ATI NU 160 Final Exam Spring 2025

ATI NU 160 Final Exam Spring 2025

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Free ATI NU 160 Final Exam Spring 2025 Questions

1.

A nurse is caring for a school-age child who has a systemic disorder and is receiving antibiotics, immunosuppressants, and corticosteroids. Both of the child’s parents have a smoking history. The child reports soreness in his mouth and refuses to eat. Inspection of his mouth reveals a white, milky plaque that does not come off with rubbing. The nurse should suspect which of the following conditions

  • Dermatitis

  • Herpes simplex

  • Squamous cell carcinoma

  • Candidiasis

Explanation

Correct Answer D: Candidiasis

Explanation:

 Oral candidiasis (thrush) is a fungal infection caused by Candida albicans. It is common in immunosuppressed individuals, including those on corticosteroids, antibiotics, or chemotherapy. The defining characteristic is white, milky plaques in the mouth that do not scrape off easily. It can cause pain, difficulty eating, and a burning sensation.

Why Other Options are Wrong:

A. Dermatitis:

 Dermatitis affects the skin, not the mucous membranes of the mouth. It would not present with oral plaques or interfere with eating.

B. Herpes simplex:

 Herpes simplex causes painful vesicles that rupture and form ulcers, not white plaques. The lesions are typically localized to lips and oral mucosa but appear red and ulcerated, not milky and stuck.

C. Squamous cell carcinoma:

 Oral squamous cell carcinoma may present as non-healing sores, lesions, or lumps, but not as diffuse white plaques that resist removal. It is more common in older adults with tobacco use histories.


2.

A nurse is caring for a client admitted for renal calculus. Which of the following assessment findings should the nurse associate with renal calculi

  • Incontinence

  • Fever

  • Urinary urgency

  • Flank pain

  • Gastrointestinal upset

Explanation

Correct Answer:

B. Fever

C. Urinary urgency

D. Flank pain

 E. Gastrointestinal upset


Explanation:

 Renal calculi (kidney stones) typically cause:

Flank pain due to obstruction of the ureter or renal pelvis.

Urinary urgency when the stone irritates the lower urinary tract or causes partial obstruction.

Fever may develop if there's a secondary infection, like pyelonephritis.

Gastrointestinal upset such as nausea and vomiting is common due to visceral pain pathways shared between the GI and urinary systems.

Why Other Options are Wrong:

Incontinence

Incontinence is not typically associated with renal calculi. It is more commonly seen in neurologic disorders, bladder dysfunction, or prostate-related issues, not kidney stones.


3.

A nurse is providing teaching to a client who has long-term symptoms of GERD (gastroesophageal reflux disease). Which of the following statements should the nurse include in the educational materials

  • It is important to watch for manifestations of pancreatic cancer.

  • Follow-up with an endocrinologist as your risks for diabetes increases.

  • You will need to monitor for manifestations of liver issues.

  • It is important to follow up with a GI specialist for recommended surveillance for Barrett’s esophagus

Explanation

Correct Answer D: It is important to follow up with a GI specialist for recommended surveillance for Barrett’s esophagus.

Explanation:

 Long-term GERD can lead to Barrett’s esophagus, a condition where the normal esophageal lining changes to resemble intestinal tissue due to chronic acid exposure. This is a precancerous condition that requires regular monitoring via endoscopy to detect dysplasia or early esophageal cancer.

Why Other Options are Wrong:

A. It is important to watch for manifestations of pancreatic cancer.

 GERD is not directly associated with pancreatic cancer. There's no routine recommendation to monitor for this in GERD patients.

B. Follow-up with an endocrinologist as your risks for diabetes increases.

 GERD is not a risk factor for diabetes, and endocrinology referral is not relevant in this context.

C. You will need to monitor for manifestations of liver issues.

 Liver issues are not directly linked to GERD. This advice would be misleading in this context.


4.

 A nurse is assessing a client who has type 1 diabetes mellitus and has a blood glucose level of 550 mg/dL. Which of the following should the nurse assess the client for if diabetic ketoacidosis (DKA) is suspected

  • Mental status changes

  • Dizziness

  • Nervousness

  • Cool, clammy skin

Explanation

Correct Answer A: Mental status changes

Explanation:

 Mental status changes, such as confusion or decreased alertness, are a hallmark of severe DKA due to the effects of hyperglycemia and metabolic acidosis on the brain. Elevated ketone levels and dehydration can lead to cerebral edema and altered consciousness. This is a critical finding that suggests worsening DKA and requires urgent intervention.

Why Other Options are Wrong:

B. Dizziness:

 While dizziness may occur in many conditions, it is non-specific and not one of the key diagnostic signs of DKA. It may be present in dehydration, but mental status changes take clinical priority and are more definitive in DKA assessment.

C. Nervousness:

 This symptom is more commonly associated with hypoglycemia, not DKA. Clients with low blood sugar often feel jittery or anxious, which contrasts with the mental dulling or confusion of hyperglycemic crises like DKA.

D. Cool, clammy skin:

 This is a sign of hypoglycemia, not hyperglycemia. DKA is more often associated with dry, warm skin due to dehydration. Cool and clammy skin would not be expected in this hyperglycemic state.


5.

A nurse is caring for a client who has an open fracture of the ulna. Which of the following is a primary concern the nurse should be alert for

  • Compartment syndrome

  • Poor bone remodeling

  • Fat embolism

  • Potential for infection

Explanation

Correct Answer D: Potential for infection

Explanation:

 An open (or compound) fracture breaks through the skin, exposing the bone and internal tissues to the external environment. This significantly increases the risk of infection due to potential contamination. Infection is the primary and immediate concern following an open fracture, requiring strict aseptic wound care and usually prophylactic antibiotics.

Why Other Options are Wrong:

A. Compartment syndrome

Although this is a serious complication of fractures, it is more common in closed fractures or those with severe swelling. It is not the most immediate concern in an open fracture where skin release reduces pressure.

B. Poor bone remodeling

This is a long-term concern in fracture healing but not an immediate priority like infection in the case of an open fracture.

C. Fat embolism

 Fat embolism is a risk in long bone fractures, especially femur or pelvis, and while it’s serious, infection takes precedence in open fractures.


6.

A nurse in the emergency department is caring for a client who appears shaky, pale, clammy, and is tachycardic. The client states, “I think I’m having an anxiety attack and need some medication.” Which of the following is an appropriate action for the nurse to take

  • Activate the Rapid Response Team

  • Administer an anti-anxiety medication

  • Establish IV access

  • Check a fingerstick blood glucose level

Explanation

Correct Answer D: Check a fingerstick blood glucose level

Explanation:

 The client's symptoms (shakiness, pallor, clammy skin, tachycardia) could indicate hypoglycemia, which can mimic or be mistaken for an anxiety attack. It's essential to rule out hypoglycemia before proceeding with any other interventions. A quick fingerstick blood glucose check is noninvasive and can guide immediate treatment.

Why Other Options are Wrong:

A. Activate the Rapid Response Team:

 This is reserved for critical, rapidly deteriorating patients. While concerning, these symptoms do not yet meet the threshold without further assessment.

B. Administer an anti-anxiety medication:

 Giving medication before confirming the diagnosis could worsen hypoglycemia if present. Always rule out medical causes before attributing symptoms to anxiety.

C. Establish IV access:

 While it may be needed later, assessing the blood glucose level is faster and more appropriate for guiding immediate action.


7.

 A nurse is caring for a client who has chronic respiratory acidosis due to chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect with this client

  • Anxiety and depression

  • Polyuria

  • Delirium

  • Osteoporosis

Explanation

Correct Answer C: Delirium

Explanation:

 Chronic respiratory acidosis causes elevated carbon dioxide (CO₂) levels in the blood, leading to changes in mental status. As CO₂ builds up, it can affect brain function, resulting in confusion, restlessness, and eventually delirium. This is a hallmark symptom of severe, untreated or poorly managed respiratory acidosis.

Why Other Options are Wrong:

A. Anxiety and depression:

 While clients with chronic illnesses may experience emotional disturbances, these are not specific clinical manifestations of respiratory acidosis. Delirium is a more acute and direct indicator of CO₂ retention.

B. Polyuria:

 Polyuria is not associated with respiratory acidosis or COPD. It is more commonly linked to diabetes mellitus, diuretic use, or disorders of fluid regulation, not acid-base imbalances.

D. Osteoporosis:

 Osteoporosis is not a direct outcome of COPD or respiratory acidosis. It may occur due to long-term corticosteroid use in some COPD patients, but it is not a symptom or expected finding of acidosis itself.


8.

A nurse is teaching the partner of a client who had an acute myocardial infarction (MI) about the reason blood was drawn from the client. Which of the following statements should the nurse make regarding cardiac enzyme studies

  • These tests help determine the degree of damage to the heart tissues.

  • Cardiac enzymes will identify the location of the MI

  • Cardiac enzymes assist in diagnosing the presence of pulmonary congestion.

  • These tests will enable the provider to determine the heart structure and mobility of the heart valves

Explanation

Correct Answer A: These tests help determine the degree of damage to the heart tissues.

Explanation:

Cardiac enzyme tests (such as troponin, CK-MB, and myoglobin) are used to detect myocardial cell injury. Elevated enzyme levels confirm that heart muscle damage has occurred and help estimate the severity and timing of the infarction.

Why Other Options are Wrong:

B. Cardiac enzymes will identify the location of the MI.

Cardiac enzymes indicate that an MI has occurred but do not specify its anatomical location. An ECG or imaging studies are needed to determine the specific site of the infarction.

C. Cardiac enzymes assist in diagnosing the presence of pulmonary congestion.

Pulmonary congestion is a symptom of heart failure or fluid overload and is typically evaluated through chest x-rays, physical examination, and BNP levels—not cardiac enzyme levels.

D. These tests will enable the provider to determine the heart structure and mobility of the heart valves.

This is the role of echocardiography or other imaging studies, not cardiac enzyme tests. Enzymes reflect function and damage, not structure or valve movement.


9.

A client who has a history of myocardial infarction (MI) is prescribed aspirin 325 mg. The nurse recognizes that the aspirin is given due to which of the following actions of the medication

  • Antiplatelet aggregate

  • Antipyretic

  • Anti-inflammatory

  • Analgesic

Explanation

Correct Answer A: Antiplatelet aggregate

Explanation:

 Aspirin is given in the context of myocardial infarction (MI) for its antiplatelet effect. It inhibits the formation of thromboxane A2, which reduces platelet aggregation. This action helps prevent the formation of blood clots, which is critical in reducing the risk of recurrent MI and promoting blood flow in coronary arteries.

Why Other Options are Wrong:

B. Antipyretic

While aspirin does reduce fever, this property is not the reason it is used in the treatment or prevention of MI.

C. Anti-inflammatory

 Aspirin has anti-inflammatory properties at higher doses, but in the case of MI, the dose prescribed (often 81–325 mg) is specifically for its cardioprotective antiplatelet action, not inflammation.

D. Analgesic

Although aspirin can reduce pain, this is not its primary purpose in the treatment of MI. Other medications are typically used for pain control in that setting.


10.

 A nurse is caring for a client who came to the emergency department reporting chest pain. The provider suspects a myocardial infarction. While waiting for the troponin levels report, the client asks what this blood test will show. Which of the following explanations should the nurse provide the client

  • Troponin is an enzyme that indicates damage to brain, heart, and skeletal muscle tissues

  • Troponin is a heart muscle protein that appears in the bloodstream when there is damage to the heart.

  • Troponin is a lipid whose levels reflect the risk for coronary artery disease.

  • Troponin is a protein that helps transport oxygen throughout the body.

Explanation

Correct Answer B: Troponin is a heart muscle protein that appears in the bloodstream when there is damage to the heart.

Explanation:

 Troponin is a cardiac biomarker that is highly specific to myocardial injury. When cardiac muscle cells are damaged, as in a myocardial infarction, troponin is released into the bloodstream. Elevated levels can confirm a diagnosis of heart attack and help guide treatment decisions.

Why Other Options are Wrong:

A. Troponin is an enzyme that indicates damage to brain, heart, and skeletal muscle tissues:

 Troponin is not an enzyme; it is a protein, and it is specific to cardiac muscle (with cardiac-specific isoforms like Troponin I and T). It is not a general indicator for brain or skeletal muscle damage.

C. Troponin is a lipid whose levels reflect the risk for coronary artery disease:

 Lipids such as LDL and HDL reflect risk for coronary artery disease. Troponin is not a lipid—it is a protein used to detect actual myocardial damage, not just risk.

D. Troponin is a protein that helps transport oxygen throughout the body:

 This describes hemoglobin, not troponin. Troponin plays a role in muscle contraction in cardiac tissue but does not have any oxygen transport function.


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