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 is caring for a client in septic shock due to a wound infection. Despite aggressive
fluid resuscitation, the client has a blood pressure of 78/50 mmHg and a heart rate of 136 beats
per minute. The nurse contacts the provider. Which of the following orders should the nurse
expect to receive from the provider?
- Start infusion of Dobutamine 500 mg/250 mL D5W
- Start infusion of Norepinephrine 1 mg/250 mL D5W
- Start infusion of Nitroprusside 100 mg/250 mL D5W
- Start infusion of Nitroglycerin 50 mg/250 mL 0.9% NS
Explanation
Norepinephrine is the first-line vasopressor for septic shock when a patient remains
hypotensive despite adequate fluid resuscitation. It works by potent vasoconstriction, increasing
systemic vascular resistance and raising blood pressure while maintaining perfusion to vital
organs. Dobutamine may be used if there is myocardial dysfunction, but the priority in this case
is to stabilize blood pressure. Nitroprusside and nitroglycerin are vasodilators, which would
lower blood pressure further and are contraindicated in hypotensive septic shock.
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?
- Calcium 8.0 mg/dL
- Glucose 180 mg/dL
- Potassium 6.0 mg/dL
- 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 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.
-
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 -
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 -
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 -
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 post-operative patient is receiving opioid analgesics for pain management. Which
assessment would alert the nurse to contact the provider?
- BP of 120/80, pulse of 100, respiratory rate of 18
- BP of 110/60, pulse of 70, respiratory rate of 14
- BP of 104/72, pulse of 80, respiratory rate of 20
- BP of 96/50, pulse of 120, respiratory rate of 10
Explanation
Explanation of Correct Answer (D):
A respiratory rate of 10 breaths per minute indicates significant respiratory depression, a
dangerous opioid complication. Opioids slow the central nervous system, and a rate below 12
breaths per minute is an urgent warning sign. The low blood pressure and elevated pulse
further indicate possible hemodynamic compromise. This assessment requires immediate
notification of the provider and preparation to administer naloxone if ordered.
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?
- Heart rate
- Urine output
- BP
- 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 is caring for a client who has HIV-1 infection and is prescribed zidovudine as
part of antiretroviral therapy. The nurse should monitor the client for which of the
following adverse effects of this medication?
- Cardiac dysrhythmia
- Metabolic alkalosis
- Aplastic anemia
- Renal failure
Explanation
Explanation of Correct Answer (C):
Zidovudine is known to cause bone marrow suppression, which can lead to aplastic anemia,
neutropenia, and anemia. The nurse must monitor CBC values, especially hemoglobin,
hematocrit, and WBC counts, to detect any signs of myelosuppression. Early identification is
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)
- Active lifestyle and smoking
- Eating spicy foods and laid-back attitude
- Occasional alcohol and cocaine use
- Six-month history of H. pylori
- 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.
A nurse is interviewing a pre-operative patient scheduled for a total nephrolithotomy. Which
of the following findings would require the nurse to collaborate with the surgeon immediately
before sending the patient to the operating room?
- The client took phenytoin 100 mg with a sip of water at 5 a.m.
- The client took metoprolol 25 mg with a sip of water at 6 a.m.
- The client took warfarin 2.5 mg with a sip of water at 6 a.m.
- The client took half their morning dose of insulin at 6 a.m.
Explanation
Warfarin is a potent anticoagulant that significantly increases the risk of excessive bleeding
during surgery. Taking warfarin on the day of a surgical procedure, such as a nephrolithotomy,
can compromise hemostasis and lead to complications including intraoperative hemorrhage,
need for transfusion, or delayed wound healing. Immediate collaboration with the surgeon is
necessary to determine whether to delay the surgery, reverse the anticoagulation, or adjust
perioperative management. The nurse must communicate this finding promptly to prevent
life-threatening complications and ensure patient safety.
A nurse is planning care for a client who is to receive a competitive neuromuscular blocking
agent. Which of the following items should the nurse plan to have at the client's bedside?
- Urinary catheter insertion tray
- Temporary pacemaker
- Bag-valve-mask device
- Central venous catheterization tray
Explanation
Competitive neuromuscular blocking agents (NMBA) are used to induce paralysis by blocking
acetylcholine at the neuromuscular junction. This causes muscle paralysis, including the
respiratory muscles, which may require mechanical ventilation. A bag-valve-mask (BVM)
device should be readily available at the bedside to ensure immediate airway management and
respiratory support if the client experiences respiratory failure or difficulty breathing due to the
effects of the neuromuscular blocker.
The nurse is caring for a patient with an acute ulcerative colitis flare-up. The provider
wants to start the patient on medication. Which medications are appropriate for use in
ulcerative colitis?
(Select ALL that apply)
- Aspirin
- Ciprofloxacin
- Sumatriptan
- Ibuprofen
- Golimumab
- Methylprednisolone
Explanation
B. Ciprofloxacin
Antibiotics such as ciprofloxacin may be prescribed during severe flare-ups of ulcerative colitis
when there is concern for secondary infection. Although not used routinely, it may be used when
complications such as abscess or infection are suspected.
E. Golimumab
Golimumab is a biologic (TNF inhibitor) approved for use in moderate to severe ulcerative
colitis. It reduces inflammation by suppressing immune responses and is often used when other
medications fail to control symptoms effectively.
F. Methylprednisolone
Corticosteroids like methylprednisolone are used during acute flare-ups to rapidly decrease
inflammation. They are not used long-term but are appropriate for induction therapy to control
severe symptoms and promote remission.
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