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ATI Med-Surg Proctored Exam 2020 (Complete Version) Latest Updated Solution
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ATI Med-Surg Proctored Exam 2020 (CompleteVersion) Latest Updated Solution
1. A nurse is reinforcing teaching with a client who is postoperative after
having an ileostomy established. Which of the following instructions
should the nurse include in the teaching?
1) Empty the pouch immediately after meals.
2) Change the entire appliance once a day.
3) Limit fluid intake.
4) Avoid medications in capsule or enteric form.
2. A nurse is caring for a client with severe burns to both lower extremities.
The client is scheduled for an escharotomy and wants to know what the
procedure involves. Which of the following statements is appropriate for
the nurse to make?
1) "An escharotomy surgically removes dead tissue."
2) "A cannula will be inserted into the bone to infuse fluids and
antibiotics."
3) "A piece of skin will be removed and grafted over the burned area."
4) "Large incisions will be made in the burned tissue to improve
circulation."
3. A nurse is collecting data from a client who has a possible cataract.
Which of the following manifestations should the nurse expect the client
to report?
1) Decreased color perception
2) Loss of peripheral vision
3) Bright flashes of light
4) Eyestrain
4. A nurse is contributing to the plan of care for a client who has an
intestinal obstruction and is receiving continuous gastrointestinal
decompression using a nasogastric tube. Which of the following
interventions should the nurse include in the plan of care?
1) Measure abdominal girth daily.
2) Use sterile water to irrigate the nasogastric tube..
3) Maintain the client in Fowler’s position.
4) Moisten the client’s lips with lemon-glycerin swabs.
, 5. A nurse is caring for a client who has Cushing's syndrome. Which of the
following clinical manifestations should the nurse expect to observe?
(Select all that apply.)
1) Buffalo hump
2) Purple striations
3) Moon face
4) Tremors
5) Obese extremities
6. A nurse is caring for a client who is in the oliguric phase of acute kidney
injury. Which of the following actions should the nurse take?
1) Provide a diet high in protein.
2) Provide ibuprofen for retroperitoneal discomfort.
3) Monitor intake and output hourly
4) Encourage the client to consume at least 2 L of fluid daily.
7. A nurse is reinforcing teaching about an esophagogastroduodenoscopy
with a client who has upper gastric pain. Which of the following
statements should the nurse include in the teaching?
1) "A flexible tube is introduced through the nose during the procedure."
2) "During the procedure you are in a sitting position."
3) "You will remain NPO for 8 hours before the procedure."
4) "You will be awake while the procedure is performed."
8. A nurse is caring for a client who is difficult to arouse and very sleepy for
several hours following a generalized tonic-clonic seizure. Which of the
following descriptions should the nurse use when documenting this
finding in the medical record?
1) Aura phase
2) Presence of automatisms
3) Postictal phase
4) Presence of absence seizures
9. A nurse is caring for a client scheduled for a bone marrow biopsy. The
client expresses fear about the procedure and asks the nurse if the biopsy
will hurt. Which of the following responses should the nurse make?
1) "You must be very worried about what the biopsy will show."
,2) "You'll be asleep for the whole biopsy procedure and won't be aware of
what’s happening."
3) "Your provider scheduled this, so she will want to know you still have
questions about the procedure."
4) "The biopsy can be uncomfortable, but we will try to keep you as
comfortable as possible."
10.A nurse is assisting with planning care for a client who is recovering from
a left-hemispheric stroke. Which of the following interventions should the
nurse include in the plan?
1) Control impulsive behavior.
2) Compensate for left visual field deficits.
3) Re-establish communication.
4) Improve left-side motor function.
11.A nurse is assisting with the care of a client who has diabetes insipidus.
The nurse should monitor the client for which of the following
manifestations?
1) Hypotension
2) Polyphagia
3) Hyperglycemia
4) Bradycardia
12.A nurse is reviewing the laboratory results of a client who is
postoperative and has a respiratory rate of 7/min. The arterial blood gas
(ABG) values include:
pH 7.22
PaCO2 68 mm Hg
Base excess -2
PaO2 78 mm Hg
Oxygen saturation 80%
Bicarbonate 28 mEq/L
Which of the following interpretations of the ABG values should the
nurse make?
1) Metabolic acidosis
2) Respiratory acidosis
3) Metabolic alkalosis
4) Respiratory alkalosis
, 13.A nurse is reinforcing teaching with a client who has peripheral vascular
disease (PVD). The nurse should recognize that which of the following
statements by the client indicates a need for further teaching?
1) "I will avoid crossing my legs at the knees."
2) "I will use a thermometer to check the temperature of my bath water."
3) "I will not go barefoot."
4) "I will wear stockings with elastic tops."
14.A nurse is reinforcing teaching with a client who reports right shoulder
pain following a laparoscopic cholecystectomy. Which of the following
statements should the nurse make?
1) "The pain results from lying in one position too long during surgery."
2) "The pain occurs as a residual pain from cholecystitis."
3) "The pain will dissipate if you ambulate frequently."
4) "The pain is caused from the nitrous dioxide injected into the
abdomen."
15.A nurse is checking the suction control chamber of a client's chest tube
and notes that there is no bubbling in the suction control chamber. Which
of the following actions should the nurse take?
1) Notify the provider.
Answer Rationale:
The nurse should check for kinks and take other measures before notifying the
provider.
2) Verify that the suction regulator is on.
3) Continue to monitor the client because this is an expected finding.
4) Milk the chest tube to dislodge any clots in the tubing that may be
occluding it.
16.A nurse is assisting with the care of a client immediately following a
lumbar puncture. Which of the following actions should the nurse take?
(Select all that apply.)
1) Encourage fluid intake.
2) Monitor the puncture site for hematoma.
3) Insert a urinary catheter.
4) Elevate the client’s head of bed.
5) Apply a cervical collar to the client.
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