Med- Surgical ATI Proctored Test RN

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Sample questions from Med- Surgical ATI Proctored Test RN

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In the emergency department, a client with chest pressure has the following chart findings. Refer to the client's chart. Which actions should the nurse take immediately? Select all that apply.

   • A.Encourage the client to walk to assess exertional symptoms.
   • B.Administer prescribed chewable aspirin if not contraindicated.
   • C.Establish IV access and obtain ordered cardiac biomarkers.
   • D.Obtain a 12-lead ECG.
   • E.Give sublingual nitroglycerin without checking blood pressure or medication history.

   Rationale: The ECG, aspirin, and IV access with cardiac biomarkers support rapid evaluation and treatment of suspected acute coronary syndrome. Walking increases myocardial oxygen demand, and nitroglycerin should not be given before checking blood pressure and contraindications such as recent phosphodiesterase-5 inhibitor use. The chart shows persistent pressure and evolving ECG changes, so prompt action is required.

2. 2.Which assessment finding in a client taking digoxin should be reported before the next dose?

   • A.Apical pulse of 54/min
   • B.Blood pressure of 138/82 mm Hg
   • C.Potassium level of 4.1 mEq/L
   • D.Mild ankle edema at the end of the day

   Rationale: An apical pulse below 60/min in an adult is a reason to withhold digoxin and notify the prescriber, because the medication can further slow cardiac conduction. The blood pressure and potassium listed do not independently indicate toxicity. Mild dependent edema warrants assessment but is not the immediate medication-hold parameter.

3. 3.A client with chronic heart failure asks why daily weights are needed. Which response is best?

   • A.Weight is used to decide whether to take every medication that day.
   • B.Daily weights determine whether the heart rhythm is regular.
   • C.A sudden weight increase can indicate fluid retention before breathing worsens.
   • D.Weight changes show whether the prescribed diet contains enough protein.

   Rationale: Daily weights, measured at the same time and under similar conditions, are a sensitive indicator of fluid balance in heart failure. Rapid gain can occur before obvious edema or dyspnea and should be reported according to the care plan. Weight does not replace rhythm assessment or medication-specific instructions.

4. 4.At change of shift, a client with a new lower-extremity cast reports sudden chest pain and shortness of breath. Which action has priority?

   • A.Ask the client to cough and use an incentive spirometer.
   • B.Elevate the casted leg above the level of the heart.
   • C.Document the symptoms and reassess in 30 minutes.
   • D.Apply oxygen and activate the emergency response system.

   Answer and rationale are in the full material.

5. 5.A client with heart failure is being discharged. Which instructions should the nurse include? Select all that apply.

   • A.Follow the prescribed sodium restriction.
   • B.Take potassium supplements only if prescribed.
   • C.Weigh yourself each morning after urinating and before breakfast.
   • D.Report a gain of 2 lb (0.9 kg) in 24 hours or the threshold in your care plan.
   • E.Stop taking the diuretic when ankle swelling improves.

   Answer and rationale are in the full material.