Proctored ATI Medical Surgical 2026 Renal

Free preview · Original latest version

Sample questions from Proctored ATI Medical Surgical 2026 Renal

This material has 70 questions with answers and rationales. Here are the first 5.

1. 1.In the emergency department, a client with an acute myocardial infarction reports sudden worsening chest pressure 2 hours after admission. The client is diaphoretic, and the cardiac monitor shows new frequent premature ventricular complexes. Which action should the nurse take first?

   • A.Administer the prescribed oral beta blocker
   • B.Document the rhythm as an expected response to myocardial injury
   • C.Encourage the client to cough and use an incentive spirometer
   • D.Obtain a 12-lead ECG and assess the client's hemodynamic status

   Rationale: Worsening chest pressure with new ventricular ectopy can signal ongoing ischemia and risk of a life-threatening dysrhythmia, so rapid assessment with a 12-lead ECG and hemodynamic evaluation is the priority. A beta blocker may be appropriate after assessing blood pressure, heart rate, and contraindications, but it does not replace immediate evaluation of the change. Pulmonary hygiene does not address the suspected acute cardiac deterioration. Ventricular ectopy can occur after an infarction, but new frequent ectopy with worsening symptoms is not a finding to dismiss or merely document.

2. 2.Refer to the client's chart. Which findings require prompt notification of the provider and reassessment of the treatment plan? Select all that apply.

   • A.The client reports less ankle swelling than yesterday
   • B.The client has a potassium level of 3.2 mEq/L
   • C.The oxygen saturation decreases from 94% to 89% despite supplemental oxygen
   • D.The client has a urine output of 20 mL/hr for 2 hours
   • E.The client reports new difficulty breathing while lying flat

   Rationale: The oxygen saturation decline to 89% despite oxygen and new orthopnea suggest worsening pulmonary congestion and require prompt reassessment. Urine output of 20 mL/hr for 2 hours is below the usual adult goal of at least 0.5 mL/kg/hr and may indicate poor renal perfusion or worsening heart failure. A potassium level of 3.2 mEq/L is low and increases dysrhythmia risk, particularly in a client receiving a loop diuretic. Decreased ankle swelling suggests improvement rather than deterioration, although the overall response still requires monitoring.

3. 3.A client taking digoxin for heart failure reports nausea, poor appetite, and seeing yellow halos. The apical pulse is 54/min, and the client's potassium is 3.0 mEq/L. Which action should the nurse take?

   • A.Give the prescribed loop diuretic to reduce the risk of digoxin toxicity
   • B.Administer the scheduled digoxin with food to reduce nausea
   • C.Hold the digoxin and notify the provider of the assessment findings
   • D.Recheck the apical pulse in 4 hours and give digoxin if it is above 60/min

   Rationale: Nausea, visual halos, bradycardia, and hypokalemia are cues for digoxin toxicity; the nurse should hold the dose and promptly notify the provider. Giving digoxin with food does not address toxicity, and the client's symptoms and pulse are significant regardless of food intake. A loop diuretic can further lower potassium and increase digoxin toxicity risk. Waiting 4 hours delays response to a potentially dangerous adverse effect, and a later pulse above 60/min would not resolve the other toxicity cues.

4. 4.A charge nurse is assigning care on a telemetry unit. Which task is appropriate to delegate to an experienced assistive personnel (AP)?

   • A.Evaluate a client's response to the first dose of an antihypertensive
   • B.Obtain and record the daily weight of a stable client with heart failure
   • C.Teach a client newly prescribed warfarin how to reduce bleeding risk
   • D.Assess a client reporting new palpitations and dizziness

   Answer and rationale are in the full material.

5. 5.In the clinic, a client with hypertension reports a severe headache and blurred vision. Blood pressure is 224/126 mm Hg, and the client has new unilateral arm weakness. Which action should the nurse take?

   • A.Arrange emergency transfer for evaluation of acute end-organ injury
   • B.Give the client's usual oral antihypertensive and schedule a follow-up in 1 week
   • C.Ask the client to rest quietly for 30 minutes before repeating the blood pressure
   • D.Provide teaching about reducing dietary sodium and begin a home blood pressure log

   Answer and rationale are in the full material.