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RN VATI Adult Medical Surgical (answered) Summer 2021: all questions answered correctly.

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RN VATI Adult Medical Surgical (answered) Summer 2021: all questions answered correctly. A nurse is caring for a client who has atopic dermatitis and a prescription for triamcinolone ointment. The nurse should assess the client to monitor for which of the following adverse effects? Correct Answe...

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RN VATI Adult Medical Surgical (answered) Summer
2021: all questions answered correctly.
A nurse is caring for a client who has atopic dermatitis and a prescription for triamcinolone ointment.
The nurse should assess the client to monitor for which of the following adverse effects? Correct
Answer: Thinning of the skin.
Only apply the ointment to dry patches of the skin to avoid atrophy.

Topical Glucocorticoids Side effects Correct Answer: Tiamcinolone
- Hypopigmentation
- Excessive hair growth (hypertrichosis)
- Thinning of the skin

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? Correct Answer: Frothy sputum

Pink-tinged frothy sputum can be an early indication of pulmonary edema and can be life-threatening.
Therefore, the nurse should notify the provider immediately.

Left Sided Heart Failure Correct Answer: - Frothy sputum
- Dyspnea
- Wheezing
Treatment:
Fluid restriction & diuretics to decrease preload & pulmonary congestion

Right heart sided failure Correct Answer: - Dependent edma
- Jugular distention
- Weight gain

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, PCO2 30 mm Hg, HCO3- 24 mEq/L, PaO2 85 mm Hg. Which of the
following acid-base imbalances should the nurse identify that the client is experiencing? Correct Answer:
Respiratory alkalosis

- The pH is alkaline
- PCO2 is low representing alveolar hyperventilation & respiratory alkalosis

A nurse is assessing a client who has Cushing's syndrome. Which of the following findings should the
nurse expect? Correct Answer: Osteoporosis

Bone become thinner as a result of mineral loss & nitrogen depletion.

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? Correct Answer: A pearly, waxy nodule.

,- Basal cell carcinoma has a nodular lesion with well defined borders & pearly or waxy apperance from
ocerexposure to the sun.

Melanoma Correct Answer: Irregular border and varigated colored lesions of red, white, blue.
- Most often on the upper back or lower legs

Squamous cell carcinoma Correct Answer: Firm, nodular, and crusty lesion with an ulcerated center
from sun exposure, chronic irritation, burns, or irradiation to the skin.

weeping vescile Correct Answer: Herpes Zoster
- Weeping, blister type lesions.

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? Correct
Answer: LOW URINE SPECFIC GRAVITY.

Hyponatremia Correct Answer: - Low specific gravity
- Elevated hemoglobin

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? Correct Answer: Remove clutter
from rooms and hallways

- This allows the client is able to walk without the risk of falling or tripping over objects. Later in the
disease, the client can experience seizures, so cluttered areas could be a risk to the client

Alzheimer's interventions Correct Answer: - Single date calender
- Redirect the client by starting another activity
- Use short, simple senteces when explaining an activity
- Explanation should be done immediately before an activity

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? Correct Answer:
REFRACTORY HYPOXEMIA

- A client who has ARDS has refractory hypoxemia, which is hypoxemia that does not improve with
oxygen therapy. Extensive pulmonary edema evident on a chest x-ray is a manifestation of ARDS.

Pulmonary embolism Correct Answer: - Pleural friction rub
- Tachypnea
- Tachycardia
- Dyspnea
- Sudden, sharp chest pain

Tension pneumothorax Correct Answer: - Trachial deviation
- Dyspnea
- Tachycardia
- Tachypnea

, - Decreased or absent breath sounds over area

Lung cancer Correct Answer: Hemoptysis
Bloody expectorant when coughing

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? Correct
Answer: USE OF ASSCESSORY MUSCLES.

- A client who has status asthmaticus uses accessory muscles to help facilitate breathing, which is a
manifestation of a severe airflow obstruction. The situation is life-threatening and the nurse should
intervene immediately with strong systemic bronchodilators, epinephrine, corticosteroids, and oxygen.

status asthmaticus Correct Answer: - Labored breathing & wheezing
- Distended neck veins
- Use of accessory muscle
- Bronchodilators
- Epinephrine
- Corticosteroids
- Oxygen

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? Correct Answer: SKIN RASH.

- the nurse should determine that the priority finding is a rash, which can have a measles-like
appearance and progress to exfoliative dermatitis or Stevens-Johnson syndrome. The client should
report this finding to the provider immediately.

Phenytoin side effects Correct Answer: - Skin Rash
- Bleeding gums
- Increased facial hair
- Constipation

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? Correct Answer: CLEAR DRAINAGE OF DRESSINGS

- This is an indication of a cerebral spinal leak

lumbar laminectomy postoperative Correct Answer: - Slight elevation in temperature
- No more than 125 mL of drainage in 4 hours
- Decreased bowel sounds due to anesthesia
- Monitor for paralytic ileus

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? Correct Answer:
INCREASED ABDOMINAL GIRTH

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