ATI RN
Introduction to Nursing Questions
Question 1 of 5
How should oral care be performed on a comatose client?
Correct Answer: C
Rationale: The correct answer is C because placing the comatose client in a side-lying position with the head of the bed lowered helps prevent aspiration and allows oral secretions to drain out. This position also helps in preventing choking and ensures proper airway management. Choice A is incorrect because lemon glycerin can be harmful if aspirated and should not be applied without assessing the client's condition first. Choice B is incorrect because brushing teeth with the client lying supine can increase the risk of aspiration. Choice D is incorrect as hydrogen peroxide is not recommended for oral care in comatose clients due to its potential toxicity if ingested.
Question 2 of 5
What statement indicates the client understands instructions for an occult blood test?
Correct Answer: A
Rationale: The correct answer is A because avoiding all types of meat is crucial for an occult blood test as meat can interfere with the results. Choice B is incorrect because dark-colored foods do not impact the test. Choice C is incorrect as smoking does not affect the test. Choice D is irrelevant as aquamephyton is not related to the test.
Question 3 of 5
Who monitors the activities of each OR suite?
Correct Answer: C
Rationale: The correct answer is C, the circulating nurse. The circulating nurse is responsible for monitoring the activities of each OR suite to ensure the safety and efficiency of the operation. They coordinate the flow of the OR, manage equipment, supplies, and patient safety. The scrub nurse assists the surgeon with instruments and does not have the oversight role. The anesthesiologist focuses on the patient's anesthesia and not the overall OR activities. The surgeon's main role is to perform the surgery, not monitor the suite's activities. Thus, the circulating nurse is the correct choice for monitoring OR activities.
Question 4 of 5
How is 6mm of skin indentation described in terms of edema?
Correct Answer: D
Rationale: The correct answer is D (4+). In terms of edema, a 4+ indentation signifies severe pitting edema. This level of indentation indicates that the skin remains indented for a significant period after pressure is applied, suggesting the presence of extensive fluid accumulation in the tissues. Choices A, B, and C are incorrect because they represent lesser degrees of pitting edema, with A being mild (1+), B being moderate (2+), and C being more significant (3+), but still not as severe as 4+. Therefore, the correct choice D is determined by the depth and persistence of the skin indentation, indicating the severity of edema present.
Question 5 of 5
A client had a 1000-mL bag of 5% dextrose in 0.9% sodium chloride hung at 1500. The nurse making rounds at 1545 finds that the client is complaining of a pounding headache and is dyspneic, experiencing chills, and apprehensive, with an increased pulse rate. The intravenous (IV) bag has 400 mL remaining. The nurse should take which action first?
Correct Answer: A
Rationale: The correct action is to slow the IV infusion (choice A) first. The client is exhibiting signs of fluid overload, which can lead to serious complications. Slowing the IV infusion will help decrease the rate of fluid entering the body, alleviating the symptoms. It is important to address this issue promptly to prevent further complications. Sitting the client up in bed (choice B) may help with breathing but does not address the root cause of the symptoms. Removing the IV catheter (choice C) without addressing the fluid overload may not be enough to manage the situation. Calling the primary health care provider (PHCP) (choice D) may cause a delay in addressing the immediate need to slow down the IV infusion.