ATI MED SURG PROCTORED EXAM (Study Guide) Latest Update 2022
A client is seen in the clinic for treatment of chronic back pain. The client mentions to the clinic
nurse that at home he applies an ointment prepared from several different herbs that relieves his
lower back pain. He asks the nurse, "Should I continue using it?" Which of the following
responses by the nurse would be BEST?
1. "No. It might do you more harm than good."
2. "Yes. Continue using it, but I don't see how it could help your condition."
3. "You may think it works, but I don't believe home remedies work."
4. "Pain can be relieved in several ways. Consult your physician regarding this
home remedy."
A young adult is involved in a motorcycle accident and is brought to the emergency room. The
physician diagnoses a closed head injury with suspected subdural hematoma. Although
complaining of a severe headache, the client is alert and answers questions appropriately. The
nurse should question which of the following orders?
1. "Promethazine (Phenergan) 25 mg IM 3 h."
2. "Morphine sulfate 10 mg IM q3 4h."
3. "Docusate sodium (Colace) 50 mg PO bid."
4. "Ranitidine (Zantac) 50 mg IVPB q12h."
The nurse cares for a patient following an appendectomy. The patient takes a deep breath,
coughs, and then winces in pain. Which of the following statements, if made by the nurse to the
patient, is BEST?
1. "Take three deep breaths, hold your incision, and then cough."
2. "That was good. Do that again and soon it won't hurt as much."
3. "It won't hurt as much if you hold your incision when you cough."
4. "Take another deep breath, hold it, and then cough deeply."
The nurse teaches a well-baby class to a group of parents with toddlers. The nurse should
encourage the parents to do which of the following?
1. Exercise their children daily.
2. Use a playpen whenever possible.
3. Provide a safe play area for their children.
4. Teach their children noncompetitive activities.
The nurse returns to the desk and finds four phone messages to return. Which of the following
messages should the nurse return FIRST?
1. A woman in the first trimester of pregnancy complains of heartburn.
2. A man complains of heartburn that radiates to the jaw.
3. A woman complains of hot flashes and difficulty sleeping.
4. A boy complains of knee pain after playing basketball.
,A patient is admitted to the surgical unit with a diagnosis with rule out (R/O) intestinal
obstruction. The nurse prepares to insert a Salem sump NG tube as ordered. It is BEST for the
nurse to place the patient in which of the following positions?
1. Head of bed elevated 30-45°.
2. Head of bed elevated 60-90°.
3. Side-lying with head elevated 15°.
4. Lying flat with head turned to the left side.
The nurse monitors the fluid status of an older patient receiving IV fluids following surgery.
Which of the following symptoms suggests to the nurse that the patient has fluid volume
overload?
1. Temperature 101°F (38.3°C), BP 96/60, pulse 96 and thready.
2. Cool skin, respiratory crackles, pulse 86 and bounding.
3. Complaints of a headache, abdominal pain, and lethargy.
4. Urinary output 700 ml/24 h, CVP of 5, and nystagmus.
A woman has been recently diagnosed with systemic lupus (SLE) and shares with the nurse, "I
am thinking about getting pregnant, but I don't know how I will be able to tolerate a pregnancy
because I have lupus." Which of the following responses by the nurse is BEST?
1. "Most women find that they feel better when they are pregnant."
2. "How long have you been in remission?"
3. "Women with lupus frequently have slightly longer gestations."
4. "It is best to become pregnant within the first 6 months of diagnosis."
The multidisciplinary team decides to implement behavior modification with a client. Which
of the following nursing actions is of primary importance during this time?
1. Confirm that all staff members understand and comply with the treatment plan.
2. Establish mutually agreed-upon, realistic goals.
3. Ensure that the potent reinforcers (rewards) are important to the client.
4. Establish a fixed interval schedule for reinforcement.
A client received six units of regular insulin 3 hours ago. The nurse is MOST concerned if which
of the following is observed?
1. Kussmaul’s respirations and diaphoresis.
2. Anorexia and lethargy.
3. Diaphoresis and trembling.
4. Headache and polyuria.
, The nursing assistant reports to the nurse that a client who is 1 day postoperative after an
angioplasty refuses to eat and states, "I just don't feel good." Which of the following actions by
the nurse is BEST?
1. Talk with the client about how the client is feeling.
2. Instruct the nursing assistant to sit with the client while the client eats.
3. Contacts the physician to obtain an order for an antacid.
4. Evaluate the most recent vital signs recorded in the chart.
The nurse prepares a patient for a cesarean section. The patient says that she had major surgery
several years ago and asks if she will receive a similar "shot" before surgery. The nurse's
response should be based on an understanding that the preoperative medication given before a
cesarean section
1. contains a lower overall dosage of medication than is given before general surgery.
2. contains lower amounts of sedatives and hypnotics than are given before general
surgery.
3. contains lower amounts of narcotics than are given before general surgery.
4. contains medications similar in type and dosages to those given before general surgery.
The nurse cares for patient placed in balanced suspension traction with a Thomas splint and
Pearson attachment because of a fractured right femur. The nurse notes that the patient's left leg
is externally rotated. The nurse should take which of the following actions?
1. Place a trochanter roll on the outer aspect of the thigh.
2. Perform resistive range of motion of the left leg.
3. Adduct and internally rotate the left leg.
4. Instruct the patient to maintain the left leg in a neutral position.
The nurse prepares a 5-year-old child for surgery. The nurse notes that the child's parents are
divorced and have joint legal custody. The informed consent for surgery has been signed by the
mother. Which of the following actions by the nurse is BEST?
1. Notify the physician.
2. Inform surgery.
3. Contact the father to obtain consent.
4. Continue the child's preoperative preparation.
The nurse cares for clients on the neurology unit. What is the MOST appropriate action for the
nurse to take after noting that a client suddenly develops a fixed and dilated pupil?
1. Reassess in 5 minutes.
2. Check the client's visual acuity.
A client is seen in the clinic for treatment of chronic back pain. The client mentions to the clinic
nurse that at home he applies an ointment prepared from several different herbs that relieves his
lower back pain. He asks the nurse, "Should I continue using it?" Which of the following
responses by the nurse would be BEST?
1. "No. It might do you more harm than good."
2. "Yes. Continue using it, but I don't see how it could help your condition."
3. "You may think it works, but I don't believe home remedies work."
4. "Pain can be relieved in several ways. Consult your physician regarding this
home remedy."
A young adult is involved in a motorcycle accident and is brought to the emergency room. The
physician diagnoses a closed head injury with suspected subdural hematoma. Although
complaining of a severe headache, the client is alert and answers questions appropriately. The
nurse should question which of the following orders?
1. "Promethazine (Phenergan) 25 mg IM 3 h."
2. "Morphine sulfate 10 mg IM q3 4h."
3. "Docusate sodium (Colace) 50 mg PO bid."
4. "Ranitidine (Zantac) 50 mg IVPB q12h."
The nurse cares for a patient following an appendectomy. The patient takes a deep breath,
coughs, and then winces in pain. Which of the following statements, if made by the nurse to the
patient, is BEST?
1. "Take three deep breaths, hold your incision, and then cough."
2. "That was good. Do that again and soon it won't hurt as much."
3. "It won't hurt as much if you hold your incision when you cough."
4. "Take another deep breath, hold it, and then cough deeply."
The nurse teaches a well-baby class to a group of parents with toddlers. The nurse should
encourage the parents to do which of the following?
1. Exercise their children daily.
2. Use a playpen whenever possible.
3. Provide a safe play area for their children.
4. Teach their children noncompetitive activities.
The nurse returns to the desk and finds four phone messages to return. Which of the following
messages should the nurse return FIRST?
1. A woman in the first trimester of pregnancy complains of heartburn.
2. A man complains of heartburn that radiates to the jaw.
3. A woman complains of hot flashes and difficulty sleeping.
4. A boy complains of knee pain after playing basketball.
,A patient is admitted to the surgical unit with a diagnosis with rule out (R/O) intestinal
obstruction. The nurse prepares to insert a Salem sump NG tube as ordered. It is BEST for the
nurse to place the patient in which of the following positions?
1. Head of bed elevated 30-45°.
2. Head of bed elevated 60-90°.
3. Side-lying with head elevated 15°.
4. Lying flat with head turned to the left side.
The nurse monitors the fluid status of an older patient receiving IV fluids following surgery.
Which of the following symptoms suggests to the nurse that the patient has fluid volume
overload?
1. Temperature 101°F (38.3°C), BP 96/60, pulse 96 and thready.
2. Cool skin, respiratory crackles, pulse 86 and bounding.
3. Complaints of a headache, abdominal pain, and lethargy.
4. Urinary output 700 ml/24 h, CVP of 5, and nystagmus.
A woman has been recently diagnosed with systemic lupus (SLE) and shares with the nurse, "I
am thinking about getting pregnant, but I don't know how I will be able to tolerate a pregnancy
because I have lupus." Which of the following responses by the nurse is BEST?
1. "Most women find that they feel better when they are pregnant."
2. "How long have you been in remission?"
3. "Women with lupus frequently have slightly longer gestations."
4. "It is best to become pregnant within the first 6 months of diagnosis."
The multidisciplinary team decides to implement behavior modification with a client. Which
of the following nursing actions is of primary importance during this time?
1. Confirm that all staff members understand and comply with the treatment plan.
2. Establish mutually agreed-upon, realistic goals.
3. Ensure that the potent reinforcers (rewards) are important to the client.
4. Establish a fixed interval schedule for reinforcement.
A client received six units of regular insulin 3 hours ago. The nurse is MOST concerned if which
of the following is observed?
1. Kussmaul’s respirations and diaphoresis.
2. Anorexia and lethargy.
3. Diaphoresis and trembling.
4. Headache and polyuria.
, The nursing assistant reports to the nurse that a client who is 1 day postoperative after an
angioplasty refuses to eat and states, "I just don't feel good." Which of the following actions by
the nurse is BEST?
1. Talk with the client about how the client is feeling.
2. Instruct the nursing assistant to sit with the client while the client eats.
3. Contacts the physician to obtain an order for an antacid.
4. Evaluate the most recent vital signs recorded in the chart.
The nurse prepares a patient for a cesarean section. The patient says that she had major surgery
several years ago and asks if she will receive a similar "shot" before surgery. The nurse's
response should be based on an understanding that the preoperative medication given before a
cesarean section
1. contains a lower overall dosage of medication than is given before general surgery.
2. contains lower amounts of sedatives and hypnotics than are given before general
surgery.
3. contains lower amounts of narcotics than are given before general surgery.
4. contains medications similar in type and dosages to those given before general surgery.
The nurse cares for patient placed in balanced suspension traction with a Thomas splint and
Pearson attachment because of a fractured right femur. The nurse notes that the patient's left leg
is externally rotated. The nurse should take which of the following actions?
1. Place a trochanter roll on the outer aspect of the thigh.
2. Perform resistive range of motion of the left leg.
3. Adduct and internally rotate the left leg.
4. Instruct the patient to maintain the left leg in a neutral position.
The nurse prepares a 5-year-old child for surgery. The nurse notes that the child's parents are
divorced and have joint legal custody. The informed consent for surgery has been signed by the
mother. Which of the following actions by the nurse is BEST?
1. Notify the physician.
2. Inform surgery.
3. Contact the father to obtain consent.
4. Continue the child's preoperative preparation.
The nurse cares for clients on the neurology unit. What is the MOST appropriate action for the
nurse to take after noting that a client suddenly develops a fixed and dilated pupil?
1. Reassess in 5 minutes.
2. Check the client's visual acuity.
