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RN VATI ADULT MEDICAL SURGICAL 2021 EXAM

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FLAG • Time Remaining: 00:36:55 • Pause Remaining: 00:05:00 PAUSE 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? High lipase A high lipase level is associated with pancreatic dysfunction or renal failure and is not an expected finding with hyponatremia or dehydration. Low urine specific gravity MY ANSWER 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. Low hemoglobin A client who is dehydrated as a result of diuretic overuse can have an elevated hemoglobin level because of the difference in ratio between intravascular fluid and blood cells. High creatine kinase-MB (CK-MB) An elevated CK-MB level indicates a myocardial infarction and is not an expected finding with hyponatremia. • RN VATI Adult Medical Surgical 2019 CLOSE Question 83 loaded rationals provided Question: 83 of 90 INCORRECT FLAG • Time Remaining: 00:36:47 • Pause Remaining: 00:05:00 PAUSE 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? 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. Place a monthly calendar in the client's room. MY ANSWER The nurse should instruct the family member to place a single-date calendar in the client's room. A monthly calendar can be overwhelming and confusing to a client who has Alzheimer's disease. Use confrontation to manage the client's behavior. The nurse should instruct the family member to redirect the client by starting another activity when the client begins to act out or becomes overstimulated. Redirecting the client might help them gain focus. Review the daily schedule with the client every morning. The nurse should instruct the family member to use short, simple sentences when explaining an activity to the client. The explanation should be done immediately before the activity to aid the client's memory and ability to follow directions. • RN VATI Adult Medical Surgical 2019 CLOSE Question 82 loaded rationals provided Question: 82 of 90 CORRECT FLAG • Time Remaining: 00:36:39 • Pause Remaining: 00:05:00 PAUSE 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? An audible pleural friction rub A client who has a pulmonary embolism can have a pleural friction rub along with tachypnea, tachycardia, dyspnea, and sudden, sharp chest pain. However, a pleural friction rub is not a manifestation of ARDS. Tracheal deviation from the midline A client who has a tension pneumothorax can have tracheal deviation with dyspnea, tach

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RN VATI ADULT MEDICAL
SURGICAL 2021
CLOSE
Question 90 loaded ration als provided




Question: 90 of 90
CORRECT • Time Remaining: 00:38:42
• Pause Remaining: 00:05:00
PAUSE

FLAG
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 2019
CLOSE
Question 89 loaded ration als provided

,Question: 89 of 90
CORRECT
• Time Remaining: 00:37:45
• Pause Remaining: 00:05:00
PAUSE
FLAG
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.

Frothy sputum
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 2019
CLOSE
Question 88 loaded ration als provided




Question: 88 of 90
CORRECT
• Time Remaining: 00:37:30
• Pause Remaining: 00:05:00
PAUSE
FLAG
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, PCO 30 mm Hg, HCO 24 mEq/L, PaO 85
2 3
-
2


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 PCO is decreased, representing
2



alveolar hyperventilation and resultant respiratory alkalosis.
Respiratory acidosis
This pH is alkaline (increased) and the PCO is decreased. A decreased pH
2



and an increased PCO indicate respiratory acidosis.
2


Metabolic alkalosis
This HCO 24 mEq/L is within the expected range of 21 to 28 mEq/L and the
3
-




pH is alkaline (increased). An increased pH and HCO indicate metabolic
-
3



alkalosis.
Metabolic acidosis
This HCO 24 mEq/L is within the expected range of 21 to 28 mEq/L and the
3
-




pH is alkaline (increased). A decreased pH and HCO indicate metabolic
-
3



acidosis.


RN VATI Adult Medical Surgical 2019
CLOSE
Question 87 loaded ration als provided




Question: 87 of 90
CORRECT
• Time Remaining: 00:37:22
• Pause Remaining: 00:05:00
PAUSE
FLAG

, 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 2019
CLOSE
Question 86 loaded ration als provided




Question: 86 of 90
CORRECT
• Time Remaining: 00:37:13
• Pause Remaining: 00:05:00
PAUSE
FLAG
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?

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