VATI Med Surg Questions With
Rationale
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? -
CORRECT ANSWER ✔✔✔✔✔ A pearly, waxy nodule.
- Basal cell carcinoma has a nodular lesion with well defined borders & pearly or waxy
appearance resulting from overexposure to the sun. especially on the face, head, and
neck.
-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 client who has squamous cell carcinoma has a firm, nodular, and crusty lesion with a
ulcerated center, resulting from sun exposure, chronic irritation, burns, or irradiation to
the skin.
A nurse in an emergency department is assessing a client who is overusing prescribed
diuretics and has a sodium level of 127 mEq/L. Which of the following laboratory
findings should the nurse expect? - CORRECT ANSWER ✔✔✔✔✔ LOW URINE
SPECFIC 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.
A home health nurse is assisting a client with planning care for a family member who
has Alzheimer's disease. Which of the following instructions should the nurse include? -
CORRECT ANSWER ✔✔✔✔✔ Remove clutter from rooms and hallways
- This allows the client is able to walk without the risk of falling or tripping over objects.
Later in the disease, the client can experience seizures, so cluttered areas could be a
risk to the client
A nurse is caring for a client who has developed acute respiratory distress syndrome
(ARDS). Which of the following findings should the nurse identify as a manifestation of
this syndrome? - CORRECT ANSWER ✔✔✔✔✔ REFRACTORY HYPOXEMIA
- A client who has ARDS has refractory hypoxemia, which is hypoxemia that does not
improve with oxygen therapy. Extensive pulmonary edema evident on a chest x-ray is a
manifestation of ARDS.
,An emergency room nurse is assessing a client who has asthma and difficulty
breathing. Which of the following findings should indicate to the nurse that the client is
experiencing status asthmaticus? - CORRECT ANSWER ✔✔✔✔✔ USE OF
ASSCESSORY MUSCLES.
- A client who has status asthmaticus uses accessory muscles to help facilitate
breathing, which is a manifestation of a severe airflow obstruction. The situation is life-
threatening and the nurse should intervene immediately with strong systemic
bronchodilators, epinephrine, corticosteroids, and oxygen.
A nurse is teaching a client who has a new prescription for PHENYTOIN to treat a
seizure disorder. Which of the following adverse effects should the nurse instruct the
client to report IMMEDIATELY to the provider? - CORRECT ANSWER ✔✔✔✔✔ SKIN
RASH.
- the nurse should determine that the priority finding is a rash, which can have a
measles-like appearance and progress to exfoliative dermatitis or Stevens-Johnson
syndrome. The client should report this finding to the provider immediately.
A nurse is monitoring a client following a LUMBAR LAMINECTOMY. The client has a
drain and indwelling urinary catheter. The nurse should identify which of the following
findings as an indication of a COMPLICATION of the surgery? - CORRECT ANSWER
✔✔✔✔✔ CLEAR DRAINAGE OF DRESSINGS
- This is an indication of a cerebral spinal leak
A nurse is assessing a client who has RIGHT-SIDED HEART FAILURE. Which of the
following findings should the nurse identify as a manifestation of RIGHT- SIDED HEART
FAILURE? - CORRECT ANSWER ✔✔✔✔✔ INCREASED ABDOMINAL GIRTH
A nurse is caring for a client who recently assumed the role of caregiver for their aging
parents who have chronic illnesses. The nurse should identify that which of the following
statements by the client indicates ACCEPTANCE of the role change? - CORRECT
ANSWER ✔✔✔✔✔ " I changed the floor plan of our homes to accommodate my
father's wheelchair. "
A nurse is caring for a client who is receiving VANCOMYCIN intermittent IV bolus
therapy for METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS. Which of the
following findings is an indication to the nurse that the client is experiencing an
ADVERSE EFFECT of the medication? - CORRECT ANSWER ✔✔✔✔✔ THE
CLIENT IS BECOMING FLUSHED.
- Flushing is a manifestation of an infusion reaction to vancomycin that also causes a
rash on the face and upper body, called red man syndrome. Red man syndrome results
from infusing vancomycin to rapidly. The nurse should infuse the medication over at
least 60 mins.
, A nurse is caring for a male client who has a new prescription for CYCLOSPORINE
following a kidney transplant. Which of the following findings should the nurse identify
as an adverse effect of this therapy? - CORRECT ANSWER ✔✔✔✔✔ BUN 24 mg/dL.
- A BUN of 24 mg/dL is above the expected reference range of 10 to 20 mg/dL,
indicating renal impairment. An adverse effect of cyclosporine is nephrotoxicity
A nurse is caring for a client who has DUMPING SYNDROME following a gastric
resection. The nurse should monitor the client for which of the following complications of
DUMPING SYNDROME? - CORRECT ANSWER ✔✔✔✔✔ IRON DEFICIENCY
ANEMIA.
- The nurse should monitor the client for manifestations of anemia, such as pallor,
tachycardia, and fatigue.
Rapid emptying of the stomach contents into the intestine can lead to reduced
absorption of iron in the duodenum, causing iron-deficiency anemia.
A nurse is assessing a client who takes SALMETEROL to treat moderate asthma.
Which of the following findings should indicate to the nurse that the medication has
been effective? - CORRECT ANSWER ✔✔✔✔✔ The client's daily peak expiratory
flow (PEF) measures 85% above personal best.
- A client who has asthma should use a peak flow meter twice daily to monitor asthma
control. A PEF in the green zone, or 80% or above personal best, indicates the
effectiveness of medication therapy.
A nurse is providing teaching about health promotion activities for a client who has a
new diagnosis of type 1 diabetes mellitus. Which of the following statements by the
client indicates an understanding of the teaching? - CORRECT ANSWER ✔✔✔✔✔ " I
WILL CHECK MY BLOOD SUGAR LEVEL BEFORE EXCERCISING. "
- Clients who have diabetes mellitus should not exercise if their blood glucose level is
less than 80 mg/dL or greater than 250 mg/dL. A client who has type 1 diabetes mellitus
and is hyperglycemic can experience even higher blood glucose levels. Hypoglycemia
can also occur during exercise and up to 24 hr following exercise
A nurse is providing teaching to a client who has a new prescription for WARFARIN.
Which of the following medications should the nurse instruct the client to avoid? -
CORRECT ANSWER ✔✔✔✔✔ ASPIRIN & NAPROXEN.
- Aspirin is an antiplatelet medication. It can increase the risk of bleeding when taken
with warfarin.
- . Naproxen is an NSAID that relieves mild to moderate pain. It can increase the risk of
bleeding if taken with warfarin.
Rationale
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? -
CORRECT ANSWER ✔✔✔✔✔ A pearly, waxy nodule.
- Basal cell carcinoma has a nodular lesion with well defined borders & pearly or waxy
appearance resulting from overexposure to the sun. especially on the face, head, and
neck.
-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 client who has squamous cell carcinoma has a firm, nodular, and crusty lesion with a
ulcerated center, resulting from sun exposure, chronic irritation, burns, or irradiation to
the skin.
A nurse in an emergency department is assessing a client who is overusing prescribed
diuretics and has a sodium level of 127 mEq/L. Which of the following laboratory
findings should the nurse expect? - CORRECT ANSWER ✔✔✔✔✔ LOW URINE
SPECFIC 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.
A home health nurse is assisting a client with planning care for a family member who
has Alzheimer's disease. Which of the following instructions should the nurse include? -
CORRECT ANSWER ✔✔✔✔✔ Remove clutter from rooms and hallways
- This allows the client is able to walk without the risk of falling or tripping over objects.
Later in the disease, the client can experience seizures, so cluttered areas could be a
risk to the client
A nurse is caring for a client who has developed acute respiratory distress syndrome
(ARDS). Which of the following findings should the nurse identify as a manifestation of
this syndrome? - CORRECT ANSWER ✔✔✔✔✔ REFRACTORY HYPOXEMIA
- A client who has ARDS has refractory hypoxemia, which is hypoxemia that does not
improve with oxygen therapy. Extensive pulmonary edema evident on a chest x-ray is a
manifestation of ARDS.
,An emergency room nurse is assessing a client who has asthma and difficulty
breathing. Which of the following findings should indicate to the nurse that the client is
experiencing status asthmaticus? - CORRECT ANSWER ✔✔✔✔✔ USE OF
ASSCESSORY MUSCLES.
- A client who has status asthmaticus uses accessory muscles to help facilitate
breathing, which is a manifestation of a severe airflow obstruction. The situation is life-
threatening and the nurse should intervene immediately with strong systemic
bronchodilators, epinephrine, corticosteroids, and oxygen.
A nurse is teaching a client who has a new prescription for PHENYTOIN to treat a
seizure disorder. Which of the following adverse effects should the nurse instruct the
client to report IMMEDIATELY to the provider? - CORRECT ANSWER ✔✔✔✔✔ SKIN
RASH.
- the nurse should determine that the priority finding is a rash, which can have a
measles-like appearance and progress to exfoliative dermatitis or Stevens-Johnson
syndrome. The client should report this finding to the provider immediately.
A nurse is monitoring a client following a LUMBAR LAMINECTOMY. The client has a
drain and indwelling urinary catheter. The nurse should identify which of the following
findings as an indication of a COMPLICATION of the surgery? - CORRECT ANSWER
✔✔✔✔✔ CLEAR DRAINAGE OF DRESSINGS
- This is an indication of a cerebral spinal leak
A nurse is assessing a client who has RIGHT-SIDED HEART FAILURE. Which of the
following findings should the nurse identify as a manifestation of RIGHT- SIDED HEART
FAILURE? - CORRECT ANSWER ✔✔✔✔✔ INCREASED ABDOMINAL GIRTH
A nurse is caring for a client who recently assumed the role of caregiver for their aging
parents who have chronic illnesses. The nurse should identify that which of the following
statements by the client indicates ACCEPTANCE of the role change? - CORRECT
ANSWER ✔✔✔✔✔ " I changed the floor plan of our homes to accommodate my
father's wheelchair. "
A nurse is caring for a client who is receiving VANCOMYCIN intermittent IV bolus
therapy for METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS. Which of the
following findings is an indication to the nurse that the client is experiencing an
ADVERSE EFFECT of the medication? - CORRECT ANSWER ✔✔✔✔✔ THE
CLIENT IS BECOMING FLUSHED.
- Flushing is a manifestation of an infusion reaction to vancomycin that also causes a
rash on the face and upper body, called red man syndrome. Red man syndrome results
from infusing vancomycin to rapidly. The nurse should infuse the medication over at
least 60 mins.
, A nurse is caring for a male client who has a new prescription for CYCLOSPORINE
following a kidney transplant. Which of the following findings should the nurse identify
as an adverse effect of this therapy? - CORRECT ANSWER ✔✔✔✔✔ BUN 24 mg/dL.
- A BUN of 24 mg/dL is above the expected reference range of 10 to 20 mg/dL,
indicating renal impairment. An adverse effect of cyclosporine is nephrotoxicity
A nurse is caring for a client who has DUMPING SYNDROME following a gastric
resection. The nurse should monitor the client for which of the following complications of
DUMPING SYNDROME? - CORRECT ANSWER ✔✔✔✔✔ IRON DEFICIENCY
ANEMIA.
- The nurse should monitor the client for manifestations of anemia, such as pallor,
tachycardia, and fatigue.
Rapid emptying of the stomach contents into the intestine can lead to reduced
absorption of iron in the duodenum, causing iron-deficiency anemia.
A nurse is assessing a client who takes SALMETEROL to treat moderate asthma.
Which of the following findings should indicate to the nurse that the medication has
been effective? - CORRECT ANSWER ✔✔✔✔✔ The client's daily peak expiratory
flow (PEF) measures 85% above personal best.
- A client who has asthma should use a peak flow meter twice daily to monitor asthma
control. A PEF in the green zone, or 80% or above personal best, indicates the
effectiveness of medication therapy.
A nurse is providing teaching about health promotion activities for a client who has a
new diagnosis of type 1 diabetes mellitus. Which of the following statements by the
client indicates an understanding of the teaching? - CORRECT ANSWER ✔✔✔✔✔ " I
WILL CHECK MY BLOOD SUGAR LEVEL BEFORE EXCERCISING. "
- Clients who have diabetes mellitus should not exercise if their blood glucose level is
less than 80 mg/dL or greater than 250 mg/dL. A client who has type 1 diabetes mellitus
and is hyperglycemic can experience even higher blood glucose levels. Hypoglycemia
can also occur during exercise and up to 24 hr following exercise
A nurse is providing teaching to a client who has a new prescription for WARFARIN.
Which of the following medications should the nurse instruct the client to avoid? -
CORRECT ANSWER ✔✔✔✔✔ ASPIRIN & NAPROXEN.
- Aspirin is an antiplatelet medication. It can increase the risk of bleeding when taken
with warfarin.
- . Naproxen is an NSAID that relieves mild to moderate pain. It can increase the risk of
bleeding if taken with warfarin.
