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ATI MED SURG EXAM REAL 2025 EXAM ACTUAL
QUESTIONS AND CORRECT verified ANSWERS GRADE A
GUARANTEE PASS
A nurse is caring for a client who is experiencing supraventricular tachycardia. Upon assessing the client, the nurse observes the following findings: heart rate 200/min, blood pressure 78/40 mm Hg, and respiratory rate 30/min. Which of the following actions should the nurse take? a. Defibrillate the client's heart. b. Perform synchronized cardioversion. c. Begin cardiopulmonary resuscitation. d. Administer lidocaine IV bolus. - CORRECT ANSWER b. perform synchronized cardioversion A nurse is teaching a young adult client how to perform testicular selfexam.
- use one or both hands? examine at same time?
- roll each testicle how?
- perform when?
- how often? - CORRECT ANSWER - use both hands to examine one testicle at a time
- roll each testicle horizontally between the thumb and the fingers to feel for any deep lumps in the center
- during or after warm bath/shower
- once a month A nurse is assessing a client following the administration of magnesium sulfate 1 g IV bolus. For which of the following adverse effects should the nurse monitor?
- reflexes?
- BP?
- breathing?
- cardiac - CORRECT ANSWER - depressed or absent reflexes
- decreased BP
- respiratory paralysis
- depressed cardiac function/heart block Magnesium sulfate can be used to treat what cardiac conditions? What is an adverse cardiac effect? - CORRECT ANSWER treats cardiac dysrhythmias such as torsades de pointes and refractory ventricular fibrillation AE: depressed cardiac function including heart block A nurse is planning care to decrease psychosocial health issues for a client who is starting dialysis treatments for chronic kidney disease. Which of the following interventions should the nurse include in the plan? a. Remind the client that dialysis treatments are not difficult to incorporate into daily life. b. Inform the client that dialysis will result in a cure. c. Tell the client that it is possible to return to similar previous levels of activity. d. Begin health promotion teaching during the first dialysis treatment. - CORRECT ANSWER c. Tell the client that it is possible to return to similar previous levels of activity. The nurse should help the client develop realistic goals and activities to have a productive life T/F: Before starting dialysis, the nurse should inform the client of the difficulty of incorporating dialysis into daily life to allow the client to develop realistic expectations. - CORRECT ANSWER True. T/F: Dialysis is a cure for CKD. - CORRECT ANSWER False, it is a lifelong management. For a client starting dialysis, when should the nurse begin health and lifestyle teaching? - CORRECT ANSWER In the first weeks after starting the dialysis treatment once the client feels better physically and emotionally. effect of hypokalemia on EKG - CORRECT ANSWER - flatted T wave
- presence of U wave
What is pulses paradoxus? - CORRECT ANSWER When the systolic BP is at least 10 mmhg higher on expiration than on inspiration. pericarditis findings
- HR
- EKG abnormality
- 3 symptoms
- what relieves the chest pain - CORRECT ANSWER - tachycardia
- ST-T spiking (elevation)
- dyspnea, hiccups, nonproductive cough
- chest pain relieved by sitting upright or leaning forward The nurse should increase the intake of food containing what for a client who has megaloblastic anemia? - CORRECT ANSWER folic acid Which adventitious breath sound? "high-pitched musical squeak on inspiration or expiration through a narrow or obstructed airway." - CORRECT ANSWER wheezes Which adventitious breath sound? "coarse, loud, low-pitched sounds during inspiration or expiration. Coughing often clears the airway and stops the sound."
- CORRECT ANSWER rhonchi Which adventitious breath sound? "loud, dry, rubbing or grating sounds over the lower lateral anterior chest surface during inspiration or expiration." - CORRECT ANSWER friction rub A client who had a recent myocardial infarction is at risk for left-sided heart failure. ________ are breath sounds caused by movement of air through airways partially or intermittently occluded with fluid and are associated with heart failure and frothy sputum. These sounds are heard at the end of inspiration and are not cleared by coughing. - CORRECT ANSWER crackles Post-PTCA with stent placement, the nurse should plan to administer scheduled doses of what? This maintains the patency of the client's coronary arteries following the PTCA by preventing platelet aggregation and thrombus formation around the newly placed stent. -
CORRECT ANSWER aspirin Patients who receive numerous blood transfusions (eg a sickle cell patient) are at risk of what electrolyte imbalances? - CORRECT ANSWER hyperkalemia - transfused blood relases more K because of hemolysis hypocalcemia - the citrate in the transfused blood binds the calcium in blood so it's excreted The client who has received several blood transfusions is at risk for development of hemosiderosis, which is excess storage of ____ in the body. The excess can come from overuse of supplements or from receiving frequent blood transfusions, as in sickle cell anemia. - CORRECT ANSWER iron T/F: The nurse should instruct the client who has stomatitis to avoid the use of lemon-glycerine swabs because they cause drying and irritation of the mucous membranes. - CORRECT ANSWER true The nurse should instruct the client with stomatitis to rinse the mouth out with_______, _______, or _________ solution every 2 to 3 hr to promote comfort and healing. - CORRECT ANSWER hydrogen peroxide solution, baking soda solution or warm saline ABGs normal pH normal PaCO normal HCO3 - CORRECT ANSWER pH 7.35-7. PaCO2 35- 45 HCO3 22- 26 How can you determine respiratory/metabolic acidosis/alkalosis? - CORRECT ANSWER First look at the pH. <7.35 = acidosis; >7.45=alkalosis. Then look at CO2. If abnormal = respiratory. If CO2 normal and HCO3 abnormal = metabolic. isoniazid for TB
- how long is it usually prescribed for?
- monitor what organ?
6 days there may only be mucus drainage patient with encephalitis from West Nile virus - what level of precautions?
- vital signs how often?
- neuro status how often?
- risk of what?
- bed position?
- surroundings? - CORRECT ANSWER - standard precautions
- vital signs q 2 hrs
- neuro status at least q 4 hrs - risk of increased ICP:
- head of bed elevated 30-45 degrees
- dark room, low-stimulation environment to promote comfort and decrease agitation patient with epistaxis
- what position
- apply what
- blow nose?
- when to try something else? - CORRECT ANSWER - sitting leaning forward
- apply ice pack or cold compress
- apply direct lateral pressure for 10 minutes. if that doesn't work, try nasal packing or other interventions
- avoid blowing nose for 24 hrs afterward patient on TPN
- if TPN is not available, give what fluid?
- change tubing how often?
- blood glucose checks how often?
- weights how often? - CORRECT ANSWER - give 10% dextrose in water or 20% dextrose in water - change tubing every 24 hrs
- check blood glucose every 4 hrs
- daily weights s/sx of increased intracranial pressure:
- BP
- HR
- other - CORRECT ANSWER widened pulse pressure/increased systolic BP bradycardia pupil changes LOC changes nausea and vomiting _________ is a deep, rapid respiratory pattern of hyperventilation that can occur in a client who has diabetic ketoacidosis. - CORRECT ANSWER Kussmaul respirations Kussmaul respirations is a deep, rapid respiratory pattern of hyperventilation that can occur in a client who has what condition? - CORRECT ANSWER diabetic ketoacidosis This is a breathing pattern of deep to shallow breaths, followed by periods of apnea. - CORRECT ANSWER Cheyne Stokes respirations Cheyne-Stokes respirations can be the result of a drug overdose or __________ and can precede death. - CORRECT ANSWER increased intracranial pressure This is a pattern of breathing in which the chest wall contracts during inspiration and expands during expiration. This can occur in a client who has sustained rib fractures. - CORRECT ANSWER flail chest aka paradoxical breathing What are some risk factors for breast cancer? - CORRECT ANSWER obesity, alcohol use (dose dependent - 3+ drinks/week), oral contraceptive use, family history/genetics, over age 50, nulliparity, early menarche, late menopause, hormone replacement therapy, increased breast density, first pregnancy after age 30 post radical prostatectomy with indwelling urinary catheter - shower/bath?
- change urinary drainage bag how often?
- use what to prevent constipation?
- bladder control? - CORRECT ANSWER - shower only for 2-3 weeks, no baths
- change bag and tubing once a week
- use stool softener (not suppositories) to prevent constipation - do kegels to regain bladder control. may be incontinent for 1-2 years after surgery discharged post-op mastectomy with Jackson Pratt drain - empty tube how often?
- baths or showers?
- when will drain and stitches be removed?
- topical corticosteroid creams may be used (not antibacterial creams)
- CORRECT ANSWER T/F: Antihistamines are used to treat vertigo, as in the treatment of Ménière's disease. However, vertigo is not a manifestation of histamine release. - CORRECT ANSWER true How does the release of histamine in an allergic reaction affect mucus secretion and the bronchi? - CORRECT ANSWER increased mucus secretion, bronchial constriction, bronchospasms What labs should be monitored prior to a liver biopsy and why? - CORRECT ANSWER platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT). Many people with liver disease have clotting defects and are at risk for bleeding/hemorrhage from a liver biopsy. (Normally the liver cells use vitamin K to make prothrombin.) The nurse should expect the client who is experiencing perforation of a peptic ulcer to exhibit manifestations of a ______ abdomen and severe pain in the abdomen or back that radiates to the _____ shoulder. Vomiting of blood and shock (high HR + low BP) can occur if the perforation causes hemorrhaging. - CORRECT ANSWER boardlike right What are two procedures that could be used to visualize polyps in the colon? - CORRECT ANSWER a sigmoidoscopy or barium enema What procedure is used to identify an obstruction in the biliary tract? - CORRECT ANSWER an ERCP What is used to determine the presence of free air in the abdomen? - CORRECT ANSWER an x-ray or fluoroscopy An EGD is used to visualize what areas with a lighted tube to detect a tumor, ulceration, or obstruction? - CORRECT ANSWER esophagus, stomach, duodenum The head of the bed should be elevated at least how many degrees (semi-Fowler's position) while a tube feeding is administered. This position uses gravity to help
the feeding move down through the digestive system and lessens the possibility of regurgitation? - CORRECT ANSWER at least 30 degrees!!! The hepatitis __ vaccine is recommended for those who travel, especially military personnel. It is also recommended for other at-risk groups. - CORRECT ANSWER hep A Hepatitis B immune globulin is given as part of the standard childhood immunizations. It can be administered as early as birth, especially in infants born to hepatitis B surface antigen (HBsAg) negative mothers. These infants should receive the second dose between __ and __ months of age. - CORRECT ANSWER (first shot within 12 hrs of birth) second shot: between 1 and 4 months of age A liver lobectomy is used for a client who has localized ____ of a lobe of the liver.
- CORRECT ANSWER cancer Endoscopic sclerotherapy is the injection of a sclerotherapy agent during endoscopy to target ____ ____ that are actively bleeding. This promotes thrombosis, which eventually leads to sclerosis. - CORRECT ANSWER esophageal varices Fulminant hepatic failure, most often caused by ___ __, is characterized by the development of hepatic encephalopathy within weeks of the onset of disease in a client without prior evidence of hepatic dysfunction. Mortality remains high, even with treatment modalities such as blood or plasma exchanges, charcoal hemoperfusion, and corticosteroids. Consequently, ___ ___ has become the treatment of choice for these clients. - CORRECT ANSWER viral hepatitis liver transplantation A transjugular intrahepatic portal-systemic shunt is placed to treat esophageal varices through placement of a stent into the portal vein. The stent serves as a shunt between the portal circulation and the hepatic vein, thereby reducing ___ ___. - CORRECT ANSWER portal hypertension The ___ laboratory test is specific to the hepatobiliary system in which levels can be raised by alcohol and hepatotoxic drugs. Therefore, it is useful for monitoring drug toxicity and excessive alcohol use. - CORRECT ANSWER GGT = gamma-glutamyl transferase
c. malignant melanoma d. squamous cell carcinoma - CORRECT ANSWER a. actnic keratosis Which lesion is described: pearly papule with ulcerated center a. actinic keratosis b. basal cell carcinoma c. malignant melanoma d. squamous cell carcinoma - CORRECT ANSWER b. basal cell carcinoma Which lesion is described: irregularly shaped with blue tones a. actinic keratosis b. basal cell carcinoma c. malignant melanoma d. squamous cell carcinoma - CORRECT ANSWER c. malignant melanoma Which lesion is described: firm nodule with crust a. actinic keratosis b. basal cell carcinoma c. malignant melanoma d. squamous cell carcinoma - CORRECT ANSWER d. squamous cell carcinoma expected findings in resuscitation phase after major burn:
- hemoglobin
- hematocrit
- potassium
- albumin
- sodium - CORRECT ANSWER hemoglobin elevated hematocrit elevated potassium elevated albumin decreased sodium decreased With ____ intention, a clean wound is closed mechanically, leaving well- approximated edges and minimal scarring. A surgical incision is an example of a wound that heals by ____ intention. - CORRECT ANSWER primary
patient recently extubated. what are signs of tracheal stenosis? (a complication of extubation) - CORRECT ANSWER increased coughing, inability to cough up secretions, difficulty talking/breathing Who should get the pneumococcal vaccine? How many shots is it? When can they repeat it if they aren't sure if they got it? - CORRECT ANSWER adults 65 and up one shot if their last shot was over five years ago and they're 65 now, they should get it what does dantrolene treat? what organ is it toxic to? - CORRECT ANSWER muscle spasticity (e.g. cerebral palsy, multiple sclerosis) malignant hyperthermia hepatotoxic - contradincated in patients with liver disease s/p radical mastectomy
- when to begin arm exercises?
- position of affected arm in bed?
- avoid what arm position when ambulating to prevent contractures? - when to begin ambulating? - CORRECT ANSWER - begin arm exercises + ambulation on first postoperative day
- keep affected arm elevated in bed
- avoid flexed position when ambulating to prevent contractures What is a drug used to treat diabetes inspidus? What is a sign of the adverse effect of water intoxication that may occur? - CORRECT ANSWER desmopressin headache What type of lesion is each of these skin conditions? a. freckles or rubella rash b. herpes simplex, poison ivy, chickenpox c. allergic reaction d. warts and elevated moles - CORRECT ANSWER a. macules b. vesicles c. wheal d. papules where should an estradiol patch be applied? - CORRECT ANSWER the abdomen/trunk (not breasts)
- radiation to the tumor from an external source - CORRECT ANSWER a. brachytherapy - radiactive insertion/infusion into/near tumor b. teletherapy - radiation from external source c. stereotactic body radiotherapy - precise high-dose radiation after tumor imagingchl Chlorpromazine (Thorazine) - CORRECT ANSWER typical antipsychotic anticholingergic effects orthostatic hypotension sedation Should children with HIV get vaccines? - CORRECT ANSWER yes, all of them! full dose, no delay, nothing special #1 reason for death after MI - CORRECT ANSWER dysrhythmias What is the effect of hypercalcemia and hypocalcemia on the QT interval? - CORRECT ANSWER hypercalcemia = shortened QT interval hypocalcemia = prolonged QT interval What is the effect of hyperkalemia and hypokalemia on an EKG? - CORRECT ANSWER hyperkalemia = widened QRS and peaked T waves hypokalemia = flatted T wave and cardiac dysrhythmias What are some signs of adrenal insufficiency, an adverse effect of long-term use of inhaled corticosteroids like fluticasone? - CORRECT ANSWER anorexia, weakness, nausea, hypotension, hypoglycemia what are expected findings in mild preeclampsia? what would signify a progression to severe preeclampsia? - CORRECT ANSWER proteinuria +2, elevated BUN (over 20), platelets <100,000 all expected more severe - +4 deep tendon reflexes - patient needs to be hospitalized and get magnesium to prevent seizures bronchoscopy - sedation?
- NPO?
- consent?
- head position?
- sputum specimen? - CORRECT ANSWER - pt will receive sedation and not remember procedure - NPO 4-8 hrs prior
- informed consent required
- neck hyperextended
- provider can obtain sputum specimens during it meds if choice for chronic gout and gout attack? - CORRECT ANSWER allopurinol and colchicine complete intestinal obstruction - bowel sounds?
- pass stool/flatus? - CORRECT ANSWER - bowel sounds HYPERACTIVE above the obstruction and ABSENT below
- no flatus or stool What condition would cause absent bowel sounds in all 4 quadrants? - CORRECT ANSWER paralytic ileus cardiac cath - sedation?
- position/special things after?
- fluids?
- feeling when dye is injected - CORRECT ANSWER - mild sedation beforehand
- lie flat or with HOB slightly elevated (no more than 30 degrees) a few hours after. keep leg straight - may get soft knee brace after
- lots of IV and oral fluids after to flush dye out
- warm feeling like hot flush when dye is injected tactile fremitus and crackles are signs of what - CORRECT ANSWER pneumonia subcutaneous emphysema is aka what and is a sign of what - CORRECT ANSWER crepitus air leak into subq tissue - sign of pneumothorax Vanillymandelic acid test is done to detect - CORRECT ANSWER excess catecholamines = epinephrine and norepinephrine = pheochromocytoma RIFLE system - CORRECT ANSWER Risk of renal dysfunction
ANSWER amlodipine and nifedipine Normal Absolute Neutrophil Count - CORRECT ANSWER 2500 - 8000 adverse effects of clozapine (think blood work) - CORRECT ANSWER agranulocytosis, dyslipidemia, hyperglycemia clomiphene is a fertility med that works by promoting what? - CORRECT ANSWER follicular maturation smoking is a contraindication to oral contraceptives because both cause what - CORRECT ANSWER MI and strokes a patient can begin oral contraceptives how long after childbirth? - CORRECT ANSWER 4 weeks meds that interfere with oral contraceptives - CORRECT ANSWER antifungal anti-TB anti-HIV anticonvulsants what to monitor with valproic acid - CORRECT ANSWER platelets/PT/PTT LFTs bleeding and liver problems post-BKA - mattress type?
- turn how often?
- prone how often?
- rewrap pressure bandage how often?
- position residual limb how?
- wrap bandage how? - CORRECT ANSWER - firm mattress
- turn slowly (to prevent muscle spasms) every 2 hrs
- prone 20-30 min every 3-4 hours
- rewrap pressure bandage on residual limb 3 times a day/every 4-6 hours or more
- push down on limb in bed
- figure 8 pattern distal to proximal Theophylline toxicity - CORRECT ANSWER tachycardia, tremors, seizures, diarrhea, restlessness, irritability, CNS stimulation
IV nitroprusside
- what color should it be?
- how to protect it from light?
- how to administer?
- change solution bag how often?
- purpose? - CORRECT ANSWER - light brown
- cover with opaque bag
- administer via continuous IV infusion, set infusion pump based on patient's weight
- change solution q 24 hrs
- potent vasodilator, brings down BP rapidly NPO patient has NG tube to suction. Reports nausea. First action? - CORRECT ANSWER irrigate tube with normal saline (to assess patency) amount of air in lungs after forced expiration - CORRECT ANSWER residual volume amount of air in lungs after normal expiration - CORRECT ANSWER functional residual capacity amount of air lungs hold after max inhale - CORRECT ANSWER total lung capacity max exhale after max inhale - CORRECT ANSWER vital lung capacity risk factors for vitamin D deficiency - CORRECT ANSWER obese, older, pregnant, dark skin alosetron treats what? what is a related AE? notify provider if doesn't work within how long? what special thing does patient have to do? AE on HR? - CORRECT ANSWER treats IBS-D set the aloe AE - constipation therapeutic response = less abdominal pain and diarrhea notify provider if still diarrhea after a month sign risk management program agreement can cause tachycardia
