Concepts for Nursing Practice Giddens Test Bank

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: 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.

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.

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.

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.