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RN VATI Adult Medical Surgical LATEST
(2020/2021)
Question 90 loaded rationals provided
Question:
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.
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RN VATI Adult Medical Surgical 2019
CLOSE
Question 89 loaded rationals 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 rationals 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 2 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 PCO is decreased, representing alveolar hyperventilation
2
and resultant respiratory alkalosis.
Respiratory acidosis
This pH is alkaline (increased) and the PCO is decreased. A decreased pH and an increased
2
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 pH is alkaline
3
-
(increased). An increased pH and HCO indicate metabolic alkalosis.
3
-
Metabolic acidosis
This HCO 24 mEq/L is within the expected range of 21 to 28 mEq/L and the pH is alkaline
3
-
(increased). A decreased pH and HCO indicate metabolic acidosis.
3
-
•
RN VATI Adult Medical Surgical 2019
CLOSE
Question 87 loaded rationals 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 rationals 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?
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
RN VATI Adult Medical Surgical LATEST
(2020/2021)
Question 90 loaded rationals provided
Question:
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 rationals 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 rationals 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 2 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 PCO is decreased, representing alveolar hyperventilation
2
and resultant respiratory alkalosis.
Respiratory acidosis
This pH is alkaline (increased) and the PCO is decreased. A decreased pH and an increased
2
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 pH is alkaline
3
-
(increased). An increased pH and HCO indicate metabolic alkalosis.
3
-
Metabolic acidosis
This HCO 24 mEq/L is within the expected range of 21 to 28 mEq/L and the pH is alkaline
3
-
(increased). A decreased pH and HCO indicate metabolic acidosis.
3
-
•
RN VATI Adult Medical Surgical 2019
CLOSE
Question 87 loaded rationals 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 rationals 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?
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
