ATI RN
Introduction to Nursing 203 Quizlet Questions
Question 1 of 5
The home health nurse is visiting a patient with chronic obstructive pulmonary disease (COPD). Which nursing action is appropriate to implement for a patient who has an impaired breathing pattern due to anxiety?
Correct Answer: B
Rationale: The correct answer is B: Teach the patient how to use the pursed-lip technique. This is because the pursed-lip technique helps improve breathing efficiency and reduce anxiety-related hyperventilation in COPD patients. By prolonging exhalation, it promotes better gas exchange and decreases respiratory rate, ultimately easing breathing difficulties. A: Titrating O2 is important in COPD patients, but in this case, addressing the anxiety-induced breathing pattern is more immediate. C: Discussing diet is important for overall health in COPD, but it doesn't directly address the breathing pattern due to anxiety. D: Using sedative medications can be harmful, as it may depress the respiratory drive further in COPD patients.
Question 2 of 5
A young adult patient with cystic fibrosis (CF) is admitted to the hospital with increased dyspnea. Which intervention should the nurse include in the plan of care?
Correct Answer: D
Rationale: The correct answer is D: Perform chest physiotherapy every 4 hours. In CF patients, mucus buildup in the lungs can lead to respiratory distress. Chest physiotherapy helps loosen and clear the mucus, improving breathing. This intervention is essential in managing respiratory symptoms in CF patients. A: Schedule a sweat chloride test - This test is used to diagnose CF but is not an immediate intervention for a patient experiencing increased dyspnea. B: Arrange for a hospice nurse visit - Hospice care is not appropriate for a young adult with CF experiencing increased dyspnea unless the patient is in end-of-life care. C: Place the patient on a low-sodium diet - While nutrition is important in CF management, a low-sodium diet is not the priority when a patient is struggling to breathe.
Question 3 of 5
The nurse teaching a group of adults about cancer warning signs presents to the group a list of the seven possible warning signs of cancer that is used by the American Cancer Society. What should this list NOT include?
Correct Answer: A
Rationale: The correct answer is A: Areas of alopecia. This is because alopecia, which refers to hair loss, is not typically recognized as a common warning sign of cancer according to the American Cancer Society. The other choices (B, C, D) are commonly known warning signs of cancer such as sores that do not heal, nagging cough or hoarseness, and indigestion or difficulty swallowing, respectively. It is important for the nurse to provide accurate and relevant information to the group in order to educate them effectively on cancer warning signs.
Question 4 of 5
A patient with chronic heart failure who is taking a diuretic and an angiotensin-converting enzyme (ACE) inhibitor and who is on a low-sodium diet tells the home health nurse about a 5-Ib weight gain in the past 3 days. What is the nurse's priority action?
Correct Answer: B
Rationale: The correct answer is B: Assess the patient for manifestations of acute heart failure. In this scenario, the patient's sudden weight gain could indicate fluid retention, a common sign of acute heart failure exacerbation. Assessing the patient for other symptoms such as shortness of breath, increased fatigue, or edema can help determine if the patient's condition is worsening. This immediate assessment is crucial for prompt intervention to prevent further complications. Choices A, C, and D are incorrect as they do not address the urgency of the situation. Teaching about sodium restriction is important but not the priority in this acute situation. Asking about medication use and dietary intake can wait until the immediate concern of acute heart failure exacerbation is addressed.
Question 5 of 5
The nurse is performing an assessment on a patient brought to the emergency department for treatment for dehydration. The nurse assesses a respiratory rate of 26 breaths/minute, a heart rate of 110 beats/minute, a blood pressure of 86/50 mm Hg, and a temperature of 39.5 C. The patient becomes dizzy when transferred from the wheelchair to a bed. The nurse notes cool, clammy skin. Which diagnosis does the nurse suspect?
Correct Answer: A
Rationale: The correct diagnosis is A: Fluid volume deficit (FVD). The patient's vital signs and symptoms indicate hypovolemia. A respiratory rate of 26 breaths/minute, heart rate of 110 beats/minute, low blood pressure, high temperature, dizziness upon position change, and cool, clammy skin are all indicative of FVD. The increased respiratory and heart rates are compensatory mechanisms to maintain oxygen delivery in response to decreased circulating volume. The low blood pressure and cool, clammy skin suggest poor perfusion due to decreased fluid volume. These findings align with the clinical presentation of dehydration. Summary of other choices: B: Fluid volume excess (FVE) - Contradicted by the patient's low blood pressure, cool, clammy skin, and symptoms of dehydration. C: Mild extracellular fluid (ECF) deficit - Symptoms and vital signs are indicative of severe rather than mild fluid deficit. D: Renal failure - Not supported by the information provided;