ATI RN
Transcultural Concepts in Nursing Care Test Bank Questions
Question 1 of 9
A school-age client with a history of multiple allergies is prescribed epinephrine (EpiPen™) for prevention of anaphylactic shock. The client's mother says to the nurse, "I thought shock was about heart failure." Which response by the nurse is the most appropriate?
Correct Answer: A
Rationale: The most appropriate response by the nurse is Option A, "Allergic response is the most fatal type of shock; other types involve loss of blood, heart failure, and liver failure." This response is accurate because anaphylactic shock, which is caused by severe allergic reactions, can be life-threatening if not treated promptly with epinephrine (EpiPen™). While heart failure is a serious type of shock, anaphylactic shock is specifically related to severe allergic reactions and not heart failure. The nurse's response educates the mother about the seriousness of anaphylactic shock in relation to allergic responses and highlights that other types of shock can involve different organ system failures.
Question 2 of 9
The nurse identifies the diagnosis of Deficient Fluid Volume as appropriate for a patient with a nasogastric tube for gastric decompression. Which actions should the nurse perform to support this diagnosis? Select all that apply.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 3 of 9
What type of stroke occurs when the blood supply to a part of the brain is cut off by a thrombus, embolus, or stenosis?
Correct Answer: D
Rationale: An ischemic stroke occurs when the blood supply to a part of the brain is obstructed, typically by a thrombus (a blood clot that forms in a blood vessel and remains attached to its place of origin) or an embolus (a blood clot that travels from a different part of the body and becomes lodged in a blood vessel in the brain). Another cause of ischemic stroke can be stenosis, which is the narrowing of a blood vessel, restricting blood flow to the brain. When the brain does not receive sufficient oxygen and nutrients due to the blockage, brain cells can be damaged or die, leading to a stroke. Ischemic strokes account for the majority of strokes and are essential to manage promptly to minimize brain damage and long-term disability.
Question 4 of 9
The nurse is caring for a client with hypertrophic cardiomyopathy. Based on this diagnosis, which class of medications does the nurse anticipate being prescribed?
Correct Answer: D
Rationale: Beta blockers are commonly prescribed for patients with hypertrophic cardiomyopathy due to their ability to help lower heart rate, reduce myocardial oxygen demand, and improve diastolic filling time. They can also help to prevent arrhythmias in these patients. Digoxin, vasodilators, and nitrates are not typically used as first-line treatment for hypertrophic cardiomyopathy.
Question 5 of 9
The nurse is assessing muscle strength. What should the nurse ask the patient to do to assess facial muscle strength?
Correct Answer: A
Rationale: Asking the patient to clench their teeth is a common way to assess muscle strength in the face, particularly the muscles involved in the jaw. Clenching the teeth engages the muscles responsible for this action, such as the masseter muscle. Assessing the ability to clench the teeth provides insight into the strength and function of these facial muscles.
Question 6 of 9
The nurse is assessing an adult client with a cardiac dysrhythmia. Which finding would the nurse identify as possibly contributing to this client's dysrhythmia?
Correct Answer: A
Rationale: Consuming caffeinated coffee can potentially contribute to cardiac dysrhythmias in susceptible individuals. Caffeine is a stimulant that can increase heart rate and blood pressure, leading to arrhythmias in some people. Regular intake of caffeinated beverages can disrupt the normal electrical activity of the heart, especially in those with underlying cardiac conditions. Therefore, the nurse would identify drinking caffeinated coffee as a possible contributing factor to the client's dysrhythmia.
Question 7 of 9
A client is admitted to the hospital for a surgical intervention due to peripheral vascular disease (PVD). The nurse should be prepared to answer questions about which procedure?
Correct Answer: C
Rationale: Patients with peripheral vascular disease (PVD) often undergo percutaneous transluminal angioplasty (PTA) as a non-surgical intervention to improve blood flow in the affected arteries. PTA involves the use of a catheter with a balloon at its tip, which is inflated at the site of arterial narrowing to widen the vessel by compressing the plaque and stretching the arterial walls. This procedure helps restore blood flow and can alleviate symptoms such as claudication and ischemia in patients with PVD. Stent placement, endarterectomy, and atherectomy are other interventions that may be used in the management of PVD, but PTA is specifically known for its role in improving arterial blood flow in these patients.
Question 8 of 9
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.
Question 9 of 9
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.