ATI RN
Chapter 1 Introduction to Nursing Quizlet Questions
Question 1 of 5
In a client with long-term emphysema, the nurse might expect to see which condition when inspecting the nails?
Correct Answer: B
Rationale: The correct answer is B: Clubbing. In a client with long-term emphysema, clubbing of the nails may be present due to chronic hypoxia. Clubbing is characterized by an enlargement of the fingertips and a loss of the normal angle between the nail and the nail bed. This occurs as a result of chronic oxygen deprivation. The other choices are incorrect because: A) A rapid blanch test is not relevant to nail inspection in emphysema; C) Koilonychia is associated with iron deficiency anemia, not emphysema; D) Paronychia is an infection of the nail fold, which is not directly related to emphysema.
Question 2 of 5
Constipation is one of the most frequent complaints of elders. When assessing this problem, which action should be the nurse's priority?
Correct Answer: B
Rationale: The correct answer is B: Obtain a health and dietary history. This is the priority action because it helps identify potential causes of constipation such as inadequate fiber intake, dehydration, medications, or underlying health conditions. It guides appropriate interventions. Choice A (Obtain a complete blood count) is not the priority as it does not directly address the cause of constipation. Choice C (Refer to a provider for a physical examination) may be necessary but not the initial priority. Choice D (Measure height and weight) is not relevant to assessing constipation in elders.
Question 3 of 5
A negative peripheral pulse post cardiac catheterization indicates:
Correct Answer: A
Rationale: The correct answer is A: Clot formation on the femoral artery. A negative peripheral pulse post cardiac catheterization suggests impaired blood flow due to a clot in the femoral artery, affecting pulse palpation. Decreased oxygen on the foot (B) would not directly cause a negative pulse. Blood clots on the heart (C) would not be detected through a peripheral pulse assessment. Impending hemorrhage (D) would typically present with different signs such as hypotension or tachycardia, not a negative peripheral pulse.
Question 4 of 5
To properly perform the endotracheal insertion, the nurse:
Correct Answer: B
Rationale: Step-by-step rationale for choice B: 1. Inserting the catheter until coughing or resistance is felt ensures proper placement without causing trauma. 2. This technique helps clear secretions effectively without causing damage to the airway. 3. It allows the nurse to gauge the depth of insertion based on the patient's response. 4. Stopping at coughing or resistance prevents going too far and potentially damaging the airway. Summary: A: Turning on wall suction to 180 mmHg is incorrect as it can cause trauma to the airway. C: Withdrawing the catheter while continuously suctioning is incorrect as it can lead to hypoxia. D: Reentering the tracheostomy after suctioning the mouth is incorrect as it can introduce pathogens to the airway.
Question 5 of 5
This refers to the stiffening of the body that occurs 2–4 hours after death.
Correct Answer: B
Rationale: Rigor mortis is the correct answer as it refers to the stiffening of the body post-death, typically occurring 2-4 hours after death. This process is due to the chemical changes in the muscles, causing them to become rigid. Algor mortis refers to the cooling of the body after death. Livor mortis is the pooling of blood in the lower parts of the body post-death. Manor mortis is not a recognized term in forensic sciences.