ATI Comprehensive Medical Surgical Exam

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Free ATI Comprehensive Medical Surgical Exam Questions

1.

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

  • Ask the client if she is receiving her pain medication.

  • Assume care of the nurse's clients.

  • Report the nurse's behavior to a charge nurse.

  • 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.


2.

 A nurse is caring for a client who has a traumatic brain injury and is experiencing increased intracranial pressure. Which of the following actions should the nurse take to decrease the intracranial pressure

  • Maintain the head of the client's bed at a 10° angle.

  • Suction the client's airway every hour.

  • Reposition the client by using the log rolling technique.

  • Use a pillow to flex the client's neck.

Explanation

Correct Answer C. Reposition the client by using the log rolling technique.

Explanation

Using the log rolling technique maintains spinal alignment and avoids twisting the neck and torso, which can otherwise increase intracranial pressure (ICP). Proper body positioning is crucial in managing elevated ICP to promote venous drainage and prevent further injury.

Why Other Options Are Wrong

A. Maintain the head of the client's bed at a 10° angle

A 10° elevation is too low. ICP is best reduced by elevating the head of the bed to about 30°, which facilitates cerebral venous outflow.

B. Suction the client's airway every hour

Routine suctioning can raise ICP due to coughing and stimulation. It should only be done as needed, not on a fixed hourly basis.

D. Use a pillow to flex the client's neck

Neck flexion can obstruct venous return from the brain and increase ICP. The head and neck should be kept in a neutral, midline position.


3.

A nurse is teaching a client about manifestations of rejection following a liver transplant. Which of the following findings should the nurse include in the teaching

  •  Slow pulse

  • Upper-left abdominal pain

  • Yellowing of the skin

  • Diarrhea

Explanation

Correct Answer C. Yellowing of the skin

Explanation

Yellowing of the skin (jaundice) is a classic sign of liver dysfunction and may indicate liver transplant rejection. Other signs of rejection can include right upper quadrant pain, dark urine, fatigue, fever, and elevated liver enzymes. Jaundice occurs due to impaired bilirubin processing by a failing or rejected liver.

Why Other Options Are Wrong

A. Slow pulse

A slow heart rate (bradycardia) is not a common sign of liver transplant rejection. It may be associated with other conditions or medications but is not a key indicator of rejection.

B. Upper-left abdominal pain

The liver is located in the right upper quadrant, not the left. Rejection would typically cause right-sided upper abdominal pain.

D. Diarrhea

Diarrhea is not a primary sign of liver transplant rejection. It can be a side effect of immunosuppressant medications but does not directly indicate rejection.


4.

 A nurse is planning research-based care for a client who has cystic fibrosis. Which of the following resources should the nurse use

  • National Patient Safety Goals

  • Clinical practice guidelines

  • Professional standards review

  • Acuity index

Explanation

Correct Answer B. Clinical practice guidelines

Explanation

Clinical practice guidelines are evidence-based recommendations that guide healthcare professionals in the care of specific conditions, such as cystic fibrosis. These guidelines incorporate the latest research and expert consensus to ensure that patients receive high-quality, effective, and consistent care tailored to their diagnosis.

Why Other Options Are Wrong

A. National Patient Safety Goals

These focus on overall patient safety initiatives (like preventing infections or falls), not on condition-specific, research-based care plans.

C. Professional standards review

This evaluates professional performance and adherence to standards, but does not offer specific, research-based clinical guidance for managing a particular illness.

D. Acuity index

An acuity index measures the level of care a patient needs, not how to treat a specific condition like cystic fibrosis using research-based protocols.


5.

 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

  • I will increase my intake of high-carbohydrate foods.

  • I can drink 4 ounces of alcohol twice a week.

  • I can donate my blood 1 year after I have recovered

  • 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


6.

 A nurse is caring for a client who has experienced a myocardial infarction and received thrombolytic therapy. Which of the following actions should the nurse take

  • Set an automated blood pressure cuff for every 5 min.

  • Administer IM morphine for pain as needed.

  • Apply an ice pack to stop minor bleeding.

  • Minimize the number of venipunctures the client receives.

Explanation

Correct Answer D. Minimize the number of venipunctures the client receives.

Explanation

Thrombolytic therapy increases the client's risk for bleeding due to its clot-dissolving effects. To reduce this risk, the nurse should limit invasive procedures such as venipunctures. When blood draws are necessary, they should be done with caution and through existing lines when possible to prevent trauma and bleeding complications.

Why Other Options Are Wrong

A. Set an automated blood pressure cuff for every 5 min

Frequent automatic cuff inflations can cause bruising and bleeding, especially on anticoagulated clients. Blood pressure should be monitored frequently but not at a rate that increases bleeding risk.

B. Administer IM morphine for pain as needed

IM injections are contraindicated for clients who have received thrombolytics due to the risk of bleeding into the muscle tissue. Pain medications should be given IV if needed.

C. Apply an ice pack to stop minor bleeding

Ice packs may help with vasoconstriction, but direct pressure is the first-line action for minor bleeding. Also, ice does not address systemic bleeding risk associated with thrombolytics.


7.

A community health nurse is conducting a windshield survey. Which of the following actions should the nurse take to gather data using this method

  • Sending out written surveys to community members over the age of 50

  • Travelling through the community neighborhoods for visual observations

  • Holding a community meeting to gather information

  • 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.


8.

 A nurse is teaching a group of newly hired nurses about professional organizations. Which of the following information should the nurse include in the teaching about the American Nurses Association (ANA)

  • The ANA publishes standards of professional performance.

  • The ANA identifies yearly National Patient Safety Goals.

  • The ANA maintains information about sentinel events.

  • The ANA accredits health care facilities.

Explanation

Correct Answer A. The ANA publishes standards of professional performance.

Explanation

The American Nurses Association (ANA) develops and publishes the Standards of Professional Nursing Practice, which include both standards of care and standards of professional performance. These standards serve as a guide for ethical, competent, and safe nursing practice across the profession.

Why Other Options Are Wrong

B. The ANA identifies yearly National Patient Safety Goals

This is the role of The Joint Commission, not the ANA.

C. The ANA maintains information about sentinel events

Sentinel event tracking is also handled by The Joint Commission, not the ANA.

D. The ANA accredits health care facilities

Health care facility accreditation is conducted by organizations like The Joint Commission or DNV Healthcare, not the ANA.


9.

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

  •  Adjust the screws on the traction to clean the pin sites

  • Use the halo device to turn the client in bed

  • Remove the pillow from the client's bed

  • 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.


10.

.A nurse manager is discussing types of settings in the health care delivery system with a newly licensed nurse. Which of the following locations should the nurse include as an example of a primary care setting

  • A community health clinic

  • Assisted living center

  • Urgent care clinic

  • A mental health crisis center

Explanation

Correct Answer A. A community health clinic

Explanation

A community health clinic is a classic example of a primary care setting. Primary care focuses on health promotion, disease prevention, early detection, and management of common illnesses. These clinics often serve as the first point of contact in the health care system and are staffed by providers such as family physicians, nurse practitioners, or physician assistants.

Why Other Options Are Wrong

B. Assisted living center

This is a residential care setting, not a primary care facility. It provides help with daily living activities, not routine medical care or preventive services.

C. Urgent care clinic

This setting provides episodic care for acute issues that are not emergencies. While it offers some similar services to primary care, it is not considered a true primary care setting because it lacks continuity of care.

D. A mental health crisis center

This facility provides specialized emergency mental health services and is not a general primary care setting. It addresses acute psychiatric needs rather than ongoing, routine health care.


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