RN VATI ADULT MEDICAL SURGICAL
CERTIFICATION EVALUATION COMPLETE
QUESTIONS AND SOLUTIONS GRADED
APLUS
●● 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?
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.
●● 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
thefollowing acid-base imbalances should the nurse identify that the
client is experiencing?
Answer: Respiratory alkalosis
- The pH is alkaline (increased)
- PCO2 is decreased representing alveolar hyperventilation & resultant
respiratory alkalosis
,●● A nurse is assessing a client who has Cushing's syndrome. Which of
the following findings should the nurse expect?
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?
Answer: A pearly, waxy nodule.
- Basal cell carcinoma has a nodular lesion with well defined borders &
pearly or waxy appearance resulting from overexposure to the sun.
especially on the face, head, and neck.
-A client who has melanoma has a lesion with irregular borders and
variegated colors of red, white, and blue, most often on the upper back
or lower legs.
-A client who has squamous cell carcinoma has a firm, nodular, and
crusty lesion with a ulcerated center, resulting from sun exposure,
chronic irritation, burns, or irradiation to the skin.
●● 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?
,Answer: LOW URINE SPECFIC GRAVITY.
-A client who has hyponatremia as a result of diuretic overuse has a low
urine specific gravity. The increased excretion of water alters the ratio of
particulate matter, which affects the specific gravity.
●● 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?
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
●● 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?
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.
, ●● 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?
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.
●● 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?
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.
●● 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?
CERTIFICATION EVALUATION COMPLETE
QUESTIONS AND SOLUTIONS GRADED
APLUS
●● 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?
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.
●● 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
thefollowing acid-base imbalances should the nurse identify that the
client is experiencing?
Answer: Respiratory alkalosis
- The pH is alkaline (increased)
- PCO2 is decreased representing alveolar hyperventilation & resultant
respiratory alkalosis
,●● A nurse is assessing a client who has Cushing's syndrome. Which of
the following findings should the nurse expect?
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?
Answer: A pearly, waxy nodule.
- Basal cell carcinoma has a nodular lesion with well defined borders &
pearly or waxy appearance resulting from overexposure to the sun.
especially on the face, head, and neck.
-A client who has melanoma has a lesion with irregular borders and
variegated colors of red, white, and blue, most often on the upper back
or lower legs.
-A client who has squamous cell carcinoma has a firm, nodular, and
crusty lesion with a ulcerated center, resulting from sun exposure,
chronic irritation, burns, or irradiation to the skin.
●● 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?
,Answer: LOW URINE SPECFIC GRAVITY.
-A client who has hyponatremia as a result of diuretic overuse has a low
urine specific gravity. The increased excretion of water alters the ratio of
particulate matter, which affects the specific gravity.
●● 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?
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
●● 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?
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.
, ●● 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?
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.
●● 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?
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.
●● 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?
