ATI RN
Client Safety Alternatives to Restraints Quizlet Questions
Question 1 of 5
In qualitative research, a guiding principle in deciding sample size is:
Correct Answer: C
Rationale: The correct answer is C: Data saturation. In qualitative research, data saturation is the point where new data no longer brings additional insights or changes in themes. This principle guides sample size determination as it ensures enough data is collected to reach this saturation point, leading to a comprehensive understanding of the phenomenon under study. Effect size (
A) is more relevant in quantitative research, while the number of variables (
B) and sub-group analysis (
D) are factors that may influence the complexity of the study but are not directly related to determining sample size in qualitative research.
Question 2 of 5
First defense against infection
Correct Answer: B
Rationale: The correct answer is B: Intact skin. Intact skin acts as the first defense against infection by forming a physical barrier that prevents pathogens from entering the body. It is composed of multiple layers, including the epidermis and dermis, which provide protection against microbes. Skin also produces antimicrobial substances and has immune cells that can defend against pathogens. A: Skin is not specific enough, as damaged skin may not provide effective protection. C and D are incomplete answers and do not accurately describe the primary role of intact skin in defending against infections.
Question 3 of 5
After prolonged cardiopulmonary bypass, a patient develops increasing shortness of breath and hypoxemia. To determine whether the patient has acute respiratory distress syndrome (ARDS) or pulmonary edema caused by left ventricular failure, the nurse will anticipate assisting with
Correct Answer: D
Rationale: The correct answer is D, inserting a pulmonary artery catheter. This is the most appropriate action to differentiate between ARDS and pulmonary edema caused by left ventricular failure. The pulmonary artery catheter can provide valuable information such as pulmonary artery pressure, pulmonary capillary wedge pressure, and cardiac output. In ARDS, the pulmonary artery pressure and pulmonary capillary wedge pressure are typically low, whereas in pulmonary edema due to left ventricular failure, these pressures are elevated.
Positioning the patient for a chest radiograph (
A) would provide anatomical information but not differentiate between ARDS and pulmonary edema. Drawing blood for arterial blood gases (
B) can provide information on oxygenation but may not be sufficient to differentiate between the two conditions. Obtaining a ventilation-perfusion scan (
C) is not typically used to differentiate between ARDS and pulmonary edema.
Question 4 of 5
Maintenance of fluid balance in the patient with ARDS involves
Correct Answer: C
Rationale:
Step-by-step rationale for choice C being correct:
1. ARDS patients have increased capillary permeability leading to fluid leakage into the lungs.
2. Mild fluid restriction helps prevent fluid overload and pulmonary edema.
3. Diuretics help manage any excess fluid accumulation.
4. Hydration using colloids (choice
A) can exacerbate fluid overload.
5. Surfactant (choice
B) is used in neonatal respiratory distress syndrome, not ARDS.
6. Keeping hemoglobin level >12 g/dL (choice
D) is unrelated to fluid balance in ARDS.
Question 5 of 5
A nurse on an obstetrics-gynecology unit is planning care for four clients after receiving change of shift report. Which of the following clients should the nurse assess first?
Correct Answer: D
Rationale: The correct answer is D because an ectopic pregnancy is a medical emergency that requires immediate assessment and intervention to prevent life-threatening complications. The nurse should prioritize assessing this client first to monitor for signs of rupture, such as severe abdominal pain and hypovolemic shock.
Choice A is incorrect because although the client had a late term miscarriage, it is not an immediate emergency compared to an ectopic pregnancy.
Choice B is incorrect as a bilateral tubal ligation is a routine surgical procedure with a lower risk of complications compared to an ectopic pregnancy.
Choice C is incorrect as mastitis, while uncomfortable, is not as urgent as an ectopic pregnancy that requires immediate attention.
In summary, the nurse should prioritize assessing the client admitted for an ectopic pregnancy first due to the potential life-threatening nature of the condition.