Concepts for Nursing Practice Giddens Test Bank

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.

Correct Answer: A

Rationale: The correct answer is that the younger client will need more frequent monitoring than the older client. This is because age can influence how the body processes medications, including anticoagulants. While older adults may require lower dosages due to changes in metabolism and potential increased sensitivity to medications, they may still require less monitoring than younger individuals. The younger client may need more frequent monitoring to ensure the anticoagulant is being effective and not causing any adverse effects, given variations in metabolism and potential multi-drug interactions. Age is just one factor to consider when individualizing care for clients on anticoagulant therapy, and close monitoring is essential for both age groups.

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.

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.

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.