ATI 250 Midpoint Assessment

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Sample questions from ATI 250 Midpoint Assessment

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical-surgical unit, the nurse receives report on four clients. Which client should the nurse assess first?

   • A.A 72-year-old client with heart failure who has bilateral ankle edema and is due for a morning weight
   • B.A 39-year-old client scheduled for discharge who needs reinforcement about a low-sodium diet
   • C.A 45-year-old client with pancreatitis reporting abdominal pain of 8 on a scale of 0 to 10 despite prescribed analgesia
   • D.A 68-year-old client with pneumonia whose SpO2 decreased from 94% to 88% on 2 L/min oxygen and who is newly restless

   Rationale: The client with pneumonia has new hypoxemia and restlessness, which can indicate worsening oxygenation and require immediate assessment and intervention. Uncontrolled pain requires timely follow-up, but the other client's acute respiratory change takes priority. Edema and a due weight are important ongoing heart-failure assessments but do not indicate an immediate change in stability. Discharge teaching can be completed after urgent needs are addressed.

2. 2.During a home visit, a 74-year-old client with limited mobility says, "I have not been able to pick up my new prescriptions." The client has two days of medication remaining and reports no acute symptoms. Which action should the nurse take first?

   • A.Assess the client's medication list, access barriers, and available support for obtaining the prescriptions
   • B.Call the prescriber and request that all medications be discontinued until the client can obtain them
   • C.Tell the client to double the next dose after the prescriptions are picked up
   • D.Document the client's statement and plan to discuss it at the next scheduled visit

   Rationale: The nurse should first clarify which medications are involved and assess the reason the client cannot obtain them so that a safe, individualized plan can be coordinated. Discontinuing all medications without a prescriber's direction is unsafe. Doubling doses can cause toxicity and is not an appropriate response to missed medication. Waiting until the next visit risks an avoidable interruption in therapy.

3. 3.Refer to the client's chart. Which actions should the nurse take now to address the client's change in condition? Select all that apply.

   • A.Activate the facility's rapid response process because the client's condition is deteriorating
   • B.Immediately assess the client's airway, breathing, circulation, and current mental status
   • C.Ask the nursing assistant to assess the client's neurologic status and report back in 30 minutes
   • D.Recheck the blood glucose and report the critical value to the provider while initiating the prescribed hypoglycemia protocol
   • E.Wait for the next scheduled vital signs before escalating care because the client is already receiving oxygen

   Rationale: The chart shows an acute decline: the client is newly difficult to arouse, the respiratory rate has fallen from 20 to 10/min, SpO2 has fallen from 96% to 89% despite oxygen, and glucose is 54 mg/dL. The nurse should immediately assess the client, activate the rapid response process for deterioration, and address and report the low glucose according to the prescribed protocol. Waiting for routine observations delays escalation despite worsening findings. A nursing assistant cannot assess neurologic status or replace the nurse's immediate evaluation.

4. 4.In a pediatric clinic, a 6-year-old client with fever and a new widespread rash is scheduled to be seen in a shared waiting area. Which action should the nurse take first?

   • A.Provide a routine appointment card and advise the family to return if the rash worsens
   • B.Place the client in a separate room and initiate appropriate precautions while notifying the provider
   • C.Ask the family to wait in the lobby until an examination room becomes available
   • D.Collect a throat culture in the waiting area before moving the client

   Answer and rationale are in the full material.

5. 5.A provider prescribes an intravenous medication for a 52-year-old client. Before administration, the nurse notes that the prescribed dose is ten times higher than the dose listed in the medication reference. Which action should the nurse take?

   • A.Administer the dose because the provider's prescription takes precedence over a reference
   • B.Reduce the dose to the amount in the reference and document the change
   • C.Hold the medication and clarify the prescription with the prescriber before administration
   • D.Ask another nurse to administer the medication so the responsibility is shared

   Answer and rationale are in the full material.