RN VATI ADULT MEDICAL SURGICAL 2019 EXAM QUESTIONS,ANSWERS AND EXPLANATIONS

RN VATI ADULT MEDICAL SURGICAL 2019 EXAM QUESTIONS,ANSWERS AND EXPLANATIONS 1) 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? ● Increased pigmentation ● Topical glucocorticoid therapy can cause the adverse effect of hypopigmentation. ● Localized hair loss ● Long-term glucocorticoid therapy can cause hypertrichosis, or excessive hair growth, especially on the facial area. ● Thinning of the skin ○ Thinning of the skin and delayed healing are adverse effects of topical glucocorticoid preparations. The client should only apply the ointment to dry patches of the skin because topical steroids can cause atrophy of the dermisand epidermis, which can result in thinning of the skin. 2) A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse identify as amanifestation of left-sided heart failure? ● Dependent edema ● Jugular distention ● Weight gain ● Frothy sputum ○ The nurse should identify that frothy sputum, dyspnea, and wheezing are manifestations of left-sided heart failure.Treatment includes fluid restriction and diuretics to decrease preload and reduce pulmonary congestion. 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. 3.) 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, HCO - 24 mEq/L, PaO2 85 mm Hg. Which of the following acid-base imbalances shouldthe nurse identify that the client is experiencing? ● Respiratory alkalosis ○ This pH is alkaline (increased) and the PCO2 is decreased, representing alveolarhyperventilation and resultant respiratory alkalosis. ● Respiratory acidosis ○ This pH is alkaline (increased) and the PCO2 is decreased. A decreased pH and an increased PCO2 indicaterespiratory acidosis. ● Metabolic alkalosis ○ This HCO - 24 mEq/L is within the expected range of 21 to 28 mEq/L and the pH is alkaline (increased). Anincreased pH and HCO - indicate metabolic alkalosis. ● Metabolic acidosis ○ This HCO - 24 mEq/L is within the expected range of 21 to 28 mEq/L and the pH is alkaline (increased). Adecreased pH and HCO - indicate metabolic acidosis 3) A nurse is assessing a client who has Cushing's syndrome. Which of the following findings should the nurse expect? ● Vitiligo ● Osteoporosis ○ Osteoporosis is a common finding with Cushing's syndrome. Bones become thinner as a result of mineralloss and nitrogen depletion, and the risk for fractures increases. ● Myxedema ● Heat intolerance 4) A nurse is inspecting the skin of a client who has basal cell carcinoma. The nurse should identify which of the following lesioncharacteristics on the client's skin? ● A pearly, waxy nodule ○ A client who has basal cell carcinoma has a nodular lesion with well-defined borders and a pearly or waxyappearance, resulting from overexposure to the sun, especially on the face, head, and neck. ● An irregular border on a variegated-colored lesion ○ 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 firm, nodular, crusty, or ulcerated lesion ○ A client who has squamous cell carcinoma has a firm, nodular, and crusty lesion with an ulcerated center,resulting from sun exposure, chronic irritation, burns, or irradiation to the skin. ● A weeping vesicle ○ A client who has herpes zoster has weeping, blister-type lesions. 5.) A nurse is assessing a client who has hypocalcemia. In which of the following areas should the nurse tap on the client's face todetect 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 hashypocalcemia will display a Chvostek's sign, which is a twitching of the facial muscle. 6.) A nurse in an emergency department is assessing a client who is overusing prescribed diuretics and has a sodium level of 127mEq/L. Which of the following laboratory findings should the nurse expect? ● Low urine specific 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. Low hemoglobin ● Low Hemoglobin ○ A client who is dehydrated as a result of diuretic overuse ca