VATI MED SURGE ASSESSMENT. QUESTIONS AND ANSWERS

VATI MED SURGE ASSESSMENT.
QUESTIONS AND ANSWERS

Avnnursevnisvncaringvnforvnavnclientvnwhovnhasvnatopicvndermatitisvnandvnavnprescriptionvnforv
ntriamcinolonevnointment.vnThevnnursevnshouldvnassessvnthevnclientvntovnmonitorvnforvnwhic

hvnofvnthevnfollowingvnadversevneffects?vn-vnanswer--Thinningvnofvnthevnskin.vn
Onlyvnapplyvnthevnointmentvntovndryvnpatchesvnofvnthevnskinvntovnavoidvnatrophy.

TopicalvnGlucocorticoidsvnSidevneffectsvn-vnanswer--Tiamcinolonevn
-vnHypopigmentationvn
-vnExcessivevnhairvngrowthvn(hypertrichosis)vn
-vnThinningvnofvnthevnskin

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



Pink-
tingedvnfrothyvnsputumvncanvnbevnanvnearlyvnindicationvnofvnpulmonaryvnedemavnandvncanvn
bevnlife-threatening.vnTherefore,vnthevnnursevnshouldvnnotifyvnthevnprovidervnimmediately.

LeftvnSidedvnHeartvnFailurevn-vnanswer---vnFrothyvnsputumvn
-vnDyspneavn
-vnWheezingvn
Treatment:vn
Fluidvnrestrictionvn&vndiureticsvntovndecreasevnpreloadvn&vnpulmonaryvncongestion

Rightvnheartvnsidedvnfailurevn-vnanswer---vnDependentvnedmavn
-vnJugularvndistentionvn
-vnWeightvngain

Avnnursevnisvncaringvnforvnavnclientvnwhovnisvnexperiencingvnanxietyvnasvnwellvnasvnnumbnes
svnandvntinglingvnofvnthevnlipsvnandvnfingers.vn
Thevnclient'svnABGsvnare:vnpHvn7.48,vnPCO2vn30vnmmvnHg,vnHCO3-vn24vnmEq/
L,vnPaO2vn85vnmmvnHg.vnWhichvnofvnthevnfollowingvnacid-
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.

Melanomavn-vnanswer--
Irregularvnbordervnandvnvarigatedvncoloredvnlesionsvnofvnred,vnwhite,vnblue.vn
-vnMostvnoftenvnonvnthevnuppervnbackvnorvnlowervnlegs

Squamousvncellvncarcinomavn-vnanswer--
Firm,vnnodular,vnandvncrustyvnlesionvnwithvnanvnulceratedvncentervnfromvnsunvnexposure,vnc
hronicvnirritation,vnburns,vnorvnirradiationvntovnthevnskin.

weepingvnvescilevn-vnanswer--HerpesvnZostervn
-vnWeeping,vnblistervntypevnlesions.

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

-
Avnclientvnwhovnhasvnhyponatremiavnasvnavnresultvnofvndiureticvnoverusevnhasvnavnlowvnurine
vnspecificvngravity.vnThevnincreasedvnexcretionvnofvnwatervnaltersvnthevnratiovnofvnparticulate

vnmatter,vnwhichvnaffectsvnthevnspecificvngravity.



Hyponatremiavn-vnanswer---vnLowvnspecificvngravityvn
-vnElevatedvnhemoglobin

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

-
Thisvnallowsvnthevnclientvnisvnablevntovnwalkvnwithoutvnthevnriskvnofvnfallingvnorvntrippingvnov
vn

ervnobjects.vnLatervninvnthevndisease,vnthevnclientvncanvnexperiencevnseizures,vnsovncluttere
dvnareasvncouldvnbevnavnriskvntovnthevnclient

, Alzheimer'svninterventionsvn-vnanswer---vnSinglevndatevncalendervn
-vnRedirectvnthevnclientvnbyvnstartingvnanothervnactivityvn
-vnUsevnshort,vnsimplevnsentecesvnwhenvnexplainingvnanvnactivityvn
-vnExplanationvnshouldvnbevndonevnimmediatelyvnbeforevnanvnactivity

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



-
AvnclientvnwhovnhasvnARDSvnhasvnrefractoryvnhypoxemia,vnwhichvnisvnhypoxemiavnthatvnd
vn

oesvnnotvnimprovevnwithvnoxygenvntherapy.vnExtensivevnpulmonaryvnedemavnevidentvnonvn
avnchestvnx-rayvnisvnavnmanifestationvnofvnARDS.

Pulmonaryvnembolismvn-vnanswer---vnPleuralvnfrictionvnrubvn
-vnTachypnea
-vnTachycardiavn
-vnDyspneavn
-vnSudden,vnsharpvnchestvnpain

Tensionvnpneumothoraxvn-vnanswer---vnTrachialvndeviationvn
-vnDyspneavn
-vnTachycardiavn
-vnTachypneavn
-vnDecreasedvnorvnabsentvnbreathvnsoundsvnovervnarea

Lungvncancervn-vnanswer--Hemoptysisvn
Bloodyvnexpectorantvnwhenvncoughing

Anvnemergencyvnroomvnnursevnisvnassessingvnavnclientvnwhovnhasvnasthmavnandvndifficulty
vnbreathing.vnWhichvnofvnthevnfollowingvnfindingsvnshouldvnindicatevntovnthevnnursevnthatvnth

evnclientvnisvnexperiencingvnstatusvnasthmaticus?vn-vnanswer--
USEvnOFvnASSCESSORYvnMUSCLES.vn

-
vnAvnclientvnwhovnhasvnstatusvnasthmaticusvnusesvnaccessoryvnmusclesvntovnhelpvnfacilitate
vnbreathing,vnwhichvnisvnavnmanifestationvnofvnavnseverevnairflowvnobstruction.vnThevnsituati

onvnisvnlife-
threateningvnandvnthevnnursevnshouldvnintervenevnimmediatelyvnwithvnstrongvnsystemicvnbr
onchodilators,vnepinephrine,vncorticosteroids,vnandvnoxygen.

statusvnasthmaticusvn-vnanswer---vnLaboredvnbreathingvn&vnwheezingvn
-vnDistendedvnneckvnveinsvn
-vnUsevnofvnaccessoryvnmusclevn
-vnBronchodilatorsvn
-vnEpinephrinevn
-vnCorticosteroids
-vnOxygen