ATI Comprehensive Medical Surgical Exam
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Free ATI Comprehensive Medical Surgical Exam Questions
A nurse is assisting a licensed practical nurse (LPN) to plan care for several clients. The nurse is unsure which tasks are within the scope of practice for an LPN. Which of the following resources should the nurse consult for clarification
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The American Nurses Association
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The State Board of Nursing
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The Accreditation Commission for Education in Nursing
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The National Council of State Boards of Nursing
Explanation
Correct Answer B. The State Board of Nursing
Explanation
Each State Board of Nursing (BON) defines the legal scope of practice for LPNs, RNs, and APRNs within that state. Because nurse practice acts vary by state, the BON is the most authoritative and legally binding resource for determining what tasks an LPN can or cannot perform in that particular state.
Why Other Options Are Wrong
A. The American Nurses Association (ANA)
The ANA provides standards and guidelines for professional nursing practice, mostly for registered nurses, but it does not define LPN scope of practice.
C. The Accreditation Commission for Education in Nursing (ACEN)
The ACEN is responsible for accrediting nursing education programs, not for setting practice standards or scopes of practice.
D. The National Council of State Boards of Nursing (NCSBN)
While the NCSBN supports state boards and developed the NCLEX, it does not define individual state practice acts. The correct and legal scope is determined by the State Board of Nursing.
A nurse is caring for a client who is receiving mannitol for increased intracranial pressure. The nurse should identify which of the following findings as an adverse effect of this medication
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Hyperglycemia
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Dehydration
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Tinnitus
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Peripheral edema
Explanation
Correct Answer B. Dehydration
Explanation
Mannitol is an osmotic diuretic used to reduce intracranial pressure by drawing fluid out of brain tissue. A common adverse effect is dehydration due to excessive diuresis. The nurse should monitor for signs such as dry mucous membranes, decreased skin turgor, hypotension, and concentrated urine output.
Why Other Options Are Wrong
A. Hyperglycemia
Mannitol is not known to significantly raise blood glucose levels; this effect is more commonly associated with corticosteroids.
C. Tinnitus
Tinnitus is typically associated with ototoxic drugs like aminoglycosides, not mannitol.
D. Friction rub
A friction rub is a sign of pericarditis or pleuritis and is unrelated to mannitol therapy.
A nurse is developing the plan of care for a client who has a spinal cord injury and is in halo traction. Which of the following actions should the nurse include in the plan
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Adjust the screws on the traction to clean the pin sites
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Use the halo device to turn the client in bed
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Remove the pillow from the client's bed
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Ensure a screwdriver is available at the bedside
Explanation
Correct Answer D. Ensure a screwdriver is available at the bedside
Explanation
A screwdriver must be kept at the bedside at all times for clients in halo traction. In the event of an emergency, such as cardiac arrest, the halo vest may need to be quickly removed to allow for procedures like CPR. This is a critical safety precaution and part of standard care for clients with halo traction.
Why Other Options Are Wrong
A. Adjust the screws on the traction to clean the pin sites
Only a healthcare provider trained in the procedure should adjust traction screws. Nurses should clean pin sites but must not manipulate the device hardware.
B. Use the halo device to turn the client in bed
Using the halo device to reposition a client can cause injury or dislodgment of the device. The nurse should support the client’s body and follow proper turning techniques without pulling on the halo.
C. Remove the pillow from the client's bed
A small pillow may be allowed to provide comfort and alignment. Removing it unnecessarily may cause discomfort or poor positioning. Pillow use depends on the specific protocol and physician orders.
A nurse is caring for a client who has Cushing's disease. The nurse should identify that which of the following assessments is the priority
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Monitor the client's sodium level.
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Check the client's pressure areas for skin breakdown.
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Auscultate the client's lungs for crackles.
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Check the client's weight.
Explanation
Correct Answer C. Auscultate the client's lungs for crackles.
Explanation
In clients with Cushing’s disease, fluid retention and sodium retention can lead to pulmonary edema or heart failure, making crackles in the lungs a potential life-threatening complication. Auscultating the lungs for crackles helps identify early signs of fluid overload, which requires immediate intervention to prevent respiratory compromise.
Why Other Options Are Wrong
A. Monitor the client's sodium level
Hypertension and sodium retention are common in Cushing’s, but monitoring sodium is not as urgent as identifying signs of fluid overload affecting respiratory status.
B. Check the client's pressure areas for skin breakdown
Skin integrity is important in Cushing’s due to thinning skin, but this is a lower priority compared to assessing for respiratory compromise.
D. Check the client's weight
Daily weights help monitor fluid retention, but lung assessment takes precedence, especially if fluid is shifting into the lungs and impairing gas exchange.
A nurse is performing triage tagging during a disaster drill. Which of the following disaster triage tags should the nurse apply to a client who has a fracture of the tibia with exposed bone and tissue
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Nonurgent
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Expectant
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Urgent
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Emergent
Explanation
Correct Answer C. Urgent
Explanation
A client with a tibia fracture and exposed bone and tissue is experiencing a serious but not immediately life-threatening injury. This condition requires care within a few hours to prevent complications like infection or tissue necrosis but is not as critical as injuries that compromise airway, breathing, or circulation. Therefore, this client is tagged as Urgent (Yellow tag) in disaster triage.
Why Other Options Are Wrong
A. Nonurgent
This category (Green tag) is for minor injuries, such as abrasions or minor sprains. An open fracture is too severe for this classification.
B. Expectant
This category (Black tag) is used for clients who are not expected to survive, even with immediate intervention. A tibia fracture is treatable, so this does not apply.
D. Emergent
Emergent (Red tag) is reserved for life-threatening injuries requiring immediate intervention to survive (e.g., airway obstruction, major bleeding, shock). An open tibia fracture doesn’t meet that level of urgency.
A nurse manager is providing feedback to a new nurse about her job performance. Which of the following statements by the nurse manager is an example of the coaching technique
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Consider asking for assistance when catheterizing a female client.
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Try to do things differently next time because this is a skill you are required to perform.
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After observing your interaction with clients and family members, I think you are doing fine.
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Your time-management skills need to improve in order to get off on time
Explanation
Correct Answer A. Consider asking for assistance when catheterizing a female client.
Explanation
Coaching involves guiding, supporting, and encouraging a staff member to enhance performance or develop professionally. The statement in option A is constructive and offers a specific, helpful suggestion without criticism, guiding the nurse toward better outcomes while promoting growth and confidence.
Why Other Options Are Wrong
B. Try to do things differently next time because this is a skill you are required to perform.
This comes across as directive and critical, lacking the supportive tone typical of coaching. It emphasizes obligation rather than guidance.
C. After observing your interaction with clients and family members, I think you are doing fine.
This feedback is vague and nonspecific, which does not help the nurse know what is being done well or how to improve. Coaching requires clear, actionable input.
D. Your time-management skills need to improve in order to get off on time.
This is a judgmental statement and focuses on a negative outcome rather than offering supportive strategies for improvement, which coaching should provide.
A nurse is teaching about self-management with a client who has viral hepatitis. Which of the following statements by the client indicates an understanding of the teaching
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I will increase my intake of high-carbohydrate foods.
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I can drink 4 ounces of alcohol twice a week.
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I can donate my blood 1 year after I have recovered
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I will take acetaminophen for a headache.
Explanation
Correct Answer A. I will increase my intake of high-carbohydrate foods.
Explanation
Clients with viral hepatitis benefit from a high-carbohydrate, moderate-protein, and low-fat diet, as carbohydrates are the body's main energy source and are easier for the damaged liver to metabolize. Proper nutrition helps support liver function and recovery during the healing process.
Why Other Options Are Wrong
B. I can drink 4 ounces of alcohol twice a week.
Alcohol must be avoided completely in clients with hepatitis, as it can worsen liver inflammation and accelerate liver damage.
C. I can donate my blood 1 year after I have recovered.
Clients who have had viral hepatitis, especially types B or C, are permanently deferred from donating blood, due to the risk of virus transmission.
D. I will take acetaminophen for a headache.
Acetaminophen is hepatotoxic and should be used with extreme caution or avoided in clients with liver disease. Even small doses can worsen liver injury
A nurse is evaluating a group of nurses and assistive personnel (AP) on a medical-surgical unit. Which of the following findings should the nurse plan to report to the charge nurse as a possible indication of nursing malpractice
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An AP often requests additional assistance with client transfers.
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A nurse requests a change in the client care shift assignment.
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A nurse requests to perform the narcotic count on each assigned shift.
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An AP often requests that a nurse recheck clients' blood pressures.
Explanation
Correct Answer C. A nurse requests to perform the narcotic count on each assigned shift.
Explanation
While performing a narcotic count is a standard nursing duty, volunteering to do the narcotic count on every shift may raise red flags. This behavior could indicate a possible attempt to manipulate or divert controlled substances, which is a serious concern and a potential indicator of malpractice or unethical behavior. The pattern should be investigated and reported to ensure medication security and patient safety.
Why Other Options Are Wrong
A. An AP often requests additional assistance with client transfers.
This is a safe and appropriate action that reflects good clinical judgment to prevent injury to the client or staff. It is not a concern.
B. A nurse requests a change in the client care shift assignment.
Nurses may have valid personal or professional reasons for requesting assignment changes. This is not suggestive of malpractice.
D. An AP often requests that a nurse recheck clients' blood pressures.
This shows appropriate delegation and communication. APs should notify nurses of abnormal readings and are encouraged to ask for confirmation. This supports safe practice.
A nurse manager is providing an in-service on legal responsibilities for newly licensed nurses. Which of the following should the nurse manager include as an example of professional negligence
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Discussing a client's diagnosis with a nurse from a different unit
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Giving an IM medication after the client refuses it
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Refusing to allow a client to leave the facility without a provider's order
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Administering a stat medication 2 hr after the medication is prescribed
Explanation
Correct Answer D. Administering a stat medication 2 hr after the medication is prescribed
Explanation
Professional negligence occurs when a nurse fails to act in a way a reasonably prudent nurse would, resulting in harm or risk to the client. A stat medication is meant to be given immediately, typically within 30 minutes. Giving it 2 hours later is a breach of standard care and an example of negligence.
Why Other Options Are Wrong
A. Discussing a client's diagnosis with a nurse from a different unit
This is a breach of confidentiality or HIPAA violation, but not professional negligence.
B. Giving an IM medication after the client refuses it
This is battery, a form of intentional tort, not negligence.
C. Refusing to allow a client to leave the facility without a provider's order
This could be considered false imprisonment, another intentional tort, not negligence.
A nurse is planning to form a quality improvement group to establish guidelines that attempt to reduce health care-associated infections in the facility. The nurse should identify which of the following as the first stage of group process that involves interprofessional collaboration
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Norming
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Storming
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Forming
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Performing
Explanation
Correct Answer C. Forming
Explanation
The Forming stage is the first phase of group development. During this stage, team members are introduced, roles and responsibilities are clarified, and the group begins to understand the goals and purpose of their collaboration. It sets the foundation for successful teamwork and future progress in interprofessional collaboration.
Why Other Options Are Wrong
A. Norming
This is the third stage of group development, where team members begin to resolve differences, appreciate colleagues' strengths, and work more cohesively. It does not represent the initial stage.
B. Storming
This is the second stage and often involves conflict or competition as group members assert their ideas and challenge others. It comes after the team has formed.
D. Performing
This is the final stage where the group functions effectively toward achieving goals. It reflects maturity and productivity, not the beginning of the group process.
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