ATI Comprehensive Medical Surgical Exam
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Free ATI Comprehensive Medical Surgical Exam Questions
A nurse is assessing a client who has a dysrhythmia and is taking propranolol. Which of the following findings should the nurse identify as an adverse effect of the medication
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Fatigue
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Increased libido
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Nystagmus
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Tinnitus
Explanation
Correct Answer A. Fatigue
Explanation
Fatigue is a common adverse effect of propranolol, a nonselective beta-blocker. It occurs due to the medication’s impact on heart rate and cardiac output, which can lead to reduced energy levels and overall tiredness. Propranolol slows the heart, which helps manage dysrhythmias, but may also decrease circulation and oxygen delivery to tissues, resulting in fatigue.
Why Other Options Are Wrong
B. Increased libido
Propranolol is more likely to reduce libido or cause sexual dysfunction rather than increase it. Increased libido is not a known side effect.
C. Nystagmus
Nystagmus (involuntary eye movements) is not associated with propranolol use. It may indicate a neurological or inner ear issue but is not a typical adverse effect of beta-blockers.
D. Tinnitus
Tinnitus is not a common side effect of propranolol. While it can occur with some medications, propranolol is not typically associated with ear-related symptoms.
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.
A home health nurse is assessing the home of a client who has Parkinson's disease and recently fell. Which of the following findings should the nurse identify as increasing the client's risk for further falls
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The side table is placed next to the bed.
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The electrical cords are taped to the floor.
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Stairs are present at the front door entrance.
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Chairs in the living room have armrests.
Explanation
Correct Answer C. Stairs are present at the front door entrance.
Explanation
Clients with Parkinson’s disease often experience gait instability, shuffling steps, postural imbalance, and freezing episodes, all of which increase the risk of falling. Stairs at the entrance are a major environmental hazard, especially if handrails, ramps, or support systems are not present. Uneven surfaces and steps can easily lead to another fall.
Why Other Options Are Wrong
A. The side table is placed next to the bed
This is actually helpful, as it provides a place for the client to hold onto or to place personal items within reach, reducing fall risk.
B. The electrical cords are taped to the floor
This is an appropriate safety measure. Loose cords pose a tripping hazard, but taping them securely to the floor helps prevent falls.
D. Chairs in the living room have armrests
Chairs with armrests support safe sitting and standing, which is particularly helpful for clients with limited mobility and tremors.
. A nurse is reviewing the medical record for a client who has advanced cirrhosis. Which of the following laboratory values should the nurse expect
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Platelets 120,000/mm³
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Hgb 15 g/dL
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Sodium 140 mEq/L
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BUN 16 mg/dL
Explanation
Correct Answer A. Platelets 120,000/mm³
Explanation
Thrombocytopenia (low platelet count) is a common finding in advanced cirrhosis due to splenomegaly and portal hypertension, which lead to increased sequestration and destruction of platelets. A platelet count of 120,000/mm³ is below the normal range (150,000–400,000/mm³) and is expected in this condition.
Why Other Options Are Wrong
B. Hgb 15 g/dL
This is within the normal range for hemoglobin and is not typically expected in advanced cirrhosis, where anemia is more common due to bleeding, nutritional deficiencies, or hypersplenism.
C. Sodium 140 mEq/L
This value is normal, but clients with cirrhosis often experience hyponatremia due to fluid retention and dilutional effects from ascites and SIADH-like effects.
D. BUN 16 mg/dL
This is also a normal value, but in cirrhosis, BUN levels can be low or elevated, depending on hydration, renal function, or gastrointestinal bleeding. It is not a hallmark finding like thrombocytopenia.
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 is creating a plan for quality improvement to reduce the incidence of health care-associated infections at an acute care facility. Which of the following actions should the nurse take first
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Implement the plan in the health care setting.
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Test the plan to see if refinements are needed.
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Determine whether the plan will result in an improvement.
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Adjust the plan as necessary to improve quality.
Explanation
Correct Answer C. Determine whether the plan will result in an improvement.
Explanation
The first step in quality improvement is to evaluate whether the proposed plan has the potential to lead to measurable improvement. This involves reviewing current practices, setting goals, and ensuring the plan aligns with evidence-based strategies. Only after confirming its potential effectiveness should the plan move forward into testing and implementation.
Why Other Options Are Wrong
A. Implement the plan in the health care setting
Implementation should not occur before evaluating the plan’s potential effectiveness. Jumping to implementation too soon may waste resources.
B. Test the plan to see if refinements are needed
Testing comes after determining that the plan is likely to result in improvement. It is part of the Plan-Do-Study-Act (PDSA) cycle.
D. Adjust the plan as necessary to improve quality
This is a later step that follows testing and evaluation. Adjustments are made based on outcomes and feedback from earlier phases.
A nurse is teaching the adult child of an older adult client about Medicare. Which of the following information should the nurse include
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Medicare Part B offers assistance with paying for managed care plans.
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Medicare Part C can assist with paying for prescription medications.
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Medicare Part A will assist with paying for an inpatient stay at a medical facility.
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Medicare Part D can offer assistance with paying for outpatient provider visits.
Explanation
Correct Answer C. Medicare Part A will assist with paying for an inpatient stay at a medical facility.
Explanation
Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. It is one of the core parts of Medicare and is typically premium-free for most individuals who have paid into Social Security.
Why Other Options Are Wrong
A. Medicare Part B offers assistance with paying for managed care plans
Part B covers outpatient care, preventive services, and doctor visits, not managed care plans. Managed care is covered under Part C.
B. Medicare Part C can assist with paying for prescription medications
Part C (Medicare Advantage) may include prescription drug coverage, but this is plan-dependent, not guaranteed like with Part D.
D. Medicare Part D can offer assistance with paying for outpatient provider visits
Part D covers prescription drugs, not outpatient visits. Outpatient provider visits are part of Medicare Part B coverage.
A nurse is caring for a client who is postoperative following a colostomy placement. Which of the following referrals should the nurse make to assist the client in obtaining ostomy appliances
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Pharmacist
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Occupational therapist
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Case manager
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Paramedical technician
Explanation
Correct Answer C. Case manager
Explanation
A case manager is responsible for coordinating resources and services that the client will need after discharge. This includes arranging for ostomy supplies and appliances, home health services, and follow-up care. They ensure the client has access to necessary medical equipment and support.
Why Other Options Are Wrong
A. Pharmacist
Pharmacists manage medications, not medical equipment or ostomy appliances.
B. Occupational therapist
OTs help clients with self-care skills and adaptive equipment but are not responsible for arranging supply access.
D. Paramedical technician
This role typically supports clinical tasks under supervision but is not involved in discharge planning or supply coordination.
A nurse educator is teaching about the Code of Ethics for Nurses to a group of newly licensed nurses. Which of the following statements should the nurse include
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The Code varies in each of the 50 states.
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The Code provides a framework for assessing specific ethical dilemmas.
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The Code guides professional nursing behavior.
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The Code states that a nurse's first accountability is to the nurse's employer.
Explanation
Correct Answer C. The Code guides professional nursing behavior.
Explanation
The ANA Code of Ethics for Nurses provides a comprehensive guide to professional conduct, emphasizing the values and obligations of the profession. It outlines the ethical principles and standards that nurses are expected to follow, such as respect, advocacy, and accountability to patients.
Why Other Options Are Wrong
A. The Code varies in each of the 50 states.
Incorrect. The ANA Code of Ethics is a national standard and does not vary by state. State laws may vary, but the ethical code remains consistent nationwide.
B. The Code provides a framework for assessing specific ethical dilemmas.
While the Code offers broad ethical guidance, it does not provide specific solutions or frameworks for assessing individual dilemmas. It supports general decision-making but not case-specific directions.
D. The Code states that a nurse's first accountability is to the nurse's employer.
Incorrect. The nurse's primary commitment is to the patient, not the employer, according to the Code of Ethics. Patient advocacy comes first in professional responsibility.
A nurse is caring for a client who is postoperative following a craniotomy for a tumor removal and has a surgical drain in place. Which of the following actions should the nurse take
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Provide the client with clear liquids after 8 hr postoperative.
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Apply a warm, moist compress if the client develops periorbital edema.
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Measure the surgical drain output every 12 hr.
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Maintain the client's head in a midline, neutral position.
Explanation
Correct Answer D. Maintain the client's head in a midline, neutral position.
Explanation
Maintaining the head in a midline, neutral position promotes optimal venous drainage from the brain and helps reduce intracranial pressure (ICP), which is especially important after a craniotomy. Improper positioning can impair cerebral circulation and contribute to complications.
Why Other Options Are Wrong
A. Provide the client with clear liquids after 8 hr postoperative
The return to oral intake depends on neurological status, gag reflex, and bowel sounds, not just a timed schedule. Automatically giving fluids at 8 hours may not be safe.
B. Apply a warm, moist compress if the client develops periorbital edema
Warm compresses are not recommended in the immediate post-craniotomy phase. They can increase blood flow and exacerbate swelling. Cold compresses are more appropriate early on if needed.
C. Measure the surgical drain output every 12 hr
Surgical drain output should be monitored more frequently, typically every 1–2 hours initially, to detect signs of excessive bleeding or CSF leakage early.
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