ATI RN
Concepts for Nursing Practice Giddens Test Bank Questions
Question 1 of 9
A patient with adrenal cortex dysfunction is experiencing an increased amount of glucocorticoids being released into the general circulation. For which psychologic response should the nurse plan care for this patient?
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.
Question 2 of 9
A nurse working in the intensive care unit (ICU) is caring for a client in progressive hemorrhagic shock. What does the nurse understand about the physiology of progressive shock?
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.
Question 3 of 9
The nurse is instructing a client on lifestyle changes to promote a healthy cardiovascular system. Which of the following should be included in this teaching session? Select all that apply.
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.
Question 4 of 9
A client who had outpatient surgery is given an instruction sheet in preparation for discharge. When the nurse asks if the instructions are clear, the client says, "I'll read them later when I have my glasses; besides, you told me everything I need to know." Based on these statements, what would the nurse suspect?
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.
Question 5 of 9
The nurse is assessing a client who is 20 weeks pregnant. Which health issue should the nurse recognize as increasing this client's risk for the development of preeclampsia?
Correct Answer: D
Rationale: Obesity is a significant risk factor for the development of preeclampsia in pregnancy. Preeclampsia is characterized by high blood pressure and signs of damage to other organ systems, typically after 20 weeks of pregnancy. Obesity can lead to increased inflammation and affect the function of blood vessels, which can contribute to the development of preeclampsia. It is essential for the nurse to recognize obesity as a risk factor in this scenario to provide appropriate monitoring and interventions to ensure the health and safety of both the client and the baby.
Question 6 of 9
The nurse is concerned after performing a neurovascular assessment on an older patient with a lower arm cast. Which finding caused the nurse to become concerned?
Correct Answer: A
Rationale: A neurovascular assessment is performed to evaluate nerve function, circulation, and tissue perfusion. Pale, cold fingers indicate poor circulation, which can be a sign of compromised blood flow from the cast causing decreased oxygen supply to the tissues. This finding is concerning as it suggests potential nerve or vascular compromise, which could lead to serious complications if not addressed promptly. It is important for the nurse to report this finding to the healthcare provider for further evaluation and intervention.
Question 7 of 9
A patient is experiencing changes in the renal system. What diagnostic test should the nurse expect to be prescribed to determine this patient’s glomerular filtration rate and glomerular damage?
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.
Question 8 of 9
The nurse is positioning a client with left-sided heart failure in bed. Which sleeping position is most appropriate for this client?
Correct Answer: B
Rationale: In a client with left-sided heart failure, lying on the left side can help reduce the workload on the heart by promoting better venous return and reducing preload. This position can help decrease the amount of blood in the pulmonary circulation and improve cardiac output. Placing one pillow under the head can provide comfort and proper alignment of the airway, allowing for easier breathing. It is important to avoid excessive elevation of the head as it could increase pressure on the heart and impede circulatory function. This position can also help prevent complications such as pulmonary congestion and fluid accumulation in the lungs.
Question 9 of 9
A 72-year-old client diagnosed with hypertrophic cardiomyopathy (HCM) is speaking to the healthcare team about treatment options. Which treatment option would likely not be recommended for this client, even though it is commonly used to treat younger clients with this condition?
Correct Answer: D
Rationale: Although physical activity restrictions are commonly recommended for younger clients with hypertrophic cardiomyopathy (HCM) to reduce the risk of sudden cardiac death, this may not be the best option for a 72-year-old client. Older adults can still benefit from regular physical activity to maintain overall health and mobility. It is important to individualize the exercise recommendations based on the client's overall health status, functional capacity, and specific considerations related to their condition. In this case, the healthcare team would likely focus on other treatment options such as beta-blocker or calcium channel blocker administration, and consider the potential benefits of defibrillator implantation for the older client with HCM.