ATI RN
Introduction to Nursing Final Exam Quizlet Questions
Question 1 of 5
Which of the following is a priority nursing action when administering oral care to a dependent client?
Correct Answer: B
Rationale: The correct answer is B: Wear disposable gloves. This is a priority nursing action to prevent the spread of infection and protect both the client and the caregiver. By wearing disposable gloves, the nurse maintains proper infection control practices and reduces the risk of transmitting pathogens during oral care procedures. A: Assisting the client to a dorsal recumbent position is not specifically related to oral care and is not a priority action. C: Using a firm toothbrush may cause injury to the client's gums and oral tissues, so it is not the best choice for oral care. D: Irrigating the mouth with hydrogen peroxide is not a recommended practice for routine oral care, as it can be harmful if ingested and may cause irritation to the oral mucosa.
Question 2 of 5
Nurse De Silva knows he can perform chest physiotherapy:
Correct Answer: B
Rationale: Correct Answer: B (One hour after meals) Rationale: Performing chest physiotherapy one hour after meals helps prevent aspiration during the procedure. Waiting allows food to move from the stomach to the small intestine, reducing the risk of aspiration. Performing chest physiotherapy immediately before meals (A) or during meals (C) could increase the risk of aspiration. Similarly, performing it before bedtime (D) may also increase the risk of aspiration as the patient lies down after the procedure.
Question 3 of 5
A client is admitted to the Emergency Department after a motorcycle accident that resulted in the client's skidding across a cement parking lot. Since the client was wearing shorts, there are large areas on the legs where the skin is ripped off. This wound is best described as:
Correct Answer: A
Rationale: The correct answer is A: Abrasion. An abrasion is a wound caused by friction, resulting in the removal of the superficial layers of skin. In this scenario, the client skidding across a cement parking lot caused the skin to be ripped off, which aligns with the definition of an abrasion. Choice B: Unapproximated, is incorrect because it refers to wound edges that are not brought together for healing, which is not the primary characteristic of the described wound. Choice C: Laceration, is incorrect as lacerations are typically caused by sharp objects cutting through the skin, rather than by friction as in the case of the motorcycle accident. Choice D: Eschar, is incorrect as eschar refers to a thick, hard, blackened crust that forms over a burn or necrotic tissue, which is not the case in this scenario.
Question 4 of 5
To give a Z-track injection, the nurse measures the correct medication dose and then draws a small amount of air into the syringe. What is the rationale for this action?
Correct Answer: B
Rationale: The correct answer is B: Adding air prevents the drug from flowing back into the needle track. When giving a Z-track injection, the nurse pulls the skin to the side before inserting the needle. By adding air into the syringe after drawing up the medication, a small air bubble is created above the medication in the syringe. This air bubble creates a seal when the needle is withdrawn, preventing the medication from leaking back into the needle track and causing irritation or staining. Incorrect choices: A: Adding air does not decrease pain caused by the injection. C: Adding air does not prevent the solution from entering a blood vessel. D: Adding air does not ensure that the client receives the entire dose.
Question 5 of 5
A client is dehydrated and requires 0.5 L of dextrose 5% in water to infuse at 50 ml/hour. If the solution is hung at 1:00 pm, what time will the solution be completed?
Correct Answer: C
Rationale: The solution requires 0.5 L to be infused at 50 ml/hour. To determine the time it will be completed, first calculate the total infusion time: 0.5 L / 50 ml/hour = 10 hours. Since the solution is hung at 1:00 pm, add 10 hours to get the completion time, which is 11:00 pm (Choice C). Choice A (6:00 PM) is incorrect because it does not account for the full 10-hour infusion time. Choice B (9:00 PM) is incorrect as it also does not consider the complete infusion duration. Choice D (12:00 mn) is incorrect since it overlooks the 1-hour difference between 11:00 pm and midnight.