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 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.
A nurse is caring for a client who has hypovolemic shock. Which of the following should
the nurse recognize as an expected finding?
- A. Bradypnea
- B. Oliguria
- C. Hypertension
- D. Flushing of the skin
Explanation
Explanation of Correct Answer (B):
Hypovolemic shock causes a severe reduction in circulating blood volume, leading to decreased
perfusion of vital organs. The kidneys receive less blood flow, which results in oliguria (low
urine output). This is an early and critical sign indicating impaired renal perfusion and
progressing shock. Monitoring urine output is essential because it reflects the effectiveness of
circulation and tissue perfusion.
Pressure injuries can occur to the skin and underlying tissues due to pressure, shear or
friction. Which of the following can reduce the incidence of pressure injuries in hospitalized
clients?
(Select All that Apply)
- A. Inspect the sacrum for blanching
- B. Maintaining the head of the bed at a 45-degree angle
- C. Optimizing nutrition
- D. Frequent turning and positioning
- E. Frequent skin assessments
Explanation
A. Inspect the sacrum for blanching
Early assessment helps detect tissue damage before breakdown occurs. Checking for blanching
identifies impaired circulation and allows interventions before a pressure injury develops.
C. Optimizing nutrition
Proper nutrition, especially protein, vitamins, and hydration, promotes tissue repair and skin
integrity. Malnutrition increases the risk of pressure ulcers and delays healing.
D. Frequent turning and positioning
Repositioning at regular intervals reduces prolonged pressure on bony prominences. Turning
every 2 hours is a standard intervention to prevent pressure injuries.
E. Frequent skin assessments
Ongoing inspection allows early identification of redness, moisture, or irritation. Monitoring
high-risk areas ensures timely care and prevents skin breakdown.
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.
Complete the sentence using the drop down selections
When caring for a HIV+ patient the nurse is aware that —-------- (white plaque in te mourn/
diarrhea/ sore throat/ erectile dysfunction) indicates an opportunistic infection. It is caused by
—------ (herpes simplex/ candidiasis/ amoebiasis/ Bacterial infection) and treated with
—----(Trimetoprim-sulfamethoxarpie/ Amphotericin/ Peniciilin/ Fluconazole)
- A. White plaque in the mouth … Candidiasis … Fluconazole
- B. Diarrhea … Amoebiasis … Trimethoprim-sulfamethoxazole
- C. Sore throat … Herpes simplex … Penicillin
- D. Erectile dysfunction … Bacterial infection … Amphotericin
Explanation
White plaque in the mouth is a common sign of oral candidiasis, an opportunistic infection
often seen in HIV+ patients with low CD4 counts. The infection is caused by the fungus
Candida albicans and is treated effectively with fluconazole, an antifungal medication. Early
recognition and treatment help prevent systemic spread and improve the patient’s ability to eat
and maintain nutrition.
A nurse is caring for a patient who has suffered a major burn. Of the lab values listed,
which would be concerning as it is a strong indicator of massive cell destruction?
- A. Calcium 8.0 mg/dL
- B. Glucose 180 mg/dL
- C. Potassium 6.0 mg/dL
- D. Sodium 180 mEq/L
Explanation
Explanation of Correct Answer (C):
When major burns occur, massive cell destruction leads to the release of large amounts of
intracellular potassium into the bloodstream. A potassium level of 6.0 mg/dL indicates
hyperkalemia, which is a dangerous sign of cellular breakdown and can lead to life-threatening
cardiac arrhythmias. This value requires immediate intervention to prevent cardiac
complications.
A nurse is caring for a client with the diagnosis of Clostridium difficile. While providing care
to the client, the nurse’s glove tears. After removing the soiled gloves, what is the priority action
by the nurse?
- A. Wash hands with soap and water
- B. Don a clean pair of nonsterile gloves
- C. Wash hands with a biohazard wipe from a nearby container
- D. Wash hands with alcohol-based hand sanitizer
Explanation
Clostridium difficile is a spore-forming bacterium that is not reliably killed by alcohol-based
hand sanitizers. When a glove tears, the nurse’s hands may be contaminated. The priority action
is to wash hands thoroughly with soap and water, which mechanically removes spores and
reduces the risk of transmission to other patients or surfaces. After washing, the nurse should
don a clean pair of nonsterile gloves before continuing care. This sequence ensures proper
infection control and patient safety.
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.
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.
The nurse is assessing a patient with peritonitis. What findings should they expect?
(Select ALL that apply)
- A. Decreased urinary output
- B. Inability to pass stool
- C. Rigid abdomen
- D. Hyperactive bowel sounds
- E. Frequent bowel movements
Explanation
A. Decreased urinary output
Peritonitis causes significant inflammation and fluid shifts into the peritoneal cavity. As fluid
moves out of the vascular space, blood pressure may decrease and kidney perfusion becomes
impaired. This leads to oliguria (reduced urine output), which is a serious sign of declining
circulation. The nurse should closely monitor intake and output and assess for signs of
dehydration or hypovolemic shock. B. Inability to pass stool
A common complication of peritonitis is paralytic ileus, a temporary shutdown of intestinal
motility. The intestines stop moving, leading to an inability to pass stool or gas. This is a key
assessment finding and indicates serious abdominal inflammation. The abdomen may feel
distended, and bowel sounds may be absent or hypoactive.
C. Rigid abdomen
A rigid or “board-like” abdomen is a classic hallmark of peritonitis and indicates severe
irritation of the peritoneum. This rigidity is caused by involuntary muscle guarding due to
extreme pain and inflammation. This finding is an emergency and suggests worsening infection
or possible progression to sepsis. The nurse must notify the provider immediately and anticipate
diagnostic testing and IV antibiotics.
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