Giddens Concepts for Nursing Practice Test Bank

Questions 14

ATI RN

ATI RN Test Bank

Giddens Concepts for Nursing Practice Test Bank Questions

Question 1 of 5

The nurse has identified Ineffective Peripheral Tissue Perfusion as a nursing diagnosis for a client with disseminated intravascular coagulation (DIC). What intervention would be appropriate for the client?

Correct Answer: B

Rationale: In the context of Ineffective Peripheral Tissue Perfusion in a client with disseminated intravascular coagulation (DIC), administering oxygen is the most appropriate intervention. DIC is a serious condition characterized by widespread clotting in small blood vessels throughout the body, leading to tissue ischemia and inadequate perfusion. Administering oxygen can support tissue oxygenation and improve perfusion to the peripheral tissues, helping to alleviate the effects of decreased blood flow and oxygen delivery caused by DIC. Oxygen therapy can help optimize oxygen levels in the blood and tissues, promoting better tissue perfusion and overall patient outcomes. Monitoring oxygen saturation and ensuring adequate oxygen delivery are crucial aspects of managing tissue perfusion in clients with DIC.

Question 2 of 5

Following surgery, a patient has not voided for 12 hours. What assessment should the nurse make?

Correct Answer: C

Rationale: Following surgery, a patient not voiding for 12 hours raises concerns for urinary retention, especially if the patient was catheterized during the surgical procedure. With urinary retention, the bladder can become distended and palpating for bladder distention can help determine if the patient is experiencing this issue. If the bladder is distended, interventions may be needed to address the urinary retention to prevent complications such as urinary tract infection or bladder distention-related discomfort. The other assessment options (percuting for gastric tympany, auscultating for bowel sounds, inspecting for edema of the urethra) are not as relevant in assessing a patient's urinary status post-surgery.

Question 3 of 5

A community health nurse is providing education to a group of adults regarding myocardial infarction (MI). When discussing ways to prevent the number of MI-related deaths, which statement by the nurse is inappropriate?

Correct Answer: B

Rationale: While taking a baby aspirin daily can be beneficial for some individuals at increased risk of heart attacks or strokes, it is not a general recommendation for everyone to prevent myocardial infarction (MI). There are potential risks associated with aspirin use, such as gastrointestinal bleeding, which could outweigh the benefits for individuals at low risk of a heart attack. It is important for individuals to consult with their healthcare provider before starting any regimen of daily aspirin therapy. The other statements (A, C, D) focus on increasing awareness, knowledge, and prompt action in response to a suspected MI, which are appropriate measures for prevention and improving outcomes.

Question 4 of 5

The nurse is caring for a premature infant diagnosed with patent ductus arteriosus (PDA). Which medication should the nurse anticipate administering to this client?

Correct Answer: A

Rationale: Indomethacin is a medication commonly used to treat patent ductus arteriosus (PDA) in premature infants. PDA is a condition where the ductus arteriosus, a blood vessel that connects the pulmonary artery to the aorta, fails to close after birth. Indomethacin works by inhibiting prostaglandin synthesis, which helps to promote closure of the ductus arteriosus. This medication is often used in premature infants with PDA to prevent complications and improve outcomes. Propranolol is a beta-blocker used for different conditions, antibiotics are used to treat infections, and Prostaglandin E1 is used to maintain ductal patency in certain cardiac conditions where closure is not desired.

Question 5 of 5

A client with preeclampsia begins to demonstrate manifestations of seizure activity. Which intervention by the nurse is most likely to protect the client and fetus from injury?

Correct Answer: B

Rationale: Placing the client on the left side and protecting the airway is the most appropriate intervention to protect the client and the fetus from injury during a seizure. This position helps to prevent aspiration of vomitus and maintains an open airway. Placing the client on the left side also enhances maternal and fetal perfusion by reducing pressure on the vena cava, improving blood flow to the placenta, and decreasing the risk of supine hypotensive syndrome. Elevating the client's legs (Option A) and placing the client in the supine position (Option C) are contraindicated as they may worsen the client's condition in the context of preeclampsia and seizure activity. Elevating the head of the bed (Option D) does not address the immediate need to protect the airway and maintain proper positioning during a seizure.

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