ATI PROCTORED MEDICAL SURGICAL PRACTICE QUESTIONS AND ANSWERS EXAM 2023/2024
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ATI PROCTORED MEDICAL SURGICAL PRACTICE QUESTIONS AND ANSWERS EXAM 2023/2024
A nurse is assessing a client who has manifestations of acromegaly. Which of the following findings should the nurse expect?
A. Thinning of skeletal bone structure
B. Concave chest wall
C. High-pitched voice
D...
ATI PROCTORED MEDICAL SURGICAL
PRACTICE QUESTIONS AND ANSWERS EXAM
2023/2024
A nurse is assessing a client who has manifestations of acromegaly. Which of the following findings
should the nurse expect?
A. Thinning of skeletal bone structure
B. Concave chest wall
C. High-pitched voice
D. Increased head size
Correct Answer: D.
Increased head size
A client who has acromegaly will present with an enlarged head size due to the excessive production
of growth hormones after closing of the epiphyses (the "growth plate" at the ends of the long bones)
by the pituitary gland. This results in the gradual enlargement of the client's body tissues such as the
bones of the face, jaw, hands, feet, and skull.
Incorrect Answers: A. A client who has acromegaly will have skeletal thickening due to the increased
growth hormones secreted by the pituitary gland.
B. A client who has acromegaly will have a barrel-shaped chest due to the increased growth hormones
that enlarge the skeletal system.
C. A client who has acromegaly will have vocal deepening due to hypertrophy of the vocal cords from
the increased growth hormones secreted by the pituitary gland.
A nurse is providing teaching to a client who has cervical cancer and is scheduled to receive
brachytherapy in an ambulatory care clinic. Which of the following statements by the client indicates
an understanding of the teaching?
A. "I need to lie still in bed during my brachytherapy treatment."
B. "I will have an implant placed once a month during my brachytherapy treatment."
C. "I must stay at least 3 feet away from others between brachytherapy treatments."
D. "I should expect some blood in my urine after each brachytherapy treatment."
Correct Answer: A.
"I need to lie still in bed during my brachytherapy treatment."
The nurse should confirm that the client understands the need to remain on bed rest with limited
movement while the radioactive implant is in place to prevent dislodgment.
Incorrect Answers: B. The nurse should explain that the provider often prescribes brachytherapy
treatments 1 to 2 times per week.
,C. The nurse should explain that the client does not emit any radiation between treatments;
therefore, there are no restrictions regarding contact with others.
D. The nurse should explain that blood in the urine is not expected after brachytherapy treatment.
The client should notify the provider immediately if she develops this manifestation.
A nurse is planning care for a client who has AIDS and has developed stomatitis. Which of the
following interventions should the nurse include in the plan of care?
A. Rinse the mouth with chlorhexidine solution every 2 hr
B. Limit fluid intake with meals
C. Provide oral hygiene with a firm-bristled toothbrush after each meal
D. Avoid salty foods
Correct Answer: D.
Avoid salty foods
Stomatitis is an inflammation of the mucosa of the mouth, usually with ulcerations. Foods that are
spicy, acidic, or salty should be avoided to prevent further irritation and damage to the oral mucosa.
Incorrect Answers: A. Chlorhexidine is an antiseptic that could cause further irritation to the oral
mucosa. The nurse should provide the client with 0.9% sodium chloride solution or baking soda to mix
with water and use as a rinse aid.
B. The nurse should plan to provide moist foods and liquids with meals to decrease the client's
discomfort and to promote nutritional intake.
C. The client's oral care should be provided with a soft-bristled toothbrush to avoid further irritation
and damage to the oral mucosa.
A charge nurse receives notification of the admission of a client who is coughing frequently and
whose sputum is pink, frothy, and copious. The client has a history of night sweats, anorexia, and
weight loss. Which of the following actions should the nurse take? (Select all that apply.)
A. Assign the client to a private room with negative-pressure airflow.
B. Add contact precautions to the client's plan of care.
C. Wear an N95 respirator when entering the client's room.
D. Ensure the client's environment provides 4 exchanges of fresh air per minute.
E. Institute protective environment precautions as soon as the client arrives on the unit.
Correct Answers: A.
Assign the client to a private room with negative-pressure airflow.
C.
Wear an N95 respirator when entering the client's room.
,This client's history and present status suggest tuberculosis, a communicable infection that mandates
a private room with negative-pressure airflow. Airborne precautions will be required, including
wearing an N95 respirator when entering the client's room.
Incorrect Answers:B. Tuberculosis is a communicable infection that mandates a different type of
transmission-based precautions in addition to standard precautions.
D. Tuberculosis mandates the provision of a well-ventilated room with 6–12 exchanges of fresh air per
minute.
E. Protective environment precautions are for immunocompromised clients who are at high risk of
infection (e.g. clients who had chemotherapy).
A nurse is preparing a 24-hr urine specimen for a client who is suspected to have pheochromocytoma.
Which of the following laboratory tests from the 24-hr urine specimen should the nurse use to
determine the client's condition?
A. Creatinine clearance
B. Vanillylmandelic acid (VMA)
C. 17-hydroxycorticosteroids (17-OHCS)
D. Protein
Correct Answer: B.
Vanillylmandelic acid (VMA)
The VMA test is used to determine if the client has pheochromocytoma, which measures the level of
catecholamine metabolites in a 24-hour urine sample. Pheochromocytoma is a tumor of the adrenal
gland that causes excess release of the catecholamines epinephrine and norepinephrine, which are
hormones that regulate blood pressure and heart rate.
Incorrect Answers:A. A 24-hour urine specimen for creatinine clearance is used to evaluate the
client’s renal function by calculating the glomerular filtration rate of the kidneys.
C. A 24-hour urine specimen for 17-OHCS is used to determine if the client is producing an adequate
amount of cortisol. An increase of cortisol in the specimen can indicate Cushing’s disease.
D. A 24-hr urine specimen for protein is used to evaluate the client’s renal function.
A nurse is teaching a female client with a new diagnosis of systemic lupus erythematosus (SLE) about
factors that can trigger an exacerbation of SLE. The nurse should determine that the client requires
further teaching if she identifies which of the following as an exacerbation factor?
A. Exercise
B. Pregnancy
C. Infection
D. Sunlight
Correct Answer: A.
Exercise
SLE is a chronic autoimmune disease that develops when the immune system becomes hyperactive
and attacks healthy body tissue. This attack results in generalized inflammation and creates
, manifestations associated with the specific involved tissues. Most clients who have SLE can follow an
exercise program to increase their cellular aerobic capacity and improve immune function, and the
client should follow a program with her provider's assistance. This client needs additional teaching
about the importance of exercise to keep her muscles and joints active.
Incorrect Answers:B. Due to hormonal changes, pregnancy can exacerbate SLE. The nurse should
advise the client of the risks. If the client becomes pregnant, she should be monitored closely for renal
and cardiovascular effects.
C. Infections, especially streptococcal or viral infections, stress the body and can trigger an
exacerbation of SLE. In addition, many clients who have SLE take steroids, placing them at higher risk
of infection.
D. Exposure to sunlight and artificial ultraviolet light is the leading cause of SLE exacerbations,
especially the characteristic skin lesions and butterfly rash. Clients should use a sunscreen with a high
sun protection factor (SPF) and cover their skin with appropriate clothing and hats when exposed to
sunlight.
A nurse is caring for client who has human immunodeficiency virus (HIV). Which of the following types
of isolation should the nurse implement to prevent the transmission of HIV?
A. Protective isolation
B. Droplet precautions
C. Standard precautions
D. Airborne precautions
Correct Answer: C.
Standard precautions
Standard precautions should be implemented with every client to prevent the spread of infection
transmitted by direct or indirect contact with infectious blood or body fluids. Because HIV is spread
through blood and bodily fluids, standard precautions are appropriate.
Incorrect Answers:A. Protective isolation keeps a client who is immunocompromised from acquiring
communicable infections that are prevalent in the hospital setting, but it does not prevent the
transmission of HIV.
B. Droplet precautions prevent transmission of infectious diseases over short distances via air
droplets. HIV is not spread by air droplets, so droplet precautions are not necessary.
D. Airborne precautions are measures taken to prevent the spread of diseases transmitted by the air.
HIV is not spread by the air, so airborne precautions are not necessary.
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A nurse is preparing a client for thoracentesis. In which of the following positions should the nurse
place the client?
A. Lying flat on the affected side
B. Prone with the arms raised over the head
C. Supine with the head of the bed elevated
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