ATI RN
Multidimensional Basis of Health Protective Behaviors Questions
Question 1 of 5
Nurse Tina prepares a client for peritoneal dialysis. Which of the following actions should the nurse take first?
Correct Answer: B
Rationale: The correct first action is to warm the dialysate solution. This is crucial to prevent hypothermia and abdominal discomfort during the procedure. Warming the solution helps maintain the client's body temperature. Assessing for a bruit and a thrill (choice A) is important but not the first step. Positioning the client on the left side (choice C) is needed during the procedure but not the initial step. Inserting a Foley catheter (choice D) is not necessary for peritoneal dialysis.
Question 2 of 5
The nurse is ware that the most relevant knowledge about oxygen administration to a male client with COPD is
Correct Answer: A
Rationale: The correct answer is A because in COPD patients, administering low flow oxygen at 1-2L/min helps maintain the hypoxic drive for breathing without causing oxygen toxicity. This is crucial as these patients rely on hypoxia to stimulate their respiratory drive due to chronically elevated CO2 levels. Choice B is incorrect because hypercapnia, not hypoxia, stimulates the central chemoreceptors. Choice C is incorrect as a nasal cannula is more appropriate for oxygen administration in COPD patients due to the risk of CO2 retention with a non-rebreathing mask. Choice D is incorrect as pulse oximetry is used to monitor oxygen saturation, not blood gases.
Question 3 of 5
Ricardo is scheduled for a prostatectomy, and the anesthesiologist plans to use a spinal (subarachnoid) block during surgery. In the operating room, the nurse positions the client according to the anesthesiologist's instructions. Why does the client require special positioning for this type of anesthesia?
Correct Answer: C
Rationale: The correct answer is C: To prevent cerebrospinal fluid (CSF) leakage. During a spinal block, the needle is inserted into the subarachnoid space where the cerebrospinal fluid is located. Proper positioning ensures that the needle puncture site is correctly aligned, minimizing the risk of CSF leakage. Preventing CSF leakage is crucial to maintain the effectiveness of the anesthesia and prevent complications such as post-dural puncture headache. Incorrect choices: A: To prevent confusion - Positioning is not related to preventing confusion during anesthesia. B: To prevent seizures - Seizures are not a common concern with spinal blocks and are not prevented by specific positioning. D: To prevent cardiac arrhythmias - Positioning in this case is not directly related to preventing cardiac arrhythmias during a prostatectomy with a spinal block.
Question 4 of 5
A male client has jugular distention. On what position should the nurse place the head of the bed to obtain the most accurate reading of jugular vein distention?
Correct Answer: C
Rationale: The correct answer is C: Raised 30 degrees. Placing the client's head at a 30-degree angle allows gravity to pull the blood down from the head, providing a more accurate reading of jugular vein distention. In a supine position (choice D), the distention may be underestimated. High Fowler's position (choice A) may increase venous return and elevate the jugular vein further. Raising the bed by 10 degrees (choice B) may not provide enough angle for optimal blood flow.
Question 5 of 5
A female client is scheduled to receive a heart valve replacement with a porcine valve. Which of the following types of transplant is this?
Correct Answer: D
Rationale: The correct answer is D: Xenogeneic. A porcine valve is derived from pigs, making it a xenogeneic transplant. Allogeneic (A) refers to transplant between genetically different individuals of the same species. Autologous (B) involves using the patient's own tissue. Syngeneic (C) is transplant between genetically identical individuals, such as identical twins. In this case, since the heart valve is from a different species (pig), the correct term is xenogeneic.