Exam (elaborations)
NUTR-GE NURSE-UN24RN VATI Adult Medical Surgical 2019.
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NUTR-GE NURSE-UN24RN VATI Adult Medical Surgical 2019.
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*****A nurse is caring for a client who has atopic dermatitis and a prescription fortriamcinolone ointment. The nurse should assess the client to monitor for which of the
following adverse effects?
Thinning of the skin
MY ANSWER
*****A nurse is assessing a client who has left-sided heart failure. Which of the
following findings should the nurse identify as a manifestation of left-sided heart failure?
Frothy sputum
MY ANSWER
****A nurse is caring for a client who is experiencing anxiety as well as numbness and tingling
of the lips and fingers. The client's ABGs are: pH 7.48, PCO 30 mm Hg, HCO 24 mEq/L,
2 3
-
PaO 85 mm Hg. Which of the following acid-base imbalances should the nurse identify that the
2
client is experiencing?
Respiratory alkalosis
MY ANSWER
****A nurse is assessing a client who has Cushing's syndrome. Which of the following findings
should the nurse expect?
Osteoporosis
MY ANSWER
****A nurse is inspecting the skin of a client who has basal cell carcinoma. The nurse should
identify which of the following lesion characteristics on the client's skin?
A pearly, waxy nodule
MY ANSWER
****A nurse is assessing a client who has hypocalcemia. In which of the following areas should
the nurse tap on the client's face to detect the presence of Chvostek's sign? (You will find hot
spots to select in the artwork below. Select only the hot spot that corresponds to your answer.)
A is correct. The nurse should tap the client's cheek just in front of the ear and below the
zygomatic arch. The client who has hypocalcemia will display a Chvostek's sign, which is a
twitching of the facial muscle.
,B is incorrect. The nurse should apply upward pressure at the supraorbital ridge, below the
eyebrow, to assess for tenderness and inflammation of the frontal sinuses.
C is incorrect. The nurse should palpate the jaw and mastoid muscle of a client who has
temporomandibular joint dysfunction. This can be caused by misaligned teeth, arthritis, or
grinding of the teeth. With palpation, the nurse might feel a click, pop, or grating sensation when
the client opens or closes the jaw.
Bottom of Form
****A nurse in an emergency department is assessing a client who is overusing
prescribed diuretics and has a sodium level of 127 mEq/L. Which of the following
laboratory findings should the nurse expect?
Low urine specific gravity
MY ANSWER
***A home health nurse is assisting a client with planning care for a family member who has
Alzheimer's disease. Which of the following instructions should the nurse include?
Review the daily schedule with the client every morning.
***A nurse is caring for a client who has developed acute respiratory distress syndrome (ARDS).
Which of the following findings should the nurse identify as a manifestation of this syndrome?
Refractory hypoxemia
MY ANSWER
***An emergency room nurse is assessing a client who has asthma and difficulty breathing.
Which of the following findings should indicate to the nurse that the client is experiencing status
asthmaticus?
Use of accessory muscles
MY ANSWER
, ****A nurse is teaching a client who has a new prescription for phenytoin to treat a
seizure disorder. Which of the following adverse effects should the nurse instruct the
client to report immediately to the provider?
Skin rash
MY ANSWE
***A nurse is monitoring a client following a lumbar laminectomy. The client has a drain
and indwelling urinary catheter. The nurse should identify which of the following findings
as an indication of a complication of the surgery?
Clear drainage on the dressings
MY ANSWER
***A nurse is assessing a client who has right-sided heart failure. Which of the following findings
should the nurse identify as a manifestation of right-sided heart failure?
Increased abdominal girth
MY ANSWER
***A nurse is caring for a client who recently assumed the role of caregiver for their
aging parents who have chronic illnesses. The nurse should identify that which of the
following statements by the client indicates acceptance of the role change?
"I changed the floor plan of our home to accommodate my father's wheelchair."
****A nurse is caring for a client who is receiving vancomycin intermittent IV bolus therapy for
methicillin-resistant Staphylococcus aureus (MRSA). Which of the following findings is an
indication to the nurse that the client is experiencing an adverse effect of the medication?
The client is becoming flushed.
MY ANSWER
***A nurse is caring for a male client who has a new prescription for cyclosporine following a
kidney transplant. Which of the following findings should the nurse identify as an adverse effect
of this therapy?
BUN 24 MG DL
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