ATI RN
Client Safety Nursing Questions
Question 1 of 5
Which intervention takes priority for the client receiving hospice care?
Correct Answer: D
Rationale: The correct answer is D because assisting the client out of bed and into a chair promotes mobility and helps prevent complications such as pressure ulcers and muscle atrophy. This intervention also enhances the client's quality of life by providing them with social interaction and a change of scenery. Turning & repositioning (choice A) is important for preventing pressure ulcers but is not the priority for a client in hospice care who may not have a long prognosis. Providing small frequent nutritious meals (choice C) is also important but may not be the priority if the client has a decreased appetite or is not able to eat due to their condition.
Question 2 of 5
A nurse is caring for a patient preparing for discharge from the hospital the next day. The patient does not read. His family caregiver will be visiting before discharge. What can the nurse do to facilitate the patient's understanding of his discharge instructions? (Select all that apply.)
Correct Answer: B
Rationale: The correct answer is B: Sit facing the patient so he is able to watch your lip movements and facial expressions. This approach enhances communication by allowing the patient to visually observe the nurse's non-verbal cues, which can aid in understanding despite the patient's inability to read. By facing the patient directly, the nurse can convey empathy and provide a visual connection that can facilitate comprehension. This method promotes effective communication and patient engagement. Rationales for why the other choices are incorrect: A: Yelling is not an appropriate or effective communication strategy, as it can be perceived as aggressive or disrespectful. C: While presenting one idea or concept at a time can be helpful, it does not address the visual communication aspect necessary for a non-reader. D: Sending a written copy of the instructions home is not helpful for a patient who cannot read. Additionally, relying solely on the family caregiver to review the instructions may not ensure the patient's full understanding.
Question 3 of 5
The ANA code of nursing ethics articulates that the nurse 'promotes, advocates for, and strives to protect the health, safety, and rights of the patient.' This includes the protection of patient privacy. On the basis of this principle, if you participate in a public online social network such as Facebook, could you post images of a patient's x-ray film if you obscured or deleted all patient identifiers?
Correct Answer: C
Rationale: The correct answer is C: No, because, even though patient identifiers are removed, someone could identify the patient on the basis of other comments that you make online about his or her condition and your place of work. Rationale: 1. The ANA code emphasizes protecting patient privacy. 2. Even if identifiers are removed, other information can identify the patient. 3. Posting x-ray images can lead to patient identification through contextual clues. 4. Disclosing patient information without consent violates privacy rights. 5. Upholding patient confidentiality is crucial in healthcare settings. Summary: Choice A is incorrect because patient identification is not solely based on identifiers. Choice B is incorrect as autonomy doesn't override patient privacy rights. Choice D is irrelevant to the question of patient privacy. Choice C is correct as it highlights the potential risk of patient identification despite removing identifiers.
Question 4 of 5
When explaining respiratory failure to the patient's family, what should the nurse use as an accurate description?
Correct Answer: C
Rationale: The correct answer is C: Inadequate gas exchange to meet the metabolic needs of the body. This is the accurate description of respiratory failure as it reflects the core issue of the condition - the lungs' inability to effectively exchange oxygen and carbon dioxide to support the body's metabolic needs. Explanation for why the other choices are incorrect: A: The absence of ventilation - This is too simplistic and does not encompass the full spectrum of respiratory failure, which involves both ventilation and gas exchange. B: Any episode in which part of the airway is obstructed - This describes airway obstruction, not respiratory failure, which involves broader issues with gas exchange. D: An episode of acute hypoxemia caused by a pulmonary dysfunction - This choice focuses only on hypoxemia and pulmonary dysfunction, which are components of respiratory failure but do not fully capture the complexity of the condition.
Question 5 of 5
Which arterial blood gas (ABG) result is most consistent with early-stage ARDS?
Correct Answer: B
Rationale: The correct answer is B (pH 7.45, PaCO2 30 mm Hg, PaO2 55 mm Hg) as it indicates early-stage ARDS. In ARDS, there is hypoxemia, resulting in low PaO2 levels. The low PaO2 can lead to respiratory alkalosis, hence the high pH (normal or slightly alkalotic). The low PaCO2 (hypocapnia) is a compensatory mechanism to maintain pH. Choices A, C, and D do not reflect the typical ABG findings in early-stage ARDS. A (pH 7.30, PaCO2 50 mm Hg, PaO2 60 mm Hg) shows respiratory acidosis and lower PaO2. C (pH 7.38, PaCO2 40 mm Hg, PaO2 92 mm Hg) indicates better oxygenation and less likely to be early ARDS. D (