ATI RN
Client Safety in Nursing Questions
Question 1 of 5
In most ethical dilemmas in health care, the solution to the dilemma requires negotiation among members of the health care team. Why is the nurse's point of view valuable?
Correct Answer: C
Rationale: The correct answer is C because nurses develop a unique relationship with the patient, which allows them to provide valuable insights into the patient's preferences, values, and needs. This relationship enables nurses to advocate effectively for the patient's best interests and ensure that the patient's voice is heard in ethical discussions. Choice A is incorrect because understanding the principle of autonomy is not unique to nurses and does not necessarily make their point of view more valuable in ethical dilemmas. Choice B is also incorrect as the scope of practice does not inherently make the nurse's point of view more valuable in ethical discussions; it simply defines the tasks they are allowed to perform. Choice D is incorrect because while the nurse's code of ethics may recommend their presence at ethical discussions, it does not inherently make their point of view more valuable than other healthcare team members.
Question 2 of 5
What is a key strategy in preventing ventilator-associated pneumonia (VAP) in patients with ARDS?
Correct Answer: B
Rationale: The correct answer is B: Frequent oral care with chlorhexidine. This is key in preventing VAP by reducing bacterial colonization in the oral cavity, decreasing the risk of aspiration. Nasopharyngeal suctioning (A) can irritate the airway and increase the risk of infection. Administering prophylactic antibiotics (C) can lead to antibiotic resistance. Increasing tidal volumes (D) can worsen lung injury in ARDS patients. Overall, maintaining good oral hygiene is crucial in preventing VAP in patients with ARDS.
Question 3 of 5
A patient with hypercapnic respiratory failure has a respiratory rate of 8 and an SpO2 of 89%. The patient is increasingly lethargic. Which collaborative intervention will the nurse anticipate?
Correct Answer: B
Rationale: The correct answer is B: Endotracheal intubation and positive pressure ventilation. In hypercapnic respiratory failure, the patient's respiratory rate is low, indicating inadequate ventilation. The SpO2 of 89% and increasing lethargy suggest severe hypoxemia and impending respiratory failure. Endotracheal intubation allows for mechanical ventilation to improve oxygenation and ventilation. Positive pressure ventilation can help improve gas exchange and prevent further deterioration. A: Administration of 100% oxygen by non-rebreather mask would not address the underlying issue of inadequate ventilation in hypercapnic respiratory failure. C: Insertion of a mini-tracheostomy with frequent suctioning is not the initial intervention for managing hypercapnic respiratory failure. D: Initiation of bilevel positive pressure ventilation (BiPAP) may not be sufficient for this patient with impending respiratory failure; endotracheal intubation provides better control over ventilation and oxygenation.
Question 4 of 5
A patient with acute respiratory distress syndrome (ARDS) has progressed to the fibrotic phase. The patient's family members are anxious about the patient's condition and are continuously present at the hospital. In addressing the family's concerns, it is important for the nurse to
Correct Answer: A
Rationale: The correct answer is A because in the fibrotic phase of ARDS, the chance of survival is poor. Supporting the family and helping them understand this realistic expectation is crucial for their emotional preparation. Choice B is incorrect because maintaining mechanical ventilation at home post-discharge is not feasible. Choice C is incorrect as transferring the patient to a long-term care facility may not be appropriate at this stage. Choice D is incorrect because stating that the disease process has started to resolve is inaccurate in the fibrotic phase.
Question 5 of 5
A patient with acute respiratory distress syndrome (ARDS) is receiving oxygen by a nonrebreather mask, but arterial blood gas measurements still show poor oxygenation. As the nurse responsible for this patient's care, you would anticipate a physician order for what action?
Correct Answer: A
Rationale: The correct answer is A: Perform endotracheal intubation and initiate mechanical ventilation. In ARDS, nonrebreather mask may not provide adequate oxygenation due to severe lung damage. Intubation and mechanical ventilation can provide higher levels of oxygen and positive end-expiratory pressure to improve oxygenation. CPAP (choice B) may not be sufficient for severe cases of ARDS. Administering furosemide (Lasix) (choice C) is not appropriate for poor oxygenation in ARDS. Calling a code for respiratory arrest (choice D) is premature and not indicated unless the patient's condition deteriorates to that extent.