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ATI RN ADULT MEDICAL SURGICAL PROCTORED EXAM
2025 - 2026 WITH 100% CORRECT ANSWERS AND
RATIONALES (GRADED A+)
RN Q ue st i o n90 l o a d e d r at i o nal s pr o v i d e d VATI Adult Medical Surgical
QUIZ: 90 of 90
CORRECT
A nurse is caring for a client who has atopic dermatitis and a prescription for triamcinolone ointment. The nurse should assess the client to monitor for which of the following adverse effects? Increased pigmentation Topical glucocorticoid therapy can cause the adverse effect of hypopigmentation. Localized hair loss Long-term glucocorticoid therapy can cause hypertrichosis, or excessive hair growth, especially on the facial area. Thinning of the skin MY ANSWER Thinning of the skin and delayed healing are adverse effects of topical glucocorticoid preparations. The client should only apply the ointment to dry patches of the skin because topical steroids can cause atrophy of the dermis and epidermis, which can result in thinning of the skin. Increased sensitivity to the sun The nurse should instruct the client to avoid excessive sun exposure when taking topical fluticasone; however, triamcinolone ointment does not cause photosensitivity.
- RN VATI Adult Medical Surgical 2023 Q ue stio n89^ CLOSE l o a d e d r at i o nal s pr o v i d e d
QUIZ: 89 of 90
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- A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse identify as a manifestation of left-sided heart failure?
Dependent edema The nurse should identify that dependent edema is a manifestation of right-sided heart failure due to right ventricular failure and fluid retention from pressure building up in the venous system. Jugular distention The nurse should identify that jugular vein distention is a manifestation of right-sided heart failure due to right ventricular failure and fluid retention from pressure building up in the venous system. Weight gain The nurse should identify that weight gain is a manifestation of right-sided heart failure due to right ventricular failure and fluid retention from pressure building up in the venous system. MY ANSWER The nurse should identify that frothy sputum, dyspnea, and wheezing are manifestations of left- sided heart failure. Treatment includes fluid restriction and diuretics to decrease preload and reduce pulmonary congestion. Pink-tinged frothy sputum can be an early indication of pulmonary edema and can be life-threatening. Therefore, the nurse should notify the provider immediately.
- RN VATI Adult Medical Surgical 2023 Q ue stio n88^ CLOSE l o a d e d r at i o nal s pr o v i d e d
QUIZ: 88 of 90
CORRECT
Frothy sputum
Vitiligo is the loss of pigment from areas of a client's skin, causing irregular, white patches. Vitiligo is a manifestation of adrenal-gland hypofunction. MY ANSWER Osteoporosis is a common finding with Cushing's syndrome. Bones become thinner as a result of mineral loss and nitrogen depletion, and the risk for fractures increases. Myxedema A client who has hypothyroidism can develop myxedema that causes mucinous cellular edema around the eyes, across the upper back, and in the hands and feet. Heat intolerance A client who has hyperthyroidism can develop heat intolerance, along with an increase in sweating.
- RN VATI Adult Medical Surgical 2023 Q ue stio n86^ CLOSE l o a d e d r at i o nal s pr o v i d e d
QUIZ: 86 of 90
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A nurse is inspecting the skin of a client who has basal cell carcinoma. The nurse should identify which of the following lesion characteristics on the client's skin? MY ANSWER A client who has basal cell carcinoma has a nodular lesion with well-defined borders and a pearly or waxy appearance, resulting from overexposure to the sun, especially on the face, head, and neck. An irregular border on a variegated-colored lesion Osteoporosis A pearly, waxy nodule
A client who has melanoma has a lesion with irregular borders and variegated colors of red, white, and blue, most often on the upper back or lower legs. A firm, nodular, crusty, or ulcerated lesion A client who has squamous cell carcinoma has a firm, nodular, and crusty lesion with an ulcerated center, resulting from sun exposure, chronic irritation, burns, or irradiation to the skin. A weeping vesicle A client who has herpes zoster has weeping, blister-type lesions.
- RN VATI Adult Medical Surgical 2023 Q ue stio n85^ CLOSE l o a d e d r at i o nal s pr o v i d e d
QUIZ: 85 of 90
CORRECT
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A nurse is assessing a client who has hypocalcemia. In which of the following areas should the nurse tap on the client's face to detect the presence of Chvostek's sign? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.)
A nurse in an emergency department is assessing a client who is overusing prescribed diuretics and has a sodium level of 127 mEq/L. Which of the following laboratory findings should the nurse expect? High lipase A high lipase level is associated with pancreatic dysfunction or renal failure and is not an expected finding with hyponatremia or dehydration. MY ANSWER A client who has hyponatremia as a result of diuretic overuse has a low urine specific gravity. The increased excretion of water alters the ratio of particulate matter, which affects the specific gravity. Low hemoglobin A client who is dehydrated as a result of diuretic overuse can have an elevated hemoglobin level because of the difference in ratio between intravascular fluid and blood cells. High creatine kinase-MB (CK-MB) An elevated CK-MB level indicates a myocardial infarction and is not an expected finding with hyponatremia.
- RN VATI Adult Medical Surgical 2023 Q ue st i o n83^ CLOSE l o a d e d r at i o nal s pr o v i d e d
QUIZ: 83 of 90
Low urine specific gravity
INCORRE
CT
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A home health nurse is assisting a client with planning care for a family member who has Alzheimer's disease. Which of the following instructions should the nurse include? Remove clutter from rooms and hallways. The nurse should instruct the family member to remove clutter from rooms and hallways so the client is able to walk without the risk of falling or tripping over objects. Later in the disease, the client can experience seizures, so cluttered areas could be a risk to the client. Place a monthly calendar in the client's room. MY ANSWER The nurse should instruct the family member to place a single-date calendar in the client's room. A monthly calendar can be overwhelming and confusing to a client who has Alzheimer's disease. Use confrontation to manage the client's behavior. The nurse should instruct the family member to redirect the client by starting another activity when the client begins to act out or becomes overstimulated. Redirecting the client might help them gain focus. The nurse should instruct the family member to use short, simple sentences when explaining an activity to the client. The explanation should be done immediately before the activity to aid the client's memory and ability to follow directions.
RN VATI Adult Medical Surgical 2023 Q ue stio n82^ CLOSE l o a d e d r at i o nal s pr o v i d e d
QUIZ: 82 of 90
CORRECT
- Time Remaining: 00:36: Review the daily schedule with the client every morning.
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An emergency room nurse is assessing a client who has asthma and difficulty breathing. Which of the following findings should indicate to the nurse that the client is experiencing status asthmaticus? Coughing Status asthmaticus causes labored breathing and wheezing. Coughing indicates that the client is exchanging air and is a manifestation of pneumonia, not status asthmaticus. A client who has status asthmaticus has distended neck veins while trying to facilitate breathing due to increased pulmonary pressure. Use of accessory muscles MY ANSWER A client who has status asthmaticus uses accessory muscles to help facilitate breathing, which is a manifestation of a severe airflow obstruction. The situation is life-threatening and the nurse should intervene immediately with strong systemic bronchodilators, epinephrine, corticosteroids, and oxygen. Presence of coarse crackles The presence of coarse crackles indicates air movement through fluid-filled airways and is a manifestation of pneumonia, not status asthmaticus.
RN VATI Adult Medical Surgical 2023 Q ue stio n80^ CLOSE l o a d e d r at i o nal s pr o v i d e d
QUIZ: 80 of 90
CORRECT
Flat neck veins
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A nurse is teaching a client who has a new prescription for phenytoin to treat a seizure disorder. Which of the following adverse effects should the nurse instruct the client to report immediately to the provider? Tender, bleeding gums Gingival hyperplasia is an overgrowth of gum tissue that causes the gums to bleed, swell, and become tender. Gingival hyperplasia is nonurgent adverse effect when a client is taking phenytoin; therefore, there is another finding that is the priority. The nurse should advise the client to maintain good oral hygiene with a soft toothbrush and to follow up with an oral health professional. Increased facial hair Hirsutism, an increased growth of hair in unexpected places on the client's body, is nonurgent because it is an expected finding for a client who is taking phenytoin. Constipation Constipation is nonurgent because it is an expected finding for a client who is taking phenytoin. MY ANSWER When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is a rash, which can have a measles-like appearance and progress to exfoliative dermatitis or Stevens-Johnson syndrome. The client should report this finding to the provider immediately.
- RN VATI Adult Medical Surgical 2023 Q ue st i o n79^ CLOSE l o a d e d r at i o nal s pr o v i d e d
QUIZ: 79 of 90
INCORRECT
- Time Remaining: 00:36:
- Pause Remaining: 00:05: Skin rash
Increased abdominal girth S 3 gallop An S 3 /S 4 summation gallop is an expected finding with left-sided heart failure due to pulmonary congestion and increased left ventricular pressure that causes a decrease in cardiac output and poor tissue perfusion. Weak peripheral pulses Weak peripheral pulses are an expected finding with left-sided heart failure due to decreased cardiac output. MY ANSWER Increased abdominal girth is an expected finding with right-sided heart failure due to systemic congestion and an enlarged liver and spleen. Systemic congestion can lead to fluid retention and increased pressure in the venous system, which can manifest with edema in the lower extremities. Wheezing Wheezing is an expected finding with left-sided heart failure due to pulmonary congestion and systolic dysfunction.
- RN VATI Adult Medical Surgical 2023 Q ue st i o n77^ CLOSE l o a d e d r at i o nal s pr o v i d e d
QUIZ: 77 of 90
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- Time Remaining: 00:36:
- Pause Remaining: 00:05: PAUSE A nurse is caring for a client who recently assumed the role of caregiver for their aging parents who have chronic illnesses. The nurse should identify that which of the following statements by the client indicates acceptance of the role change? The nurse should identify that the client has accepted the role change of caring for their aging parents by changing the floor plan of the home to accommodate their father's wheelchair. "I'm so stressed out that it makes it difficult for me to manage everything." "I changed the floor plan of our home to accommodate my father's wheelchair."
This response indicates role overload because the client is feeling overwhelmed with having to care for their aging parents. "At times, I get so frustrated with how to care for my parents." This response indicates role strain, in which the client feels unsure and frustrated about caring for their aging parents. Feelings of inadequacy can also occur with role strain. "I am learning to take care of my parents as I go." MY ANSWER This response indicates role ambiguity, in which the client feels unsure about how to care for their aging parents. This might create stress for the client.
- RN VATI Adult Medical Surgical 2023 Q ue stio n76^ CLOSE l o a d e d r at i o nal s pr o v i d e d
QUIZ: 76 of 90
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- Time Remaining: 00:36:
- Pause Remaining: 00:05: PAUSE A nurse is caring for a client who is receiving vancomycin intermittent IV bolus therapy for methicillin-resistant Staphylococcus aureus (MRSA). Which of the following findings is an indication to the nurse that the client is experiencing an adverse effect of the medication? The client can have an adverse effect called red man syndrome, which causes hypotension and tachycardia, due to infusing the vancomycin too rapidly. The nurse should infuse the medication over at least 60 min. The client is becoming flushed. MY ANSWER Flushing is a manifestation of an infusion reaction to vancomycin that also causes a rash on the face and upper body, called red man syndrome. Red man syndrome results from The client's blood pressure is elevated.
A BUN of 24 mg/dL is above the expected reference range of 10 to 20 mg/dL, indicating renal impairment. An adverse effect of cyclosporine is nephrotoxicity. The nurse should monitor the client for increases in BUN and creatinine and report any elevation to the provider. A rise in BUN could indicate transplant rejection. Potassium 3.5 mEq/L A potassium level of 3.5 mEq/L is within the expected reference range of 3.5 to 5 mEq/L and does not indicate nephrotoxicity. However, the nurse should report a dramatic change in potassium level to the provider.
- RN VATI Adult Medical Surgical 2023 Q ue stio n74^ CLOSE l o a d e d r at i o nal s pr o v i d e d
QUIZ: 74 of 90
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- Time Remaining: 00:35:
- Pause Remaining: 00:05: PAUSE A nurse is caring for a client who has dumping syndrome following a gastric resection. The nurse should monitor the client for which of the following complications of dumping syndrome? Weight gain Anorexia can result from dumping syndrome because the client can easily become reluctant to eat to avoid the unpleasant manifestations of this syndrome, resulting in weight loss. MY ANSWER The nurse should monitor the client for manifestations of anemia, such as pallor, tachycardia, and fatigue. Rapid emptying of the stomach contents into the intestine can lead to reduced absorption of iron in the duodenum, causing iron-deficiency anemia. Hypercalcemia Hypocalcemia, rather than hypercalcemia, is a manifestation of dumping syndrome due to rapid gastric emptying. Iron-deficiency anemia
Reduced heart rate Nausea, abdominal cramping, and tachycardia are manifestations of dumping syndrome due to rapid gastric emptying.
- RN VATI Adult Medical Surgical 2023 Q ue stio n73^ CLOSE l o a d e d r at i o nal s pr o v i d e d
QUIZ: 73 of 90
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- Time Remaining: 00:35:
- Pause Remaining: 00:05: PAUSE A nurse is assessing a client who takes salmeterol to treat moderate asthma. Which of the following findings should indicate to the nurse that the medication has been effective? A client who has asthma should use a peak flow meter twice daily to monitor asthma control. A PEF in the green zone, or 80% or above personal best, indicates the effectiveness of medication therapy. The client's ABGs shows a pH level of 7.32. A pH level of 7.32 indicates the client is in an acidotic state. Acidosis occurs with bronchoconstriction and indicates the medication has not been effective. The client's forced expiratory volume is decreased after treatment with medication. MY ANSWER Forced expiratory volume measures the amount of air the client exhales during 1 second and is part of pulmonary function testing. Effective use of a bronchodilator should increase the client's forced expiratory volume. The client's wheezing is limited to expiratory. The client's daily peak expiratory flow (PEF) measures 85% above personal best.
"I should soak my feet daily in warm, soapy water." Health promotion activities for a client who has diabetes mellitus includes foot care. Clients should inspect their feet and wash them daily with warm water and soap. However, clients should not soak their feet because this can lead to maceration of the skin and skin breakdown.
- RN VATI Adult Medical Surgical 2023 Q ue stio n71^ CLOSE l o a d e d r at i o nal s pr o v i d e d
QUIZ: 71 of 90
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- Time Remaining: 00:35:
- Pause Remaining: 00:05: PAUSE A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following medications should the nurse instruct the client to avoid? (Select all that apply.) Ferrous sulfate Echinacea Dextromethorphan MY ANSWER Ferrous sulfate is incorrect. Ferrous sulfate is an iron supplement and has no known interaction with warfarin. Echinacea is incorrect. Echinacea is a supplement that a client might take to improve the immune system and has no known interaction with warfarin. Aspirin is correct. Aspirin is an antiplatelet medication. It can increase the risk of bleeding when taken with warfarin. Aspirin Naproxen
Dextromethorphan is incorrect. Dextromethorphan is a cough suppressant and has no known interaction with warfarin. Naproxen is correct. Naproxen is an NSAID that relieves mild to moderate pain. It can increase the risk of bleeding if taken with warfarin.
- RN VATI Adult Medical Surgical 2023 Q ue stio n70^ CLOSE l o a d e d r at i o nal s pr o v i d e d
QUIZ: 70 of 90
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- Time Remaining: 00:35:
- Pause Remaining: 00:05: PAUSE A nurse is assisting with the care of a client who is scheduled for a thoracentesis. Which of the following interventions should the nurse plan to take? Inform the client that they must empty their bladder before the procedure. A client who is undergoing a paracentesis should empty their bladder before the procedure to prevent injury to the bladder. This action is not necessary before a thoracentesis. Weigh the client before and after the procedure. The nurse should weigh a client who is scheduled for a paracentesis before and after the procedure to identify how much fluid the procedure removes from the client's abdomen. This action is not necessary before and after a thoracentesis. MY ANSWER The nurse should place the client leaning forward over the bedside table for a thoracentesis. This allows the provider complete access to the client's chest and back. This position also expands the spaces between the ribs where the pleural fluid accumulates. Keep the client on bed rest after the procedure. Place the client leaning forward over the bedside table for the procedure.
