ATI RN ADULT MEDICAL SURGICAL PROCTORED EXAM REVIEW

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 MY ANSWER 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 dermis and epidermis, which can result in thinning of the skin. Increased sensitivity to the sun The nurse should instruct the client to avoid excessive sun exposure when taking topical fluticasone; however, triamcinolone ointment does not cause photosensitivity. • RN VATI Adult Medical Surgical Que stion89 loade drational s provide d Question: 89 of 90 CORRECT • Time Remaining: 00:37:45 FLAG • Pause Remaining: 00:05:00 PAUSE 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? Dependent edema The nurse should identify that dependent edema is a manifestation of right-sided heart failure due to right ventricular failure and fluid retention from pressure building up in the venous system. Jugular distention The nurse should identify that jugular vein distention is a manifestation of right-sided heart failure due to right ventricular failure and fluid retention from pressure building up in the venous system. Weight gain The nurse should identify that weight gain is a manifestation of right-sided heart failure due to right ventricular failure and fluid retention from pressure building up in the venous system. MY ANSWER 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. • RN VATI Adult Medical Surgical CLOSE Que stion88 loade drational s provide d Question: 88 of 90 CORRECT FLAG • Time Remaining: 00:37:30 • Pause Remaining: 00:05:00 PAUSE 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? Respiratory alkalosis MY ANSWER This pH is alkaline (increased) and the PCO2 is decreased, representing alveolar hyperventilation and resultant respiratory alkalosis. Respiratory acidosis This pH is alkaline (increased) and the PCO2 is decreased. A decreased pH and an increased PCO2 indicate respiratory acidosis. Metabolic alkalosis This HCO3- 24 mEq/L is within the expected range of 21 to 28 mEq/L and the pH is alkaline (increased). An increased pH and HCO3- indicate metabolic alkalosis. Metabolic acidosis This HCO3- 24 mEq/L is within the expected range of 21 to 28 mEq/L and the pH is alkaline (increased). A decreased pH and HCO3- indicate metabolic acidosis. • RN VATI Adult Medical Surgical CLOSE Que stion87 loade drational s provide d Question: 87 of 90 CORRECT FLAG • Time Remaining: 00:37:22 • Pause Remaining: 00:05:00 PAUSE A nurse is assessing a client who has Cushing's syndrome. Which of the following findings should the nurse expect? Vitiligo Vitiligo is the loss of pigment from areas of a client's skin, causing irregular, white patches. Vitiligo is a manifestation of adrenal-gland hypofunction. Osteoporosis MY ANSWER Osteoporosis is a common finding with Cushing's syndrome. Bones become thinner as a result of mineral loss and nitrogen depletion, and the risk for fractures increases. Myxedema A client who has hypothyroidism can develop myxedema that causes mucinous cellular edema around the eyes, across the upper back, and in the hands and feet. Heat intolerance A client who has hyperthyroidism can develop heat intolerance, along with an increase in sweating. • RN VATI Adult Medical Surgical CLOSE Que stion86 loade drational s provide d Question: 86 of 90 CORRECT FLAG • Time Remaining: 00:37:13 • Pause Remaining: 00:05:00 PAUSE 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? A pearly, waxy nodule MY ANSWER A client who has basal cell carcinoma has a nodular lesion with well-defined borders and a pearly or waxy appearance, 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