MED SURG 450RN VATI Adult Medical Surgical 2021 LATEST

RN VATI Adult Medical Surgical 2021

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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

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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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 rightsided 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. Pinktinged 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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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 HCO -24 mEq/L is within the expected range of 21 to 28 mEq/L and the

pH is alkaline (increased). An increased pH and HCO -

indicate metabolic

alkalosis.

Metabolic acidosis

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

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

indicate metabolic

 acidosis.

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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.

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• Time Remaining: 00:37:13

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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?

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Version 2021
Category Exam (elaborations)
Pages 17
Language English
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