ATI Med-Surg Questions

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Sample questions from ATI Med-Surg Questions

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

1. 1.A 68-year-old client is admitted to the medical unit with pneumonia. The client is newly confused, has a temperature of 39.1 C (102.4 F), heart rate 124/min, respiratory rate 30/min, blood pressure 86/48 mm Hg, and oxygen saturation 90% on room air. Which action should the nurse take first?

   • A.Obtain a sputum culture before starting treatment
   • B.Apply oxygen and activate the rapid response system
   • C.Administer the prescribed oral antipyretic
   • D.Encourage the client to drink oral fluids

   Rationale: Hypotension, tachycardia, confusion, and tachypnea suggest sepsis with impaired perfusion, so oxygenation and urgent escalation are the priorities. A sputum culture is appropriate but must not delay stabilization; an oral antipyretic does not address shock. Oral fluids are unsafe as the initial response in a confused, unstable client.

2. 2.A 54-year-old client with type 1 diabetes is admitted to the emergency department with vomiting and abdominal pain. The client is drowsy, has deep rapid respirations, glucose 486 mg/dL, potassium 5.3 mEq/L, and arterial pH 7.18. Which prescription should the nurse implement first?

   • A.Begin isotonic IV fluid replacement
   • B.Administer IV regular insulin
   • C.Give IV sodium bicarbonate
   • D.Restrict fluids until glucose decreases

   Rationale: Initial treatment of diabetic ketoacidosis includes isotonic fluid replacement to restore circulating volume and perfusion. Insulin is essential but follows initial fluid assessment and treatment; bicarbonate is generally reserved for extreme acidemia. Fluid restriction worsens the severe dehydration common in ketoacidosis.

3. 3.A 73-year-old client with heart failure is receiving IV furosemide on a telemetry unit. The client reports new palpitations; the monitor shows frequent premature ventricular contractions, and the potassium level is 2.8 mEq/L. Which action is most appropriate?

   • A.Continue the infusion and recheck potassium in 4 hours
   • B.Hold the furosemide and notify the health care provider
   • C.Encourage the client to ambulate to reduce the ectopy
   • D.Administer the next dose of digoxin as scheduled

   Rationale: Severe hypokalemia with ventricular ectopy is a potentially dangerous dysrhythmia risk, and ongoing loop diuretic therapy may worsen potassium loss. Waiting four hours allows a preventable complication to progress, while ambulation is inappropriate during active ectopy. Digoxin can increase dysrhythmia risk in hypokalemia and should not be given without prompt review.

4. 4.A 62-year-old client arrives at the emergency department 45 minutes after sudden onset of right-sided weakness and difficulty speaking. Blood pressure is 178/96 mm Hg, glucose is 112 mg/dL, and oxygen saturation is 96%. Which action should the nurse anticipate first?

   • A.Give aspirin before imaging
   • B.Prepare the client for a noncontrast head CT
   • C.Lower the blood pressure rapidly with an IV medication
   • D.Offer water to assess swallowing

   Answer and rationale are in the full material.

5. 5.A 79-year-old client with a hip fracture is 12 hours postoperative on an orthopedic unit. The client is restless, has an oxygen saturation of 87% on room air, respiratory rate 28/min, and new confusion. Which action should the nurse take first?

   • A.Reorient the client and reduce room noise
   • B.Apply oxygen and assess respiratory status
   • C.Administer the prescribed opioid for presumed pain
   • D.Ask the family to remain at the bedside

   Answer and rationale are in the full material.