RN 2025 Adult Medical Surgical ATI Proctored Exam ALL FORMS!.pdf, Exams of Nursing

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RN 2025 Adult Medical Surgical ATI Proctored Exam

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• RN VATI Adult Medical Surgical 2025 Q u e CLOSEsti on 90 loa de drat i ona ls p r o v i d e d

Question: 90 of 90

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• Time Remaining: 00:38:
• Pause Remaining: 00:05: PAUSE A nurse is caring for a client who has atopic dermatitis and a prescription for triamcinoloneointment. 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 becausetopical 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 topicalfluticasone; however, triamcinolone ointment does not cause photosensitivity.

RN VATI Adult Medical Surgical 2019 Q u e CLOSEsti on 89 loa de drat i ona ls p r o v i d e d

Question: 89 of 90

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• Time Remaining: 00:37:

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Downloaded by: kiaritalaboy | kiarita.laboy@gmail.com Respiratoryialkalosis

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• Time Remaining: 00:37:
• Pause Remaining: 00:05: PAUSE A nurse is caring for a client who is experiencing anxiety as well as numbness and tingling of thelips and fingers. The client's ABGs are: pH 7.48, PCO 2 30 mm Hg, HCO 3 -^24 mEq/L, PaO 2 85 mm (^) Hg. Which of the following acid-base imbalances should the nurse identify that the client is experiencing? MY ANSWER This pH is alkaline (increased) and the PCO 2 is decreased, representing alveolar hyperventilation and resultant respiratory alkalosis. Respiratory acidosis This pH is alkaline (increased) and the PCO 2 is decreased. A decreased pH and an increased PCO 2 indicate respiratory acidosis. Metabolic alkalosis This HCO 3 -^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 3 -^ indicate metabolic alkalosis. Metabolic acidosis This HCO 3 -^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 3 -^ indicate metabolic acidosis.

RN VATI Adult Medical Surgical 2019 Q u e CLOSEsti on 87 loa de drat i ona ls p r o v i d e d

Question: 87 of 90

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• Time Remaining: 00:37:
• Pause Remaining: 00:05: PAUSE A nurse is assessing a client who has Cushing's syndrome. Which of the following findingsishould the nurse expect? Vitiligo

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Downloaded by: kiaritalaboy | kiarita.laboy@gmail.com 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 aresult of mineral loss and nitrogen depletion, and the risk for fractures increases. Myxedema A client who has hypothyroidism can develop myxedema that causes mucinous cellularedema 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 insweating.

• RN VATI Adult Medical Surgical 2019 Q u e CLOSEsti on 86 loa de drat i ona ls p r o v i d e d

Question: 86 of 90

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• Time Remaining: 00:37:
• Pause Remaining: 00:05: PAUSE A nurse is inspecting the skin of a client who has basal cell carcinoma. The nurse should identifywhich of the following lesion characteristics on the client's skin? 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 Aipearly,iwaxyinodule

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Downloaded by: kiaritalaboy | kiarita.laboy@gmail.com 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 atwitching of the facial muscle. B is incorrect. The nurse should apply upward pressure at the supraorbital ridge, belowthe 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, orgrinding of the teeth. With palpation, the nurse might feel a click, pop, or grating sensationiwhen the client opens or closes the jaw.

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Downloaded by: kiaritalaboy | kiarita.laboy@gmail.com Lowiurineispecificigravity

• RN VATI Adult Medical Surgical 2019 Q u e CLOSEsti on 84 loa de drat i ona ls p r o v i d e d

Question: 84 of 90

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• Time Remaining: 00:36:
• Pause Remaining: 00:05: PAUSE A nurse in an emergency department is assessing a client who is overusing prescribed diureticsand 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 anexpected finding with hyponatremia or dehydration. MY ANSWER A client who has hyponatremia as a result of diuretic overuse has a low urine specific gravity. The increased excretion of water alters the ratio of particulate matter, whichaffects the specific gravity. Low hemoglobin A client who is dehydrated as a result of diuretic overuse can have an elevated hemoglobinlevel because of the difference in ratio between intravascular fluid and blood cells. High creatine kinase-MB (CK-MB) An elevated CK-MB level indicates a myocardial infarction and is not an expected findingiwith hyponatremia.

RN VATI Adult Medical Surgical 2019 Q u e CLOSEsti on 83 loa de drat i ona ls p r o v i d e d

Question: 83 of 90

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Downloaded by: kiaritalaboy | kiarita.laboy@gmail.com Refractoryihypoxemia

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• Pause Remaining: 00:05: PAUSE A nurse is caring for a client who has developed acute respiratory distress syndrome (ARDS). Which of thefollowingfindings should thenurse identify as a manifestation of this syndrome? An audible pleural friction rub A client who has a pulmonary embolism can have a pleural friction rub along with tachypnea, tachycardia, dyspnea, and sudden, sharp chest pain. However, a pleural frictionrub is not a manifestation of ARDS. Trachealdeviation from the midline A client who has a tension pneumothorax can have tracheal deviation with dyspnea, tachycardia, and tachypnea. On auscultation, breath sounds over the area of the pneumothorax are decreased or absent. However, tracheal deviation is not a manifestationof ARDS. MY ANSWER ARDS is a systemic inflammatory response to trauma, sepsis, burns, pancreatitis, and blooditransfusions, when excess lung fluid dilutes surfactant activity in the lungs. A client who has ARDS has refractory hypoxemia, which is hypoxemia that does not improve with oxygen therapy. Extensive pulmonary edema evident on a chest x-ray is a manifestation of ARDS. Bloody expectorant when coughing A client who has lung cancer or laryngeal trauma can have hemoptysis. However, bloodyexpectorant is not a manifestation of ARDS.

RN VATI Adult Medical Surgical 2019 Q u e CLOSEsti on 81 loa de drat i ona ls p r o v i d e d

Question: 81 of 90

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Downloaded by: kiaritalaboy | kiarita.laboy@gmail.com Flat ineckiveins

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• Time Remaining: 00:36:
• Pause Remaining: 00:05: PAUSE An emergency room nurse is assessing a client who has asthma and difficulty breathing. Whichof the following findings should indicate to the nurse that the client is experiencing status asthmaticus? Coughing Status asthmaticus causes labored breathing and wheezing. Coughing indicates that theclient is exchanging air and is a manifestation of pneumonia, not status asthmaticus. A client who has status asthmaticus has distended neck veins while trying to facilitatebreathing due to increased pulmonary pressure. Use of accessory muscles MY ANSWER A client who has status asthmaticus uses accessory muscles to help facilitate breathing, which is a manifestation of a severe airflow obstruction. The situation is life- threateningand the nurse should intervene immediately with strong systemic bronchodilators, epinephrine, corticosteroids, and oxygen. Presence of coarse crackles The presence of coarse crackles indicates air movement through fluid-filled airways and isa manifestation of pneumonia, not status asthmaticus.

RN VATI Adult Medical Surgical 2019 Que^ Cs t i o n i 80 Lil o a d e^ Od r a t ionals ipr ov^ Si d e id^ E

Question: 80 of 90

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• Time Remaining: 00:36:
• Pause Remaining: 00:05: PAUSE

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Downloaded by: kiaritalaboy | kiarita.laboy@gmail.com Clearidrainageionitheidressings

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A nurse is monitoring a client following a lumbar laminectomy. The client has a drain and indwellingurinary catheter. Thenurse should identifywhich of the following findings as anindication of a complication of the surgery? Oral temperature of 37.2° C (99° F) The nurse should expect a slight elevation of the client's temperature postoperatively.However, an increased temperature elevation or a spike can indicate an infection. The nurse should identify clear drainage on or around the dressing as an indication of acerebral spinal leak and should report this finding to the provider immediately. Drain output 75 mL in 4 hr The nurse should expect the client to have no more than 125 mL of drain output in 4 hr. Decreased bowel sounds in all quadrants of the abdomen MY ANSWER The nurse should expect decreased bowel sounds when caring for a client following a laminectomy due to anesthesia and pain medication. The nurse should continue to monitorthe client to assess for a paralytic ileus.

• RN VATI Adult Medical Surgical 2023 Que^ Cs t i o n i 78 Lil o a d e iOd r a t ionals ipr ov^ Si d e id^ E

Question: 78 of 90

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• Time Remaining: 00:36:
• Pause Remaining: 00:05: PAUSE A nurse is assessing a client who has right-sided heart failure. Which of the following findingsishould the nurse identifyas a manifestation of right-sided heart failure?

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Downloaded by: kiaritalaboy | kiarita.laboy@gmail.com S 3 gallop An S 3 /S 4 summation gallop is an expected finding with left-sided heart failure due to pulmonary congestion and increased left ventricular pressure that causes a decrease incardiac output and poor tissue perfusion. Weak peripheral pulses Weak peripheral pulses are an expected finding with left-sided heart failure due todecreased cardiac output. MY ANSWER Increased abdominal girth is an expected finding with right-sided heart failure due to systemic congestion and an enlarged liver and spleen. Systemic congestion can lead to fluidretention and increased pressure in the venous system, which can manifest with edema in the lower extremities. Wheezing Wheezing is an expected finding with left-sided heart failure due to pulmonary congestionand systolic dysfunction.

• RN VATI Adult Medical Surgical 2019 Que^ Cs t i o n i 77 Lil o a d e iOd r a t ionals ipr ov^ Si d e id^ E

Question: 77 of 90

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• Time Remaining: 00:36:
• Pause Remaining: 00:05: PAUSE A nurse is caring for a client who recently assumed the role of caregiver for their aging parents who have chronic illnesses. The nurse should identify that which of the following statements bythe client indicates acceptance of the role change? The nurse should identify that the client has accepted the role change of caring for theiraging parents by changing the floor plan of the home to accommodate their father's wheelchair. "I'm so stressed out that it makes it difficult for me to manage everything." "Iichangeditheiflooriplaniof iourihomeitoiaccommodateimyifather'siwheelchair." Increasediabdominaligirth

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Downloaded by: kiaritalaboy | kiarita.laboy@gmail.com infusing vancomycin too rapidly. The nurse should infuse the medication over at least 60min. The client reportsblurred vision. Blurred vision is not a manifestation of an infusion reaction to vancomycin. Vancomycin can have sensory implications, however. Although rare, it can cause ototoxicity, which isigenerally reversible. The client is experiencing polyuria. Polyuria is not a manifestation of an infusion reaction to vancomycin. However,vancomycin can cause renal failure.

• RN VATI Adult Medical Surgical 2019 Q u e CLOSEsti on 75 loa de drat i ona ls p r o v i d e d

Question: 75 of 90

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• Time Remaining: 00:35:
• Pause Remaining: 00:05: PAUSE A nurse is caring for a male client who has a new prescription for cyclosporine following a kidney transplant. Which of the following findings should the nurse identify as an adverse effectof this therapy? WBC count 8,000/mm^3 A WBC count of 8,000/mm<sup3< sup=""> is within the expected reference range of 5,000to 10,000/mm^3. If the client develops leukopenia, the nurse should notify the provider because the client is at risk for infection when taking an immunosuppressant such as cyclosporine.</sup3<> RBC count 6 million/mm^3 An RBC count of 6 million/mm^3 is within the expected reference range of 4.7 to 6. million/mm^3 for men and 4.2 to 5.4 million/m^3 for women. If the client's RBC count decreases, the nurse should notify the provider because the client is at risk for bleedingifollowing an organ transplant. BUNi 24 img/dL

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Downloaded by: kiaritalaboy | kiarita.laboy@gmail.com Iron-deficiencyianemia A BUN of 24 mg/dL is above the expected reference range of 10 to 20 mg/dL, indicatingirenal impairment. An adverse effect of cyclosporine is nephrotoxicity. The nurse shouldmonitor the client for increases in BUN and creatinine and report any elevation to the provider. A rise in BUN could indicate transplant rejection. Potassium 3.5 mEq/L A potassium level of 3.5 mEq/L is within the expected reference range of 3.5 to 5 mEq/L and does not indicate nephrotoxicity. However, the nurse should report a dramatic changeiin potassium level to the provider.

• RN VATI Adult Medical Surgical 2019 Que^ Cs t i o n i 74 Lil o a d e iOd r a t ionals ipr ov^ Si d e id^ E

Question: 74 of 90

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• Time Remaining: 00:35:
• Pause Remaining: 00:05: PAUSE A nurse is caring for a client who has dumping syndrome following a gastric resection. The nurse should monitorthe clientfor which of thefollowing complications of dumping syndrome? Weight gain Anorexia can result from dumping syndrome because the client can easily become reluctant to eat to avoid the unpleasant manifestations of this syndrome, resulting inweight loss. MY ANSWER The nurse should monitor the client for manifestations of anemia, such as pallor, tachycardia, and fatigue. Rapid emptying of the stomach contents into the intestine can leadto reduced absorption of iron in the duodenum, causing iron-deficiency anemia. Hypercalcemia Hypocalcemia, rather than hypercalcemia, is a manifestation of dumping syndrome due torapid gastric emptying.

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Downloaded by: kiaritalaboy | kiarita.laboy@gmail.com "Iiwill icheckimyiblood isugarilevelibeforeiexercising." Salmeterol is a long-acting bronchodilator that helps prevent asthma attacks. Wheezing is anarrowing of the airways and indicates that the medication has not been effective.

• RN VATI Adult Medical Surgical 2019 Q u e CLOSEsti on 72 loa de drat i ona ls p r o v i d e d

Question: 72 of 90

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• Time Remaining: 00:35:
• Pause Remaining: 00:05: PAUSE A nurse is providing teaching about health promotion activities for a client who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements by the client indicatesan understanding of the teaching? "If I can keep myhemoglobin A1C less than 6.5%, I will be cured of diabetes." Tight control of blood glucose levels can minimize complications associated with diabetesmellitus such as cardiovascular disease, nephropathy, neuropathy, and retinopathy. The nurse should instruct the client that type 1 diabetes mellitus is a chronic condition that causes the body to fail to manufacture insulin and cannot currently be cured. MY ANSWER Clients who have diabetes mellitus should not exercise if their blood glucose level is less than 80 mg/dL or greater than 250 mg/dL. A client who has type 1 diabetes mellitus and ishyperglycemic can experience even higher blood glucose levels. Hypoglycemia can also occur during exercise and up to 24 hr following exercise. The nurse should instruct the client to monitor blood glucose levels before, during, and following exercise. "I should have my eyes checked every 2 years." Microvascular changes to the vessels in the eyes occurs with elevated blood glucose levels,which can lead to retinopathy. To monitor for changes to the eyes, the client should have eye examinations every year.

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Downloaded by: kiaritalaboy | kiarita.laboy@gmail.com "I should soak myfeet daily in warm, soapy water." Health promotion activities for a client who has diabetes mellitus includes foot care. Clientsshould inspect their feet and wash them daily with warm water and soap. However, clients should not soak their feet because this can lead to maceration of the skin and skin breakdown.

• RN VATI Adult Medical Surgical 2023 Que^ Cs t i o n i 71 Lil o a d e iOd r a t ionals ipr ov^ Si d e id^ E

Question: 71 of 90

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• Time Remaining: 00:35:
• Pause Remaining: 00:05: PAUSE A nurse is providing teaching to a client who has a new prescription for warfarin. Which of thefollowing medications should the nurse instruct the client to avoid? (Select all that apply.) Ferrous sulfateEchinac ea Aspirin Dextromethorphan Naproxen MY ANSWER Ferrous sulfate is incorrect. Ferrous sulfate is an iron supplement and has no knowninteraction with warfarin. Echinacea is incorrect. Echinacea is a supplement that a client might take to improve theimmune system and has no known interaction with warfarin. Aspirin is correct. Aspirin is an antiplatelet medication. It can increase the risk of bleedingiwhen taken with warfarin.