ATI PROCTOREDATI RN
MEDSURG 2024/2025
PROCTORED EXAM NEW
UPDATE 2019 VERSION
• A nurse is performing a venipuncture on an older adult client whose veins
are difficult. Which of the following actions should the nurse take?
a. Apply cool compresses
b. Elevate the client’s extremity using a pillow
c. Tap the skin around the insertion site
d. Raise the angle of the catheter to 30 degrees above the insertion site
• A nurse is caring for a client in the ER following a myocardial infarction.
which of the following actions should the nurse anticipate if the client
develops asystole?
a. Administer atropine
b. Defibrillate with 200 joules
c. Starts a continuous lidocaine infusion
d. Begin CPR – first line of medical management is CPR and ACLS.

• A nurse is caring for a client with severe burn injury. The nurse should
recognize which of the following client findings as an indication of
hypovolemic shock?
a. Potassium 5.2 mEq/L
b. Capillary refill 1.5 seconds
c. Urine output 45 mL/hr
d. PaCO3 37 mmHg
• A critical care nurse is assessing a client who has a severe head injury. In
response to painful stimuli the client does not open her eyes, displays
decerebrate posturing, and makes incomprehensible sounds. Which of the
following Glasgow coma scale scores should the nurse assign the client?
a. 2
b. 5
c. 10
d. 13
• A nurse is teaching a client who has heart failure about self-management
techniques. Which of the following statements by the client indicates an
understanding of the teaching?

c. I will expect swelling in my feet and ankle
d. I will weigh myself every other day
• A nurse is providing discharge teaching for a client who has new
tracheostomy. Which of the following statements by the client indicates an
understanding of the teaching
a. I’ll insert the obturator after cleaning my stoma
b. I’ll cut a slit in a clean gauze pad to use as a stoma dressing
c. I’ll cleanse the cannula with half strength hydrogen peroxide
d. I’ll remove the soiled tracheostomy ties prior to cleaning my stoma
• A nurse is caring for a client who has a sealed radiation implant which of
the following actions should the nurse take?
a. Limit family member visits to 30 min per day – pg. 583
➢ Limit visitors to 30-min visits, and have visitors maintain 6 feet distance
from the source
b. Give the dosimeter badge to the oncoming nurse at the end of the shift
c. Apply second pair of gloves before touching the clients implant if it dislodges
d. Remove soiled linens from the room after each change
• A nurse is reviewing the medical record of a client who has
pneumonia. Which of the following serum laboratory values should the
nurse expect?
a. WBC count 15,000/mm

b. Hematocrit 35%
c. Sodium 130 mg/dl
d. BUN 8 mg/dl
• A nurse is planning care for a client who has a newly implanted
arteriovenous graft in the right arm. Which of the following actions
should the nurse include in the plan of care?
a. Instruct the client to avoid lifting the right arm for 72 hr
b. Check blood pressure in the right arm
c. Palpate the site for thrill
d. Insert a saline lock into a site 10 cm (4in) distal to the graft
• A nurse in the emergency department is caring for a client who has a
gunshot wound to the abdomen. which of the following should the nurse take
first?
a. Check the color of the client’s skin – Assessment first
b. Prepare the client’s clothing

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• A nurse is assessing a client who has an arteriovenous (AV) fistula in the
left forearm. Which of the following findings should the nurse identify as an
indication of a complication at the vascular access site?
a. Presence of palpable thrill
b. 2 + left radial pulse
c. Absence of bruit – pg. 367
d. Dilated appearance of the AV site
• A nurse is caring for a client who is receiving continuous bladder irrigation
following a transurethral resection of the prostate. The client reports spasms
and the nurse observes decreased urinary output. Which of the following
actions should the nurse take?
a. Decrease traction on the catheter
b. Remove the indwelling urinary catheter
c. Flush the catheter manually with 0.9% sodium chloride
d. Administer ibuprofen 400 mg for pain relief
• A nurse is caring for a client who has contusion of the brainstem and reports
thirst. The client’s urinary output was 4,000 mL over the past 24 hr. The
nurse should anticipate a prescription for which of the following IV
medications?
a. Desmopressin – pg.500
➢ Desmopressin, which is a synthetic ADH, or aqueous vasopressin
administered intranasally, orally, or parenterally. Results in
increased water absorption from kidneys and decreased urine

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output.
b. Epinephrine
c. Furosemide
d. Nitroprusside
• A nurse is preparing to administer daily medications to a client who is
undergoing a procedure at 1000 that requires IV contrast dye. Which of the
following routine medications to give at 0800 should the nurse withhold?
a. Valproic acid
b. Metformin – pg.530
c. Metoprolol
d. Fluticasone
Stop Metformin for 48 hr before any type of elective radiographic test with iodinated
contrast dye and restart 48 hr after (can cause lactic acidosis due to acute kidney injury).

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• A nurse is preparing a client who is to undergo a thoracentesis. The nurse
should place the client in which of the following positions?
a. On her affected side with her head lowered
b. In high-Fowler’s position with her arms at her side
c. Prone position with her arms above her head
d. Upright on the edge of the bed leaning over the bedside table
• A nurse is teaching a client about the use of an incentive spirometer. Which
of the following instructions should the nurse include in the teaching?
a. Position the mouthpiece 2.5 cm (1in) from the mouth
b. Hold breaths 3 to 5 seconds before exhaling
c. Place hands on the upper abdomen during inhalation
d. Exhale slowly through pursed lips
• A nurse is caring for a client who is 2 days postoperative following abdominal
surgery and has a prescription for opioid analgesia. Which of the following
actions should the nurse implement to help facilitate the client’s recovery?
a. Provide analgesic medication prior to physical activities
b. Inform the client to monitor for loose stools while taking opioid analgesia
c. Withhold analgesic medication unless the client reports pain
d. Administer naloxone if the client’s respiratory rate is greater than 24/min
Give analgesic to relieve pain before getting involved in any physical activity

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• A nurse is preparing to assist the provider with thoracentesis for a client
who has left pleural effusion. Which of the following interventions is the
priority for the nurse?
a. Describe the sensation the client will feel during the procedure
b. Reinforce the importance of lying still during the procedure
c. Administer a sedative medication
d. Determine whether the client has an allergy to local anesthetics - Assessment
• A nurse is reviewing the medical record of a client who has nephrotic
syndrome. Which of the following findings should the nurse expect?
a. Decreased serum lipid levels
b. Proteinuria
c. Hypoalbuminemia
d. Decreased coagulation

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• A nurse is planning care for a client following a cardiac catheterization.
Which of the following actions should the nurse take?
a. Limit the client’s fluid intake to 1 L per day
b. Keep the client on bed rest for 24 hr
c. Change the client’s dressing every 8 hr
d. Maintain the client’s affected extremity in extension
• A nurse is caring for a client who has a traumatic brain injury. The client,
who has been quiet and cooperative, becomes agitated and restless. Which of
the following assessments should the nurse perform first?
a. Urinary output
b. Motor responses – pg.75
c. Blood pressure
d. Blood glucose
• 61. A nurse is providing discharge teaching to a client who has systemic
lupus erythematosus. Which of the following statements by the client indicates
an understanding of the teaching? (Select all that apply)
a. I will use NSAIDS to treat aches and pains – pg.561
b. I will use cosmetics without moisturizer
c. I will disinfect skin lesions with rubbing alcohol
d. I will wear long sleeve when outdoor
e. I will increase my intake of sodium
CLIENT EDUCATION

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●● Avoid UV and prolonged sun exposure. Use sunscreen when outside and exposed to
sunlight. ●● Use mild protein shampoo and avoid harsh hair treatments.
●● Use steroid creams for skin rash.
●● Report peripheral and periorbital edema promptly.
●● Report evidence of infection related to immunosuppression.
●● Avoid crowds and individuals who are sick, because illness can precipitate an
exacerbation.
●● Educate client of childbearing age regarding risks of pregnancy with lupus and
treatment medications
• A nurse is reviewing the laboratory results of a client who has COPD and
severe dyspnea. Which of the following ABG values should the nurse expect?
a. PaCO2 50 mmHg
b. pH 7.4
c. PaO2 95 mmHg

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2019 ATI RN Medsurg Proctored Exam with Answers (66 Solved Questions)

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