RN ADULT MEDICAL SURGICAL RETAKE GRADED A+ (question and answer).pdf

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RNk VATIk Adultk Medicalk Surgicalk201
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Q ue stion 90 loade d rationals provi de d




Question: 90 of 90 k k k


CORRECT • Timek Remaining:k 00:38:42
• Pausek Remaining:k 00:05:00
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FLAG
Aknursekiskcaringkforkakclientkwhokhaskatopickdermatitiskandkakprescriptionkforktriamcinolone
ointment.k Thek nursek shouldk assessk thek clientk tok monitork fork whichk ofk thekfollowingk adver
sek effects?


Increasedkpigmentation

Topicalk glucocorticoidk therapyk cank causekthek adversek effectk ofkhypopigmentation.

Localizedk hairk loss

Long-
termkglucocorticoidktherapykcankcausekhypertrichosis,korkexcessivekhairkgrowth,eikkkksp
eciallyk onkkthekkfacialk area.

Thinningkofkthekskin

MY kkkkkkkkkkk ANSWER




Thinningk ofk thek skink andk delayedk healingk arek adversek effectsk ofk topicalk glucocorticoidk
preparations.kThekclientkshouldkonlykapplykthekointmentktokdrykpatcheskofkthekskinkbeca
usetopicalksteroidskcankcausekatrophykofkthekdermiskandkepidermis,kwhichkcankresultk ink
thinningk ofk thek skin.

Increasedk sensitivityk tok thek sun

Theknursekshouldkinstructkthekclientktokavoidkexcessiveksunkexposurekwhenktakingktopicalfluticas
one;k however,k triamcinolonek ointmentk doesk notk causek photosensitivity.

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RNk VATIk Adultk Medicalk Surgicalk 2019
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Q ue stion 89 loade d rationals provi de d




Question: 89 of 90 k k k


CORRECT
• Timek Remaining:k 00:37:45

, • Pausek Remaining:k 00:05:00
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FLAG
Ak nursek iskassessingk akclientk whokhask left-
sidedk heartk failure.k Whichkofkthek followingkfindingsishouldk theknursek identifykask akmanifes
tationk ofk left-sidedk heartk failure?


Dependentk edema

Theknursekshouldkidentifykthatkdependentkedemakiskakmanifestationkofkright-
sidedkheartkfailurekduektokrightkventricularkfailurekandkfluidkretentionkfromkpressurekbuild
ingkupkinkthevenousk system.

Jugularkdistention

Theknursekshouldkidentifykthatkjugularkveinkdistentionkiskakmanifestationkofkright-
sidedkheartfailurekduektokrightkventricularkfailurekandkfluidkretentionkfromkpressurek buil
dingkupk ink thek venousk system.

Weightk gain

Theknursekshouldk identifyk thatk weightkgainkiskak manifestationk ofkright-
sidedkheartkfailurekduektokrightkventricularkfailurekandkfluidkretentionkfromkpressurekbui
ldingkupkinkthek venoussystem.

Frothyksputum
MY kkkkkkkkkkkkkk ANSWER




Theknursekshouldkidentifykthatkfrothyksputum,kdyspnea,kandkwheezingkarekmanifestation
skofleft-
sidedkheartkfailure.kTreatmentkincludeskfluidkrestrictionkandkdiureticsktokdecreasekprelo
adkandkreducekpulmonarykcongestion.kPink-
tingedkfrothyksputumk cank bek ank earlyk indicationk ofk pulmonaryk edemak andk cank bek life-
threatening.kTherefore,k thek nursek shouldk notifyk thek providerk immediately.


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Q ue stion 88 loade d rationals provi de d




Question: 88 of 90 k k k


CORRECT

, • Timek Remaining:k 00:37:30
• Pausek Remaining:k 00:05:00
PAUSE
FLAG
Ak nursek isk caringk fork ak clientk whok iskexperiencingk anxietyk askwellk asknumbnessk andk tinglingk ofkt
helipsk andk fingers.k Thek client'sk ABGsk are:k pHk 7.48,k PCO2kkkkkkkk30k mmk Hg,kHCO3-
24k mEq/L,k PaO2
k85 k mm k Hg.k Whichk ofk thek followingk acid-
basek imbalancesk shouldk thek nursek identifykthatkthekclientk isk experiencing?

Respiratorykalkalosis


MY kkkkkkkkkkk ANSWER




Thisk pHkkisk alkalinekk(increased)kkandkkthek PCO 2


isk decreased,kkrepresentingk alveolar
khyperventilationk andk resultantk respiratoryk alkalosis.


Respiratorykacidosis
Thisk pHkkisk alkalinekk(increased)kkandkkthek PCO 2


isk decreased.kkAk decreasedkkpHk andk ankincreasedkkPCO 2


indicatekkrespiratoryk acidosis.
Metabolickalkalosis
Thisk HCO 3-


24k mEq/Lk isk withink thek expectedk rangek ofk 21k tokk28k mEq/Lkkandk thek pHkkisk alkaline
(increased).kkAnk increasedkkpHk andk HCO indicatekkmetabolick alkalosis.
k 3-


Metabolickacidosis
Thisk HCO 3-


24k mEq/Lk isk withink thek expectedk rangek ofk 21k tokk28k mEq/Lkkandk thek pHkkisk alkaline
k(increased).kkAk decreasedk pHkkandkkHCO indicatek metabolick acidosis. 3-




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Q ue stion 87 loade d rationals provi de d




Question: 87 of 90 k k k


CORRECT • Timek Remaining:k 00:37:22
• Pausek Remaining:k 00:05:00
PAUSE

FLAG
Ak nursek iskassessingk akclientk whok haskCushing'sksyndrome.k Whichk ofk thek followingkfindingsi
shouldk thek nursek expect?


Vitiligo