MED SURG 450 RN_VATI_Adult_Medical_Surgical_100% | RN VATI Adult Medical Surgical_Graded A

Document Content and Description Below

RN VATI Adult Medical Surgical • RN VATI Adult Medical Surgical 2019 CLOSE Question 90 loaded rationales provided Question: 90 of 90 CORRECT • Time Remaining: 00:38:42 • Pause Remainin... g: 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 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, 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? Respiratory alkalosis MY ANSWER This pH is alkaline (increased) and the PCO2 is decreased, representing alveolar hyperventilation and resultant respiratory alkalosis. Respiratory acidosis This pH is alkaline (increased) and the PCO2 is decreased. A decreased pH and an increased PCO2 indicate respiratory acidosis. Metabolic alkalosis This HCO3- 24 mEq/L is within the expected range of 21 to 28 mEq/L and the pH is alkaline (increased). An increased pH and HCO3- indicate metabolic alkalosis. Metabolic acidosis This HCO3- 24 mEq/L is within the expected range of 21 to 28 mEq/L and the pH is alkaline (increased). A decreased pH and HCO3- indicate metabolic acidosis. • 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 A client who has squamous cell carcinoma has a firm, nodular, and crusty lesion with an ulcerated center, resulting from sun exposure, chronic irritation, burns, or irradiation to the skin. A weeping vesicle A client who has herpes zoster has weeping, blister-type lesions. • RN VATI Adult Medical Surgical 2019 CLOSE Question 85 loaded rationals provided Question: 85 of 90 CORRECT • Time Remaining: 00:37:02 • Pause Remaining: 00:05:00 PAUSE FLAG A nurse is assessing a client who has hypocalcemia. In which of the following areas should the nurse tap on the client's face to detect the presence of Chvostek's sign? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.) 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 Chvostek's sign, which is a twitching of the facial muscle. B is incorrect. The nurse should apply upward pressure at the supraorbital ridge, below the eyebrow, to assess for tenderness and inflammation of the frontal sinuses. C is incorrect. The nurse should palpate the jaw and mastoid muscle of a client who has temporomandibular joint dysfunction. This can be caused by misaligned teeth, arthritis, or grinding of the teeth. With palpation, the nurse might feel a click, pop, or grating sensation when the client opens or closes the jaw. • RN VATI Adult Medical Surgical 2019 CLOSE Question 84 loaded rationals provided Question: 84 of 90 CORRECT • Time Remaining: 00:36:55 • Pause Remaining: 00:05:00 PAUSE FLAG 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 - - - - - - - - - - - - - - - - -RN VATI Adult Medical Surgical 2019 CLOSE Question 4 loaded rationals provided Question: 4 of 90 CORRECT • Time Remaining: 00:28:24 • Pause Remaining: 00:05:00 PAUSE FLAG A nurse is providing discharge teaching to a client who has COPD. Which of the following instructions should the nurse include in the teaching? "Schedule controlled coughing exercises after meals." The client should schedule controlled coughing exercises before meals to clear mucus, which can improve dietary intake. "Consume a diet that is high in calories." MY ANSWER Dyspnea decreases energy available for eating. Therefore, the nurse should encourage the client to eat soft, high-calorie and high-protein foods to prevent weight loss. "Practice breath-holding." The nurse should teach the client to use pursed-lip breathing and avoid breath-holding, which can increase the amount of air that is trapped in the lungs. Pursed-lip breathing decreases the amount of stale air in the lungs and decreases dyspnea by forcefully and slowly exhaling through pinched lips, as if to whistle. "Perform arm-reaching exercises." The client should avoid activities involving the arms because this type of activity limits the availability of the accessory muscles essential for ventilation, which results in decreased exercise tolerance. • RN VATI Adult Medical Surgical 2019 CLOSE Question 3 loaded rationals provided Question: 3 of 90 CORRECT • Time Remaining: 00:28:18 • Pause Remaining: 00:05:00 PAUSE FLAG A nurse is assessing a client's understanding of a surgical procedure prior to witnessing their signature on the informed consent form. The nurse determines that the client does not understand what the procedure will involve. Which of the following actions should the nurse take? Provide teaching about the surgical procedure for the client. The responsibility of discussing the surgical procedure, including the risks, benefits, and alternative therapies, belongs to the provider who will be performing the procedure. If the information the nurse gives to the client is incorrect or incomplete, the nurse is liable and might face legal action. Instruct the client's spouse to sign the consent form. Any client who is competent should sign their own surgical consent form. A spouse or guardian can sign the form if the client is incompetent, incapacitated, or a minor. Read the consent form to the client using words the client will understand. The consent form should be read to a client who is unable to read. However, the nurse should recognize that the consent form does not contain all of the educational information regarding the procedure that the provider shared with the client. Therefore, reading the consent form to the client will not increase the client's understanding of the procedure, risks, benefits, and alternative treatments. Contact the provider who will be performing the procedure. MY ANSWER The nurse should advocate for the client by informing the provider if the client does not understand the procedure. It is the responsibility of the provider to discuss the procedure more fully with the client. • RN VATI Adult Medical Surgical 2019 CLOSE Question 2 loaded rationals provided Question: 2 of 90 CORRECT • Time Remaining: 00:28:11 • Pause Remaining: 00:05:00 PAUSE FLAG A nurse is providing teaching to a client who is scheduled for a bronchoscopy. Which of the following statements should the nurse include in the teaching? "You will not be able to eat or drink after the procedure until you are able to cough." MY ANSWER A client who had a bronchoscopy received a local anesthetic that can suppress the cough reflex. The cough reflex protects the client from aspirating fluids or food. Therefore, the client should not eat or drink until the cough reflex returns. "You will drink a contrast solution 30 minutes prior to the procedure." A bronchoscopy allows for direct visualization of bronchial structures and does not require the use of a contrast solution. The client should be NPO for 4 to 8 hr prior to the test. "The purpose of this procedure is to remove excess fluid from your lungs." A bronchoscopy allows for direct visualization of bronchial structures to identify disorders, collect specimens, remove foreign bodies or secretions, stop bleeding, remove lesions, or provide brachytherapy or radiation to the endobronchial area. A thoracoscopy removes excess fluid from the pleural cavity. "You will need to lie on your back for 4 to 6 hours following the procedure." Following a bronchoscopy, the client is at risk for hypoxia and dyspnea. Therefore, the nurse should elevate the head of the client's bed. • RN VATI Adult Medical Surgical 2019 CLOSE Question 1 loaded rationals provided Question: 1 of 90 CORRECT • Time Remaining: 00:28:06 • Pause Remaining: 00:05:00 PAUSE FLAG A nurse is caring for a client who is 24 hr postoperative following a total hip arthroplasty. Which of the following actions should the nurse take? Place the affected leg in external rotation. The nurse should keep the affected extremity in a neutral position to prevent dislocation. Manifestations of a dislocation of the hip include inward rotation of the affected leg, sudden severe pain, and shortening of the surgical extremity. Encourage the client to use the incentive spirometer every shift. The nurse should encourage the client to cough, breathe deeply, and use the incentive spirometer every 2 hr to prevent pneumonia and atelectasis, which is the collapse of alveoli. Atelectasis can lead to poor oxygen exchange and pneumonia. Instruct the client to lean forward when rising from a chair. To prevent dislocation of the hip, the client should not flex the hip more than 90º at any time. Leaning forward when rising from a chair flexes the hip more than 90º. Maintain abduction of the affected extremity. MY ANSWER The nurse should ensure that the affected extremity is in a position of abduction to prevent hip dislocation. The nurse should place an abductor pillow or several pillows between the client's legs to keep the affected extremity in abduction while the client is in bed. [Show More]

Last updated: 1 year ago

Preview 1 out of 116 pages