ATI NUR 213 Midpoint Assessment FA II 2025 Assessment I
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Free ATI NUR 213 Midpoint Assessment FA II 2025 Assessment I Questions
A provider tells the nurse that a patient with a peptic ulcer is being placed on a proton pump
inhibitor. Which medication would the nurse anticipate the provider ordering?
- A. Famotidine
- B. Ranitidine
- C. Pantoprazole
- D. Cimetidine
Explanation
Pantoprazole is a proton pump inhibitor (PPI) that works by irreversibly blocking the
hydrogen-potassium ATPase enzyme system in the stomach lining, reducing gastric acid
secretion. PPIs are commonly prescribed for peptic ulcers to promote healing and prevent
complications. Famotidine, ranitidine, and cimetidine are H2 receptor antagonists, which also
reduce acid but work through a different mechanism and are not classified as proton pump
inhibitors.
A nurse is teaching a client who has tuberculosis and is to start medication therapy with
isoniazid, rifampin and pyrazinamide. Which of the following instructions should the nurse
include?
- A. "Drink at least 8 ounces of water when you take the pyrazinamide tablet."
- B. "Take isoniazid with an antacid."
- C. "Provide a sputum specimen every 2 weeks to the clinic for testing."
- D. "Expect your sputum cultures to be negative after 6 months of therapy."
Explanation
Explanation of Correct Answer (A):
Pyrazinamide can cause hyperuricemia and hepatotoxicity, so adequate fluid intake is essential
to help prevent gout and promote renal excretion of uric acid. Patients should take the medication
with a full glass of water and report any joint pain or swelling. Monitoring liver function is also
important during therapy.
You are caring for a patient with a positive TB skin test (15 mm), a productive cough for
two months, and unintentional weight loss. Which of the following orders will assist with
the diagnosis of active tuberculosis?
(Select ALL that apply)
- A. Admit to a negative pressure room
- B. Heart healthy diet
- C. Collect specimen x3 mornings for acid-fast bacilli
- D. Vital signs every shift
- E. CBC, BMP, HIV viral load, VDRL
Explanation
A. Admit to a negative pressure room
Patients with suspected or confirmed active TB must be placed in airborne isolation using a
negative pressure room. This prevents the spread of Mycobacterium tuberculosis by keeping air
from escaping into the hallway and protecting others in the facility.
C. Collect specimen x3 mornings for acid-fast bacilli
The most definitive diagnostic test for active TB is sputum culture for acid-fast bacilli (AFB).
Three early-morning specimens are collected on separate days. This is essential for laboratory
confirmation and guides treatment.
E. CBC, BMP, HIV viral load, VDRL
Patients with active TB should be assessed for possible comorbidities and coinfections such as
HIV and syphilis. CBC and BMP also help evaluate overall health and organ function before
starting treatment, as TB therapy can be hepatotoxic.
A nurse is monitoring a client who was admitted with a severe burn injury and is receiving IV
fluid resuscitation therapy. The nurse should identify a decrease in which of the following
findings as an indication of adequate fluid replacement?
- A. Heart rate
- B. Urine output
- C. BP
- D. Weight
Explanation
In the early phase of burn injury, fluid loss and hypovolemia cause an increase in heart rate as
the body compensates for the decreased circulating blood volume. As adequate fluid
replacement occurs, the heart rate should decrease, indicating that the body is no longer in a
compensatory state of shock. This decrease in heart rate is a positive sign of improved
circulatory volume and the effectiveness of fluid resuscitation.
A nurse in a community health clinic is caring for a client who has a history of HIV.
Diagnostic Results
January
Laboratory:
CD4 cell count 200 cells/mm2 (600 - 1500 celis/mm3)
June
Laboratory
CD4 cell count 90 celis/mm" (600-1500 cells/mm3)
Chest x-ray:
Bilateral white infiltrates consistent with pneumonia
Physical Examination
January
Reports flu-like manifestations: headache body aches, sore throat low grade fever.
Swollen lymph nodes.
Dry skin with rash.
Weight loss of 15 lb over last 3 months with report of diarrhea and anorexia.
June
Client appears emaciated. Weight loss of 20 lb over last 6 months with report of chronic diarrhea.
inability to eat due to oral ulcers
Extreme weakness and fatigue.
Based on the assessment findings, which of the following are consistent with HIV Stage I or HIV
Stage III (AIDS)? Each finding may support more than one stage.
-
A. Chest x-ray: Bilateral white infiltrates; Latest CD4 count: 90 cells/mm³; Skin condition: Dry
skin with rash; Weight changes: 20 lb weight loss over 6 months -
B. Chest x-ray: Clear; Latest CD4 count: 200 cells/mm³; Skin condition: Dry skin with rash;
Weight changes: 15 lb weight loss over 3 months -
C. Chest x-ray: Bilateral white infiltrates; Latest CD4 count: 200 cells/mm³; Skin condition:
Clear skin; Weight changes: 15 lb weight loss over 3 months -
D. Chest x-ray: Clear; Latest CD4 count: 90 cells/mm³; Skin condition: Dry skin with rash;
Weight changes: 20 lb weight loss over 6 months
Explanation
The client’s chest x-ray showing bilateral infiltrates and CD4 count of 90 cells/mm³ are
consistent with HIV Stage III (AIDS) due to opportunistic infections and severe
immunosuppression. Dry skin with rash is an early manifestation consistent with HIV Stage I.
Weight loss occurs in both stages, but is more severe in AIDS due to chronic diarrhea, inability
to eat, and emaciation. This combination of findings demonstrates progression from early HIV to
advanced AIDS.
The nurse is caring for a patient with a new diagnosis of gastroesophageal reflux disease. The
patient asks what types of food they should avoid. The nurse tells the patient to avoid which of
the following foods? (Select all that apply.)
- A. French fries
- B. Chocolate
- C. Grapefruit
- D. Chicken
- E. Oatmeal
Explanation
A. French fries
French fries are high in fat, which can delay gastric emptying and relax the lower esophageal
sphincter. This increases the risk of acid reflux and worsens GERD symptoms.
B. Chocolate
Chocolate contains methylxanthines, which relax the lower esophageal sphincter and allow
stomach acid to reflux into the esophagus, aggravating heartburn and discomfort.
C. Grapefruit
Grapefruit is acidic and can increase stomach acidity, irritating the esophagus and worsening
GERD symptoms such as heartburn and regurgitation.
A nurse is caring for a client who is experiencing anaphylactic shock in response to the
administration of penicillin. Which of the following medications should the nurse administer
first?
- A. Dobutamine
- B. Methylprednisolone
- C. Furosemide
- D. Epinephrine
Explanation
Epinephrine is the first-line treatment for anaphylactic shock because it rapidly reverses the
life-threatening effects of severe allergic reactions. It works by vasoconstriction to increase
blood pressure, bronchodilation to improve airway patency, and inhibition of further mediator
release from mast cells and basophils. Administering epinephrine immediately is critical to
prevent airway obstruction, hypotension, and cardiovascular collapse, which are the most
urgent threats to the client’s life during anaphylaxis.
A nurse assessing a client determines that he is in the compensatory stage of shock.
Which of the following findings support this conclusion?
- A. Anuria
- B. Petechiae
- C. Confusion
- D. Blood pressure 84/50 mm Hg
Explanation
Explanation of Correct Answer (C):
In the compensatory stage of shock, the body activates mechanisms to maintain perfusion to
vital organs. One key sign is altered mental status, including confusion, restlessness, or anxiety,
caused by decreased cerebral perfusion. The blood pressure often remains within normal or
A nurse is working on a surgical unit and is caring for a client who returned from the
Post-Anesthesia Care Unit (PACU) 90 minutes ago. Which interventions will decrease the
client’s risk of developing a pulmonary embolism?
(Select ALL that apply)
- A. Apply compression stockings
- B. Administer aspirin and warfarin
- C. Encourage the client to do active leg exercises
- D. Maintain the head of the bed at 90 degrees
- E. Ambulate the client safely
Explanation
A. Apply compression stockings
Compression stockings improve venous return by applying external pressure to the lower
extremities. This helps prevent venous stasis, which is a major contributor to deep vein
thrombosis (DVT) and pulmonary embolism. They are a standard preventive measure after
surgery and should be applied as early as possible unless contraindicated. C. Encourage the client to do active leg exercises
Postoperative clients often have limited mobility, which increases their risk of clot formation.
Active leg exercises mimic normal muscle contractions, enhance circulation, prevent venous
pooling, and help reduce the risk of DVT. Exercises such as ankle pumps, leg lifts, and foot
circles should be encouraged early.
E. Ambulate the client safely
Early ambulation is one of the most effective interventions to prevent pulmonary embolism.
Walking promotes blood flow, stimulates deep breathing, expands the lungs, and prevents venous
stasis. Ambulation should begin as soon as safely possible following surgery and anesthesia
recovery.
An occupational health nurse provides monthly lunch-and-learn sessions to employees
of a rail transportation manufacturer. This month, they are providing education on the risk
factors for peptic ulcer disease. Which risk factors should the nurse include in the
educational session?
(Select ALL that apply)
- A. Active lifestyle and smoking
- B. Eating spicy foods and laid-back attitude
- C. Occasional alcohol and cocaine use
- D. Six-month history of H. pylori
- E. Alcohol abuse and smoking
Explanation
C. Occasional alcohol and cocaine use
Substances like alcohol and cocaine irritate the gastric mucosa and increase acid production,
which can lead to the development of peptic ulcers. Cocaine also causes vasoconstriction,
reducing blood flow to the stomach lining, which further increases the risk.
D. Six-month history of H. pylori
Infection with Helicobacter pylori is the leading cause of peptic ulcer disease. The bacteria
weaken the stomach’s protective mucosal layer and promote inflammation. A known history of
infection is a major medical risk factor that must be addressed.
E. Alcohol abuse and smoking
Both alcohol and smoking contribute to ulcer formation. Alcohol increases acid secretion and
irritates the stomach lining, while smoking reduces mucosal blood flow and slows healing. These
factors significantly raise the risk of peptic ulcer disease.
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