ATI NUR 4355 Fall 2025 Final Exam

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Free ATI NUR 4355 Fall 2025 Final Exam Questions

1.

A nurse is assessing an 18-month-old toddler at a wellness visit in the health care provider's office. During the assessment, the nurse asks the parent about developmental milestones. The parent states that the toddler has not said their first word yet. Which of the following priority actions by the nurse is accurate?

  • Complete a screening test for autism spectrum disorder (ASD).

  • Ask the parent if the toddler has a history of hospitalizations or surgeries.

  • Ask the parent about recent immunizations.

  • Educate the parent that toddlers do not typically say their first word until 18–20 months of age.

Explanation

Explanation

By 12–15 months, most toddlers should have spoken at least one word. Delayed speech at 18 months is a potential red flag for developmental disorders, including autism spectrum disorder. Early screening allows timely identification and intervention to support communication and social development. While educating parents about typical milestones is important, the priority is to evaluate for potential developmental delays. Questions about hospitalizations or immunizations are secondary and do not directly address delayed speech.

Correct Answer Is:
A. Complete a screening test for autism spectrum disorder (ASD).

Why the other options are incorrect:
While educating parents about typical milestones is important, the priority is to evaluate for potential developmental delays. Questions about hospitalizations or immunizations are secondary and do not directly address delayed speech.
2.

A nurse is caring for a 3-year-old toddler who was newly admitted with pertussis in stage 2 (the paroxysmal stage) of the illness. Which of the following interventions should the nurse perform first?

  • Monitor intake and output.

  • Provide a nutritious meal.

  • Request play activities from the play therapist.

  • Allow the child to sleep and take a nap.

Explanation

Explanation

During the paroxysmal stage of pertussis, the child experiences severe coughing spells that can lead to fluid loss, dehydration, and risk of airway compromise. Monitoring intake and output is the priority to assess hydration status and ensure adequate fluid replacement. Providing meals, play, or rest is secondary and should be adapted around the child’s respiratory status and ability to tolerate interventions safely.

Correct Answer Is:
A. Monitor intake and output.

Why the other options are incorrect:
Providing meals, play, or rest is secondary and should be adapted around the child’s respiratory status and ability to tolerate interventions safely.
3.

A pediatric client has been diagnosed with primary hypothyroidism. Which underlying cause should the nurse most likely suspect?

  • Excessive iodine intake causing thyroid gland overactivity.

  • Hashimoto’s thyroiditis causing autoimmune destruction of thyroid tissue.

  • Pituitary gland failure resulting in decreased TSH secretion.

  • Congenital absence of the hypothalamus leading to insufficient TRH production.

Explanation

Explanation

Primary hypothyroidism originates from dysfunction of the thyroid gland itself. Hashimoto’s thyroiditis is the most common cause in children and adolescents and results from an autoimmune process that gradually destroys thyroid tissue, leading to decreased production of thyroid hormones. Pituitary or hypothalamic disorders cause secondary or tertiary hypothyroidism, not primary disease, and excessive iodine intake does not cause hypothyroidism through thyroid overactivity.

Correct Answer Is:
B. Hashimoto’s thyroiditis causing autoimmune destruction of thyroid tissue.

Why the other options are incorrect:
Pituitary or hypothalamic disorders cause secondary or tertiary hypothyroidism, not primary disease, and excessive iodine intake does not cause hypothyroidism through thyroid overactivity.
4.

A nurse is teaching the parents of an infant who has been diagnosed with otitis media (OM) about ways to prevent future OM infections. Which of the following statements by the parents indicates further teaching is needed?

  • “We will avoid exposing our baby to secondhand smoke and sick individuals.”

  • “Our child can continue to receive breastfeeding.”

  • “We do not need to finish the prescribed antibiotic once the baby seems better to avoid unnecessary medication.”

  • “We will always feed our baby in an upright position to help prevent ear infections.”

Explanation

Explanation

Antibiotics prescribed for otitis media must be taken for the full course, even if symptoms improve, to ensure complete eradication of the infection. Stopping antibiotics early can allow bacteria to survive, leading to recurrence of infection and increasing the risk of antibiotic resistance. Parents should be taught that completing the entire prescription is essential for effective treatment and prevention of complications.

Correct Answer Is:
C. “We do not need to finish the prescribed antibiotic once the baby seems better to avoid unnecessary medication.”

Why the other options are incorrect:
Stopping antibiotics early can allow bacteria to survive, leading to recurrence of infection and increasing the risk of antibiotic resistance. Parents should be taught that completing the entire prescription is essential for effective treatment and prevention of complications.
5.

A nurse is caring for a family immediately after the death of their child. The family expresses intense grief and wishes to remain with the child for as long as possible. Which of the following nursing actions is the most appropriate to support the family during this time?

  • Immediately arrange for the removal of the child’s body to the morgue to allow the family privacy.

  • Use language such as “passed away” when discussing the child’s death to soften the impact.

  • Delay any contact with the family until the attending physician pronounces the death to avoid interfering with medical protocols.

  • Encourage the family to participate in bathing and collecting mementos, explaining the changes they may observe in the child’s body.

Explanation

Explanation

Allowing families to participate in postmortem care and collect keepsakes supports grieving and promotes closure. The nurse should explain normal postmortem changes, provide emotional support, and respect the family’s wishes to remain with the child. Immediate removal of the body, delaying contact, or using euphemistic language alone does not actively support the family in processing grief or engaging in meaningful rituals.

Correct Answer Is:
D. Encourage the family to participate in bathing and collecting mementos, explaining the changes they may observe in the child’s body.

Why the other options are incorrect:
Immediate removal of the body, delaying contact, or using euphemistic language alone does not actively support the family in processing grief or engaging in meaningful rituals.
6.

A nurse is teaching the parents of a child who has a terminal illness about advance care planning (ACP). Which of the following statements should the nurse include?

  • “ACP helps clients decide the preferred location of death and advance directives.”

  • “ACP is invalid if the client chooses curative treatment.”

  • “ACP are legal documents that go into effect if clients are unable to make decisions.”

  • “ACP does not take into account the individual’s cultural influences.”

Explanation

Explanation

Advance care planning is a process that helps clients and families clarify goals of care, values, and preferences for future healthcare, including advance directives and preferred location of care or death. ACP can occur alongside curative treatment and is not limited to end-of-life care. While ACP may result in legal documents, it is broader than the documents themselves and explicitly considers cultural, spiritual, and personal influences.

Correct Answer Is:
A. “ACP helps clients decide the preferred location of death and advance directives.”

Why the other options are incorrect:
ACP can occur alongside curative treatment and is not limited to end-of-life care. While ACP may result in legal documents, it is broader than the documents themselves and explicitly considers cultural, spiritual, and personal influences.
7.

A school nurse is discussing the impact of media on adolescents’ perception of health issues with the members of a school board. Which of the following statements should the nurse make?

  • “Adolescents are critical thinkers and can distinguish between accurate health information and misleading media content.”

  • “Media can play a significant role in shaping adolescents’ perception of health, as it can both inform and misinform them about various health issues.”

  • “Adolescents are not easily influenced by media when it comes to health concerns. They rely on health care professionals for accurate information.”

  • “Media has no impact on adolescents’ health perceptions; their attitudes are solely shaped by their peers.”

Explanation

Explanation

Adolescents are highly influenced by media, including social media, television, and online content, which can shape their beliefs, attitudes, and behaviors related to health. Media can be a valuable source of health education, but it can also spread misinformation, unrealistic body images, and inaccurate health messages. Recognizing this dual influence is important for developing effective health education and media literacy programs.

Correct Answer Is:
B. “Media can play a significant role in shaping adolescents’ perception of health, as it can both inform and misinform them about various health issues.”
8.

A nurse is caring for a preschool-aged child. The parent reports that they speak only in Spanish at home and that the child is having trouble recognizing letters in English at preschool. Which of the following responses should the nurse make?

  • “Speaking a different language at home shouldn’t affect learning how letters sound.”

  • “Children who are learning a new language sometimes have difficulty learning new letters.”

  • “It’s great that you’re teaching them another language at this age.”

  • “You should have them evaluated by our speech team.”

Explanation

Explanation

Preschool-aged children who are exposed to a second language may temporarily struggle with letter recognition and phonics in the new language. This is a normal part of bilingual language development and does not necessarily indicate a learning or speech disorder. The nurse should provide reassurance and normalize the experience rather than suggest unnecessary evaluation or dismiss the parent’s concern.

Correct Answer Is:
B. “Children who are learning a new language sometimes have difficulty learning new letters.”

Why the other options are incorrect:
This is a normal part of bilingual language development and does not necessarily indicate a learning or speech disorder. The nurse should provide reassurance and normalize the experience rather than suggest unnecessary evaluation or dismiss the parent’s concern.
9.

A nurse is providing care to a 5-year-old child who has been diagnosed with autism spectrum disorder. The child’s parents state they are feeling overwhelmed, stressed, and burnt out. Which of the following interventions should the nurse recommend for the parents to help them cope?

  • Eye Movement Desensitization and Reprocessing (EMDR)

  • Acceptance and Commitment Therapy (ACT)

  • Cognitive-Behavioral Therapy (CBT)

  • Play Therapy and Art Therapy

Explanation

Explanation

Cognitive-Behavioral Therapy is an evidence-based intervention that helps caregivers identify negative thought patterns, develop coping strategies, and manage stress more effectively. CBT is commonly recommended for parents of children with chronic conditions, including autism spectrum disorder, to address caregiver burnout, anxiety, and depression. It focuses on practical skills that improve emotional regulation, problem-solving, and resilience. EMDR is used for trauma, play therapy targets children, and ACT is less commonly used as a first-line approach for caregiver stress.

Correct Answer Is:
C. Cognitive-Behavioral Therapy (CBT)

Why the other options are incorrect:
EMDR is used for trauma, play therapy targets children, and ACT is less commonly used as a first-line approach for caregiver stress.
10.

A 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?

  • “Preschool-aged children thrive on routine, so you shouldn't change their eating.”

  • “As long as they're getting the appropriate calories, you don't need to change their diet.”

  • “Preschool-aged children are finicky eaters, so there isn't much you can do except provide what they will eat.”

  • “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.

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