ATI RN
Introduction to Nursing Quizlet Questions
Question 1 of 5
The nurse prepares to perform light palpation. How is light palpation performed?
Correct Answer: A
Rationale: The correct answer is A: By indenting the skin ½" to ¾" (1.3 to 1.9 cm). Light palpation is performed by gently pressing down on the skin with the fingertips to a depth of ½" to ¾" to assess superficial structures. This depth allows the nurse to feel for tenderness, texture, temperature, and moisture without causing discomfort or disrupting deeper tissues. Choices B, C, and D are incorrect because they describe depths or techniques that are too deep or not appropriate for light palpation, which should be gentle and shallow. Option B (1" to 2") and C (1" using both hands) would be too deep and could potentially cause discomfort to the patient. Option D (1" and then releasing quickly) does not maintain the consistent light pressure needed for accurate assessment of superficial structures.
Question 2 of 5
A client is 2 days post operative. The vital signs are: BP - 120/70, HR - 110, RR - 26, and Temperature - 100.4 degrees Fahrenheit (38 degrees Celsius). The client suddenly becomes profoundly short of breath, skin color is gray. Which assessment would have alerted the nurse first to the client's change in condition?
Correct Answer: B
Rationale: The correct answer is B: Respiratory rate. A sudden change in the client's respiratory rate, especially if the client becomes profoundly short of breath, indicates a critical change in condition such as respiratory distress or failure. This is a priority assessment as it directly relates to the client's oxygenation and respiratory status. In this scenario, the client's increased respiratory rate of 26 breaths per minute, along with the symptoms of profound shortness of breath and gray skin color, indicates potential respiratory compromise. Monitoring the respiratory rate would have alerted the nurse first to the client's deteriorating condition. Summary of other choices: A: Heart rate - Although an elevated heart rate of 110 bpm is present, it is less indicative of respiratory distress compared to the respiratory rate in this situation. C: Blood pressure - The blood pressure of 120/70 is within normal range and may not be the first indicator of respiratory distress. D: Temperature - A temperature of 100.4 degrees Fahrenheit is slightly
Question 3 of 5
When teaching suicide prevention to the parents of a 15 year-old who recently attempted suicide, the nurse describes the following behavioral cue:
Correct Answer: C
Rationale: The correct answer is C: Giving away valued personal items. This is a critical behavioral cue for suicide risk as it indicates a potential desire to say goodbye or tie up loose ends before attempting suicide. It is a warning sign that should be taken seriously and addressed promptly. Choices A, B, and D are not directly related to suicide risk assessment and do not specifically indicate imminent danger. Angry outbursts, fear of being alone, and experiencing a loss are important considerations in mental health but do not directly signal an immediate risk of suicide.
Question 4 of 5
When administering oxygen with a partial rebreather mask, which of the following observations is most important to report to the respiratory therapy departments?
Correct Answer: B
Rationale: The correct answer is B: The reservoir bag collapses during inspiration. This is important to report because it indicates inadequate oxygen delivery to the patient, potentially leading to hypoxemia. The reservoir bag should remain inflated to ensure a sufficient oxygen supply. A: Moisture accumulation inside the mask is common and not a cause for concern unless excessive. C: The mask covering the mouth and nose is expected and does not impact oxygen delivery. D: The strap being snug ensures a proper fit but does not directly impact oxygen delivery. In summary, choice B is the correct answer as it directly relates to the effectiveness of oxygen delivery, while the other choices are not as critical in this context.
Question 5 of 5
The ability of an individual to cope with death is dependent upon a number of factors. Which person likely has the most difficulty coping with a death?
Correct Answer: A
Rationale: The correct answer is A because losing a child is considered one of the most devastating experiences a person can face, regardless of the circumstances. The sudden death of a young person on the brink of adulthood adds layers of complexity and emotional pain. The loss of potential, unfulfilled dreams, and the traumatic nature of the accident all contribute to the intense grief and difficulty in coping. Choice B is incorrect because while the child may experience grief and confusion, the emotional impact is typically less compared to losing a child. Choice C is incorrect as the relationship with the alcoholic spouse may have been strained due to addiction, potentially lessening the emotional attachment. Choice D is incorrect as the grandparent may experience grief over the loss of their grandchild, but the intensity is generally lower than losing a child directly.