VATI MED SURG QUESTIONS AND ANSWERS

VATI MED SURG QUESTIONS AND
ANSWERS

Avnnursevnisvncaringvnforvnavnclientvnwhovnhasvnatopicvndermatitisvnandvnavnprescriptionvnforv
ntriamcinolonevnointment.vnThevnnursevnshouldvnassessvnthevnclientvntovnmonitorvnforvnwhic

hvnofvnthevnfollowingvnadversevneffects?vn-vnanswer--Thinningvnofvnthevnskin.vn

Onlyvnapplyvnthevnointmentvntovndryvnpatchesvnofvnthevnskinvntovnavoidvnatrophy.

Avnnursevnisvnassessingvnavnclientvnwhovnhasvnleft-
sidedvnheartvnfailure.vnWhichvnofvnthevnfollowingvnfindingsvnshouldvnthevnnursevnidentifyvnas
vnavnmanifestationvnofvnleft-sidedvnheartvnfailure?vn-vnanswer--Frothyvnsputumvn



Pink-
tingedvnfrothyvnsputumvncanvnbevnanvnearlyvnindicationvnofvnpulmonaryvnedemavnandvncanvn
bevnlife-threatening.vnTherefore,vnthevnnursevnshouldvnnotifyvnthevnprovidervnimmediately.

Avnnursevnisvncaringvnforvnavnclientvnwhovnisvnexperiencingvnanxietyvnasvnwellvnasvnnumbnes
svnandvntinglingvnofvnthevnlipsvnandvnfingers.vnThevnclient'svnABGsvnare:vnpHvn7.48,vnPCO2vn
30vnmmvnHg,vnHCO3-vn24vnmEq/L,vnPaO2vn85vnmmvnHg.vnWhichvnofvnthefollowingvnacid-
basevnimbalancesvnshouldvnthevnnursevnidentifyvnthatvnthevnclientvnisvnexperiencing?vn-
vnanswer--Respiratoryvnalkalosisvn



-vnThevnpHvnisvnalkalinevn(increased)
-
vnPCO2vnisvndecreasedvnrepresentingvnalveolarvnhyperventilationvn&vnresultantvnrespirato

ryvnalkalosis

AvnnursevnisvnassessingvnavnclientvnwhovnhasvnCushing'svnsyndrome.vnWhichvnofvnthevnfollo
wingvnfindingsvnshouldvnthevnnursevnexpect?vn-vnanswer--Osteoporosisvn

Bonevnbecomevnthinnervnasvnavnresultvnofvnmineralvnlossvn&vnnitrogenvndepletion.

Avnnursevnisvninspectingvnthevnskinvnofvnavnclientvnwhovnhasvnbasalvncellvncarcinoma.vnThevn
nursevnshouldvnidentifyvnwhichvnofvnthevnfollowingvnlesionvncharacteristicsvnonvnthevnclient'
svnskin?vn-vnanswer--Avnpearly,vnwaxyvnnodule.

-
vnBasalvncellvncarcinomavnhasvnavnnodularvnlesionvnwithvnwellvndefinedvnbordersvn&vnpearlyv
norvnwaxyvnappearancevnresultingvnfromvnoverexposurevntovnthevnsun.vnespeciallyvnonvnthe
vnface,vnhead,vnandvnneck.vn

-
Avnclientvnwhovnhasvnmelanomavnhasvnavnlesionvnwithvnirregularvnbordersvnandvnvariegated
vncolorsvnofvnred,vnwhite,vnandvnblue,vnmostvnoftenvnonvnthevnuppervnbackvnorvnlowervnlegs.

,-
Avnclientvnwhovnhasvnsquamousvncellvncarcinomavnhasvnavnfirm,vnnodular,vnandvncrustyvnles
ionvnwithvnavnulceratedvncenter,vnresultingvnfromvnsunvnexposure,vnchronicvnirritation,vnburn
s,vnorvnirradiationvntovnthevnskin.

Avnnursevninvnanvnemergencyvndepartmentvnisvnassessingvnavnclientvnwhovnisvnoverusingvnp
rescribedvndiureticsvnandvnhasvnavnsodiumvnlevelvnofvn127vnmEq/
L.vnWhichvnofvnthevnfollowingvnlaboratoryvnfindingsvnshouldvnthevnnursevnexpect?vn-
vnanswer--LOWvnURINEvnSPECFICvnGRAVITY.

-
Avnclientvnwhovnhasvnhyponatremiavnasvnavnresultvnofvndiureticvnoverusevnhasvnavnlowvnurine
vnspecificvngravity.vnThevnincreasedvnexcretionvnofvnwatervnaltersvnthevnratiovnofvnparticulate

vnmatter,vnwhichvnaffectsvnthevnspecificvngravity.



Avnhomevnhealthvnnursevnisvnassistingvnavnclientvnwithvnplanningvncarevnforvnavnfamilyvnmem
bervnwhovnhasvnAlzheimer'svndisease.vnWhichvnofvnthevnfollowingvninstructionsvnshouldvnth
evnnursevninclude?vn-vnanswer--Removevncluttervnfromvnroomsvnandvnhallwaysvn

-
Thisvnallowsvnthevnclientvnisvnablevntovnwalkvnwithoutvnthevnriskvnofvnfallingvnorvntrippingvnov
vn

ervnobjects.vnLatervninvnthevndisease,vnthevnclientvncanvnexperiencevnseizures,vnsovncluttere
dvnareasvncouldvnbevnavnriskvntovnthevnclient

Avnnursevnisvncaringvnforvnavnclientvnwhovnhasvndevelopedvnacutevnrespiratoryvndistressvnsy
ndromevn(ARDS).vnWhichvnofvnthevnfollowingvnfindingsvnshouldvnthevnnursevnidentifyvnasvna
vnmanifestationvnofvnthisvnsyndrome?vn-vnanswer--REFRACTORYvnHYPOXEMIA



-
AvnclientvnwhovnhasvnARDSvnhasvnrefractoryvnhypoxemia,vnwhichvnisvnhypoxemiavnthatvnd
vn

oesvnnotvnimprovevnwithvnoxygenvntherapy.vnExtensivevnpulmonaryvnedemavnevidentvnonvn
avnchestvnx-rayvnisvnavnmanifestationvnofvnARDS.

Anvnemergencyvnroomvnnursevnisvnassessingvnavnclientvnwhovnhasvnasthmavnandvndifficulty
vnbreathing.vnWhichvnofvnthevnfollowingvnfindingsvnshouldvnindicatevntovnthevnnursevnthatvnth

evnclientvnisvnexperiencingvnstatusvnasthmaticus?vn-vnanswer--
USEvnOFvnASSCESSORYvnMUSCLES.vn

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vnAvnclientvnwhovnhasvnstatusvnasthmaticusvnusesvnaccessoryvnmusclesvntovnhelpvnfacilitate
vnbreathing,vnwhichvnisvnavnmanifestationvnofvnavnseverevnairflowvnobstruction.vnThevnsituati

onvnisvnlife-
threateningvnandvnthevnnursevnshouldvnintervenevnimmediatelyvnwithvnstrongvnsystemicvnbr
onchodilators,vnepinephrine,vncorticosteroids,vnandvnoxygen.

AvnnursevnisvnteachingvnavnclientvnwhovnhasvnavnnewvnprescriptionvnforvnPHENYTOINvntovntr
eatvnavnseizurevndisorder.vnWhichvnofvnthevnfollowingvnadversevneffectsvnshouldvnthevnnurs
evninstructvnthevnclientvntovnreportvnIMMEDIATELYvntovnthevnprovider?vn-vnanswer--
SKINvnRASH.vn

, -
thevnnursevnshouldvndeterminevnthatvnthevnpriorityvnfindingvnisvnavnrash,vnwhichvncanvnhave
vn

avnmeasles-likevnappearancevnandvnprogressvntovnexfoliativevndermatitisvnorvnStevens-
vn

Johnsonvnsyndrome.vnThevnclientvnshouldvnreportvnthisvnfindingvntovnthevnprovidervnimmedi
ately.

AvnnursevnisvnmonitoringvnavnclientvnfollowingvnavnLUMBARvnLAMINECTOMY.vnThevnclient
vnhasvnavndrainvnandvnindwellingvnurinaryvncatheter.vnThevnnursevnshouldvnidentifyvnwhichvn

ofvnthevnfollowingvnfindingsvnasvnanvnindicationvnofvnavnCOMPLICATIONvnofvnthevnsurgery?
vn-vnanswer--CLEARvnDRAINAGEvnOFvnDRESSINGS



-vnThisvnisvnanvnindicationvnofvnavncerebralvnspinalvnleak

AvnnursevnisvnassessingvnavnclientvnwhovnhasvnRIGHT-
SIDEDvnHEARTvnFAILURE.vnWhichvnofvnthevnfollowingvnfindingsvnshouldvnthevnnursevnide
ntifyvnasvnavnmanifestationvnofvnRIGHT-vnSIDEDvnHEARTvnFAILURE?vn-vnanswer--
INCREASEDvnABDOMINALvnGIRTH

Avnnursevnisvncaringvnforvnavnclientvnwhovnrecentlyvnassumedvnthevnrolevnofvncaregivervnforvnt
heirvnagingvnparentsvnwhovnhavevnchronicvnillnesses.vnThevnnursevnshouldvnidentifyvnthatvn
whichvnofvnthevnfollowingvnstatementsvnbyvnthevnclientvnindicatesvnACCEPTANCEvnofvnthev
nrolevnchange?vn-

vnanswer--"vnIvnchangedvnthevnfloorvnplanvnofvnourvnhomesvntovnaccommodatevnmyvnfather's

vnwheelchair.vn"



AvnnursevnisvncaringvnforvnavnclientvnwhovnisvnreceivingvnVANCOMYCINvnintermittentvnIVvnb
olusvntherapyvnforvnMETHICILLIN-
RESISTANTvnSTAPHYLOCOCCUSvnAUREUS.vnWhichvnofvnthevnfollowingvnfindingsvnisvn
anvnindicationvntovnthevnnursevnthatvnthevnclientvnisvnexperiencingvnanvnADVERSEvnEFFEC
Tvnofvnthevnmedication?vn-vnanswer--THEvnCLIENTvnISvnBECOMINGvnFLUSHED.vn

-
vnFlushingvnisvnavnmanifestationvnofvnanvninfusionvnreactionvntovnvancomycinvnthatvnalsovnca
usesvnavnrashvnonvnthevnfacevnandvnuppervnbody,vncalledvnredvnmanvnsyndrome.vnRedvnman
vnsyndromevnresultsvnfromvninfusingvnvancomycinvntovnrapidly.vnThevnnursevnshouldvninfus

evnthevnmedicationvnovervnatvnleastvn60vnmins.

AvnnursevnisvncaringvnforvnavnmalevnclientvnwhovnhasvnavnnewvnprescriptionvnforvnCYCLOSP
ORINEvnfollowingvnavnkidneyvntransplant.vnWhichvnofvnthevnfollowingvnfindingsvnshouldvnth
evnnursevnidentifyvnasvnanvnadversevneffectvnofvnthisvntherapy?vn-vnanswer--BUNvn24vnmg/
dL.vn

-vnAvnBUNvnofvn24vnmg/
dLvnisvnabovevnthevnexpectedvnreferencevnrangevnofvn10vntovn20vnmg/
dL,vnindicatingvnrenalvnimpairment.vnAnvnadversevneffectvnofvncyclosporinevnisvnnephrotoxi
city

AvnnursevnisvncaringvnforvnavnclientvnwhovnhasvnDUMPINGvnSYNDROMEvnfollowingvnavngas
tricvnresection.vnThevnnursevnshouldvnmonitorvnthevnclientvnforvnwhichvnofvnthevnfollowingvnc