ATI Comprehensive Medical Surgical Exam
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Free ATI Comprehensive Medical Surgical Exam Questions
A nurse removes a fall hazard that is in an older adult client's path. The nurse should identify that this action is an example of which of the following ethical principles
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Fidelity
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Autonomy
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Veracity
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Nonmaleficence
Explanation
Correct Answer D. Nonmaleficence
Explanation
Nonmaleficence is the ethical principle that refers to the duty to do no harm. By removing a fall hazard, the nurse is taking proactive steps to prevent injury, thereby fulfilling the obligation to protect the client from harm. This is a direct example of applying nonmaleficence in practice.
Why Other Options Are Wrong
A. Fidelity
Fidelity involves keeping promises and commitments to the client, such as following through with care or being trustworthy—not directly preventing harm.
B. Autonomy
Autonomy is the client's right to make their own decisions about care. Removing a fall hazard is about safety, not decision-making.
C. Veracity
Veracity refers to truth-telling and honesty in communication, not actions taken to prevent physical harm.
A nurse manager is training a group of staff nurses to become nurse preceptors. Which of the following statements by a staff nurse indicates an understanding of the training
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Preceptorship offers an opportunity for socialization along with teaching.
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A preceptor program often raises the operating costs of a facility.
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A preceptor will set goals for a newly licensed nurse.
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Preceptorship will last for a period of 12 months.
Explanation
Correct Answer A. Preceptorship offers an opportunity for socialization along with teaching.
Explanation
Preceptorship helps newly licensed nurses not only learn clinical skills and policies but also become integrated into the unit’s culture, building professional relationships and improving socialization into the workplace. This supportive relationship promotes confidence, competence, and collaboration.
Why Other Options Are Wrong
B. A preceptor program often raises the operating costs of a facility.
While preceptorship requires resources, it is viewed as a cost-effective investment that improves nurse retention, reduces turnover, and promotes safe, competent care.
C. A preceptor will set goals for a newly licensed nurse.
Effective preceptorship involves collaborative goal-setting. Goals should be developed together by the preceptor and preceptee to reflect learning needs and promote accountability.
D. Preceptorship will last for a period of 12 months.
Preceptorships usually last from a few weeks to a few months, depending on the unit and facility. A 12-month duration is more typical of mentorship programs, not preceptorship.
A community health nurse is conducting a windshield survey. Which of the following actions should the nurse take to gather data using this method
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Sending out written surveys to community members over the age of 50
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Travelling through the community neighborhoods for visual observations
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Holding a community meeting to gather information
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Researching national statistics on disease outbreaks among adolescents
Explanation
Correct Answer B. Travelling through the community neighborhoods for visual observations
Explanation
A windshield survey is a method of community assessment in which the nurse drives or walks through a community to make visual observations. This allows the nurse to gather firsthand data about the community’s environment, such as housing conditions, access to healthcare, public transportation, recreational areas, and signs of health or safety issues.
Why Other Options Are Wrong
A. Sending out written surveys to community members over the age of 50
This is a written survey, not a windshield survey. It collects self-reported data rather than observational.
C. Holding a community meeting to gather information
This method involves direct community engagement, but it is not part of a windshield survey, which is observational and passive.
D. Researching national statistics on disease outbreaks among adolescents
This involves secondary data analysis, not direct observation of the local community environment.
A nurse is caring for a client who has an unrepaired hip fracture. Which of the following actions should the nurse take to prevent the client from developing a deep-vein thrombosis
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Massage the client's legs.
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Increase the client's fluid intake.
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Place the client in Buck's traction.
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Provide the client with a diet that is high in vitamin K.
Explanation
Correct Answer B. Increase the client's fluid intake.
Explanation
Adequate hydration helps maintain blood volume and reduces blood viscosity, which can lower the risk of venous stasis and clot formation. For clients with limited mobility, such as those with hip fractures, promoting fluid intake is a simple and effective measure to reduce the risk of developing a deep-vein thrombosis (DVT).
Why Other Options Are Wrong
A. Massage the client's legs
Leg massage is contraindicated because it can dislodge an existing clot, potentially leading to a pulmonary embolism, which is life-threatening.
C. Place the client in Buck's traction
Buck’s traction is used for pain relief and stabilization before surgery, but it does not directly prevent DVT. It may actually contribute to immobility if not paired with other preventive measures.
D. Provide the client with a diet that is high in vitamin K
Vitamin K promotes clotting, which is not advisable in DVT prevention. In fact, high vitamin K intake can interfere with anticoagulant therapy if prescribed.
A nurse manager on a risk management committee is providing strategies to decrease the number of medical errors at the facility. Which of the following strategies should the nurse include
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Suggest increasing the number of providers who have ICU specialization.
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Educate the nursing staff about the benefits of voluntary reporting of medication errors that caused no harm.
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Eliminate the use of barcoding for medication administration.
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Propose computerized provider order entry.
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Recommend overriding the preset limits available on IV smart pumps.
Explanation
Correct Answers
B. Educate the nursing staff about the benefits of voluntary reporting of medication errors that caused no harm
D. Propose computerized provider order entry
Explanation
B. Educate the nursing staff about the benefits of voluntary reporting of medication errors that caused no harm
Encouraging voluntary reporting promotes a non-punitive culture of safety, allowing facilities to track near misses and prevent future errors.
D. Propose computerized provider order entry
Computerized provider order entry (CPOE) reduces transcription errors, improves accuracy, and enhances communication, all of which are proven strategies to reduce medical errors.
Why Other Options Are Wrong
A. Suggest increasing the number of providers who have ICU specialization
While specialized training is valuable, this is not a direct or practical strategy for broadly reducing facility-wide medical errors.
C. Eliminate the use of barcoding for medication administration
Barcoding is a highly effective safety strategy for ensuring correct patient, drug, dose, time, and route. Eliminating it would increase errors.
E. Recommend overriding the preset limits available on IV smart pumps
Overriding preset limits can bypass critical safety checks and increase the risk of medication errors, especially with high-alert drugs.
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 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 assessing the nutritional status of an adult client who is experiencing acute kidney injury. The nurse should identify that which of the following laboratory values indicates an adequate nutritional intake
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Hgb 10 g/dL
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Serum albumin 3.7 g/dL
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Serum creatinine 2.0 mg/dL
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BUN 22 mg/dL
Explanation
Correct Answer B. Serum albumin 3.7 g/dL
Explanation
Serum albumin is a key indicator of long-term nutritional status, especially protein intake. A normal albumin level (3.5–5.0 g/dL) suggests adequate nutritional intake. In clients with acute kidney injury, maintaining normal albumin levels can be challenging, so a value of 3.7 g/dL reflects good protein nutrition and overall intake despite the condition.
Why Other Options Are Wrong
A. Hgb 10 g/dL
This value is below normal (normal range: 12–16 g/dL for women, 14–18 g/dL for men) and can indicate anemia, which may result from poor nutrition, chronic illness, or kidney disease.
C. Serum creatinine 2.0 mg/dL
This value is elevated (normal range: 0.6–1.3 mg/dL) and reflects kidney dysfunction, not nutritional adequacy. It is not a marker for assessing nutrition.
D. BUN 22 mg/dL
This value is slightly elevated (normal range: 7–20 mg/dL). BUN levels can fluctuate with hydration, kidney function, and protein metabolism, but alone do not confirm adequate nutrition.
A nurse is caring for a client who has developed sinus bradycardia following a myocardial infarction. Which of the following medications should the nurse plan to administer
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Digoxin
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Propranolol
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Atropine
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Adenosine
Explanation
Correct Answer C. Atropine
Explanation
Atropine is the first-line medication used to treat symptomatic sinus bradycardia. It works by blocking the vagus nerve's effect on the heart, increasing the heart rate. In clients with bradycardia following a myocardial infarction, prompt administration of atropine can help restore adequate cardiac output.
Why Other Options Are Wrong
A. Digoxin
Digoxin slows the heart rate and increases cardiac contractility. It is contraindicated in bradycardia, as it could worsen the condition.
B. Propranolol
Propranolol is a beta-blocker that further decreases the heart rate and is not appropriate in cases of bradycardia.
D. Adenosine
Adenosine is used to treat supraventricular tachycardia (SVT), not bradycardia. It temporarily slows conduction through the AV node and would worsen a slow heart rate.
A nurse is planning to provide wound care for a client. According to the practice guidelines, which of the following actions should the nurse take
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Irrigate noninfected wounds with sterile water
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Cleanse the wound from the inside toward the outside
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Pat the wound dry immediately after cleansing it
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Warm the irrigant in a microwave prior to cleansing the wound
Explanation
Correct Answer B. Cleanse the wound from the inside toward the outside
Explanation
The correct technique for wound cleansing is to move from the least contaminated area to the most contaminated area. This means cleaning from the center (or inside) of the wound outward toward the surrounding skin. This method reduces the risk of introducing bacteria from the surrounding skin into the wound bed and promotes proper healing.
Why Other Options Are Wrong
A. Irrigate noninfected wounds with sterile water
Sterile normal saline—not sterile water—is the preferred irrigant for noninfected wounds. It is isotonic and does not harm tissue. Sterile water can cause cell damage due to its hypotonic nature.
C. Pat the wound dry immediately after cleansing it
Wounds should generally be allowed to air dry slightly or be gently blotted if directed, but aggressive drying can disturb granulation tissue or introduce contaminants. Drying is not always appropriate, especially for wounds being treated with moist healing strategies.
D. Warm the irrigant in a microwave prior to cleansing the wound
Microwaving irrigant solutions is unsafe because it can lead to uneven heating and potential tissue burns. If warming is necessary, the solution should be placed in a warm water bath and checked for appropriate temperature
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