Correct Answer: A

Rationale: The nurse would suspect that the client may be unable to read the instructions because the client mentioned needing glasses to read them later. Additionally, the client also stated that everything they need to know has already been told to them by the nurse, indicating potential difficulty with reading or understanding written instructions. It would be important for the nurse to explore further and provide alternative methods of communication or support to ensure the client receives and comprehends the necessary information for postoperative care.

Correct Answer: C

Rationale: Progressive shock leads to a mismatch between oxygen demand and supply, causing a shift from aerobic to anaerobic metabolism in cells. As oxygen delivery decreases due to factors such as decreased blood volume or cardiac output, cells are unable to meet their energy needs through aerobic metabolism. This results in the conversion of pyruvate to lactate through anaerobic glycolysis, leading to lactic acidosis and further cellular dysfunction. Recognizing this shift in metabolism is crucial for the nurse to intervene promptly to restore tissue perfusion and prevent further organ damage in the client in hemorrhagic shock.

Correct Answer: D

Rationale: Creatinine clearance is a diagnostic test that helps determine both the glomerular filtration rate (GFR) and the extent of glomerular damage in the renal system. Creatinine is a waste product produced by muscles and excreted by the kidneys. A decrease in the glomerular filtration rate indicates impaired kidney function, which could be due to glomerular damage or other renal issues. By measuring the amount of creatinine in the blood and urine over a specific period of time, creatinine clearance provides an estimate of the GFR. This test is commonly used to assess kidney function in patients with renal disease or renal impairment.

Correct Answer: C

Rationale: An increased amount of glucocorticoids being released can lead to an inhibition of the immune response. Glucocorticoids have anti-inflammatory effects and suppress the immune system, which can make the patient more susceptible to infections and impair the body's ability to fight off pathogens. This can manifest as an increased risk of infections and slower wound healing in the patient with adrenal cortex dysfunction. The other options, such as delayed onset of puberty, decreased metabolic rate, and increased response to glucagon, are not directly related to the effects of increased glucocorticoids on the immune response.

Correct Answer: B

Rationale: B. Reduce saturated fats in the diet: Consuming high levels of saturated fats can lead to an increase in cholesterol levels, which can contribute to the development of cardiovascular diseases. Therefore, reducing saturated fats in the diet can help maintain a healthy cardiovascular system.