ATI RN
Transcultural Concepts in Nursing Care Test Bank Questions
Question 1 of 5
A nurse conducted a safety class for a group of older adult clients in the community on fall prevention. During a follow-up visit in the home of one of these clients, the nurse sees a number of fall hazards she identified during her class. What should the nurse document regarding the learning outcome for this client?
Correct Answer: C
Rationale: The nurse should document that the client understood the teaching given in the class but chose to ignore it. This reflects the concept of non-compliance, where the client has the knowledge and understanding of the fall prevention measures but consciously chooses not to implement them. It is important for healthcare providers to document when patients understand the information provided but do not follow through with recommended actions, as this can help in further tailoring interventions and support to increase compliance and improve health outcomes.
Question 2 of 5
The nurse is caring for a pregnant woman with congenital heart disease. The woman asks if she will be able to have a vaginal delivery. Which answer by the nurse is correct?
Correct Answer: C
Rationale: A vaginal birth is preferred over a Cesarean section for women who have aortic stenosis. Aortic stenosis is a type of congenital heart disease that restricts blood flow from the heart to the rest of the body due to a narrowing of the aortic valve. In women with aortic stenosis, the increased blood volume and heart rate during labor and delivery can put extra strain on the heart. However, in most cases, vaginal delivery is preferred over a Cesarean section to avoid the risks associated with major abdominal surgery, such as bleeding, infection, and thrombophlebitis. A vaginal birth allows for a more gradual and controlled increase in cardiac output compared to the more sudden changes that can occur during a Cesarean section. Additionally, the stress of labor may mimic the stress test for some patients, providing valuable information about their heart function. However, each case is unique and must be evaluated by the healthcare team
Question 3 of 5
The nurse is providing discharge teaching to a client recovering from deep venous thrombosis (DVT). Which instructions are appropriate for 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 4 of 5
Which pathological change related to disseminated intravascular coagulation (DIC) occurs late in the course of the disease?
Correct Answer: A
Rationale: Disseminated intravascular coagulation (DIC) is a complex, life-threatening condition characterized by widespread activation of coagulation within the blood vessels. In the early stages of DIC, there is excessive clot formation (formation of small clots) throughout the body due to the dysregulation of coagulation factors. As the disease progresses, the body's clotting factors become depleted, leading to a state of systemic anticoagulation. This anticoagulant state increases the risk of hemorrhage (bleeding) as the blood is no longer able to adequately clot. Therefore, hemorrhage is a pathological change that occurs late in the course of DIC.
Question 5 of 5
Which best describes the effects of the renal system on blood pressure?
Correct Answer: B
Rationale: The renal system plays a crucial role in regulating blood pressure through various mechanisms. Renin is an enzyme released by the kidneys in response to low blood pressure or low blood volume. Renin acts on angiotensinogen to convert it into angiotensin I, which is further converted into angiotensin II by angiotensin-converting enzyme (ACE) in the lungs. Angiotensin II is a potent vasoconstrictor, leading to an increase in blood pressure by constricting blood vessels. Additionally, angiotensin II stimulates the release of aldosterone, a hormone that promotes sodium and water retention in the kidneys, leading to an increase in blood volume and further elevating blood pressure. Therefore, the release of renin by the renal system ultimately leads to an increase in blood pressure.