ATI RN
Giddens Concepts for Nursing Practice Test Bank Questions
Question 1 of 5
A client with preeclampsia begins to demonstrate manifestations of seizure activity. Which intervention by the nurse is most likely to protect the client and fetus from injury?
Correct Answer: B
Rationale: Placing the client on the left side and protecting the airway is the most appropriate intervention to protect the client and the fetus from injury during a seizure. This position helps to prevent aspiration of vomitus and maintains an open airway. Placing the client on the left side also enhances maternal and fetal perfusion by reducing pressure on the vena cava, improving blood flow to the placenta, and decreasing the risk of supine hypotensive syndrome. Elevating the client's legs (Option A) and placing the client in the supine position (Option C) are contraindicated as they may worsen the client's condition in the context of preeclampsia and seizure activity. Elevating the head of the bed (Option D) does not address the immediate need to protect the airway and maintain proper positioning during a seizure.
Question 2 of 5
The nurse is preparing to discharge a client recovering from a pulmonary embolism (PE). Which topics should the nurse to include in the teaching session? Select all that apply.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 3 of 5
A 67-year-old client with a history of type II diabetes mellitus and chronic hypertension is admitted to the emergency department after a myocardial infarction. Which type of shock should the nurse be prepared to treat in this client?
Correct Answer: A
Rationale: Given the client's history of type II diabetes mellitus, chronic hypertension, and recent myocardial infarction, the most likely type of shock for the nurse to be prepared to treat in this client is cardiogenic shock. Cardiogenic shock occurs when the heart is unable to pump effectively, leading to inadequate perfusion of vital organs. This can be a complication of myocardial infarction, as damage to the heart muscle can impair its ability to pump blood effectively. Patients with a history of diabetes and hypertension are at increased risk for cardiovascular diseases, such as myocardial infarction, which can lead to cardiogenic shock. Symptoms of cardiogenic shock include hypotension, tachycardia, cool and clammy skin, and altered mental status. Treatment may involve medications to support cardiac function, such as inotropes, and interventions to improve oxygen delivery, such as oxygen therapy and fluid administration.
Question 4 of 5
The nurse is assessing the endocrine system of an older female patient. Which finding is considered an expected age-related change in this system?
Correct Answer: B
Rationale: As individuals age, particularly older women, there tends to be a decrease in facial hair growth. This change is considered a normal part of the aging process and an expected age-related change in the endocrine system. The other options presented, including normal heart tones, thyroid nodules, and an enlarged and firm pituitary gland, are not typically associated with normal aging of the endocrine system.
Question 5 of 5
Following surgery, a patient has not voided for 12 hours. What assessment should the nurse make?
Correct Answer: C
Rationale: Following surgery, a patient not voiding for 12 hours raises concerns for urinary retention, especially if the patient was catheterized during the surgical procedure. With urinary retention, the bladder can become distended and palpating for bladder distention can help determine if the patient is experiencing this issue. If the bladder is distended, interventions may be needed to address the urinary retention to prevent complications such as urinary tract infection or bladder distention-related discomfort. The other assessment options (percuting for gastric tympany, auscultating for bowel sounds, inspecting for edema of the urethra) are not as relevant in assessing a patient's urinary status post-surgery.