ATI NUR 250 Summer 1 2025 Midpoint Assessment
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Free ATI NUR 250 Summer 1 2025 Midpoint Assessment Questions
A nurse is caring for a client.
Nurses' Notes
0800:
Client is admitted with a 3-day history of abdominal cramps and diarrhea.
Client reports 4 to 5 liquid stools/day.
Client was taking amoxicillin/clavulanate for a respiratory tract infection,
500 mg PO q 12 hr for 10 days. Antibiotics completed 7 days ago.
Abdomen soft, nondistended with hyperactive bowel sounds audible in 4 quadrants.
Stool contains mucous and is foul-smelling.
Stool sent for culture
Laboratory Results
Laboratory Results
1400:
Stool culture positive for Clostridium difficile (negative)
A nurse is caring for the client. Which of the following actions should the nurse take
-
Wear a protective gown while caring for the client.
-
Place the client in a private room.
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Wear an N-95 respirator while caring for the client.
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Place the client in a negative pressure room.
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Place a mask on the client when they leave their room.
Explanation
Correct Answers:
A. Wear a protective gown while caring for the client
B. Place the client in a private room
Explanation:
A. Wear a protective gown while caring for the client
Contact precautions are required for C. difficile infections. The nurse should wear a gown to prevent the spread of spores, which can persist on surfaces and clothing.
B. Place the client in a private room
Clients with C. difficile should be placed in a private room to limit the risk of transmission to other patients, as the infection is highly contagious and spread by contact with contaminated surfaces or hands.
Why the Other Options Are Incorrect:
C. Wear an N-95 respirator while caring for the client
An N-95 respirator is used for airborne precautions (e.g., tuberculosis), not for C. difficile, which is transmitted through contact.
D. Place the client in a negative pressure room
Negative pressure rooms are for airborne infections. C. difficile does not require this type of isolation.
E. Place a mask on the client when they leave their room
Clients with C. difficile do not need to wear a mask when leaving the room because the infection is not spread by droplets or airborne particles. The focus is on contact precautions.
A patient tells the nurse that she takes aspirin for menstrual cramps, but she does not feel that it works well. What will the nurse suggest?
- A) The patient should increase the dose until pain is controlled.
- B) The patient should use a first-generation nonsteroidal anti-inflammatory medication instead.
- C) The patient should use acetaminophen because of its anti-inflammatory effects.
- D) The patient should avoid any type of COX inhibitor because of the risk of Reye's syndrome.
Explanation
First-generation NSAIDs like ibuprofen or naproxen are often more effective than aspirin for treating menstrual cramps, as they provide stronger COX inhibition, which reduces the production of prostaglandins responsible for uterine contractions and pain. These medications are commonly recommended for dysmenorrhea.
Why the other options are incorrect:
A) The patient should increase the dose until pain is controlled:
Increasing aspirin dosage without guidance can raise the risk of toxicity and bleeding.
C) The patient should use acetaminophen because of its anti-inflammatory effects:
Acetaminophen is not a strong anti-inflammatory and is generally less effective for menstrual cramps compared to NSAIDs.
D) The patient should avoid any type of COX inhibitor because of the risk of Reye's syndrome:
Reye's syndrome is a concern with aspirin use in children and teenagers, especially during viral illnesses—not in adult women treating menstrual cramps.
Which of the following findings indicates the nurse should further assess the client before administering antihypertensive medication
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The client reports having trouble sleeping the previous night.
-
The client reports dizziness when ambulating to the bathroom.
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The client has a urine output of 400 mL for the past 8 hr.
-
The client ate 60% of their breakfast.
Explanation
Correct Answer B: The client reports dizziness when ambulating to the bathroom.
Explanation:
Dizziness upon ambulation may indicate orthostatic hypotension or an already low blood pressure, which could be worsened by administering an antihypertensive medication. Before giving the medication, the nurse should assess the client’s vital signs, especially blood pressure, and determine if it is safe to proceed with the dose or if it should be held and the provider notified.
Why the Other Options Are Incorrect:
A. The client reports having trouble sleeping the previous night
This finding is unrelated to the immediate effects or safety of antihypertensive medication and does not require further assessment before administration.
C. The client has a urine output of 400 mL for the past 8 hr
This output is within a normal range (minimum of 30 mL/hr or 240 mL in 8 hours), so it does not indicate a concern that would delay antihypertensive administration.
D. The client ate 60% of their breakfast
While food intake may influence medication absorption, this is not a significant concern for most antihypertensives and does not require withholding the medication.
Which of the following types of transmission-based precautions should the nurse plan to use for a client with a new diagnosis of methicillin-resistant Staphylococcus aureus (MRSA)
-
Airborne
-
Droplet
-
Contact
-
Protective
Explanation
Correct Answer C: Contact
Explanation:
MRSA is primarily transmitted through direct contact with infected wounds, secretions, or contaminated surfaces. Therefore, contact precautions are required. This includes placing the client in a private room, wearing gloves and gowns when entering the room, and practicing strict hand hygiene to prevent the spread of infection to other patients or healthcare workers.
Why the Other Options Are Incorrect:
A. Airborne
Airborne precautions are used for infections transmitted via small particles suspended in the air, such as tuberculosis or measles. MRSA does not spread this way.
B. Droplet
Droplet precautions are used for pathogens spread through large respiratory droplets, such as influenza or meningitis. MRSA requires contact, not droplet, precautions.
D. Protective
Protective (reverse) precautions are used for immunocompromised clients to protect them from infections, not for clients with contagious infections like MRSA.
A patient has had blood pressures of 150/95 and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient's diagnostic tests are all normal. The nurse will expect this patient's provider to order:
- A) An adrenergic neuron blocker
- B) A beta blocker
- C) Counseling on lifestyle changes
- D) A thiazide diuretic
Explanation
This patient meets the criteria for Stage 1 hypertension (systolic 130–139 or diastolic 80–89 mm Hg), but with normal diagnostic tests and no evidence of end-organ damage, the first-line recommendation is lifestyle modification. These include dietary changes, exercise, weight loss, limiting alcohol, and reducing sodium intake. Medications are typically considered if lifestyle changes are ineffective or if the patient has additional risk factors. Why the other options are incorrect:
A) An adrenergic neuron blocker:
These are rarely used due to significant side effects and are not first-line treatment.
B) A beta blocker:
Beta blockers are not recommended as initial therapy for uncomplicated hypertension unless the patient has other conditions like heart failure or post-MI.
D) A thiazide diuretic:
Although effective, this medication would be considered after lifestyle changes have been attempted and failed or if additional risk factors exist.
A nurse on a medical unit is reviewing the laboratory reports for a client. Which of the following laboratory values is the priority to report to the provider?
-
Sodium 135 mEq/L
-
BUN 9.5 mg/dL
-
Potassium level 3 mEq/L
-
Creatinine 0.4 mg/dL
Explanation
Correct Answer: C. Potassium level 3 mEq/L
Explanation:
A potassium level of 3 mEq/L indicates hypokalemia, which can cause serious cardiac dysrhythmias, muscle weakness, and respiratory compromise. Because potassium directly affects cardiac conduction, this finding is the priority to report to the provider for immediate intervention. The other lab values—sodium 135 mEq/L, BUN 9.5 mg/dL, and creatinine 0.4 mg/dL—are within or near normal limits and do not require urgent action. Prompt correction of potassium imbalance is essential for client safety.
A nurse is caring for four clients who are all requesting assistance. Which of the following clients should the nurse assist first?
-
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.
A nurse is performing a medication reconciliation while admitting an older adult client transferred from a long-term care facility. Which of the following should the nurse identify as part of the medication reconciliation process?
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Discontinuation of medications
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Recommendation for prescribed medications
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Medications from another facility
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Medications from another pharmacy
Explanation
Correct Answer: C. Medications from another facility
Explanation:
Medication reconciliation is the process of comparing a client’s current medication orders with all medications the client has been taking—including those from another facility—to ensure accuracy and prevent errors such as omissions, duplications, or interactions. This step is crucial during transitions of care, such as hospital admission, transfer, or discharge. The nurse must verify all prescribed, over-the-counter, and facility-administered medications before the provider updates or continues the medication list.
The healthcare provider orders Lasix 40 mg IV now. The concentration available is Lasix 20 mg/mL. How many mL will the patient receive?
- A) 5 mL
- B) 6 mL
- C) 4 mL
- D) 2 mL
Explanation
Use the formula:
Ordered dose ÷ Concentration = Volume to administer
40 mg ÷ 20 mg/mL = 2 mL
The patient will receive 2 mL of the IV Lasix solution to get the prescribed 40 mg dose.
Why the other options are incorrect:
A) 5 mL:
5 mL × 20 mg/mL = 100 mg, which is more than ordered.
B) 6 mL:
6 mL × 20 mg/mL = 120 mg, which exceeds the prescribed dose.
C) 4 mL:
4 mL × 20 mg/mL = 80 mg, which is twice the ordered amount.
A nurse is assessing a client's environment. Which of the following client statements indicates that a client is living in a faulty built environment?
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The client reports a lack of community centers in their neighborhood.
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The client reports there are no bike paths or running trails in their community.
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The client reports contaminants in their drinking water at home.
-
The client reports that there is limited public parking on their street.
Explanation
Correct Answer: C. The client reports contaminants in their drinking water at home.
Explanation:
A faulty built environment refers to surroundings that negatively impact health due to structural, chemical, or safety issues—such as contaminated water, poor ventilation, or unsafe housing conditions. Contaminants in drinking water directly indicate an environmental hazard that can cause disease or long-term health problems. The other options relate more to community planning or accessibility issues rather than environmental faults that endanger health or safety within the physical home environment.
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