ATI RN
Transcultural Concepts in Nursing Care Test Bank Questions
Question 1 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.
Question 2 of 5
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 3 of 5
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 4 of 5
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 5 of 5
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: In this scenario, the correct action for the nurse to perform to support the diagnosis of Deficient Fluid Volume in a patient with a nasogastric tube for gastric decompression is to measure abdominal girth every 4 to 8 hours (Option A). This is because a decrease in abdominal girth may indicate fluid volume deficit, which can be caused by gastric suctioning through the nasogastric tube. Providing the patient with generous amounts of oral fluids (Option B) may exacerbate the fluid volume deficit due to the ongoing gastric decompression. Keeping an accurate record of intake and output every 2 to 4 hours (Option C) is important but does not directly address the specific issue of fluid volume deficit related to gastric decompression. Documenting the amount and color of nasogastric tube drainage every shift (Option D) is relevant for monitoring the patient's condition but does not directly address fluid volume status. Listening to bowel sounds before checking the placement of the nasogastric tube (Option E) is important for ensuring proper tube placement but does not specifically address fluid volume deficits. Educationally, it is crucial for nurses to understand the rationale behind each nursing action to provide safe and effective patient care. Understanding the signs and symptoms of fluid volume deficits and appropriate interventions in patients with nasogastric tubes is essential for delivering optimal nursing care in various clinical settings.