RN 2023 Adult Medical Surgical ATI Proctored
QUESTIONS WITH HIGHLIGHTED CORRECT ANSWERS
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1. 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?
A. Increased pigmentation
B. Localized hair loss
C. Thinning of the skin
D. Increased sensitivity to the sun ANS C. Thinning of the skin
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.
2. 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?
A. Dependent edema
B. Jugular distention
C. Weight gain
D. Frothy sputum ANS D. Frothy sputum
The nurse should identify that frothy sputum, dyspnea, and wheezing are manifes- tations 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.
3. A nurse is caring for a client who is experiencing anxiety as well as numb- ness and
tingling of the lips and fingers. The client's ABGs are ANS 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?
A. Respiratory alkalosis
B. Metabolic alkalosis
,C. Respiratory acidosis
,D. Metabolic acidosis ANS A. Respiratory alkalosis
This pH is alkaline (increased) and the PCO2 is decreased, representing alveolar
hyperventilation and resultant respiratory alkalosis.
4. A nurse is assessing a client who has Cushing's syndrome. Which of the following
findings should the nurse expect?
A. Vitiligo
B. Osteoporosis
C. Myxedema
D. Heat intolerance ANS B. Osteoporosis
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.
5. 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. A pearly, waxy nodule
B. An irregular border on a variegated-colored lesion
C. A firm, nodular, crusty, or ulcerated lesion
D. A weeping vesicle ANS A. A pearly, waxy nodule
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.
6. A nurse is assessing a client who has hypocalcemia. In which of the follow- ing areas should
the nurse tap on the client's face to detect the p resence of
Chvostek's sign? ANS A is correct.
The nurse should tap the client's cheek just in front of the ear and below the
zygomatic arch. The client who has hypocalcemia will display a Ckvo whichstek's sign,
is a
twitching of the facial muscle.
7. 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?
A. High lipase
B. Low urine specific gravity
C. Low hemoglobin
D. High creatine kinase-MB (CK-MB) ANS B. Low urine specific 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.
8. 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?
A. Remove clutter from rooms and hallways.
B. Place a monthly calendar in the client's room.
C. Use confrontation to manage the client's behavior.
D. Review the daily schedule with the client every morning. ANS A. Remove clutter from
rooms and hallways.
The nurse should instruct the family member to remove clutter from rooms and hallways so
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.
9. 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?
A. An audible pleural friction rub
B. Tracheal deviation from the midline
C. Refractory hypoxemia
D. Bloody expectorant when coughing ANS C. Refractory hypoxemia
ARDS is a systemic inflammatory response to trauma, sepsis, burns, pancreatitis, and blood
transfusions, when excess lung fluid dilutes surfactant activity in the lungs. A client who
has ARDS has refractory hypoxemia, which is hypoxemia that does not improve with
QUESTIONS WITH HIGHLIGHTED CORRECT ANSWERS
aaaa
1. 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?
A. Increased pigmentation
B. Localized hair loss
C. Thinning of the skin
D. Increased sensitivity to the sun ANS C. Thinning of the skin
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.
2. 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?
A. Dependent edema
B. Jugular distention
C. Weight gain
D. Frothy sputum ANS D. Frothy sputum
The nurse should identify that frothy sputum, dyspnea, and wheezing are manifes- tations 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.
3. A nurse is caring for a client who is experiencing anxiety as well as numb- ness and
tingling of the lips and fingers. The client's ABGs are ANS 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?
A. Respiratory alkalosis
B. Metabolic alkalosis
,C. Respiratory acidosis
,D. Metabolic acidosis ANS A. Respiratory alkalosis
This pH is alkaline (increased) and the PCO2 is decreased, representing alveolar
hyperventilation and resultant respiratory alkalosis.
4. A nurse is assessing a client who has Cushing's syndrome. Which of the following
findings should the nurse expect?
A. Vitiligo
B. Osteoporosis
C. Myxedema
D. Heat intolerance ANS B. Osteoporosis
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.
5. 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. A pearly, waxy nodule
B. An irregular border on a variegated-colored lesion
C. A firm, nodular, crusty, or ulcerated lesion
D. A weeping vesicle ANS A. A pearly, waxy nodule
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.
6. A nurse is assessing a client who has hypocalcemia. In which of the follow- ing areas should
the nurse tap on the client's face to detect the p resence of
Chvostek's sign? ANS A is correct.
The nurse should tap the client's cheek just in front of the ear and below the
zygomatic arch. The client who has hypocalcemia will display a Ckvo whichstek's sign,
is a
twitching of the facial muscle.
7. 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?
A. High lipase
B. Low urine specific gravity
C. Low hemoglobin
D. High creatine kinase-MB (CK-MB) ANS B. Low urine specific 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.
8. 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?
A. Remove clutter from rooms and hallways.
B. Place a monthly calendar in the client's room.
C. Use confrontation to manage the client's behavior.
D. Review the daily schedule with the client every morning. ANS A. Remove clutter from
rooms and hallways.
The nurse should instruct the family member to remove clutter from rooms and hallways so
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.
9. 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?
A. An audible pleural friction rub
B. Tracheal deviation from the midline
C. Refractory hypoxemia
D. Bloody expectorant when coughing ANS C. Refractory hypoxemia
ARDS is a systemic inflammatory response to trauma, sepsis, burns, pancreatitis, and blood
transfusions, when excess lung fluid dilutes surfactant activity in the lungs. A client who
has ARDS has refractory hypoxemia, which is hypoxemia that does not improve with
