ATI RN
Transcultural Concepts in Nursing Care 7th Edition Test Bank Questions
Question 1 of 5
The nurse is caring for a child with congestive heart failure (CHF). Which clinical manifestations does the nurse anticipate when assessing this child? Select all that apply.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 2 of 5
The nurse is planning care for a client admitted with a cardiac dysrhythmia. Which action would be the most appropriate for this client?
Correct Answer: C
Rationale: Monitoring serum electrolyte levels would be the most appropriate action for a client admitted with a cardiac dysrhythmia. Electrolyte imbalances, particularly potassium and magnesium, can lead to cardiac dysrhythmias. Therefore, it is crucial to monitor and maintain proper electrolyte levels to prevent or manage dysrhythmias. Restricting fluids, encouraging bedrest, or instructing in a low-fat diet are not the priority actions for managing a cardiac dysrhythmia.
Question 3 of 5
Which form of peripheral vascular disease is characterized by thickening, loss of elasticity, and calcification of arterial walls?
Correct Answer: A
Rationale: Arteriosclerosis is a form of peripheral vascular disease characterized by the thickening, loss of elasticity, and calcification of arterial walls. This results in the narrowing and hardening of the arteries, leading to reduced blood flow to tissues and organs. Atherosclerosis, on the other hand, specifically refers to the buildup of plaque (composed of fat, cholesterol, calcium, and other substances) on the inner walls of arteries, which contributes to arteriosclerosis. Chronic venous insufficiency is a condition involving poor blood flow from the legs back to the heart, often causing swelling and skin changes. Deep venous thrombosis is the formation of a blood clot in a deep vein, commonly in the legs.
Question 4 of 5
The nurse is administering albumin 5% to a client in shock. Which nursing action is appropriate when assessing this client?
Correct Answer: B
Rationale: When administering albumin 5% to a client in shock, it is essential to monitor for signs of fluid overload, as albumin is a volume expander. Auscultating breath sounds for crackles is a key nursing action to assess for pulmonary edema, which can be a manifestation of fluid overload. Crackles on auscultation indicate the presence of fluid in the lungs, which may require immediate intervention to prevent respiratory compromise. Therefore, monitoring for crackles in the breath sounds is crucial to detect and address potential complications related to the administration of albumin in this client.
Question 5 of 5
During a 6-month well-baby check up, the mother mentions to the nurse that her infant seems to be sleeping just as much as she did as a newborn, and she seems to do everything with her left hand. The nurse recognizes that these are warning signs of stroke that occurred early in life. What other question should the nurse ask to assess for signs of stroke?
Correct Answer: A
Rationale: Jerking movements in the face, arms, or legs can be a sign of seizures, which can occur as a result of a stroke in infants. This question is important to assess whether the infant may have experienced any seizure activity, which could indicate a potential stroke. It helps the nurse gather more information to understand the infant's symptoms and assess the possibility of a stroke event.