) Avoiding coughing because it increases pain
Correct Answer: Using an incentive spirometer regularly
Rationale: Incentive spirometry promotes alveolar expansion and helps prevent atelectasis
after surgery. Early mobility, coughing, and deep breathing also support pulmonary function.
Fluid restriction and prolonged bed rest can increase complications, while avoiding coughing
can impair secretion clearance and contribute to respiratory problems.
4. During a sterile dressing change, the nurse's sterile glove touches the edge of the
bed. What is the appropriate action?
A) Continue because the glove remains visually clean
B) Clean the glove with antiseptic solution
C) Replace only the dressing
D) Change the contaminated glove before continuing
Correct Answer: Change the contaminated glove before continuing
Rationale: Contact with a nonsterile surface contaminates a sterile glove. Antiseptic solution
cannot restore sterility, and simply replacing the dressing does not correct contamination of
the nurse's hand. Maintaining aseptic technique requires replacing contaminated equipment
or gloves before continuing a sterile procedure.
5. Which postoperative finding should the nurse recognize as requiring prompt
intervention?
A) Urine output of 35 mL/hr
B) Incisional discomfort rated 3/10
C) Temperature of 37.2°C (99.0°F)
D) Oxygen saturation of 86% on room air
Correct Answer: Oxygen saturation of 86% on room air
Rationale: An oxygen saturation of 86% indicates significant hypoxemia and requires
immediate assessment and intervention. Mild incisional discomfort, a temperature of 37.2°C,
and urine output of 35 mL/hr may be acceptable depending on the client's overall condition.
,Airway and breathing problems take priority because inadequate oxygenation can rapidly
cause organ dysfunction.
6. Which instruction is most appropriate when teaching a client how to prevent
postoperative venous thromboembolism?
A) Remain in bed until the first postoperative dressing change
B) Perform prescribed leg exercises and ambulate as allowed
C) Massage the calves every two hours
D) Keep the knees flexed while resting
Correct Answer: Perform prescribed leg exercises and ambulate as allowed
Rationale: Leg exercises and early ambulation promote venous return and decrease venous
stasis. Calf massage is inappropriate when thrombosis is suspected because it could
potentially dislodge a clot. Prolonged immobility and sustained knee flexion impede venous
circulation and increase thromboembolic risk.
7. A client asks why two identifiers are required before medication administration.
Which explanation is best?
A) They reduce the risk of giving medication to the wrong client
B) They determine whether the client understands the medication
C) They eliminate the need to check the medication label
D) They determine whether the prescribed dose is appropriate
Correct Answer: They reduce the risk of giving medication to the wrong client
Rationale: Two approved identifiers, such as name and date of birth, help ensure that the
medication is administered to the intended client. Identification does not replace medication-
label checks or clinical assessment. Safe medication administration requires multiple
verification steps rather than relying on a single safety mechanism.
8. Which intervention is most appropriate for a client at high risk for pressure injury?
A) Massage reddened areas over bony prominences
B) Limit protein intake
C) Reposition the client according to an individualized schedule
D) Keep the head of the bed elevated as much as possible
Correct Answer: Reposition the client according to an individualized schedule
Rationale: Regular repositioning reduces prolonged pressure and supports tissue perfusion.
Massaging reddened tissue can cause additional injury, inadequate protein can impair
, healing, and unnecessary elevation increases shear and pressure. Prevention also includes
moisture management, nutrition, skin inspection, mobility, and appropriate support surfaces.
9. Which finding most strongly suggests that a client understands instructions about
incentive spirometry?
A) The client inhales rapidly through the device
B) The client exhales forcefully into the device
C) The client uses the device only when short of breath
D) The client slowly inhales while attempting to raise the indicator
Correct Answer: The client slowly inhales while attempting to raise the indicator
Rationale: Incentive spirometry requires a slow, sustained inhalation that expands the lungs
and raises the indicator. It is not primarily an exhalation exercise and should be performed
regularly as prescribed rather than only when symptoms develop. Correct technique
promotes alveolar recruitment and reduces postoperative pulmonary complications.
10. A nurse receives a prescription that appears inconsistent with the client's condition.
What should the nurse do first?
A) Administer it because the prescription was written by a provider
B) Ask another nurse to administer it
C) Clarify the prescription with the prescribing provider
D) Document that the client refused treatment
Correct Answer: Clarify the prescription with the prescribing provider
Rationale: The nurse has a professional responsibility to question an order that appears
unsafe or inappropriate. Administering a potentially harmful prescription without
clarification does not protect the client. The nurse should assess the concern, verify relevant
information, and communicate with the prescriber before proceeding.
SECTION 2: Neurological Disorders
Questions 11–17
11. Which finding is most concerning in a client who experienced a stroke?
A) Sudden unilateral weakness and difficulty speaking
B) Mild headache present for several hours
C) Increased appetite
D) Bilateral ankle edema
Correct Answer: Sudden unilateral weakness and difficulty speaking
PROCTORED ASSESSMENT – QUESTIONS AND
ANSWERS | 2026/2027 LATEST UPDATE
SECTION 1: Foundations, Assessment, Safety, and Perioperative Nursing
Questions 1–10
1. Which assessment finding requires the nurse to obtain additional information when
completing an admission assessment for an adult client?
A) Blood pressure of 128/76 mm Hg
B) New onset confusion reported by the client's family
C) Oral temperature of 37.0°C (98.6°F)
D) Respiratory rate of 16/min
Correct Answer: New onset confusion reported by the client's family
Rationale: Acute confusion is not an expected finding and can indicate hypoxia, infection,
metabolic disturbance, medication effects, or another acute condition. The other findings are
within expected adult ranges and do not independently indicate immediate deterioration. A
change from baseline mental status is particularly important because it can be an early sign
of physiologic instability.
2. A nurse is implementing a client's plan of care. Which action represents the
implementation phase of the nursing process?
A) Reviewing the client's serum potassium level
B) Identifying acute pain as a nursing diagnosis
C) Administering the prescribed analgesic
D) Determining whether the client's pain goal was achieved
Correct Answer: Administering the prescribed analgesic
Rationale: Implementation is the phase in which the nurse carries out interventions
established during planning. Reviewing laboratory data is assessment, identifying a nursing
diagnosis is diagnosis, and determining whether goals were achieved is evaluation. Correctly
distinguishing the five nursing-process phases helps the nurse organize care and document
interventions accurately.
, 3. A client is scheduled for elective abdominal surgery. Which intervention should the
nurse teach to reduce the risk of postoperative pulmonary complications?
A) Restricting oral fluids after surgery
B) Remaining in bed for the first 24 hr
C) Using an incentive spirometer regularly
D) Avoiding coughing because it increases pain
Correct Answer: Using an incentive spirometer regularly
Rationale: Incentive spirometry promotes alveolar expansion and helps prevent atelectasis
after surgery. Early mobility, coughing, and deep breathing also support pulmonary function.
Fluid restriction and prolonged bed rest can increase complications, while avoiding coughing
can impair secretion clearance and contribute to respiratory problems.
4. During a sterile dressing change, the nurse's sterile glove touches the edge of the
bed. What is the appropriate action?
A) Continue because the glove remains visually clean
B) Clean the glove with antiseptic solution
C) Replace only the dressing
D) Change the contaminated glove before continuing
Correct Answer: Change the contaminated glove before continuing
Rationale: Contact with a nonsterile surface contaminates a sterile glove. Antiseptic solution
cannot restore sterility, and simply replacing the dressing does not correct contamination of
the nurse's hand. Maintaining aseptic technique requires replacing contaminated equipment
or gloves before continuing a sterile procedure.
5. Which postoperative finding should the nurse recognize as requiring prompt
intervention?
A) Urine output of 35 mL/hr
B) Incisional discomfort rated 3/10
C) Temperature of 37.2°C (99.0°F)
D) Oxygen saturation of 86% on room air
Correct Answer: Oxygen saturation of 86% on room air
Rationale: An oxygen saturation of 86% indicates significant hypoxemia and requires
immediate assessment and intervention. Mild incisional discomfort, a temperature of 37.2°C,
and urine output of 35 mL/hr may be acceptable depending on the client's overall condition.
,Airway and breathing problems take priority because inadequate oxygenation can rapidly
cause organ dysfunction.
6. Which instruction is most appropriate when teaching a client how to prevent
postoperative venous thromboembolism?
A) Remain in bed until the first postoperative dressing change
B) Perform prescribed leg exercises and ambulate as allowed
C) Massage the calves every two hours
D) Keep the knees flexed while resting
Correct Answer: Perform prescribed leg exercises and ambulate as allowed
Rationale: Leg exercises and early ambulation promote venous return and decrease venous
stasis. Calf massage is inappropriate when thrombosis is suspected because it could
potentially dislodge a clot. Prolonged immobility and sustained knee flexion impede venous
circulation and increase thromboembolic risk.
7. A client asks why two identifiers are required before medication administration.
Which explanation is best?
A) They reduce the risk of giving medication to the wrong client
B) They determine whether the client understands the medication
C) They eliminate the need to check the medication label
D) They determine whether the prescribed dose is appropriate
Correct Answer: They reduce the risk of giving medication to the wrong client
Rationale: Two approved identifiers, such as name and date of birth, help ensure that the
medication is administered to the intended client. Identification does not replace medication-
label checks or clinical assessment. Safe medication administration requires multiple
verification steps rather than relying on a single safety mechanism.
8. Which intervention is most appropriate for a client at high risk for pressure injury?
A) Massage reddened areas over bony prominences
B) Limit protein intake
C) Reposition the client according to an individualized schedule
D) Keep the head of the bed elevated as much as possible
Correct Answer: Reposition the client according to an individualized schedule
Rationale: Regular repositioning reduces prolonged pressure and supports tissue perfusion.
Massaging reddened tissue can cause additional injury, inadequate protein can impair
, healing, and unnecessary elevation increases shear and pressure. Prevention also includes
moisture management, nutrition, skin inspection, mobility, and appropriate support surfaces.
9. Which finding most strongly suggests that a client understands instructions about
incentive spirometry?
A) The client inhales rapidly through the device
B) The client exhales forcefully into the device
C) The client uses the device only when short of breath
D) The client slowly inhales while attempting to raise the indicator
Correct Answer: The client slowly inhales while attempting to raise the indicator
Rationale: Incentive spirometry requires a slow, sustained inhalation that expands the lungs
and raises the indicator. It is not primarily an exhalation exercise and should be performed
regularly as prescribed rather than only when symptoms develop. Correct technique
promotes alveolar recruitment and reduces postoperative pulmonary complications.
10. A nurse receives a prescription that appears inconsistent with the client's condition.
What should the nurse do first?
A) Administer it because the prescription was written by a provider
B) Ask another nurse to administer it
C) Clarify the prescription with the prescribing provider
D) Document that the client refused treatment
Correct Answer: Clarify the prescription with the prescribing provider
Rationale: The nurse has a professional responsibility to question an order that appears
unsafe or inappropriate. Administering a potentially harmful prescription without
clarification does not protect the client. The nurse should assess the concern, verify relevant
information, and communicate with the prescriber before proceeding.
SECTION 2: Neurological Disorders
Questions 11–17
11. Which finding is most concerning in a client who experienced a stroke?
A) Sudden unilateral weakness and difficulty speaking
B) Mild headache present for several hours
C) Increased appetite
D) Bilateral ankle edema
Correct Answer: Sudden unilateral weakness and difficulty speaking
