ATI NUR250 Spring 2 Midpoint Assessment
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Free ATI NUR250 Spring 2 Midpoint Assessment Questions
A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. When the nurse finds the client's blood glucose to be 48 mg/dL on the glucometer, he should give the client which of the following?
- 4 oz diet soda
- 1 tsp sugar
- Graham crackers
- 4 oz skim milk
Explanation
Correct Answer Is:
D) 4 oz skim milk
A blood glucose of 48 mg/dL confirms hypoglycemia, which requires immediate treatment using the "Rule of 15" — administering 15 grams of fast-acting carbohydrates and rechecking blood glucose in 15 minutes. Four ounces (120 mL) of skim milk provides approximately 15 grams of carbohydrates in a readily absorbable form. Diet soda contains no sugar and is ineffective for treating hypoglycemia. One teaspoon of sugar provides insufficient carbohydrates, and graham crackers contain fat and protein which slow glucose absorption, making them less ideal for rapid correction of hypoglycemia.
A nurse is preparing to administer a continuous heparin infusion at 1600 units/hr. Available is heparin 25,000 units in dextrose 5% in water (D₅W) 500 mL. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
- 32 mL/hr
Explanation
Correct Answer: 32 mL/hr
First, calculate the concentration of the heparin solution:
25,000 units ÷ 500 mL = 50 units/mL
Then calculate the rate needed to deliver 1600 units/hr:
1600 units/hr ÷ 50 units/mL = 32 mL/hr
This calculation ensures the client receives the precise prescribed dose of heparin, which is critical as heparin is a high-alert medication with a narrow therapeutic window — errors in dosing can result in serious bleeding or inadequate anticoagulation.
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12%
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6%
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18%
-
24%
Explanation
Correct Answer: C) 18%
The clinical manifestations described — tachycardia, tachypnea, oliguria, and orthostatic hypotension — are consistent with Class II hypovolemic shock, which corresponds to approximately 15–30% blood loss (roughly 750–1500 mL in an average adult). At this level, the body's compensatory mechanisms are activated, producing increased heart rate and respiratory rate to maintain perfusion, while decreased renal perfusion leads to oliguria. An 18% blood loss falls within this compensatory stage, making it the most consistent match for the described clinical picture.
Nurses' Notes
1000: Client is awake, alert, and oriented to person, time, and place. Bilateral breath sounds clear and present throughout. Apical pulse regular.
1200: Client reports chest tightness radiating to jaw, not relieved with rest, and periods of nausea, dizziness, and palpitations. Client is diaphoretic and appears anxious. Bilateral breath sounds clear and present throughout. Apical pulse irregular and rapid.
A nurse is caring for a client who has a history of angina. Review the Nurses' Notes and select all findings that require follow-up by the nurse.
Select all that apply:
-
Prepare medications for multiple clients at the same time
-
Wait to document medications given to clients until the end of a shift
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Provide the nurse administering medications with an identifying vest
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Remove medications from automatic dispensing systems before they are reviewed by pharmacists
Explanation
Correct Answer: C) Provide the nurse administering medications with an identifying vest
Providing nurses who are administering medications with an identifying vest is an evidence-based safety strategy designed to reduce interruptions and distractions during medication administration — one of the leading causes of medication errors. The vest signals to other staff and visitors that the nurse is performing a high-risk task requiring full concentration and should not be interrupted. Preparing medications for multiple clients simultaneously, delaying documentation, and bypassing pharmacist review all increase the risk of medication errors.
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Daily weight
-
Sodium level
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Tissue turgor
-
Intake and output
Explanation
Correct Answer: A) Daily weight
Daily weight is the most reliable and objective measure of fluid retention in clients with chronic kidney disease. A weight gain of 1 kg (2.2 lbs) corresponds to approximately 1 liter of retained fluid. Daily weights taken at the same time each day, on the same scale, in the same clothing, provide a consistent and sensitive indicator of fluid accumulation — making it the gold standard for monitoring fluid status in clients with renal disease and heart failure.
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"It sounds like you are worried about the complications of diabetes."
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"This happens if you fail to control your blood sugar."
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"I have a client that recently lost their vision."
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"There are many clients who have diabetes that don't end up losing their vision."
Explanation
Correct Answer: A) "It sounds like you are worried about the complications of diabetes."
This response demonstrates therapeutic communication through the technique of reflection — acknowledging and validating the client's feelings by restating the emotional content of what they expressed. This approach shows empathy, encourages the client to elaborate on their concerns, and builds a trusting nurse-client relationship. It prioritizes the client's emotional needs before providing any information or reassurance, which is the foundation of patient-centered care.
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Confusion
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Heart bradycardia
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Rapid skin recoil
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Pale straw-colored urine
Explanation
Correct Answer: A) Confusion
Dehydration reduces circulating blood volume, leading to decreased cerebral perfusion and electrolyte imbalances — particularly affecting sodium levels — which can cause neurological manifestations including confusion, restlessness, and decreased level of consciousness. As dehydration progresses, the brain is particularly sensitive to fluid and electrolyte shifts, making confusion a clinically significant and expected finding in moderate to severe dehydration.
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Specific characteristics of the medications
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Time at which the medication can be available from the pharmacy
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Schedule of administration that the client follows at home
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Institutional policies regarding routine medication administration times
Explanation
Correct Answer: A) Specific characteristics of the medications
The specific pharmacological characteristics of each medication — including its mechanism of action, half-life, onset and peak times, food interactions, and therapeutic requirements — are the primary factors that determine the most effective and safe administration schedule. For example, some medications must be given with food, others require consistent spacing to maintain therapeutic blood levels, and some have specific timing requirements to maximize efficacy. These pharmacological properties take precedence over pharmacy availability, client home routines, or institutional scheduling policies.
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"The dietician will help me with my diet due to diabetes."
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"The dietician will assist me in affording my medication."
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"The dietician will coordinate my care."
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"The dietician will change my treatment plan."
Explanation
Correct Answer: A) "The dietician will help me with my diet due to diabetes."
A registered dietician's primary role in diabetes management is to provide medical nutrition therapy — developing an individualized meal plan that helps the client manage blood glucose levels through appropriate carbohydrate counting, portion control, and healthy food choices. Nutrition is a cornerstone of diabetes management, and dietary counseling directly supports glycemic control, weight management, and prevention of complications.
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