ATI RN Adult Medical Surgical
Proctored Exam 2023
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Question: 90 of 90
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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
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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
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Question: 89 of 90
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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.
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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
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Question: 86 of 90
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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.
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