2023 ATI RN Medical Surgical Nursing Protected Exam With Answers (90 Solved Questions)

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ATI RN Adult Medical SurgicalProctored Exam 2023Already Graded AQue stion 90 loade dra tionals pr ovide dFLAGQuestion: 90 of 90CORRECTTime Remaining:00:38:42Pause Remaining:00:05:00PAUSEA 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 adverseeffects?Increased pigmentationTopical glucocorticoid therapy can cause the adverse effect of hypopigmentation.Localized hair lossLong-term glucocorticoid therapy can cause hypertrichosis, or excessive hair growth, especiallyon the facial area.Thinning of the skinMY ANSWE RThinning of the skin and delayed healing are adverse effects of topical glucocorticoidpreparations. 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 ofthe skin.Increased sensitivity to the sunlOMoARcPSD|13778330

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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 2019Ques tion89loadedrationalsCLOSEprovidedQuestion: 89 of 90CORRECTFLAGTime Remaining:00:37:45Pause Remaining:00:05:00PAUSEA nurse is assessing a client who has left-sided heart failure. Which of the following findingsshould the nurse identify as a manifestation of left-sided heart failure?Dependent edemaThe nurse should identify that dependent edema is a manifestation of right-sided heart failuredue to right ventricular failure and fluid retention from pressure building up in the venoussystem.Jugular distentionThe nurse should identify that jugular vein distention is a manifestation of right-sided heartfailure due to right ventricular failure and fluid retention from pressure building up in thevenous system.Weight gainThe nurse should identify that weight gain is a manifestation of right-sided heart failure due toright ventricular failure and fluid retention from pressure building up in the venous system.Frothy sputumMY ANSWE RThe nurse should identify that frothy sputum, dyspnea, and wheezing are manifestations ofleft-sided heart failure. Treatment includes fluid restriction and diuretics to decrease preloadand reduce pulmonary congestion. Pink-tinged frothy sputum can be an early indication ofpulmonary edema and can be life-threatening. Therefore, the nurse should notify the providerimmediately.Ques tion88loadedrationalsprovidedlOMoARcPSD|13778330

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Question: 88 of 90CORRECTFLAGTime Remaining:00:37:30Pause Remaining:00:05:00PAUSEA 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, PCO230 mm Hg, HCO3-24 mEq/L, PaO285 mmHg. Which of the following acid-base imbalances should the nurse identify that the client isexperiencing?Respiratory alkalosisMY ANSWE RThis pH is alkaline (increased) and the PCO2is decreased, representing alveolarhyperventilation and resultant respiratory alkalosis.Respiratory acidosisThis pH is alkaline (increased) and the PCO2is decreased. A decreased pH and an increased PCO2indicate respiratory acidosis.Metabolic alkalosisThis 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 acidosisThis 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 2019Ques tion87loadedrationalsCLOSEprovidedQuestion: 87 of 90CORRECTFLAGTime Remaining:00:37:22Pause Remaining:00:05:00PAUSEA nurse is assessing a client who has Cushing's syndrome. Which of the following findingsshould the nurse expect?lOMoARcPSD|13778330

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VitiligoVitiligo is the loss of pigment from areas of a client's skin, causing irregular, white patches.Vitiligo is a manifestation of adrenal-gland hypofunction.OsteoporosisMY ANSWE ROsteoporosis is a common finding with Cushing's syndrome. Bones become thinner as a resultof mineral loss and nitrogen depletion, and the risk for fractures increases.MyxedemaA client who has hypothyroidism can develop myxedema that causes mucinous cellular edemaaround the eyes, across the upper back, and in the hands and feet.Heat intoleranceA client who has hyperthyroidism can develop heat intolerance, along with an increase insweating.RN VATI Adult Medical Surgical 2019Ques tion86loadedrationalsCLOSEprovidedQuestion: 86 of 90CORRECTFLAGTime Remaining:00:37:13Pause Remaining:00:05:00PAUSEA 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?A pearly, waxy noduleMY ANSWE RA client who has basal cell carcinoma has a nodular lesion with well-defined borders and apearly or waxy appearance, resulting from overexposure to the sun, especially on the face,head, and neck.lOMoARcPSD|13778330

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An irregular border on a variegated-colored lesionA 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 lesionA client who has squamous cell carcinoma has a firm, nodular, and crusty lesion with anulcerated center, resulting from sun exposure, chronic irritation, burns, or irradiation to theskin.A weeping vesicleA client who has herpes zoster has weeping, blister-type lesions.RN VATI Adult Medical Surgical 2019Ques tion85loadedrationalsCLOSEprovidedQuestion: 85 of 90CORRECTFLAGTime Remaining:00:37:02Pause Remaining:00:05:00PAUSEA nurse is assessing a client who has hypocalcemia. In which of the following areas should thenurse tap on the client's face to detect the presence of Chvostek's sign? (You will find hot spotsto select in the artwork below. Select only the hot spot that corresponds to your answer.)lOMoARcPSD|13778330

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Ais correct.The nurse should tap the client's cheek just in front of the ear and below thezygomatic arch. The client who has hypocalcemia will display a Chvostek's sign, which is atwitching of the facial muscle.Bis incorrect.The nurse should apply upward pressure at the supraorbital ridge, below theeyebrow, to assess for tenderness and inflammation of the frontal sinuses.Cis incorrect.The nurse should palpate the jaw and mastoid muscle of a client who hastemporomandibular 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 sensationwhen the client opens or closes the jaw.RN VATI Adult Medical Surgical 2019Ques tion84loadedrationalsCLOSEprovidedQuestion: 84 of 90CORRECTlOMoARcPSD|13778330

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TimeRemaining:00:36:55Pause Remaining:00:05:00PAUSEA 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 thenurse expect?High lipaseA high lipase level is associated with pancreatic dysfunction or renal failure and is not anexpected finding with hyponatremia or dehydration.Low urine specific gravityMY ANSWE RA client who has hyponatremia as a result of diuretic overuse has a low urine specificgravity. The increased excretion of water alters the ratio of particulate matter, whichaffects the specific gravity.Low hemoglobinA 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 finding withhyponatremia.lOMoARcPSD|13778330

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Ques tion83loadedrationalsCLOSEprovidedQuestion: 83 of 90lOMoARcPSD|13778330

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INCORRECTTime00:36:47Pause Remaining:00:05:00PAUSEFLAGA home health nurse is assisting a client with planning care for a family member who hasAlzheimer's disease. Which of the following instructions should the nurse include?Remove clutter from rooms and hallways.The nurse should instruct the family member to remove clutter from rooms and hallways sothe client is able to walk without the risk of falling or tripping over objects. Later in thedisease, the client can experience seizures, so cluttered areas could be a risk to the client.Place a monthly calendar in the client's room.MY ANSWE RThe nurse should instruct the family member to place a single-date calendar in the client'sroom. A monthly calendar can be overwhelming and confusing to a client who has Alzheimer'sdisease.Use confrontation to manage the client's behavior.The nurse should instruct the family member to redirect the client by starting another activitywhen the client begins to act out or becomes overstimulated. Redirecting the client might helpthem gain focus.Review the daily schedule with the client every morning.The nurse should instruct the family member to use short, simple sentences when explaining anactivity to the client. The explanation should be done immediately before the activity to aid theclient's memory and ability to follow directions.RN VATI Adult Medical Surgical 2019Ques tion82loadedrationalsCLOSEprovidedQuestion: 82 of 90CORRECTFLAGTime Remaining:00:36:39Pause00:05:00PAUSElOMoARcPSD|13778330

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A nurse is caring for a client who has developed acute respiratory distress syndrome (ARDS).Which of the following findings should the nurse identify as a manifestation of this syndrome?An audible pleural friction rubA 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 friction rub is not amanifestation of ARDS.Tracheal deviation from the midlineA client who has a tension pneumothorax can have tracheal deviation with dyspnea,tachycardia, and tachypnea. On auscultation, breath sounds over the area of thepneumothorax are decreased or absent. However, tracheal deviation is not a manifestation ofARDS.Refractory hypoxemiaMY ANSWE RARDS is a systemic inflammatory response to trauma, sepsis, burns, pancreatitis, and bloodtransfusions, when excess lung fluid dilutes surfactant activity in the lungs. A client who hasARDS has refractory hypoxemia, which is hypoxemia that does not improve with oxygentherapy. Extensive pulmonary edema evident on a chest x-ray is a manifestation of ARDS.Bloody expectorant when coughingA client who has lung cancer or laryngeal trauma can have hemoptysis. However, bloodyexpectorant is not a manifestation of ARDS.RN VATI Adult Medical Surgical 2019Ques tion81loadedrationalsCLOSEprovidedQuestion: 81 of 90CORRECTFLAGTime Remaining:00:36:33Pause00:05:00PAUSEAn 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 statusasthmaticus?lOMoARcPSD|13778330

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CoughingStatus asthmaticus causes labored breathing and wheezing. Coughing indicates that the client isexchanging air and is a manifestation of pneumonia, not status asthmaticus.Flat neck veinsA client who has status asthmaticus has distended neck veins while trying to facilitate breathingdue to increased pulmonary pressure.Use of accessory musclesMY ANSWE RA client who has status asthmaticus uses accessory muscles to help facilitate breathing, which isa manifestation of a severe airflow obstruction. The situation is life-threatening and the nurseshould intervene immediately with strong systemic bronchodilators, epinephrine,corticosteroids, and oxygen.Presence of coarse cracklesThe presence of coarse crackles indicates air movement through fluid-filled airways and is amanifestation of pneumonia, not status asthmaticus.RN VATI Adult Medical Surgical 2019Ques tion80loadedrationalsCLOSEprovidedQuestion: 80 of 90CORRECTFLAGTime Remaining:00:36:27Pause Remaining:00:05:00PAUSElOMoARcPSD|13778330

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A nurse is teaching a client who has a new prescription for phenytoin to treat a seizuredisorder. Which of the following adverse effects should the nurse instruct the client to reportimmediately to the provider?Tender, bleeding gumsGingival hyperplasia is an overgrowth of gum tissue that causes the gums to bleed, swell, andbecome tender. Gingival hyperplasia is nonurgent adverse effect when a client is takingphenytoin; therefore, there is another finding that is the priority. The nurse should advise theclient to maintain good oral hygiene with a soft toothbrush and to follow up with an oral healthprofessional.Increased facial hairHirsutism, an increased growth of hair in unexpected places on the client's body, is nonurgentbecause it is an expected finding for a client who is taking phenytoin.ConstipationConstipation is nonurgent because it is an expected finding for a client who is taking phenytoin.Skin rashMY ANSWE RWhen using the urgent vs. nonurgent approach to client care, the nurse should determine thatthe priority finding is a rash, which can have a measles-like appearance and progress toexfoliative dermatitis or Stevens-Johnson syndrome. The client should report this finding to theprovider immediately.RN VATI Adult Medical Surgical 2019Ques tion79loadedrationalsCLOSEprovidedQuestion: 79 of 90INCORRECTFLAGTime Remaining:00:36:21Pause Remaining:00:05:00PAUSElOMoARcPSD|13778330

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A nurse is monitoring a client following a lumbar laminectomy. The client has a drain andindwelling urinary catheter. The nurse should identify which 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.Clear drainage on the dressingsThe nurse should identify clear drainage on or around the dressing as an indication of a cerebralspinal leak and should report this finding to the provider immediately.Drain output 75 mL in 4 hrThe 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 abdomenMY ANSWE RThe nurse should expect decreased bowel sounds when caring for a client following alaminectomy due to anesthesia and pain medication. The nurse should continue to monitor theclient to assess for a paralytic ileus.RN VATI Adult Medical Surgical 2019Ques tion78loadedrationalsCLOSEprovidedQuestion: 78 of 90CORRECTFLAGTime Remaining:00:36:15Pause Remaining:00:05:00PAUSEA nurse is assessing a client who has right-sided heart failure. Which of the following findingsshould the nurse identify as a manifestation of right-sided heart failure?lOMoARcPSD|13778330

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S3gallopAn S3/S4summation gallop is an expected finding with left-sided heart failure due to pulmonarycongestion and increased left ventricular pressure that causes a decrease in cardiac output andpoor tissue perfusion.Weak peripheral pulsesWeak peripheral pulses are an expected finding with left-sided heart failure due to decreasedcardiac output.IncreasedMYANSWERabdominal girthIncreased abdominal girth is an expected finding with right-sided heart failure due to systemiccongestion and an enlarged liver and spleen. Systemic congestion can lead to fluid retentionand increased pressure in the venous system, which can manifest with edema in the lowerextremities.WheezingWheezing is an expected finding with left-sided heart failure due to pulmonary congestion andsystolic dysfunction.RN VATI Adult Medical Surgical 2019Ques tion77loadedrationalsCLOSEprovidedQuestion: 77 of 90INCORRECTFLAGTime Remaining:00:36:06Pause Remaining:00:05:00PAUSEA nurse is caring for a client who recently assumed the role of caregiver for their aging parentswho have chronic illnesses. The nurse should identify that which of the following statements bythe client indicates acceptance of the role change?"I changed the floor plan of our home to accommodate my father's wheelchair."The nurse should identify that the client has accepted the role change of caring for their agingparents 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."lOMoARcPSD|13778330

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This response indicates role overload because the client is feeling overwhelmed with having tocare for their aging parents."At times, I get so frustrated with how to care for my parents."This response indicates role strain, in which the client feels unsure and frustrated aboutcaring for their aging parents. Feelings of inadequacy can also occur with role strain. "I amlearning to take care of my parents as I go."MY ANSWE RThis response indicates role ambiguity, in which the client feels unsure about how to care fortheir aging parents. This might create stress for the client.RN VATI Adult Medical Surgical 2019Ques tion76loadedrationalsCLOSEprovidedQuestion: 76 of 90CORRECTFLAGTime Remaining:00:36:00Pause Remaining:00:05:00PAUSEA nurse is caring for a client who is receiving vancomycin intermittent IV bolus therapy formethicillin-resistantStaphylococcus aureus(MRSA). Which of the following findings is anindication to the nurse that the client is experiencing an adverse effect of the medication?The client's blood pressure is elevated.The client can have an adverse effect called red man syndrome, which causes hypotension andtachycardia, due to infusing the vancomycin too rapidly. The nurse should infuse themedication over at least 60 min.The client is becoming flushed.MY ANSWE RlOMoARcPSD|13778330
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