ATI NUR 250 Summer 1 2025 Midpoint Assessment
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Free ATI NUR 250 Summer 1 2025 Midpoint Assessment Questions
A charge nurse in the emergency department is assigning acuity levels to four clients. To which of the following clients should the nurse assign an acuity level of 1?
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A client who has COPD and an oxygen saturation of 93%.
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A client who has a cough and a fever of 38.4° C (101.1° F).
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A client who is having stroke-like symptoms that began 30 min ago.
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A client who twisted their ankle playing soccer.
Explanation
Correct Answer: C. A client who is having stroke-like symptoms that began 30 min ago.
Explanation:
A client with stroke-like symptoms that began 30 minutes ago requires immediate and life-saving intervention, qualifying for an acuity level of 1 (emergent). Early recognition and treatment of a stroke are critical because the therapeutic window for interventions such as thrombolytic therapy is limited to a few hours. Rapid evaluation and management can prevent permanent neurological damage and improve outcomes.
A nurse is caring for a client who is 3 hr postoperative following abdominal surgery. Which of the following assessment data should the nurse report to the provider?
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Serosanguineous drainage noted on the abdominal dressing.
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The client urine output has been 50 mL since surgery.
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Postoperative laboratory results are Hgb 15% and Hct 40%.
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The client's pain level has decreased since the administration of morphine.
Explanation
Correct Answer: B. The client urine output has been 50 mL since surgery.
Explanation:
A urine output of 50 mL over 3 hours is significantly low and indicates possible decreased renal perfusion or urinary retention. Postoperative urine output should be at least 30 mL/hr, or 90 mL over 3 hours. This finding requires prompt reporting and intervention to prevent acute kidney injury. The other findings—serosanguineous drainage, stable lab values, and effective pain management—are expected postoperative outcomes and do not require immediate provider notification.
A nurse is assessing a client who is receiving continuous IV therapy through a peripheral IV. The catheter site is cool and taut, and there is IV fluid leaking. The nurse should identify that the client has manifestations of which of the following complications?
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Circulatory overload
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Infiltration
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Phlebitis
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Infection
Explanation
Correct Answer: B. Infiltration
Explanation:
Infiltration occurs when IV fluid leaks into the surrounding tissue instead of flowing into the vein. Signs include a cool, taut, and swollen insertion site, along with leakage of IV fluid and discomfort. The nurse should immediately stop the infusion, remove the IV catheter, and elevate the affected limb. A warm or cold compress may be applied depending on the solution type. Phlebitis presents with redness and warmth, infection with pus or fever, and circulatory overload affects the lungs, not the IV site.
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 the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
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20 mL/hr
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30 mL/hr
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32 mL/hr
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40 mL/hr
Explanation
Correct Answer: C. 32 mL/hr
Explanation:
Step 1: Determine the concentration.
25,000 units ÷ 500 mL = 50 units/mL
Step 2: Set up the proportion.
1600 units ÷ 50 units/mL = 32 mL/hr
Therefore, the nurse should set the IV pump to deliver 32 mL/hr to ensure the client receives the prescribed heparin dose safely and accurately.
A nurse is caring for four clients who are all requesting assistance. Which of the following clients should the nurse assist first?
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A client who is postoperative and is reporting nausea.
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A client who is requesting a bedpan.
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A client who reports they have fallen while ambulating.
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A client who reports their IV pump is beeping.
Explanation
Correct Answer: C. A client who reports they have fallen while ambulating.
Explanation:
The client who has fallen while ambulating is the priority because they are at immediate risk for injury or complications such as fractures, head trauma, or internal bleeding. The nurse must assess this client immediately to determine their level of consciousness, injuries, and need for urgent medical care. After ensuring the client’s safety and stability, the nurse can then address the other clients’ needs in order of urgency.
Which of the following actions should the nurse take when preparing to provide discharge teaching for an adolescent who has a cognitive disorder and their parents
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Include abstract imagery.
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Ensure that the television is on.
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Include medical slang.
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Use short directive statements.
Explanation
Correct Answer D: Use short directive statements
Explanation:
Using short, directive statements is the most effective approach when teaching adolescents with cognitive disorders. These individuals benefit from simple, clear, and concrete instructions that are easy to understand and follow. This technique supports comprehension, reduces confusion, and ensures better adherence to discharge instructions.
Why the Other Options Are Incorrect:
A. Include abstract imagery
Abstract concepts are often difficult to understand for individuals with cognitive impairments. Teaching should focus on concrete, practical information instead of figurative or symbolic language.
B. Ensure that the television is on
Having the television on during teaching is distracting and can reduce the client's and family's ability to focus and absorb information. A quiet, focused environment is more effective.
C. Include medical slang
Medical slang can be confusing and unprofessional, especially for clients with limited health literacy or cognitive challenges. Language should be plain, direct, and medically accurate.
Which of the following instructions should the nurse include when teaching a school-age child who has type 1 diabetes mellitus and his parents about illness management
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Limit fluid intake during meal time.
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Notify the provider if blood glucose levels are over 350 milligrams/deciliter.
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Withhold insulin dose if feeling nauseous.
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Test the urine for ketones
Explanation
Correct Answer D: Test the urine for ketones.
Explanation:
During illness, children with type 1 diabetes are at risk for diabetic ketoacidosis (DKA), especially when blood glucose is elevated or when insulin is reduced. Urine ketone testing helps identify the early presence of ketones, signaling the need for medical intervention. The nurse should teach that ketone testing is essential when the child is sick, has a fever, or has blood glucose levels consistently over 240 mg/dL.
Why the Other Options Are Incorrect:
A. Limit fluid intake during meal time.
This is incorrect. During illness, maintaining adequate hydration is crucial to help manage blood glucose levels and prevent dehydration. Fluid intake should be encouraged, not limited.
B. Notify the provider if blood glucose levels are over 350 milligrams/deciliter.
While elevated glucose levels are concerning, the standard threshold for contacting the provider is typically persistent levels over 240 mg/dL with ketones present or symptoms of DKA. Waiting until levels are over 350 mg/dL could delay important care.
C. Withhold insulin dose if feeling nauseous.
This is incorrect and potentially dangerous. Even during illness or nausea, insulin should not be withheld, as the body still needs insulin to process glucose and prevent ketone production. Skipping insulin increases the risk of DKA.
Which of the following is the correct amount in milliliters (mL) the nurse should administer per dose of potassium chloride elixir? The prescription is for 40 mEq divided into 2 equal doses every 12 hours. The available concentration is 6.7 mEq per 5 mL
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0 mL
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12 mL
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15 mL
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18 mL
Explanation
Correct Answer C: 15 mL
Explanation:
The total dose of potassium chloride is 40 mEq per day. When divided into two doses every 12 hours, each dose is:
40 mEq ÷ 2 = 20 mEq per dose
The available concentration is 6.7 mEq in 5 mL. Use the formula:
(Desired dose ÷ Available mEq) × Volume
(20 ÷ 6.7) × 5 = 2.985 × 5 = 14.93 mL
Rounded to the nearest whole number: 15 mL
Why the Other Options Are Incorrect:
A. 10 mL
10 mL would only provide about 13.4 mEq of potassium (6.7 mEq per 5 mL × 2), which is significantly less than the required 20 mEq.
B. 12 mL
12 mL provides approximately 16.08 mEq (6.7 ÷ 5 = 1.34 mEq/mL × 12 mL), which still falls short of the prescribed dose.
D. 18 mL
18 mL delivers approximately 24.12 mEq (1.34 mEq/mL × 18 mL), which exceeds the required 20 mEq and could result in overdosage.
Which of the following statements by a school-age child with a new diagnosis of type 1 diabetes mellitus indicates an understanding of the teaching
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I can store unopened bottles of insulin in the freezer.
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I should not take my regular insulin when I am sick.
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I should eat a snack half an hour before playing soccer.
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My morning blood glucose should be between 90 and 130
Explanation
Correct Answer C: I should eat a snack half an hour before playing soccer.
Explanation:
This statement shows correct understanding. Physical activity like soccer can lower blood glucose levels, increasing the risk of hypoglycemia. Eating a carbohydrate-containing snack before exercise helps maintain stable glucose levels and prevents hypoglycemia during or after physical activity. Children with type 1 diabetes are often taught to plan snacks around exercise to manage their energy and insulin needs.
Why the Other Options Are Incorrect:
A. I can store unopened bottles of insulin in the freezer.
This is incorrect. Insulin should never be frozen. Unopened insulin should be stored in the refrigerator, not the freezer, as freezing can damage its effectiveness.
B. I should not take my regular insulin when I am sick.
This is incorrect. Children with type 1 diabetes should usually continue taking insulin even when they are sick because illness can raise blood glucose levels. They may even need more frequent monitoring and insulin adjustments during illness.
D. My morning blood glucose should be between 90 and 130.
This range is more appropriate for adults. The target fasting blood glucose for school-age children with type 1 diabetes is typically 90 to 180 mg/dL, depending on their individual care plan. This response reflects a misunderstanding of the appropriate target range.
Which of the following information should be included in the situation component of the I-SBAR-R handoff report
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Client admitted with ruptured disc at L5
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Request prescription for opioid medication for pain relief
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Provider notified of client's back pain
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Client is grimacing due to pain
Explanation
Correct Answer D: Client is grimacing due to pain
Explanation:
The situation component of the I-SBAR-R report focuses on the immediate issue or concern that prompted the communication. It provides a brief summary of the client’s current condition or what is happening right now. “Client is grimacing due to pain” describes the client’s current observable problem, making it the appropriate information for the situation section.
Why the Other Options Are Incorrect:
A. Client admitted with ruptured disc at L5
This belongs in the background section, which includes relevant medical history and the reason for admission.
B. Request prescription for opioid medication for pain relief
This is part of the recommendation, where the nurse suggests a course of action or what is needed from the provider.
C. Provider notified of client's back pain
This fits into the assessment or possibly the readback component, as it communicates what has been done in response to the client’s condition, not the current situation itself.
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