ATI RN
Introduction to Community Health Nursing Questions
Question 1 of 5
Which of these clients has a problem with the transport of oxygen from the lungs to the tissues:
Correct Answer: B
Rationale: The correct answer is B: Theresa with anemia. Anemia is a condition characterized by a decrease in red blood cells or hemoglobin levels, leading to reduced oxygen-carrying capacity. This impairs the transport of oxygen from the lungs to the tissues, affecting overall oxygen delivery and tissue oxygenation. A: Carol with a tumor in the brain - Brain tumor does not directly impact oxygen transport from the lungs to tissues. C: Sonny Boy with a fracture in the femur - Fracture does not affect oxygen transport. D: Brigette with diarrhea - Diarrhea may lead to dehydration and electrolyte imbalances but does not directly affect oxygen transport.
Question 2 of 5
A client is diagnosed with deep vein thrombosis. Which nursing diagnosis should receive highest priority at this time?
Correct Answer: D
Rationale: The correct answer is D, Ineffective peripheral tissue perfusion related to venous congestion. Priority should be given to this nursing diagnosis because deep vein thrombosis can lead to impaired blood flow, potentially causing tissue ischemia and necrosis. Addressing ineffective tissue perfusion is crucial to prevent further complications such as tissue damage or even loss. Option A is incorrect as gas exchange is not the immediate concern in deep vein thrombosis. Option B is not directly related to the primary issue of venous congestion. Option C, risk for injury related to edema, is important but not as critical as ensuring adequate tissue perfusion to prevent further complications.
Question 3 of 5
During the physical examination, the nurse uses various techniques to assess structures, organs, and body systems. Which technique allows the nurse to feel for vibration and locate body structures?
Correct Answer: C
Rationale: The correct answer is C: Palpation. Palpation involves using hands to feel for vibration and locate body structures. This technique allows the nurse to assess for tenderness, texture, temperature, and size of organs or structures. Auscultation (A) involves listening for sounds using a stethoscope, not feeling. Inspection (B) involves visual examination, not tactile assessment. Percussion (D) involves tapping the body to listen for sounds, not feeling for vibration or locating structures. Palpation is the most appropriate technique for this purpose.
Question 4 of 5
Through the client’s history, you gather that the patient smokes and drinks coffee. When taking the temperature of a client who recently smoked or drank coffee, how long should the nurse wait before taking the client’s oral temperature for accurate reading?
Correct Answer: C
Rationale: The correct answer is C: 30 minutes. After smoking or drinking coffee, the client's oral temperature can be affected by the hot or cold temperature of the substances ingested. Waiting for 30 minutes allows the client's oral cavity to return to its normal temperature, ensuring an accurate reading. Choices A, B, and D are incorrect because: A: 5 minutes is too short of a time for the oral cavity to adjust to the temperature changes caused by smoking or drinking coffee. B: 15 minutes may not be sufficient for the oral cavity to stabilize, leading to a potential inaccurate reading. D: 1 hour is too long of a wait time as the oral cavity typically stabilizes within 30 minutes after smoking or drinking coffee.
Question 5 of 5
While the client has a pulse oximeter on his fingertip, the nurse notices that sunlight is shining on the area of the sensor. The nurse’s action should be:
Correct Answer: C
Rationale: The correct answer is C: Cover the fingertip sensor with a towel or bedsheet. Sunlight shining on the sensor can interfere with accurate readings. By covering the sensor, the nurse eliminates the external light source and ensures correct measurements. Choice A is incorrect because sunlight can affect the accuracy of the pulse oximeter readings. Choice B is incorrect because changing the sensor location every 4 hours does not address the immediate issue of sunlight interference. Choice D is incorrect as setting the alarm does not solve the problem of sunlight affecting the sensor's accuracy.