ATI Comprehensive Medical Surgical Exam
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Free ATI Comprehensive Medical Surgical Exam Questions
A nurse in an emergency department is performing triage for multiple clients who were injured in a building collapse caused by an earthquake. Which of the following clients should the nurse assign the highest priority for trauma care
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A client who has a compound fracture of the humerus
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A client who has a head injury with dilated and fixed pupils
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A client who has a corneal laceration
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A client who has a hemothorax
Explanation
Correct Answer D. A client who has a hemothorax
Explanation
A hemothorax involves bleeding into the chest cavity and can lead to respiratory compromise and hypovolemic shock, making it life-threatening without prompt intervention. In disaster triage, the highest priority is given to clients with conditions that are immediately life-threatening but treatable, such as compromised airway or breathing issues.
Why Other Options Are Wrong
A. A client who has a compound fracture of the humerus
This is a serious injury but not immediately life-threatening. This client can be categorized as urgent, not the highest priority.
B. A client who has a head injury with dilated and fixed pupils
Fixed and dilated pupils suggest severe brain damage or brain death. This client is expectant, meaning they are unlikely to survive even with care.
C. A client who has a corneal laceration
Although painful and potentially vision-threatening, this injury is not life-threatening and is therefore lower priority in mass casualty triage.
A nurse is assisting with mass casualty triage for a disaster event. The nurse should tag which of the following clients to receive care first
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A client who has a traumatic, lower limb amputation
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A client who is paralyzed from a high cervical spinal cord injury
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A client who has lacerations on his arms and legs
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A client who has a closed, nondisplaced fracture of the right arm
Explanation
Correct Answer A. A client who has a traumatic, lower limb amputation
Explanation
In mass casualty triage, priority is given to those with life-threatening but survivable injuries. A traumatic lower limb amputation poses a high risk of hemorrhage, which can be rapidly fatal if not treated immediately. This client would receive a red tag (immediate priority) and should be treated first to preserve life.
Why Other Options Are Wrong
B. A client who is paralyzed from a high cervical spinal cord injury
This client likely has limited survival potential in a mass casualty setting due to compromised breathing and neurological status. They would typically be assigned an expectant (black tag).
C. A client who has lacerations on his arms and legs
These are non-life-threatening injuries and would be tagged as minor (green)—treatment can be delayed.
D. A client who has a closed, nondisplaced fracture of the right arm
This is a non-urgent injury that does not require immediate intervention. This client would also receive a green tag.
A nurse is caring for a client who has Parkinson's disease and is taking carbidopa/levodopa. The nurse should identify that which of the following types of medications is contraindicated with the use of this medication
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Nonselective MAOIs
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Macrolides
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Fluoroquinolones
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Statins
Explanation
Correct Answer A. Nonselective MAOIs
Explanation
Nonselective monoamine oxidase inhibitors (MAOIs) are contraindicated with carbidopa/levodopa because their combination can lead to a hypertensive crisis. Both medications increase dopamine levels, and MAOIs also inhibit the breakdown of norepinephrine and serotonin. This excessive catecholamine activity may lead to dangerous spikes in blood pressure when taken together.
Why Other Options Are Wrong
B. Macrolides
Macrolide antibiotics (e.g., erythromycin, azithromycin) do not directly interact with carbidopa/levodopa and are not contraindicated, though caution is still used with certain infections.
C. Fluoroquinolones
These antibiotics (e.g., ciprofloxacin, levofloxacin) are not contraindicated with carbidopa/levodopa, although they can carry a risk of CNS effects like seizures, especially in older adults or those with neurological conditions.
D. Statins
Statins are used for managing cholesterol and do not have a contraindicated interaction with carbidopa/levodopa, though muscle-related side effects should be monitored.
A nurse is caring for a client who is being admitted to the emergency department with an extensive burn injury. Which of the following actions is the priority for the nurse to take
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Fluid resuscitation
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Psychological support
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Wound debridement
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Infection prevention
Explanation
Correct Answer A. Fluid resuscitation
Explanation
For a client with extensive burn injuries, fluid resuscitation is the priority during the initial (emergent) phase. Major burns cause capillary permeability, leading to massive fluid shifts, hypovolemia, and shock. Immediate and aggressive fluid replacement is critical to maintain perfusion and prevent organ failure.
Why Other Options Are Wrong
B. Psychological support
Although emotional care is important, it is not a priority in the emergent phase. Stabilizing the client physically must occur first before addressing psychological needs.
C. Wound debridement
Debridement is essential in burn care but is not the first step. It is performed after the client is stabilized with fluids and airway support.
D. Infection prevention
Infection control is critical but becomes a priority in the acute and rehabilitation phases of burn care. In the first hours, fluid replacement takes precedence to save the client’s life.
A nurse is caring for a client who has a pressure ulcer and reports experiencing minor pain. The nurse should identify that which of the following client prescriptions is a nonsteroidal, anti-inflammatory medication used to relieve minor pain
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Gabapentin
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Naproxen
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Dantrolene
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Baclofen
Explanation
Correct Answer B. Naproxen
Explanation
Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain, inflammation, and fever. It is commonly prescribed for conditions such as musculoskeletal pain, arthritis, and minor injuries. In the case of a pressure ulcer with minor discomfort, naproxen can help manage the pain and reduce inflammation at the site.
Why Other Options Are Wrong
A. Gabapentin
Gabapentin is used primarily for neuropathic pain and seizures, not for general pain or inflammation. It does not belong to the NSAID category.
C. Dantrolene
Dantrolene is a muscle relaxant used to treat conditions like spasticity and malignant hyperthermia. It is not effective for treating minor pain or inflammation.
D. Baclofen
Baclofen is a centrally acting muscle relaxant used for muscle spasticity, not for general or inflammatory pain. It is not an NSAID.
A nurse observes another nurse frequently removing narcotics from a client's medication drawer and disappearing several times throughout a shift. Which of the following actions should the nurse take
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Ask the client if she is receiving her pain medication.
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Assume care of the nurse's clients.
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Report the nurse's behavior to a charge nurse.
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Confront the nurse about the situation.
Explanation
Correct Answer C. Report the nurse's behavior to a charge nurse.
Explanation
When suspecting drug diversion or impairment, the observing nurse must follow the chain of command and report the suspicious behavior immediately to the charge nurse or nurse manager. This ensures that the situation is addressed appropriately, maintains patient safety, and allows for timely investigation and intervention according to facility policy and regulatory standards.
Why Other Options Are Wrong
A. Ask the client if she is receiving her pain medication
This may provide some insight but does not address the potential safety and legal concern. It also may not stop further misuse or protect other patients.
B. Assume care of the nurse's clients
Taking over care does not solve the root issue or ensure proper documentation and accountability. It also avoids required reporting protocols.
D. Confront the nurse about the situation
Direct confrontation is inappropriate and unsafe in this situation. It may escalate the issue or lead to defensiveness or concealment without resolution.
A nurse is caring for a client who has heart failure. Which of the following findings should indicate to the nurse that the client is experiencing cardiogenic shock
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Bradycardia
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Hypertension
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Increased urine output
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Pulmonary congestion
Explanation
Correct Answer D. Pulmonary congestion
Explanation
Pulmonary congestion is a key sign of cardiogenic shock, which occurs when the heart is unable to pump effectively, leading to backward fluid buildup into the lungs. This results in symptoms like crackles, dyspnea, hypoxia, and decreased oxygen exchange. Cardiogenic shock is life-threatening and requires immediate intervention to restore tissue perfusion and oxygenation.
Why Other Options Are Wrong
A. Bradycardia
While bradycardia may occur in some conditions, tachycardia is more commonly seen in cardiogenic shock as a compensatory response to poor perfusion.
B. Hypertension
Cardiogenic shock typically causes hypotension, not hypertension, due to low cardiac output and reduced tissue perfusion.
C. Increased urine output
In cardiogenic shock, there is decreased renal perfusion, which leads to oliguria (low urine output), not increased output.
A nurse on a medical unit realizes she administered an incorrect dose of medication to a client. Which of the following ethical principles is the nurse exhibiting by completing an incident report of the event
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Responsibility
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Authority
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Accountability
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Confidentiality
Explanation
Correct Answer C. Accountability
Explanation
By completing an incident report after making a medication error, the nurse is demonstrating accountability, which involves acknowledging and accepting responsibility for actions and their outcomes. It reflects ethical and professional conduct to ensure patient safety and system improvement.
Why Other Options Are Wrong
A. Responsibility
Responsibility refers to the duty to perform tasks and obligations as part of one’s role, but it doesn’t specifically address owning up to an error.
B. Authority
Authority is related to having the power or right to make decisions, which is not the focus in this situation.
D. Confidentiality
Confidentiality refers to protecting private patient information, not the reporting of errors or adverse events.
A nurse in an acute care facility is developing strategies to use evidence-based practice to improve client care. Which of the following actions should the nurse take to promote interprofessional collaboration
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Inform the staff of a change at the time of implementation.
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Limit evidence-based practice research responsibilities to the leader and managers on the team.
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Develop a consensus with the interprofessional team for the development of protocols.
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Use the opinion of experts to develop policies and procedures.
Explanation
Correct Answer C. Develop a consensus with the interprofessional team for the development of protocols.
Explanation
Developing a consensus among interprofessional team members ensures that multiple perspectives are considered, increasing the likelihood of staff buy-in and consistent implementation of evidence-based protocols. Collaboration enhances the quality of client care and fosters team ownership of clinical improvements.
Why Other Options Are Wrong
A. Inform the staff of a change at the time of implementation.
This approach excludes staff from the decision-making process and can result in resistance or lack of understanding about the change, reducing effectiveness.
B. Limit evidence-based practice research responsibilities to the leader and managers on the team.
Excluding frontline staff from participation in research or planning may lead to a disconnect between policy and practice. Including all team members promotes shared ownership and better outcomes.
D. Use the opinion of experts to develop policies and procedures.
While expert opinion is valuable, evidence-based practice should be based on high-quality research and collaborative decision-making rather than relying solely on individual opinions.
A nurse is assessing a client who has an abdominal aortic aneurysm. Which of the following findings should the nurse identify as a clinical emergency
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Bounding pedal pulses
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Sudden lower-back pain
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Flushed, dry skin
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Absence of a thrill
Explanation
Correct Answer B. Sudden lower-back pain
Explanation
Sudden lower-back pain in a client with an abdominal aortic aneurysm (AAA) can indicate impending or actual rupture, which is a life-threatening emergency. Rupture of an AAA can lead to rapid blood loss, hypovolemic shock, and death without immediate intervention. The pain is often described as tearing or stabbing and may radiate to the groin or legs.
Why Other Options Are Wrong
A. Bounding pedal pulses
Bounding pulses are not typically associated with AAA rupture. While diminished pulses may occur due to aortic occlusion or dissection, bounding pulses are not a sign of emergency.
C. Flushed, dry skin
This finding could be associated with fever or dehydration, but it is not specific to AAA rupture and does not indicate a clinical emergency related to the aneurysm.
D. Absence of a thrill
A thrill is a vibration felt over a vascular area, and its absence is not a critical finding. While a palpable thrill or bruit may suggest turbulent blood flow, its absence does not indicate rupture or acute danger.
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