ATI NUR 4355 Fall 2025 Final Exam
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Free ATI NUR 4355 Fall 2025 Final Exam Questions
A nurse in the emergency department is assessing an adolescent who reports sudden and severe testicular pain. Which of the following actions should the nurse take?
- A. Obtain a urology consult for immediate evaluation.
- B. Apply heat to the affected area for relief.
- C. Recommend the client take over-the-counter pain relievers and monitor pain over the next few days.
- D. Determine if the adolescent has had exposure to the mumps recently.
Explanation
Explanation
Sudden and severe testicular pain in an adolescent is a medical emergency, as it may indicate testicular torsion, which requires immediate surgical intervention to preserve testicular viability. Applying heat or using over-the-counter medications can worsen ischemia. While history of mumps can be relevant to orchitis, the priority is rapid assessment and urology evaluation to prevent permanent testicular damage.
Correct Answer Is:
A. Obtain a urology consult for immediate evaluation.Why the other options are incorrect:
Applying heat or using over-the-counter medications can worsen ischemia. While history of mumps can be relevant to orchitis, the priority is rapid assessment and urology evaluation to prevent permanent testicular damage.A nurse is providing education to a 16-year-old client who is being prescribed zidovudine (Retrovir) as antiretroviral therapy (ART) for HIV. Which of the following statements should the nurse include in the teaching?
- A. “This medication will prevent you from spreading the virus.”
- B. “You will need to take this medication as prescribed every day.”
- C. “It will be fine to take sleeping pills if you can’t sleep.”
- D. “If you have nausea and vomiting, stop the medication immediately.”
Explanation
Explanation
Adherence to antiretroviral therapy is critical for controlling HIV viral load, preventing disease progression, and reducing the risk of drug resistance. Zidovudine must be taken exactly as prescribed every day to be effective. ART does not completely eliminate the risk of transmission, additional medications should not be taken without provider approval, and side effects such as nausea should be reported rather than stopping the medication abruptly.
Correct Answer Is:
B. “You will need to take this medication as prescribed every day.”Why the other options are incorrect:
ART does not completely eliminate the risk of transmission, additional medications should not be taken without provider approval, and side effects such as nausea should be reported rather than stopping the medication abruptly.A nurse is providing education to the family of a school-aged child who has a history of atrial septal defect (ASD) with surgical repair. The child's caregivers ask the nurse if their child can play sports. Which of the following statements made by the nurse is most appropriate?
- A. “Your child can participate in activities like riding a bike, but they should not participate in sports.”
- B. “Your child can participate in team sports as tolerated.”
- C. “Your child cannot participate in any sports.”
- D. “Your child can participate in only individual sports, no team sports.”
Explanation
Explanation
After successful surgical repair of an ASD, many children can safely participate in age-appropriate physical activities, including team sports, as long as they are asymptomatic and cleared by their cardiologist. Participation should be gradual and monitored for fatigue, palpitations, or shortness of breath. Restricting all sports or only allowing individual activities is unnecessary if the child’s cardiac function is stable.
Correct Answer Is:
B. “Your child can participate in team sports as tolerated.”Why the other options are incorrect:
Restricting all sports or only allowing individual activities is unnecessary if the child’s cardiac function is stable.A nurse is caring for a 3-year-old client who has been diagnosed with acute cystitis and is prescribed cephalexin. Which of the following pathogens should the nurse identify as the most common bacterial cause of UTIs?
- A. Escherichia coli
- B. Klebsiella
- C. Enterococcus
- D. Pseudomonas aeruginosa
Explanation
Explanation
Escherichia coli (E. coli) is the most common cause of urinary tract infections in children, including acute cystitis. It is part of the normal intestinal flora and can easily contaminate the perineal area, then ascend through the urethra into the bladder, especially in young children with immature toileting hygiene. E. coli has specific virulence factors, particularly fimbriae (adhesins), that allow it to attach firmly to the urinary tract lining, resist being washed out by urine, and multiply in the bladder. This strong ability to adhere and colonize makes E. coli responsible for the majority of uncomplicated pediatric UTIs. Cephalexin is commonly used because it can be effective against many strains of E. coli when the organism is susceptible.
Correct Answer Is:
A. Escherichia coliA nurse is caring for a preschool-aged child whose parent asks how to get their child to eat healthier food. Which of the following responses should the nurse make?
- A. “Preschool-aged children thrive on routine, so you shouldn't change their eating.”
- B. “As long as they're getting the appropriate calories, you don't need to change their diet.”
- C. “Preschool-aged children are finicky eaters, so there isn't much you can do except provide what they will eat.”
- D. “You can offer different foods for them to choose from to provide variety.”
Explanation
Explanation
Preschool-aged children are developing autonomy and preferences in eating. Offering a variety of healthy foods and allowing children to make choices promotes positive eating behaviors, increases acceptance of new foods, and supports balanced nutrition. Rigid routines without variety or catering solely to the child’s current preferences can limit exposure to healthy options. Ensuring calories without considering nutrition and assuming finicky behavior is unchangeable may contribute to poor dietary habits. Providing choice encourages engagement and long-term healthy eating patterns.
Correct Answer Is:
D. “You can offer different foods for them to choose from to provide variety.”Why the other options are incorrect:
Rigid routines without variety or catering solely to the child’s current preferences can limit exposure to healthy options. Ensuring calories without considering nutrition and assuming finicky behavior is unchangeable may contribute to poor dietary habits. Providing choice encourages engagement and long-term healthy eating patterns.A nurse is teaching a newly hired nurse about the risks of cellulitis following an injury. Which of the following statements by the newly hired nurse shows the teaching was effective?
- A. “Skin abrasions cause red blood cells to respond to the area of infiltration and cause inflammation.”
- B. “Skin abrasions facilitate the entry and travel of bacteria to deeper tissue layers.”
- C. “Skin abrasions only cause cellulitis when it is deep enough to impact the dermal layer of skin.”
- D. “Skin abrasions lead to inflammation because of the proliferation of neutrophils.”
Explanation
Explanation
Cellulitis is a bacterial infection of the skin and subcutaneous tissue, often following breaks in the skin such as abrasions, cuts, or wounds. These disruptions allow bacteria, commonly Staphylococcus aureus or Streptococcus species, to enter and proliferate in deeper tissues. While inflammation occurs, it is a response to infection rather than solely neutrophil proliferation. Red blood cells do not initiate cellulitis, and even superficial abrasions can lead to infection, not just dermal-level injuries.
Correct Answer Is:
B. “Skin abrasions facilitate the entry and travel of bacteria to deeper tissue layers.”Why the other options are incorrect:
While inflammation occurs, it is a response to infection rather than solely neutrophil proliferation. Red blood cells do not initiate cellulitis, and even superficial abrasions can lead to infection, not just dermal-level injuries.A nurse is preparing to assess reflexes in a 3-day-old newborn who is currently asleep. Which reflex is most appropriately tested during the newborn's sleep state to evaluate neurological function?
- A. Sucking reflex
- B. Rooting reflex
- C. Plantar grasp reflex (Babinski)
- D. Moro (startle) reflex
Explanation
Explanation
The plantar grasp (Babinski) reflex is unique in that it can be assessed even when the newborn is in a sleep state. This reflex involves stroking the lateral aspect of the sole, which causes the toes to fan outward and the big toe to dorsiflex. It is a primitive reflex that indicates normal neurological development of the corticospinal tract. Reflexes such as sucking, rooting, and Moro require the newborn to be awake and alert, as they depend on voluntary or semi-voluntary responses to stimulation. The plantar grasp provides a reliable measure of neurological function without requiring the infant to be aroused.
Correct Answer Is:
C. Plantar grasp reflex (Babinski)Why the other options are incorrect:
Reflexes such as sucking, rooting, and Moro require the newborn to be awake and alert, as they depend on voluntary or semi-voluntary responses to stimulation. The plantar grasp provides a reliable measure of neurological function without requiring the infant to be aroused.A nurse is caring for a 12-year-old client in the acute phase of HIV. Which complication should the nurse monitor for at this time?
- A. Fever
- B. Pneumonia
- C. Kaposi’s sarcoma
- D. AIDS
Explanation
Explanation
The acute phase of HIV, also called primary HIV infection, typically occurs 2–4 weeks after exposure and presents with nonspecific viral symptoms, such as fever, malaise, lymphadenopathy, sore throat, and rash. Opportunistic infections like pneumonia, Kaposi’s sarcoma, and progression to AIDS occur later, during the chronic or advanced stages of HIV, after significant immune suppression has developed. Therefore, fever is the primary complication to monitor in the acute phase.
Correct Answer Is:
A. FeverWhy the other options are incorrect:
Opportunistic infections like pneumonia, Kaposi’s sarcoma, and progression to AIDS occur later, during the chronic or advanced stages of HIV, after significant immune suppression has developed. Therefore, fever is the primary complication to monitor in the acute phase.A nurse is educating the parents of a 3-year-old child who has autism spectrum disorder (ASD). Which of the following patterns of behavior should the nurse include in the teaching? (Select all that apply.)
- A. Fixation on certain items or topics
- B. Frequent changes in routine
- C. Display of self-harming behaviors such as head-banging
- D. Spontaneous and unpredictable behaviors
- E. Adhering to a rigid routine
- F. Avoidance of repetitive activities
Explanation
Explanation
A. Fixation on certain items or topics
Children with ASD often exhibit intense focus or preoccupation with specific objects, interests, or topics, which is a hallmark of repetitive and restricted behaviors seen in this disorder.
C. Display of self-harming behaviors such as head-banging
Self-injurious behaviors, including head-banging or biting, can occur in children with ASD, especially when they experience frustration, anxiety, or sensory overload. Recognizing these behaviors helps guide intervention and safety measures.
E. Adhering to a rigid routine
Children with ASD typically prefer predictable routines and may become distressed by changes. This need for consistency supports their coping and sense of security.
Correct Answer Is:
A. Fixation on certain items or topicsC. Display of self-harming behaviors such as head-banging
E. Adhering to a rigid routine
A nurse is teaching a client about tetanus. Which of the following statements should the nurse make? (Select all that apply.)
- A. “A deep wound that has come in contact with soil, dirt, or dust could become infected with tetanus.”
- B. “A minor wound that is not a puncture wound is not sufficient enough to allow tetanus to enter the body.”
- C. “Wounds that come in contact with contaminated animal feces can cause tetanus.”
- D. “Newborns are at risk if their parent is unvaccinated or gives birth in unsanitary conditions.”
- E. “Since there is no treatment for tetanus once acquired, vaccination is very important.”
Explanation
Explanation
A. “A deep wound that has come in contact with soil, dirt, or dust could become infected with tetanus.”
Tetanus is caused by Clostridium tetani, an anaerobic, spore-forming bacterium that thrives in environments low in oxygen. The spores are commonly found in soil and dust. Deep puncture wounds, lacerations, or burns provide an ideal anaerobic environment for the spores to germinate and produce tetanospasmin, the neurotoxin responsible for muscle rigidity and spasms. This emphasizes the need for prompt wound cleaning and assessment of vaccination status.
C. “Wounds that come in contact with contaminated animal feces can cause tetanus.”
Animal feces, particularly from farm animals like cattle, horses, and pigs, can contain C. tetani spores. Wounds exposed to feces, manure, or contaminated soil are at significant risk for infection. This is clinically relevant in children who play outdoors or in agricultural settings and underscores the importance of thorough cleansing and prophylactic vaccination.
D. “Newborns are at risk if their parent is unvaccinated or gives birth in unsanitary conditions.”
Neonatal tetanus occurs when spores enter through the umbilical cord stump or contaminated birth instruments. The risk is highest when mothers are unvaccinated and hygienic birth practices are not followed. The disease can be fatal due to generalized muscle rigidity, including respiratory muscles, highlighting the importance of maternal vaccination (Tdap) and sterile delivery techniques.
E. “Since there is no treatment for tetanus once acquired, vaccination is very important.”
Tetanus is a toxin-mediated disease with no definitive cure; management is supportive, including muscle relaxants, airway support, and wound debridement, but recovery depends on the body neutralizing the toxin. Vaccination is the most effective preventive measure, typically using the DTaP series in children, with booster Tdap vaccines in adolescents and adults. Educating clients about vaccination schedules ensures long-term immunity and prevention of severe disease outcomes.
Correct Answer Is:
A. “A deep wound that has come in contact with soil, dirt, or dust could become infected with tetanus.”C. “Wounds that come in contact with contaminated animal feces can cause tetanus.”
D. “Newborns are at risk if their parent is unvaccinated or gives birth in unsanitary conditions.”
E. “Since there is no treatment for tetanus once acquired, vaccination is very important.”
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