ATI NUR 250 Summer 1 2025 Midpoint Assessment
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Free ATI NUR 250 Summer 1 2025 Midpoint Assessment Questions
Which of the following should the nurse include in the teaching for an adolescent who has type 1 diabetes mellitus
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Obtain an influenza vaccine annually.
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Inject insulin in the deltoid muscle.
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Administer glucagon for hyperglycemia.
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Take glyburide with breakfast.
Explanation
Correct Answer A: Obtain an influenza vaccine annually.
Explanation:
Clients with type 1 diabetes mellitus are at increased risk for complications from infections, including influenza. Annual influenza vaccination is recommended to help prevent illness that could destabilize blood glucose levels or lead to hospitalization. Preventative care is an essential part of diabetes management.
Why the Other Options Are Incorrect:
B. Inject insulin in the deltoid muscle
Insulin is typically administered subcutaneously, not intramuscularly. Preferred sites include the abdomen, thighs, buttocks, and upper arms (not deep into the deltoid muscle).
C. Administer glucagon for hyperglycemia
Glucagon is used to treat severe hypoglycemia, not hyperglycemia. It raises blood glucose levels quickly in emergency situations when the client cannot eat or drink safely.
D. Take glyburide with breakfast
Glyburide is an oral antidiabetic agent used for type 2 diabetes, not type 1. Type 1 diabetes requires insulin therapy because the pancreas does not produce insulin.
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 clients should the nurse assign an acuity level of 1 in the emergency department
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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:
An acuity level of 1 is assigned to clients who are experiencing life-threatening conditions and require immediate intervention. Stroke symptoms are a medical emergency because early intervention is critical to preserve brain function. If symptoms began within 30 minutes, the client may be a candidate for thrombolytic therapy, which must be administered quickly.
Why the Other Options Are Incorrect:
A. A client who has COPD and an oxygen saturation of 93%
Although the client has a chronic condition, an SpO₂ of 93% is within an acceptable range for COPD and does not warrant the highest acuity level.
B. A client who has a cough and a fever of 38.4° C (101.1° F)
This client shows mild respiratory symptoms and is stable, likely qualifying for a lower acuity level, such as 4 or 5.
D. A client who twisted their ankle playing soccer
This is a non-urgent musculoskeletal injury with no indication of life-threatening issues and would receive a lower acuity level, typically 4 or 5.
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.
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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.
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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 should the nurse identify as one of the five rights of delegation
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Right time
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Right documentation
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Right communication
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Right room
Explanation
Correct Answer C: Right communication
Explanation:
The five rights of delegation are:
Right task
Right circumstances
Right person
Right direction/communication
Right supervision/evaluation
Right communication is essential to ensure that the task is clearly explained, including the expected outcome, any specific instructions, and when to report back to the nurse. Clear communication helps prevent errors and ensures safe, effective care.
Why the Other Options Are Incorrect:
A. Right time
This is part of time management in prioritization but is not one of the five rights of delegation.
B. Right documentation
While documentation is important, it is not listed among the five rights of delegation.
D. Right room
This is not relevant to the delegation process and is not part of the five rights.
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 actions should the nurse plan to take when preparing to administer an intramuscular injection to a client
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Use a needle that retracts.
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Recap the needle after administration.
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Dispose of the needle in a wastebasket.
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Break the needle before disposal.
Explanation
Correct Answer A: Use a needle that retracts.
Explanation:
Using a needle that retracts is a safety measure designed to prevent needlestick injuries and protect healthcare workers from bloodborne pathogens. Retractable needles are part of needle safety devices that automatically shield the sharp after use, enhancing overall safety during and after injection procedures.
Why the Other Options Are Incorrect:
B. Recap the needle after administration
Recapping needles is not recommended due to the risk of accidental needlestick injuries. Instead, the needle should be disposed of directly into a sharps container without recapping.
C. Dispose of the needle in a wastebasket
Needles should never be disposed of in a regular wastebasket. They must be placed in a designated puncture-proof sharps container to prevent injury and contamination.
D. Break the needle before disposal
Breaking the needle is unsafe and unnecessary. It increases the risk of injury and exposure to bloodborne pathogens. Safe disposal in a sharps container eliminates the need to break the needle.
Which of the following findings should the nurse identify as a modifiable risk factor for developing a disease
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Genetics
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Family history
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Sunbathing
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Age
Explanation
Correct Answer C: Sunbathing
Explanation:
Sunbathing is a modifiable risk factor because it is a behavior that the client can change. Prolonged sun exposure increases the risk for skin cancer, especially without sun protection. The nurse can educate the client on using sunscreen, wearing protective clothing, and avoiding peak sun hours to reduce this risk.
Why the Other Options Are Incorrect:
A. Genetics
Genetic makeup is non-modifiable. It can influence disease risk, but individuals cannot change their genetic code.
B. Family history
While it provides important information about predisposition to certain diseases, family history is non-modifiable.
D. Age
Age is a non-modifiable factor. Disease risk can increase with age, but it is not something the client can control.
Which of the following statements by the mother of a 7-year-old child with an upper respiratory infection and type 1 diabetes mellitus indicates a need for further instruction
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I will notify the doctor if her temperature is not controlled with acetaminophen.
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I will report a change in her breathing or any signs of confusion
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I will encourage her to drink half a cup of water or sugar-free fluids every 30 minutes.
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I will continue to check his blood sugar two times every day
Explanation
Correct Answer D: I will continue to check his blood sugar two times every day.
Explanation:
During illness, children with type 1 diabetes are at risk for developing complications such as diabetic ketoacidosis (DKA). Blood glucose should be checked more frequently than usual, typically every 3 to 4 hours, not just twice per day. More frequent monitoring helps identify hyperglycemia or hypoglycemia early and allows for timely interventions. This statement shows a misunderstanding of sick day management and requires further instruction.
Why the Other Options Are Incorrect:
A. I will notify the doctor if her temperature is not controlled with acetaminophen.
This is an appropriate response. Persistent fever may indicate worsening infection or dehydration, which requires medical attention.
B. I will report a change in her breathing or any signs of confusion.
This is correct. Changes in breathing or mental status can indicate serious complications such as DKA or hypoxia and should be reported immediately.
C. I will encourage her to drink half a cup of water or sugar-free fluids every 30 minutes.
This is appropriate. Maintaining hydration is essential during illness to prevent dehydration and help manage blood glucose levels.
Which of the following actions should the nurse take while caring for a client who is experiencing a seizure
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Place a towel under the client's head.
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Place the client in the prone position
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Hold the client's arms and legs still.
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Leave the client to get help.
Explanation
Correct Answer A: Place a towel under the client's head.
Explanation:
Placing a towel or soft object under the client’s head helps prevent head injury during a seizure. It is a safe and appropriate action that protects the client while allowing the seizure to occur without restraint. The nurse should stay with the client, ensure a safe environment, and turn the client to the side if possible to maintain airway patency after the seizure.
Why the Other Options Are Incorrect:
B. Place the client in the prone position
The prone position is not recommended during a seizure because it can compromise airway and breathing. The lateral (side-lying) position is preferred once the seizure ends to reduce the risk of aspiration.
C. Hold the client's arms and legs still
Forcibly holding the client can cause musculoskeletal injury. Seizure movements should not be restrained.
D. Leave the client to get help
The nurse should never leave the client alone during a seizure. Help should be summoned by calling out or using the call system while remaining with and protecting the client.
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