ATI RN VATIADULT MEDICALSURGICALP
f f f f f f
ROCTORED EXAM 2024 WITH NGN f f f f
AA AQue ff f f f f f f f f
s tion 90 loade d ra tionals pr ovide dAA
Afnursefisfcaringfforfafclientfwhofhasfatopicfdermatitisfandfafprescriptionfforftriamcinolonefoint
ment.fThefnursefshouldfassessfthefclientftofmonitorfforfwhichfofftheffollowingfadversefeffects
?
A
Increasedfpigmentation
Topicalfglucocorticoidftherapyfcanfcausefthefadversefeffectfoffhypopigmentation.fLocalizedfh
airfloss
Long-
termfglucocorticoidftherapyfcanfcausefhypertrichosis,forfexcessivefhairfgrowth,fespeciallyfonftheffa
cialfarea.
Thinningfoffthefskin
MY f
ANSWER
Thinningfoffthefskinfandfdelayedfhealingfarefadversefeffectsfofftopicalfglucocorticoidfpreparations.f
Thefclientfshouldfonlyfapplyfthefointmentftofdryfpatchesfoffthefskinfbecauseftopicalfsteroidsfcanfca
usefatrophyfoffthefdermisfandfepidermis,fwhichfcanfresultfinfthinningfoffthefskin.
Increasedfsensitivityftofthefsun
Thefnursefshouldfinstructfthefclientftofavoidfexcessivefsunfexposurefwhenftakingftopicalffluticasone;
fhowever,ftriamcinolonefointmentfdoesfnotfcausefphotosensitivity.
CORRECT •f TimefRemaining:f00:37:45
• PausefRemaining:f00:05:00
PAUSE
, lOM oA R f f
cP S D| 24448587
RNfVATIfAdultfMedicalfSurgicalf2019
CLOSE f f pr o v id e d
FLAG
Afnursefisfassessingfafclientfwhofhasfleft-
sidedfheartffailure.fWhichfofftheffollowingffindingsfshouldfthefnursefidentifyfasfafmanifestationfoffle
ft-sidedfheartffailure?
Dependentfedema
Thefnursefshouldfidentifyfthatfdependentfedemafisfafmanifestationfoffright-
sidedfheartffailurefdueftofrightfventricularffailurefandffluidfretentionffromfpressurefbuildingfupfinfth
efvenousfsystem.
Jugularfdistention
Thefnursefshouldfidentifyfthatfjugularfveinfdistentionfisfafmanifestationfoffright-
sidedfheartffailurefdueftofrightfventricularffailurefandffluidfretentionffromfpressurefbuildingfupfinfth
efvenousfsystem.
Weightfgain
Thefnursefshouldfidentifyfthatfweightfgainfisfafmanifestationfoffright-
sidedfheartffailurefdueftofrightfventricularffailurefandffluidfretentionffromfpressurefbuildingfupfinfth
efvenousfsystem.
Frothyfsputum
MY f
ANSWER
Thefnursefshouldfidentifyfthatffrothyfsputum,fdyspnea,fandfwheezingfarefmanifestationsfof
left-
sidedfheartffailure.fTreatmentfincludesffluidfrestrictionfandfdiureticsftofdecreasefpreloadfandfredu
cefpulmonaryfcongestion.fPink-tingedffrothyfsputumfcanfbefanfearlyfindicationfof
pulmonaryfedemafandfcanfbeflife-
threatening.fTherefore,fthefnursefshouldfnotifyfthefproviderfimmediately.
• TimefRemaining:f00:37:30
FLAG •f PausefRemaining:f00:05:00
,
, PAUSE
Afnursefisfcaringfforfafclientfwhofisfexperiencingfanxietyfasfwellfasfnumbnessfandftinglingfofftheflip
sfandffingers.fThefclient'sfABGsfare:fpHf7.48,fPCO2ff30fmmfHg,fHCO3-
fff24fmEq/L,fPaO2ff85fmmfHg.fWhichfofftheffollowingfacid-
basefimbalancesfshouldfthefnursefidentifyfthatfthefclientfisfexperiencing?
Respiratoryfalkalosis
MY f
ANSWER
ThisfpHfisfalkalinef(increased)fandfthefPCO fffisfdecreased,frepresentingfalveolarfhyperventila
2
tionfandfresultantfrespiratoryfalkalosis.
Respiratoryfacidosis
ThisfpHfisfalkalinef(increased)fandfthefPCO fffisfdecreased.fAfdecreasedfpHfandfanfincreasedfPCO fin
2 2
dicatefrespiratoryfacidosis.
Metabolicfalkalosis
ThisfHCO 3-
fff 24fmEq/Lfisfwithinfthefexpectedfrangefoff21ftof28fmEq/LfandfthefpHfisfalkalinef(increased).fAnfincre
asedfpHfandfHCO fffindicatefmetabolicfalkalosis.
3-
Metabolicfacidosis
ThisfHCO 3-
fff 24fmEq/Lfisfwithinfthefexpectedfrangefoff21ftof28fmEq/LfandfthefpHfisfalkalinef(increased).fAfdecre
asedfpHfandfHCO fffindicatefmetabolicfacidosis.
3-
CORRECT •f TimefRemaining:f00:37:22
• PausefRemaining:f00:05:00
PAUSE
FLAG
AfnursefisfassessingfafclientfwhofhasfCushing'sfsyndrome.fWhichfofftheffollowingffindingsfsho
uldfthefnursefexpect?
f f f f f f
ROCTORED EXAM 2024 WITH NGN f f f f
AA AQue ff f f f f f f f f
s tion 90 loade d ra tionals pr ovide dAA
Afnursefisfcaringfforfafclientfwhofhasfatopicfdermatitisfandfafprescriptionfforftriamcinolonefoint
ment.fThefnursefshouldfassessfthefclientftofmonitorfforfwhichfofftheffollowingfadversefeffects
?
A
Increasedfpigmentation
Topicalfglucocorticoidftherapyfcanfcausefthefadversefeffectfoffhypopigmentation.fLocalizedfh
airfloss
Long-
termfglucocorticoidftherapyfcanfcausefhypertrichosis,forfexcessivefhairfgrowth,fespeciallyfonftheffa
cialfarea.
Thinningfoffthefskin
MY f
ANSWER
Thinningfoffthefskinfandfdelayedfhealingfarefadversefeffectsfofftopicalfglucocorticoidfpreparations.f
Thefclientfshouldfonlyfapplyfthefointmentftofdryfpatchesfoffthefskinfbecauseftopicalfsteroidsfcanfca
usefatrophyfoffthefdermisfandfepidermis,fwhichfcanfresultfinfthinningfoffthefskin.
Increasedfsensitivityftofthefsun
Thefnursefshouldfinstructfthefclientftofavoidfexcessivefsunfexposurefwhenftakingftopicalffluticasone;
fhowever,ftriamcinolonefointmentfdoesfnotfcausefphotosensitivity.
CORRECT •f TimefRemaining:f00:37:45
• PausefRemaining:f00:05:00
PAUSE
, lOM oA R f f
cP S D| 24448587
RNfVATIfAdultfMedicalfSurgicalf2019
CLOSE f f pr o v id e d
FLAG
Afnursefisfassessingfafclientfwhofhasfleft-
sidedfheartffailure.fWhichfofftheffollowingffindingsfshouldfthefnursefidentifyfasfafmanifestationfoffle
ft-sidedfheartffailure?
Dependentfedema
Thefnursefshouldfidentifyfthatfdependentfedemafisfafmanifestationfoffright-
sidedfheartffailurefdueftofrightfventricularffailurefandffluidfretentionffromfpressurefbuildingfupfinfth
efvenousfsystem.
Jugularfdistention
Thefnursefshouldfidentifyfthatfjugularfveinfdistentionfisfafmanifestationfoffright-
sidedfheartffailurefdueftofrightfventricularffailurefandffluidfretentionffromfpressurefbuildingfupfinfth
efvenousfsystem.
Weightfgain
Thefnursefshouldfidentifyfthatfweightfgainfisfafmanifestationfoffright-
sidedfheartffailurefdueftofrightfventricularffailurefandffluidfretentionffromfpressurefbuildingfupfinfth
efvenousfsystem.
Frothyfsputum
MY f
ANSWER
Thefnursefshouldfidentifyfthatffrothyfsputum,fdyspnea,fandfwheezingfarefmanifestationsfof
left-
sidedfheartffailure.fTreatmentfincludesffluidfrestrictionfandfdiureticsftofdecreasefpreloadfandfredu
cefpulmonaryfcongestion.fPink-tingedffrothyfsputumfcanfbefanfearlyfindicationfof
pulmonaryfedemafandfcanfbeflife-
threatening.fTherefore,fthefnursefshouldfnotifyfthefproviderfimmediately.
• TimefRemaining:f00:37:30
FLAG •f PausefRemaining:f00:05:00
,
, PAUSE
Afnursefisfcaringfforfafclientfwhofisfexperiencingfanxietyfasfwellfasfnumbnessfandftinglingfofftheflip
sfandffingers.fThefclient'sfABGsfare:fpHf7.48,fPCO2ff30fmmfHg,fHCO3-
fff24fmEq/L,fPaO2ff85fmmfHg.fWhichfofftheffollowingfacid-
basefimbalancesfshouldfthefnursefidentifyfthatfthefclientfisfexperiencing?
Respiratoryfalkalosis
MY f
ANSWER
ThisfpHfisfalkalinef(increased)fandfthefPCO fffisfdecreased,frepresentingfalveolarfhyperventila
2
tionfandfresultantfrespiratoryfalkalosis.
Respiratoryfacidosis
ThisfpHfisfalkalinef(increased)fandfthefPCO fffisfdecreased.fAfdecreasedfpHfandfanfincreasedfPCO fin
2 2
dicatefrespiratoryfacidosis.
Metabolicfalkalosis
ThisfHCO 3-
fff 24fmEq/Lfisfwithinfthefexpectedfrangefoff21ftof28fmEq/LfandfthefpHfisfalkalinef(increased).fAnfincre
asedfpHfandfHCO fffindicatefmetabolicfalkalosis.
3-
Metabolicfacidosis
ThisfHCO 3-
fff 24fmEq/Lfisfwithinfthefexpectedfrangefoff21ftof28fmEq/LfandfthefpHfisfalkalinef(increased).fAfdecre
asedfpHfandfHCO fffindicatefmetabolicfacidosis.
3-
CORRECT •f TimefRemaining:f00:37:22
• PausefRemaining:f00:05:00
PAUSE
FLAG
AfnursefisfassessingfafclientfwhofhasfCushing'sfsyndrome.fWhichfofftheffollowingffindingsfsho
uldfthefnursefexpect?