ATI_NUR212 Midpoint Assessment Fall 2 2025
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Free ATI_NUR212 Midpoint Assessment Fall 2 2025 Questions
Which symptoms reported by the patient immediately following the surgical removal of the thyroid and parathyroid gland requires intervention by the RN? Select the "2" findings that require immediate follow-up.
- A. Earache
- B. Increased appetite
- C. Hand tremors
- D. Dizziness
- E. Foot cramps
Explanation
Explanation of Correct Answers
C. Hand tremors
Hand tremors indicate neuromuscular irritability, which is a classic sign of hypocalcemia after removal of the thyroid and parathyroid glands. The parathyroid glands regulate calcium levels; damage or removal leads to decreased calcium and possible tetany. Hypocalcemia is life-threatening if untreated and may progress to laryngospasm or seizures. Immediate assessment and possible IV calcium replacement are required.
E. Foot cramps
Foot cramps also signal hypocalcemia, another sign of increased neuromuscular excitability. Muscle cramping or spasms—especially in feet, hands, or face—require immediate intervention to prevent worsening tetany or respiratory compromise. These symptoms are early indicators and must be treated promptly.
A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream?
- A. Potassium
- B. Bicarbonate
- C. Ammonia
- D. Glucose
Explanation
Explanation of Correct Answer (C):
In clients with cirrhosis, the liver is unable to adequately convert ammonia into urea for excretion. Elevated ammonia levels can lead to hepatic encephalopathy, causing confusion, altered mental status, and even coma. Lactulose works by trapping ammonia in the gut and promoting its excretion through the stool. It also acidifies the colon, which reduces ammonia absorption. Therefore, lactulose is used primarily to lower ammonia levels, not just to relieve constipation.
A nurse is reviewing assessment data for four clients. Which of the following findings is MOST consistent with Graves’ disease?
- A. Heart rate is 54 bpm, with constipation and poor appetite
- B. Nonpitting edema noted in the extremities with thinning hair
- C. Patient has recently lost over 10 pounds in the last month and reports a fine tremor in the hands
- D. Patient is anxious and irritable with skin moist and warm
Explanation
Explanation of Correct Answer (C): Graves’ disease is a form of hyperthyroidism characterized by excessive thyroid hormone production. A rapid and unexplained weight loss combined with a fine tremor in the hands strongly indicates increased metabolic activity, which is typical of hyperthyroidism. These symptoms reflect heightened sympathetic nervous system activity, increased caloric expenditure, and neuromuscular excitability—all classic findings in Graves’ disease. The weight loss is unintentional and unexplained, making it more concerning for an endocrine disorder rather than lifestyle change.
A nurse is preparing dietary instructions for a client who has episodes of biliary colic from chronic cholecystitis. Which of the following instructions should the nurse include in the teaching plan?
- A. Avoid foods high in fat.
- B. Avoid foods high in sodium.
- C. Include foods high in fiber.
- D. Include foods high in starch and proteins.
Explanation
Explanation of Correct Answer (A):
Chronic cholecystitis and biliary colic are often triggered by the consumption of fatty foods, because fat digestion stimulates the gallbladder to contract and release bile. This can cause pain, inflammation, and worsening symptoms. Therefore, clients should avoid fatty foods such as fried foods, full-fat dairy, processed meats, and high-fat sauces. A low-fat diet reduces gallbladder stimulation and decreases discomfort during cholecystitis flare-ups.
A nurse is caring for a male client who has a urinary tract infection. Which of the following conditions is the client most likely to develop as a result of the UTI?
- A. Benign prostatic hypertrophy
- B. Erectile dysfunction
- C. Chlamydia
- D. Prostatitis
Explanation
Explanation of Correct Answer (D):
In males, urinary tract infections can spread to the prostate gland, resulting in prostatitis, which is inflammation or infection of the prostate. Bacteria from the urinary tract may ascend through the urethra and infect the prostate. Symptoms may include perineal pain, fever, dysuria, urinary retention, or pelvic discomfort. This is a common complication of UTIs specifically in male patients due to anatomical proximity.
A patient with Type 2 Diabetes has been diagnosed with Hyperglycemic Hyperosmolar Syndrome (HHS). The patient's spouse asks the RN which symptoms characterize this disorder. Which are the most appropriate responses by the RN? Select all that apply. (Select All that Apply.)
- A. Elevated BUN and creatinine
- B. Taut, dry skin
- C. Slow heart rate
- D. Elevated blood glucose
- E. Decreased osmolality
Explanation
Explanation
A. Elevated BUN and creatinine
In HHS, severe dehydration causes reduced renal perfusion, leading to elevated BUN and creatinine levels. These lab findings are markers of dehydration and impaired kidney function, which are commonly seen in HHS due to extreme fluid loss from osmotic diuresis.
B. Taut, dry skin
HHS causes profound dehydration resulting in very dry, tented, or taut skin. The osmotic diuresis caused by extremely high blood glucose levels leads to excessive urination, loss of fluids, and marked skin dryness, a key physical assessment finding.
D. Elevated blood glucose
HHS is characterized by very high blood glucose levels—usually above 600 mg/dL, without significant ketoacidosis. This elevated glucose level increases serum osmolality and draws fluid out of tissues, contributing to dehydration and neurologic changes.
A nurse is teaching a community education course about the physical complications related to substance use disorder. Which of the following findings should the nurse identify as the primary cause of liver cirrhosis?
- A. Caffeine
- B. Inhalants
- C. Cocaine
- D. Alcohol
Explanation
Explanation of Correct Answer (D):
Chronic alcohol use is the leading cause of liver cirrhosis due to repeated inflammation and scarring of liver tissue. Alcohol is metabolized by the liver, and excessive long-term use leads to fatty liver, alcoholic hepatitis, fibrosis, and ultimately cirrhosis. Cirrhosis impairs liver function and can lead to portal hypertension, jaundice, ascites, hepatic encephalopathy, and liver failure. Alcohol-related liver disease is one of the most preventable causes of mortality.
A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess the client?
- A. Brudzinski's sign
- B. Kernig's sign
- C. Babinski's sign
- D. Chvostek's sign
Explanation
Explanation of Correct Answer (D):
Following a thyroidectomy, the client is at risk for hypocalcemia due to possible injury or removal of the parathyroid glands. Tingling around the mouth, hands, and feet is an early sign of low calcium levels. The nurse should assess Chvostek’s sign, which involves tapping the facial nerve and observing for twitching of the facial muscles. A positive sign confirms neuromuscular irritability secondary to hypocalcemia.
A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose?
- A. Constipation
- B. Drowsiness
- C. Hypoactive deep-tendon reflexes
- D. Insomnia
Explanation
Explanation of Correct Answer (D):
Levothyroxine is a thyroid hormone replacement used to treat hypothyroidism. An overdose leads to symptoms of hyperthyroidism, because the body has excess thyroid hormone. Classic manifestations include insomnia, anxiety, tremors, weight loss, heat intolerance, diaphoresis, and tachycardia. Insomnia reflects an overstimulation of the nervous system and is a key indicator that the dose may be too high.
A nurse is providing teaching to a client who has hypothyroidism and has been prescribed levothyroxine. Which of the following medication instructions would the nurse include in the teaching?
- A. "Take this medication with high-protein foods."
- B. "Take this medication with a full glass of water or fruit juice."
- C. "Take this medication before a meal or several hours after a meal."
- D. "Take this medication during your morning meal."
Explanation
Explanation of Correct Answer (C): Levothyroxine must be taken on an empty stomach for best absorption. The medication should be taken first thing in the morning, ideally 30 to 60 minutes before breakfast, or at least 3–4 hours after eating. Food—especially high-fiber, calcium, iron, soy, and protein-rich foods—can interfere with absorption and reduce effectiveness. Taking it correctly improves hormone regulation and therapeutic stability.
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