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The nurse provides instructions to a client regarding the use of topical tretinoin. Which statement by the client indicates a need for further instruction? 1. "I should begin to see results in about 3 weeks." 2. "I will apply the medication liberally to the skin." 3. "I cannot use any cosmetics while I am using this medication." 4. "I will wash my hands thoroughly after applying this medication."

3. "I cannot use any cosmetics while I am using this medication."

The nurse is providing instructions to a mother of a child with atopic dermatitis (eczema) regarding the application of topical cortisone cream to the affected skin sites. Which statement made by the mother indicates an understanding of the use of this medication? 1. "I shouldn't rub the medication into the skin." 2. "The medication is applied everywhere except the face." 3. "I need to wash the sites gently before I apply the medication." 4. "I need to apply the medication generously and allow it to absorb."

3. "I need to wash the sites gently before I apply the medication."

Silver sulfadiazine is prescribed for a client with a partial-thickness burn and the nurse provides teaching about the medication. Which statement made by the client indicates a need for further teaching about the treatments? 1. "The medication is an antibacterial." 2. "The medication will help heal the burn." 3. "The medication is likely to cause stinging every time it is applied." 4. "The medication should be applied directly to the wound."

3. "The medication is likely to cause stinging every time it is applied."

The nurse is applying a topical glucocorticoid as prescribed for a client with psoriasis. The nurse would be concerned about the potential for systemic absorption of the medication if it were being applied in which situation? 1. Applied for 2 days until the irritation has resolved 2. Applied to a small area on the arm underneath a gauze dressing 3. Applied to a reddened, itchy area underneath an occlusive dressing 4. Applied to a small area on the neck and another small area on the back

3. Applied to a reddened, itchy area underneath an occlusive dressing

A hospitalized client is diagnosed with scabies. The health care provider (HCP) recommended that the client and the client's roommate be treated with lindane. Which finding, if noted on this client's chart, would alert the nurse to notify the HCP before the treatment with lindane? 1. Client history of diabetes 2. Client history of hypertension 3. Client history of seizure disorders 4. Client history of coronary artery disease

3. Client history of seizure disorders

A client with psoriasis is being treated with calcipotriene cream. Administration of high doses of this medication can cause which side or adverse effect? 1. Alopecia 2. Hyperkalemia 3. Hypercalcemia 4. Thinning of the skin

3. Hypercalcemia

A child is diagnosed with impetigo. The health care provider prescribes a topical medication for treatment. The nurse anticipates that which medication will be prescribed? 1. Cortisone 2. Acyclovir 3. Mupirocin 4. Benzoyl peroxide

3. Mupirocin

A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the HCP if the client is also taking which medication? 1. Digoxin 2. Phenytoin 3. Vitamin A 4. Furosemide

3. Vitamin A

A client is seen in the clinic for a complaint of scalp itching that has been persistent over the past several weeks. After an assessment, it is determined that the client has head lice. Permethrin shampoo is prescribed, and the nurse provides instructions to the client regarding the use of the medication. The nurse should tell the client to take which measure? 1. Put the medication in 1 time only. 2. Leave the medication in for at least 4 hours. 3. Wash, rinse, and towel-dry the hair before applying. 4. Leave the shampoo on for 8 to 12 hours and then remove by washing.

3. Wash, rinse, and towel-dry the hair before applying.

A burn client has been having 1% silver sulfadiazine applied to burns twice a day for the past 3 days. Which laboratory abnormality indicates that the client is experiencing a side or adverse effect of this medication? 1. Serum sodium of 120 mEq/L (120 mmol/L) 2. Serum potassium of 3.0 mEq/L (3.0 mmol/L) 3. White blood cell count of 3000 mm3 (3 × 109/L) 4. pH 7.30, PaCO2 of 32 mm Hg (32 mmHg), HCO3- of 19 mEq/L (19 mmol/L)

3. White blood cell count of 3000 mm3 (3 × 109/L)

An adult client was burned in an explosion. The burn initially affected the client's entire face (anterior half of the head) and the upper half of the anterior torso, and there were circumferential burns to the lower half of both arms. The client's clothes caught on fire, and the client ran, causing subsequent burn injuries to the posterior surface of the head and the upper half of the posterior torso. Using the rule of nines, what would be the extent of the burn injury? 1. 18% 2. 24% 3. 36% 4. 48%

3. 36%

The nurse is performing an assessment on a client who sustained circumferential burns of both legs. Which assessment would be the initial priority in caring for this client? 1. Assessing heart rate 2. Assessing respiratory rate 3. Assessing peripheral pulses 4. Assessing blood pressure (BP)

3. Assessing peripheral pulses

The nurse is performing an assessment on a client admitted to the nursing unit who has sustained an extensive burn injury involving 45% of total body surface area. When planning for fluid resuscitation, the nurse should consider that fluid shifting to the interstitial spaces is greatest during which time period? 1. Immediately after the injury 2. Within 12 hours after the injury 3. Between 18 and 24 hours after the injury 4. Between 42 and 72 hours after the injury

3. Between 18 and 24 hours after the injury

The nurse is caring for a client following an autograft and grafting to a burn wound on the right knee. What would the nurse anticipate to be prescribed for the client? 1. Out-of-bed activities 2. Bathroom privileges 3. Immobilization of the affected leg 4. Placing the affected leg in a dependent position

3. Immobilization of the affected leg

A client is undergoing fluid replacement after being burned on 20% of her body 12 hours ago. The nursing assessment reveals a blood pressure of 90/50 mm Hg, a pulse rate of 110 beats/minute, and a urine output of 20 mL over the past hour. The nurse reports the findings to the health care provider (HCP) and anticipates which prescription? 1. Transfusing 1 unit of packed red blood cells 2. Administering a diuretic to increase urine output 3. Increasing the amount of intravenous (IV) lactated Ringer's solution administered per hour 4. Changing the IV lactated Ringer's solution to one that contains dextrose in water

3. Increasing the amount of intravenous (IV) lactated Ringer's solution administered per hour

A client sustained a burn from cutaneous exposure to lye. At the site of injury, copious irrigation to the site was performed for 1 hour. On admission to the hospital emergency department, the nurse assesses the burn site. Which findings would indicate that the chemical burn process is continuing? 1. Eschar 2. Intact blisters 3. Liquefaction necrosis 4. Cherry-red, firm tissue

3. Liquefaction necrosis

3. White blood cell count of 3000 mm3 (3 × 109/L)

Isotretinoin is prescribed for a client to treat severe cystic acne, and the nurse provides instructions to the client regarding the medication. Which statement by the client indicates a need for further instruction? 1. "I need to take the medication with food." 2. "I will be taking the medication twice a day." 3. "I will need to take the medication for 15 to 20 weeks." 4. "I cannot crush or chew the tablets if I have difficulty swallowing them whole."

4. "I cannot crush or chew the tablets if I have difficulty swallowing them whole."

A topical corticosteroid is prescribed for a client with dermatitis. The nurse provides instructions to the client regarding the use of the medication. Which statement by the client would indicate a need for further instruction? 1. "I need to apply the medication in a thin film." 2. "I should gently rub the medication into the skin." 3. "The medication will help relieve the inflammation and itching." 4. "I should place a bandage over the site after applying the medication."

4. "I should place a bandage over the site after applying the medication."

Collagenase is prescribed for a client with a severe burn to the hand. The home care nurse provides instructions to the client regarding the use of the medication. Which client statement indicates an accurate understanding of the use of this medication? 1. "I will apply the ointment at bedtime and in the morning." 2. "I will apply the ointment once a day and leave it open to the air." 3. "I will apply the ointment twice a day and leave it open to the air." 4. "I will apply the ointment once a day and cover it with a sterile dressing."

4. "I will apply the ointment once a day and cover it with a sterile dressing."

Sodium hypochlorite is prescribed for a client with a leg wound that is draining purulent material. The home health nurse teaches a family member how to perform wound treatments. Which statement, if made by the family member, indicates a need for further teaching? 1. "A fresh solution needs to be prepared frequently." 2. "I should rinse the solution off immediately after the irrigation." 3. "The solution should not come in contact with normal skin tissue." 4. "I will soak a sterile dressing with solution and pack it into the wound."

4. "I will soak a sterile dressing with solution and pack it into the wound."

Tretinoin is prescribed for a client with acne, and the nurse provides instructions to the client regarding the medication. Which statement by the client indicates a need for further instruction? 1. "I need to avoid exposure to the sun." 2. "I should start to see results in 2 to 3 weeks." 3. "I will cleanse the skin thoroughly before applying the medication." 4. "If my skin begins to peel, I will notify the health care provider (HCP)."

4. "If my skin begins to peel, I will notify the health care provider (HCP)."

The health care provider has prescribed coal tar treatments for a client with psoriasis, and the nurse provides information to the client about the treatments. Which statement made by the client indicates a need for further education about the treatments? 1. "The medication has an unpleasant odor." 2. "The medication can cause phototoxicity." 3. "The medication can stain the skin and hair." 4. "The medication always causes systemic toxicity."

4. "The medication always causes systemic toxicity."

Collagenase is prescribed for a client with a severe burn to the hand. The nurse is providing instructions to the client and spouse regarding wound treatment. Which should the nurse include in the instructions? 1. Apply once a day and leave it open to the air. 2. Apply twice a day and leave it open to the air. 3. Apply twice a day and cover it with a sterile dressing. 4. Apply once a day and cover it with a sterile dressing.

4. Apply once a day and cover it with a sterile dressing.

The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied at which times? 1. Immediately before swimming 2. 5 minutes before exposure to the sun 3. Immediately before exposure to the sun 4. At least 30 minutes before exposure to the sun

4. At least 30 minutes before exposure to the sun

A health care provider (HCP) prescribes isotretinoin for a client with severe acne. The nurse reviews the client's record and notifies the HCP if which prescribed medication is noted on the medication record? 1. Digoxin 2. Phenytoin 3. Furosemide 4. Doxycycline

4. Doxycycline

A client with acute seborrheic dermatitis of the back, chest, and legs is receiving treatments with salicylic acid. The nurse should monitor the client for which symptom that indicates the presence of systemic toxicity from this medication? 1. Diarrhea 2. Constipation 3. Lower leg pain 4. Increased respirations

4. Increased respirations

Mafenide acetate is prescribed for a client with a burn injury to the hand. Which should the nurse include in the instructions to the client regarding the use of this medication? 1. If stinging occurs, discontinue the medication. 2. Apply a thinner film than prescribed to the burn site if the medication stings. 3. If local stinging and burning occur after the medication is applied, notify the health care provider. 4. It is normal to experience local discomfort and stinging and burning after the medication is applied.

4. It is normal to experience local discomfort and stinging and burning after the medication is applied.

A client is seen in the clinic for complaints of skin itchiness that has persisted for several weeks. After an assessment, the client is determined to have scabies. Lindane is prescribed, and the nurse provides instructions to the client regarding the use of the medication. Which action should the nurse tell the client to take? 1. Apply the cream for 2 days in a row. 2. Apply a thick layer of cream to the entire body. 3. Apply the cream to the entire body and scalp, excluding the face. 4. Leave the cream on for 8 to 12 hours, and then remove it by washing.

4. Leave the cream on for 8 to 12 hours, and then remove it by washing.

An outbreak of head lice infestation has occurred at a local school. The school nurse is providing instructions to the mothers of the children attending the school regarding the application of malathion. The nurse should tell the mothers to take which action? 1. Apply the lotion immediately after washing the hair. 2. Pour the lotion onto the hair and then rinse immediately. 3. Allow the lotion to remain on the hair for 10 minutes and then rinse with water. 4. Leave the lotion on for 8 to 12 hours, and then wash the hair with nonmedicated shampoo.

4. Leave the lotion on for 8 to 12 hours, and then wash the hair with nonmedicated shampoo.

The clinic nurse is caring for a client with a diagnosis of scabies who has just been prescribed crotamiton. The nurse instructs the client to perform which action when applying this medication? 1. Apply the medication to the entire body, washing it off after 2 hours. 2. Apply the application to the entire body, leave it on for 24 hours, and then take a cleansing bath. 3. Apply the medication to the entire body, avoiding the skin folds and creases, and wash it off in 12 hours. 4. Massage the medication into the skin from the chin downward. Apply a second application in 24 hours, followed by a cleansing bath 48 hours after the second application.

4. Massage the medication into the skin from the chin downward. Apply a second application in 24 hours, followed by a cleansing bath 48 hours after the second application.

The nurse is caring for a client at home with a diagnosis of actinic keratosis. The client tells the nurse that her skin is very dry and irritated. The treatment includes diclofenac sodium. The nurse teaches the client that this medication is from which class of medications? 1. Antiinfectives 2. Vitamin A lotions 3. Coal tar preparations 4. Nonsteroidal antiinflammatory drugs (NSAIDs)

4. Nonsteroidal antiinflammatory drugs (NSAIDs)

A client has a wound with a moderate amount of drainage and is scheduled for a dressing change. Which dressing, if selected by the student nurse, requires further intervention by the nursing instructor? 1. Foam 2. Alginate dressing 3. Hydrocolloid dressing 4. Semipermeable transparent film

4. Semipermeable transparent film

Silver sulfadiazine is prescribed for a client with a burn injury. Which laboratory finding requires the need for follow-up by the nurse? 1. Glucose level of 99 mg/dL (5.65 mmol/L) 2. Magnesium level of 1.5 mEq/L (0.75 mmol/L) 3. Platelet level of 300,000 mm3 (300 × 109/L) 4. White blood cell count of 3000 mm3 (3.0 × 109/L)

4. White blood cell count of 3000 mm3 (3.0 × 109/L)

A 60-kg client has sustained third-degree burns over 40% of the body. Using the Parkland (Baxter) formula, the minimum fluid requirements are which during the first 24 hours after the burn? 1. 1200 mL of 5% dextrose in water solution 2. 2400 mL of 0.45% normal saline solution 3. 4800 mL of 0.9% normal saline solution 4. 9600 mL of lactated Ringer's solution

4. 9600 mL of lactated Ringer's solution

4. Apply once a day and cover it with a sterile dressing.

The nurse is caring for a client who sustained superficial partial-thickness burns on the anterior lower legs and anterior thorax. Which finding does the nurse expect to note during the resuscitation/emergent phase of the burn injury? 1. Decreased heart rate 2. Increased urinary output 3. Increased blood pressure 4. Elevated hematocrit levels

4. Elevated hematocrit levels

A client is diagnosed with a full-thickness burn. The nurse plans care, knowing that which structural areas of the skin are involved? 1. Epidermis only 2. Epidermis and deeper dermis 3. Epidermis and upper layer of dermis 4. Epidermis, entire dermis, and epithelial portion of subcutaneous fat

4. Epidermis, entire dermis, and epithelial portion of subcutaneous fat

The nurse is caring for a client who was admitted to the burn unit after sustaining a burn injury covering 30% of the body. What is the most appropriate time frame for the emergent phase? 1. The entire period of time during which rehabilitation occurs 2. The period from the time the client is stable until all burns are covered with skin 3. The period from the time the burn was incurred to the time when the client is admitted to the hospital 4. The period from the time the burn was incurred to the time when the client is considered physiologically stable

4. The period from the time the burn was incurred to the time when the client is considered physiologically stable

The home health care nurse makes a home visit to a client who has an ulcer on the medial aspect of the left ankle. The wound is being treated with a hydrocolloid dressing. The nurse removes the hydrocolloid dressing, cleanses the wound as prescribed, and reapplies the hydrocolloid dressing. The nurse schedules the next visit for wound care and changing the hydrocolloid dressing in how many days, which is the maximum number of days? Fill in the blank.

7 days

A client comes to the clinic reporting skin lesions. The nurse assesses the lesions and notes they are 0.5 cm in size, elevated and solid, with very distinct borders. Based on the findings, which of the following should the nurse document the presence of? A. papules B. Macules C. Wheals D. Vesicles

Acute burn injury results in _____ shock. a.hypovolemic b.septic c.cardiogenic d.vasogenic

Children younger than _____ years of age lack the ability to concentrate urine. a.2 b.4 c.6 d.8

Cutaneous vasculitis develops from the deposit of _____ in small blood vessels as a toxic response allergen. a.immune complexes b.IgE c.complement d.T lymphocytes

Thrush may be defined as: a.the presence of Candida in the mucous membranes of the mouths of infants. b.the presence of bacteria in the nasal mucous membranes of infants. c.any viral infection of the mucous membranes of the mouths of infants. d.an acute immune response to oral medication, located in the mucosal lining of the mouths of infants.

What effect does fatal burn injury have on interleukins? a.Decreases levels of IL-2, which may decrease T helper 1 (Th1) lymphocytes b.Decreases levels of IL-4, which causes a shift in production from Th1 to Th2 lymphocytes c.Decreases levels of IL-6, which produces cytokines d.Decreases levels of IL-12, which stimulates the production of immunoglobulins

What type of shock results from decreased systemic vascular resistance (SVR)? a.Septic b.Cardiogenic c.Hypovolemic d.Heart failure

Which cell is thought to be the progenitor cell of Kaposi sarcoma? a.Endothelial b.Keratinocyte c.Melanocyte d.Exothelial

Which contagious disease creates a primary skin lesion that is a pinpointed macule, papule, or wheal with hemorrhagic puncture site? a.Pediculosis b.Tinea capitis c.Scabies d.Rubeola

Which type of psoriasis is characterized by lesions on the elbows and knees that are well demarcated, thick, silvery, scaly, and erythematous? a.Plaque b.Inverse c.Guttate d.Erythrodermic

_____ is an inflammatory disorder of the skin characterized by pruritus with lesions that have an indistinct border and is often considered synonymous with dermatitis. a.Eczema b.Psoriasis c.Atopic dermatitis d.Pityriasis rosea

_____ of the epidermis initiate immune responses and provide defense against environmental antigens. a.Langerhans cells b.Merkel cells c.Keratinocytes d.Melanocytes

The school nurse has provided instructions regarding the use of permethrin rinse to the parents of the children diagnosed with pediculosis capitis (head lice). Which statement by one of the parents indicates the need for further instruction? A. "It is applied to the hair and then shampooed out" B. "The hair should not be shampooed for 24 hours after treatment" C. "The permethrin rinse can be obtained over the counter in a local pharmacy" D. "It is applied to the hair after shampooing, left on for 10 minutes, and then rinsed out"

A. "It is applied to the hair and then shampooed out" Permethrin is an OTC scabicide that kills lice and eggs, applied after shampooing, left on for 10 minutes, and should not be shampooed for 24 hours after treatment

A patient comes to the clinic for a follow-up appointment after using a glucocorticoid ointment for eczema for 3 weeks. Because the patient is pleased with the results, she states that she would like to continue treatment with an oral glucocorticoid. What response from the nurse is most appropriate? A. "Oral glucocorticoids have more systemic side effects and are only indicated if topical glucocorticoids have been ineffective" B. Oral glucocorticoids will have fewer side effect, so your suggestion is good" C. "You make an excellent point! Topical glucocorticoids can cause skin atrophy, whereas oral agents don't have the same effect" D. "Oral glucocorticoids are more convenient to use, so I agree with your suggestion"

A. "Oral glucocorticoids have more systemic side effects and are only indicated if topical glucocorticoids have been ineffective"

A 40 year old is diagnosed with skin cancer. It is explained that the most important risk factor for skin cancer is: A. Amount of direct sun exposure at a young age B. Amount of sun exposure over age 50 C. Lifetime amount of sun exposure D. Living in equatorial regions where the sun is most intense

A. Amount of direct sum exposure at a young age

The nurse is applying a topical corticosteroid to the client with eczema. The nurse should apply the medication to which body area? Select all that apply A. Back B. Axilla C. Eyelids D. Soles of feet E. Palms of the hand

A. Back D. Soles of feet E. Palms of the hand Nurse should avoid areas of high absorption such as scalp, axilla, face, eyelids, neck, perineum, and genitalia

Which type of microbe cause Tinea infections? A. Fungus B. Virus C. Gram-negative bacterium D. Mite

A. Fungus

Individuals of which descent are more prone to developing keloids? a. Black b. Northern European c. Asian d. Native American

ANS: A Blacks are at greater risk for the development of keloids. Neither Northern Europeans, Asians, nor Native Americans are at great risk for the development of keloids.

Which process would be expected in the first 24 hours following a serious burn? a. Increased capillary permeability b. Diuresis c. Decreased levels of stress hormones d. Fluid overload

ANS: A Increased capillary permeability occurs, leading fluid to shift to interstitial spaces. Blood is shunted from the kidneys, so decreased urination occurs. Increased levels of stress hormones are secreted. Hypovolemia, not fluid overload, occurs.

A 36-year-old male is experiencing frontotemporal hair recession. He is diagnosed with male pattern baldness, which is a form of: a. alopecia. b. areata. c. hirsutism. d. paronychia.

ANS: A Male-pattern alopecia is an inherited form of irreversible baldness with hair loss in the central scalp and recession of the frontotemporal hairline. Alopecia areata is an autoimmune T-cell-mediated chronic inflammatory disease directed against hair follicles that results in hair loss. Hirsutism is a form of abnormal hair growth in women. Paronychia is an inflammation of the cuticle.

Which cells are involved in initiating immune responses in the skin? a. Langerhans cells b. Merkel cells c. Keratinocytes d. Melanocyte

ANS: A The Langerhans cells process the antigen and carry it to T cells. T cells then become sensitized to the antigen, inducing the release of inflammatory cytokines and the symptoms of dermatitis. Merkel cells are associated with nerve cells. Keratinocytes are part of the epidermal layer of the skin and are not involved in immune responses. Melanocytes synthesize the skin's pigment.

A 25-year-old paralyzed male develops a dermal pressure ulcer. When assessing the patient's skin, which finding is the first indication of this ulcer? a. Redness b. Whiteness c. Indurations d. Ulceration

ANS: A The initial sign of a pressure ulcer is redness, not whiteness. Induration and ulceration occur in later stages.

A 28-year-old male is admitted to the burn unit 2 hours after receiving second- and third-degree burns over 50% of his body surface in an industrial explosion. Abnormal vital signs include low blood pressure and tachycardia. Lab results show a high hematocrit due to: a. sickle cell syndrome. b. fluid movement out of the vascular space. c. renal failure. d. increased vascular protein secondary to increased metabolism.

ANS: B Fluid and protein movement out of the vascular compartment results in an elevated hematocrit. Sickle cell syndrome does not result in increased hematocrit. Renal failure can occur, but this does not result in an increase in the hematocrit. Protein loss leads to decreased protein, not increased.

Hypovolemia in the early stages of burn shock is directly related to: a. decreased cardiac contractility and shunting of blood away from visceral organs. b. increased capillary permeability and evaporative water loss. c. hypometabolism and renal water loss. d. bacterial infection of the wound and resulting bacteremia.

ANS: B Hypovolemia occurs due to increased capillary permeability. Decreased cardiac contractility occurs, but this is not the direct cause of hypovolemia. Blood is shunted from the kidneys, so water loss does not occur. Bacterial infection is a risk, but it is not the cause of hypovolemia.

A wound scar that is sharply elevated, irregularly shaped, and progressively enlarging is a result of excessive amounts of _____ accumulated during connective tissue repair. a. elastin b. collagen c. keratin d. calcification

ANS: B Irregular scar formation is due to excessive fibroblast activity and collagen formation. Irregular scar formation is not due to excessive elastin, keratin, or calcification.

A 13-year-old female is concerned about several pigmented skin lesions on her body. Her primary care provider tells her that these lesions must be monitored because of their ability to transform into malignant melanoma. These lesions are referred to as: a. macules. b. nevi. c. plaques. d. keloids.

ANS: B Nevi may undergo transition to malignant melanoma. Neither macules, plaques, nor keloids undergo transition to malignant melanoma.

Pityriasis rosea is caused by a: a. parasite. b. virus. c. bacteria. d. fungus.

ANS: B Pityriasis rosea is caused by a virus. Pityriasis rosea is not caused by a parasite, a bacterium, or a fungus.

Which of the following burns is most painful? a. First degree b. Second degree c. Charring d. Third degree

ANS: B Second degree burns leave tactile and pain sensors intact and are the most painful. All of the other options result in less pain.

To promote efficient wound healing, which dressing should be applied to a superficial ulcer? a. Thick and dry b. Flat and moist c. Bulky and dry d. None

ANS: B Superficial ulcers should be covered with flat, moisture-retaining dressings. Superficial ulcers should not be covered with dressings that are dry and thick (bulky). Dressings should not be avoided.

Of the sweat glands, the _____ glands are most abundant in the axillae and genital areas. a. eccrine b. apocrine c. sebaceous d. subcutaneous

ANS: B The apocrine sweat glands are located in the axillae, scalp, face, abdomen, and genital areas. The eccrine sweat glands are distributed over the body, with the greatest numbers in the palms of the hands, soles of the feet, and forehead. Neither sebaceous nor subcutaneous glands are located in the axillae and genital areas.

A 15-year-old female reports abnormal hair growth on her face and body. This condition is referred to as: a. alopecia. b. areata. c. hirsutism. d. paronychia.

ANS: C Abnormal hair growth is referred to as hirsutism. Loss of hair is alopecia. Areata is a specific form of alopecia. Paronychia is an infection around the nail.

For a patient with candidiasis, which factor will exacerbate the condition? a. Poor hygiene b. Older age c. Systemic antibiotics d. Anemia

ANS: C Candidiasis is exacerbated by the use of systemic antibiotics because the antibiotics eliminate normal flora. Candidiasis is not exacerbated by poor hygiene, advanced age, or anemia.

A client is burned through all the dermis with only a few epidermal appendages intact. This burn is classified as: a. first degree. b. superficial partial-thickness. c. deep partial-thickness. d. third degree.

ANS: C Deep partial-thickness burns involve the entire dermis, sparing skin appendages such as hair follicles and sweat glands. First-degree burns involve only the epidermis. Superficial partial-thickness burns involve deeper thickness. Third-degree burns involve destruction of the entire epidermis, dermis, and often underlying subcutaneous tissue.

A 10-year-old male is playing with matches and gets burned. His burn is waxy white in appearance. This burn is classified as: a. first degree. b. superficial partial-thickness. c. deep partial-thickness. d. third degree.

ANS: C Deep partial-thickness burns involve the entire dermis, sparing skin appendages such as hair follicles and sweat glands. These wounds look waxy white. First-degree burns are red and have no blisters. Superficial burns involve fluid-filled blisters. Third-degree burns are dry and have a leathery appearance.

A 42-year-old female presents with raised red lesions with a brownish scale. She was diagnosed with discoid lupus erythematosus. This disorder is related to: a. infection. b. trauma. c. autoimmunity. d. cancer.

ANS: C Discoid lupus is related to autoimmunity, not infection, trauma, or cancer.

Fat cells are located in the: a. epidermis. b. dermis. c. hypodermis. d. fascia beneath the skin.

ANS: C The hypodermis, also referred to as the subcutaneous layer, is an underlying layer of connective tissue that contains macrophages, fibroblasts, and fat cells. Fat cells are not found in the epidermis, the dermis, or the fascia

a.Elevated, firm circumscribed area less than 1 cm in diameter b.Elevated, firm, and rough lesion with flat top surface greater than 1 cm in diameter c. Flat circumscribed area that is less than 1 cm in diameter d.Elevated irregular-shaped area of cutaneous edema; solid, transient; with a variable diameter e.Elevated circumscribed, superficial lesion filled with serous fluid, less than 1 cm in diameter 1. Urticaria, allergic reaction 2. Varicella (chickenpox), herpes zoster (shingles) 3. Wart (verruca) or lichen planus 4. Psoriasis or seborrheic and actinic keratoses 5. Nevus (flat mole)

ANS: D ANS: E ANS: A ANS: B ANS: C

An increase in _____ is associated with pruritus. a. substance P b. norepinephrine c. dopamine d. acetylcholine

ANS: D Acetylcholine, not substance P, is one of the itch mediators. Neither norepinephrine nor dopamine is considered an itch mediator.

A 50-year-old male recently underwent a liver transplant and is taking immunosuppressive drugs. He now has painful vesicular eruptions on the face and trunk. He reports that he had chickenpox as a child. Which of the following is the most likely diagnosis based on his chicken pox history? a. Erysipelas b. Poliomyelitis c. Warts d. Herpes zoster

ANS: D Herpes zoster causes shingles, a disorder similar to chicken pox. Erysipelas is caused by strep. Poliomyelitis is not manifested by painful vesicles. Warts are not painful.

A patient wants to know which malignant skin lesion is the most serious. The correct response is: a. basal cell carcinoma. b. squamous cell carcinoma. c. Kaposi sarcoma (KS). d. malignant melanoma.

ANS: D Malignant melanoma is the most serious skin cancer. None of the remaining options poses such a significant health risk

In burn injury patients, the rule of nines and the Lund and Browder chart are used to estimate: a. depth of burn injury. b. possibility of infection. c. degree of systemic involvement. d. total body surface area burned.

ANS: D The rule of nines estimates the total body surface area burned, not the depth of burn injury. It does not estimate the degree of systemic involvement. The possibility of infection is 100%.

_____ shock is often more severe than other forms because of its sudden, rapid systemic vasodilation.

Anaphylactic

Hypovolemic shock begins to develop when intravascular volume has decreased by ______

Ans: 15% Exp: Hypovolemic shock begins to develop when intravascular volume has decreased by about 15%.

Burn injury induces almost immediate:

Ans: Hypermetabolism Exp: Burn injury induces a hypermetabolic state that persists until wound closure.

The fluid most often used in fluid resuscitation following a major burn injury is:

Ans: Lactated Ringer Exp: Lactated Ringer solution is used because it closely approximates extracellular fluid, the repository of fluid leaving the circulatory system during this phase of extensive edema formation.

The endpoint of burn shock is defined as the time when the individual is able to:

Ans: Maintain adequate urine output for 2 hours Exp: The endpoint of burn shock is defined as the state in which the individual is able to maintain urine output for 2 hours with the intravenous fluid administration rate equal to the individuals calculated maintenance rate.

The most reliable criterion of adequate fluid resuscitation following a major burn injury is:

Ans: Urine output Exp: The most reliable criterion for adequate resuscitation of burn shock is urine output

A clinical syndrome involving a systemic response to infection, which is manifested by two or more of the systemic inflammatory response syndrome (SIRS) criteria is the definition of: a.bacteremia. b.sepsis. c.severe sepsis. d.septic shock.

Blistering of the skin occurs in _____ burns. a.first-degree b.superficial second-degree c.deep second-degree d.third-degree

Burn injury induces almost immediate: a.hypervolemia. b.hypermetabolism. c.hyponatremia. d.hypotension.

Children are at high risk for pulmonary complications because of: a.immature lungs. b.anatomic differences in their airways. c.decreased immunity. d.high incidences of pneumonia.

Dressings applied to pressure ulcers should be: a.flat and dry. b.flat and moist. c.bulky and dry. d.bulky and moist.

Excessive skin blood flow may be present in _____ shock. a.hemorrhagic b.septic c.compensated d.cardiogenic

For which type of shock would antihistamines and corticosteroids be prescribed? a.Septic b.Anaphylactic c.Hypovolemic d.Cardiogenic

Inflammatory mediators that are active in frostbite include: a.leukotrienes, serotonin, and prostacyclin. b.histamine, bradykinin, and thromboxanes. c.lymphokines, leukotrienes, and fibrin. d.plasmin, lysosomal compounds, prostacyclin.

Keloids are sharply elevated, irregularly shaped, progressively enlarging scars caused by excessive amounts of _____ in the corneum during connective tissue repair. a.elastin b.collagen c.stroma d.reticular fibers

The endpoint of burn shock is defined as the time when the individual is able to: a.maintain adequate blood pressure for 4 hours. b.maintain adequate urine output for 2 hours. c.manage pain without narcotics. d.manage pain during dressing changes.

Tinea corporis (ringworm) is a _____ infection of the skin. a.nematode b.fungal c.viral d.bacterial

To determine a child's response to fluid therapy for shock, the nurse should monitor: a.hematocrit and hemoglobin levels. b.urine output and specific gravity. c.blood pressure and pulse. d.arterial blood gases and heart rate.

What is the clinical hallmark of neurogenic shock due to overstimulation of the parasympathetic nervous system? a.Heart rate greater than 100 beats/minute b.Heart rate less than 60 beats/minute c.Systolic blood pressure less than 100 mmHg d.Diastolic blood pressure less than 60 mmHg e.Fever greater than 38.8° C (102° F)

What is the first change in the skin to indicate a pressure ulcer? a.Blanchable erythema of intact skin b.Nonblanchable erythema of intact skin c.Blister at the site of pressure d.Reddish-purple discoloration

Which skin disorder begins with a single lesion that is circular, demarcated, salmon-pink, approximately 3 to 4 cm in diameter, and usually located on the trunk? a.Lichen planus b.Pityriasis rosea c.Psoriasis d.Acne rosacea

_____ is a fungal infection of the nail plate. a.Paronychia b.Onychomycosis c.Tinea corporis d.Tinea capitis

You are caring for a client who had surgery 24 hours ago and is experiencing severe pain. The client states "my pain medication is effective, but will this pain ever go away?" which of the following responses is correct? a. if the pain does not subside by this time tomorrow, you will need to be screened for the development of chronic pain b. incisional pain is usually most severe for the first 2 to 3 days, and then it progressively becomes less severe c. if the prescribed analgesics are controlling the pain we do not worry about the severity of the pain d. it is unusual for you to still have severe pain. I will contact your surgeon

B incisional pain is usually most severe for the first 2 to 3 days, and then it progressively becomes less severe

A topical corticosteroid is prescribed for an infant with dermatitis in the gluteal area. The nurse provides instructions to the mother regarding the use of the medication. Which statement by the mother indicates an understanding of the use of the medication? A. "I should not rub the medication into the skin" B. "The medication will help relieve the inflammation" C. "I need to apply the medication in a thick layer to protect the skin" D. "I should protect the area by covering it with a diaper and plastic pants

B. "The medication will help relieve the inflammation"

A nurse gives a 13 year old client an ice bag to place over her sprained ankle. How long should the nurse have the client apply the bag before removing it? A. 25 minutes B. 20 minutes C. 15 minutes D. 10 minutes

B. 20 minutes

While caring for a client recovering from a major burn injury, the nurse notes a significant increase in urine output. The nurse will plan care for which stage of burn treatment? A. Emergent B. Acute C. Rehabilitative D. Resuscitative

B. Acute The acute stage begins with the start of diuresis and ends with the closure of the burn wound. Choices A and D are incorrect because this phase begins from the onset of injury and ends through successful fluid resuscitation as evidenced by diuresis. Choice C is incorrect because the rehabilitative phase begins after the burn wound has been closed and continues until the client is able to return to the highest level of independence and functioning.

Tetracycline is prescribed for a client with sever acne. The nurse instructs the client regarding the importance of reporting which finding if it occurs? A. Sunburn B. Persistent diarrhea C. Epigastric Burning D. Abdominal cramping

B. Persistent diarrhea Adverse effects include GI irritation manifested as epigastric burning, cramps, nausea, vomiting, and diarrhea. These effects do not need to be reported unless they become persistent

A home health nurse is visiting a client who has been started on therapy with clotrimazole. The nurse determines the effectiveness of the medication by noting a decrease in which problem? A. Pain B. Rash C. Fever D. Sneezing

B. Rash Clotrimazole is an antifungal agent used in the treatment of cutaneous fungal infections

Which of the following burns is most painful A. First degree B. Second Degree C. Third Degree D. Fourth degree

B. Second Degree

When evaluating the initial laboratory values of a client with an extensive burn injury, the emergency department nurse notes an elevated hematocrit level. What does this finding indicate? A. The client did not suffer internal hemorrhage B. The client requires aggressive fluid replacement therapy C. The client inhales carbon manoxide D. The client requires anticoagulation therapy

B. The client requires aggressive fluid replacement therapy Elevated hematocrit is caused by massive loss of intravascular fluid into the interstitium (third spacing)

A nevus characterized by a small (less than 1 cm) lesion with regular edges and bristle-like hairs with a color change from skin tones to light brown is a(n) _____ nevus. a.junctional b.epidermal c.intradermal d.compound

How does a nurse describe the skin lesions caused by tinea capitis or tinea corporis? a.Pink-to-red coalescing maculopapular rash on the scalp or trunk b.Vesicles that rupture, creating a thin, flat, honey-colored crust c.Circular (round or oval) with erythema and scaling patches d.Red papules, vesicles, and pustules in clusters

Hypovolemic shock begins to develop when intravascular volume has decreased by ____%. a.5 b.10 c.15 d.20

The fluid most often used in fluid resuscitation following a major burn injury is: a.saline. b.albumin. c.lactated Ringer. d.dextrose in water.

The renin-angiotensin-aldosterone system compensates for hypovolemic shock by stimulating: a.antidiuretic hormone from the posterior pituitary to retain potassium and excrete sodium to improve myocardial contractility. b.ß1-adrenergic receptors to increase myocardial contractility, heart rate, and conduction through the atrioventricular node. c.aldosterone release, which retains sodium and hence water to increase the blood volume. d.movement of calcium into vascular smooth muscle, causing vasoconstriction and increasing systemic vascular resistance.

The severity of burn injury is assessed by: a.amount of fluid lost. b.circumference of the burn injury. c.depth of the burn injury. d.injury to other body systems.

Treatment for frostbite includes: a.application of local, dry heat. b.rubbing or massaging the area. c.immersion in warm water. d.leaving the area uncovered.

When circulatory collapse prevents using the intravenous route for burn fluid resuscitation in children, fluids may be given via _____ cannulation. a.interdermal b.intra-arterial c.intraosseous d.gastrointestinal

Which cells of the dermis release histamine and play a role in the hypersensitivity reactions of the skin? a.Histiocytes b.Fibroblasts c.Mast cells d.Macrophages

Which cells of the dermis secrete connective tissue matrix? a.Macrophages b.Mast cells c.Fibroblasts d.Histiocytes

Which contagious disease has clinical manifestations of burrows several millimeters to 1 cm long, papules, and vesicular lesions with severe itching that worsens at night? a.Pediculosis b.Tinea capitis c.Scabies d.Rubeola

Which gland releases secretions that are important in thermoregulation and cooling of the body through evaporation? a.Sebaceous b.Apocrine c.Eccrine d.Exocrine

Which of the following medications may exacerbate existing psoriasis? a.Antibiotics b.Calcium channel blockers c.Nonsteroidal anti-inflammatory drugs (NSAIDs) d.Antilipidemics

Which receptors of the autonomic nervous system regulate heat loss through the skin? a.Cholinergic b.ß-Adrenergic c.α-Adrenergic d.Anticholinergic

Which skin lesion is mediated by IgE-stimulated release of histamine, bradykinin, kallikrein, or acetylcholine from mast cells? a.Dermatitis b.Scleroderma c.Urticaria d.Cutaneous vasculitis

Women who develop hirsutism may be secreting hormones associated with: a.posterior pituitary adenoma. b.Cushing disease. c.polycystic ovaries. d.Addison disease.

____ are a collection of infected hair follicles that often occur on the back of the neck, the upper back, and lateral thighs that form a mass that evolves into an erythematous, painful, edematous mass, which drains through many openings. a.Erysipelas b.Furuncles c.Carbuncles d.Boils

_____ shock is often more severe than other forms because of its sudden, rapid systemic vasodilation. a.Septic b.Hypovolemic c.Anaphylactic d.Neurogenic

Silver sulfadiazine is prescribed for a client with a partial-thickness burn and the nurse provides teaching about the medication. Which statement made by the client indicated the need for further teaching? A. "The medication is an antibacterial" B. "The medication will help heal the burn" C. "The medication is likely to cause stinging every time it is applied" D. "The medication should be applied directly to the wound"

C. "The medication is likely to cause stinging every time it is applied" Silver sulfadiazine is an antibacterial that has a broad spectrum of activity against gram-positive bacteria, gram-negative bacteria, and yeast

A 10 year old male is playing with matches and gets burned. His burn is waxy white in appearance. This burn is classified as: A. First degree B. Superficial partial-thickness C. Deep partial-thickness D. Third degree

C. Deep partial-thickness

The fluid most often used in fluid resuscitation following major burn injury is: A. 0.9% normal saline B. Human Albumin C. Lactated Ringer D. 5% Dextrose in water

C. Lactated Ringer

Tinea capatis is an infection involving the: A. Trunk B. Feet C. Scalp D. Nails

C. Scalp Tinea capitis is ringworm of the scalp which is a fungal infection

A client is seen in the clinic for a complaint of scalp itching that has been persistent over the past several weeks. After an assessment, it is determined that the client has head lice. Permethrin shampoo is prescribed, and the nurse provides instructions to the client regarding the use of the medication. The nurse should tell the client to take which measure? A. Put the medication in 1 time only B. Leave the medication in for at least 4 hours C. Wash, rinse, and towel-dry the hair before applying D. Leave the shampoo on for 8-12 hours and then remove by washing

C. Wash, rinse, and towel-dry the hair before applying

A burn client has been having 1% silver sulfadiazine applied to burn twice a day for the past 3 days. Which lab abnormality indicates that the client is experiencing a side or adverse effect of this medication? A. Serum sodium of 120 mEq/L B. Serum potassium of 3.0 mEq/L C. White blood cell count of 3000 mm3 D. pH 7.30, PaCO2 of 32 mmHg, HCO3 of 19 mEq/L

C. White blood cell count of 3000 mm3 Transient leukopenia typically occurs after 2-3 days of treatment

An older adult man states he has a sore above his lip that has not healed and is getting bigger. The nurse observes a red scaly patch with an ulcerated center and sharp margins. The nurse recognizes these features as commonly associated with Bowen disease, a form of: a.Kaposi sarcoma. b.malignant melanoma. c.basal cell carcinoma. d.squamous cell carcinoma.

Aspirin is given to individuals being treated for frostbite in order to: a.treat fever. b.prevent plate aggregation. c.reduce pain. d.inhibit prostaglandins.

Chickenpox may be followed years later by: a.erysipelas. b.cytomegalovirus. c.warts (verrucae). d.herpes zoster.

Daily evaporative water loss following burn injury is approximately _____ times normal. a.5 b.10 c.15 d.20

The most reliable criterion of adequate fluid resuscitation following a major burn injury is: a.blood pressure. b.pulse rate. c.respiratory rate. d.urine output.

Thrush is a superficial infection that commonly occurs in children and is caused by: a.Staphylococcus. b.Streptococcus. c.herpesvirus. d.Candida albicans.

What causes renal failure after electrical burns in children? a.Cytokines released after the damaged tissue b.Immature kidneys unable to compensate for the electrical burn c.Reduction in cardiac output d.Myoglobin released from damaged muscles

What clinical manifestations do allergic, atopic, and stasis dermatitis have in common? a.Petechiae and hyperpigmentation b.Edema and vesicular lesions c.Scaling and crusting of lesions d.Erythema and pruritus

What type of shock develops with overstimulation of the parasympathetic nervous system or understimulation of the sympathetic nervous system? a.Septic shock b.Cardiogenic shock c.Anaphylactic shock d.Vasogenic shock

Which immunoglobulin is found in skin biopsy with immunofluorescent observation of people with discoid lupus erythematosus? a.IgA b.IgE c.IgG d.IgM

Which skin disorder has as its hallmark clinical manifestation skin lesions that rupture, creating a thin, flat, honey-colored crust? a.Rubella b.Tinea capitis c.Atopic dermatitis d.Vesicular impetigo

Which skin disorder is characterized by a vesicular eruption after prolonged exposure to perspiration, with subsequent obstruction of the eccrine ducts? a.Scabies b.Tinea corporis c.Pediculosis d.Miliaria

_____ is a contagious disease caused by the itch mite. a.Miliaria b.Tinea corporis c.Pediculosis d.Scabies

A topical corticosteroid is prescribed for a client with dermatitis. The nurse provides instructions to the client regarding the use of the medication. Which statement by the client would indicate the need for further instruction? A. "I need to apply the medication in a thin film" B. "I should gently rub the medication into the skin" C. "The medication will help relieve the inflammation and itching" D. "I should place a bandage over the site after applying the medication"

D. "I should place a bandage over the site after applying the medication"

The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse remind the children that chemical sunscreens are most effective when applied which times? A. Immediately before swimming B. 5 minutes before exposure to sun C. Immediately before exposure to sun D. At least 30 minutes before exposure to sun

D. At least 30 minutes before exposure to sun

A client with a total body surface are burn of 45% is experiencing hypovolemic shock. How can the nurse explain this type of shock to the client's family? A. Inflammation causes hyperemia B. Decreased peristalsis increases the risk of aspiration C. Antidiuretic hormone is released from the posterior pituitary gland D. Fluid shifts from capillaries into interstitial compartment reducing circulating fluid volumes

D. Fluid shifts from capillaries into the interstitial compartment reducing circulating fluid volumes

A 50 year old male recently underwent a liver transplant and is taking immunosuppresive drugs. He now has painful vesicular eruptions on the face and trunk. He reports that he had chickenpox as a child. Which is the most likely diagnosis based on his chickenpox history? A. Erysipelas B. Poliomyelitis C. Warts D. Herpes Zoster

D. Herpes Zoster

A patient wants to know which malignant skin lesion is the most serious. The correct response is: A. Basal cell carcinoma B. Squamous cell carcinoma C. Kaposi Sarcoma D. Malignant Melanoma

D. Malignant melanoma

Which of the following best describes the typical lesion of psoriasis? A. Purplish papules B. Firm raised pruritic nodules C. Moist red vesicles D. Silvery plaques on an erythematous base

D. Silvery plaques on an erythematous base Psoriasis is a common skin condition that speeds up the life cycle of skin cells and causes cells to build up rapidly on the surface of the skin

The most reliable criteria of adequate fluid resuscitation following a major burn injury is : A. Blood pressure B. Pulse rate C. Respiratory rate D. Urine output

D. Urine output

Silver sulfadiazine is prescribed for a client with a burn injury. Which laboratory finding requires the need for follow-up by the nurse? A. Glucose level of 99mg/dL B. Magnesium level of 1.4 mEq/L C. Platelet level of 300,000 mm3 D. White blood cell count of 3000mm3

D. White blood cell count of 3000 mm3 Adverse effect of silver sulfadiazine is leukopenia

A client is hospitalized with extensive full thickness burns of both legs. In response to the client's questions, the nurse explains that during the acute phase of burn injury, biological dressing are used primarily to A. maintain range of motion. B. reduce fluid loss. C. relieve pain. D. promote healing

D. promote healing

A client is about to undergo a biopsy of a 6-mm, bluish-red lesion. In addition to a thorough skin examination, the nurse knows the most critical assessment to be made at this time is the status of the client's A. cardiovascular system B. pulmonary function C. white blood cells. D. regional lymph nodes

D. regional lymph nodes

A client with a large healing deep partial-thickness burn of the forearm and wrist is being discharged from the burn treatment clinic. Which of the following should the nurse tell the client to avoid for a year? •Immersion in water •Sports that require wrist motion •Exposure to the sun •Application of topical lotions

Exposure to the sun A deep partial-thickness burn occurs when the first layer of skin, the epidermis, is burned all the way through, and some level of burning occurs in the underlying layer of skin, called the dermis. A deep partial-thickness burn can cause permanent scars, much like a full-thickness burn. Exposure to sun of the newly formed and healing skin in the year following a burn injury can cause more intense scarring.

Burn shock is a form of hemorrhagic shock. True or false?

Impetigo is a common viral skin infection in infants and children. True or false?

Pain experienced by patients during the thawing period after frostbite is mild because the nerve endings are anesthetized by the cold

Psoriasis is an inflammatory skin condition.

Second-degree burns can be full-thickness burns.

The same standard rule of nines used for fluid resuscitation in adults is also used for children. True or false?

A client is prescribed 1% silver sulfadiazine cream (Silvadene) to be applied to her burn wounds twice daily. After 3 days of treatment, the nurse suspects an adverse reaction to the medication when the client develops which of the following? -Hyponatremia -Leukopenia -Hyperchloremia -Hyperkalemia

Leukopenia Transient leukopenia is a common adverse effect that appears after 2 to 3 days of treatment with silver sulfadiazine cream.

A client is brought to the emergency department with severe frostbite. The nurse assessing the client knows the burned appearance of frostbitten tissue is a direct result of which of the following? •Red blood cell aggregation with microvascular occlusion •Histamine release with decreased capillary permeability •Tissue destruction by the ice crystals •Rewarming of previously damaged tissues

Red blood cell aggregation with microvascular occlusion As blood reaches freezing temperatures, red blood cells aggregate, or clump together. This causes occlusion of small blood vessels and leads to a loss of superficial blood flow. This causes a discoloration of the skin that resembles a superficial, partial-thickness burn.

A clinical syndrome involving a systemic response to infection, which is manifested by two or more of the systemic inflammatory response syndrome (SIRS) criteria is the definition of:

Sepsis

What type of shock results from decreased systemic vascular resistance (SVR)?

Septic

Atopic dermatitis is the most common cause of eczema in children. True or false?

Children younger than 2 years have a significantly higher risk for associated morbidity and mortality after thermal injury. True or false?

Cytomegalovirus is a type of herpesvirus.

Hypotension is a late sign of shock in children. True or false?

In primary multiple organ dysfunction syndrome (MODS), organ injury is directly associated with impaired perfusion. True or false?

Older adults have impaired wound healing because of a decreased blood supply and depressed immune system.

Secondary MODS results from excessive inflammatory reaction. True or false?

Shingles and chickenpox are both caused by the same herpesvirus.

The cause of organ failure in shock is depletion of protein. True or false?

The gastrointestinal system is very sensitive to inflammatory injury resulting from mediators released by macrophages. True or false?

Tinea (e.g., ringworm) and candidiasis are caused by fungi.

To compensate for hypovolemic shock, the liver and spleen add to the blood volume by disgorging stored red blood cells and plasma. True or false?

Warts are benign lesions of the skin caused by human papillomavirus (HPV).

When proteins are broken down anaerobically, ammonia and urea are produced. True or false?

The nurse is caring for a client who has a heavy exudating wound that needs autolytic debridement. which of the following wound dressings/products is most appropriate to use on the wound? a. an alginate dressing, such AlgiCell b. A hydrogel dressing, such as aquasorb c. a transparent film, such as tegaderm d. an antimicrobial dressing, such as silvasorb.

a. an alginate dressing, suchas algicell

Which of the following areas lacks blood vessels and nerves? a. epidermis b. dermis c. subcutaneous tissue d. fatty tissue

a. epidermis

Which type of microbe causes Tinea infections? a. fungus b. virus c. gram-negative bacterium d. mite

a. fungus

a nurse is collecting a wound culture from two different site. Which of the following actions should the nurse take while performing this procedure? Select all that apply a. insert a swab into the wound b. place the swab in the culture tube when done c. use the same swab for both wound sites d. touch the swab to the intact skin at the wound edges e. tap the outside of the culture tube with the swab before placing it in the tube f. press and rotate the swab several times over the wound surfaces

a. insert swab into the wound b. place the swab in the culture tube when done f. press and rotate the swab several times over the wound surfaces

the nurse is planning to replace a client's wound dressing. The deep . wound bed is to remain moist and requires packing. which of the following actions is appropriate? a. Loosely pack the dampened dressing material to prevent too much pressure on the wound bed b. insert rolled gauze into the wound; saturate it with povidone-iodine solution and cover with a moisture impervious dressing c. fill the wound with sterile saline gel and cover with a lrage transparent dressing d. instill 50 mL of normal saline into the wound and loosely cover with packing material.

a. loosely pack dampened dressing material to prevent too much pressure on the wound bed.

A nurse is explaining to a client that the client's skin in the perineal area has softened due to prolonged exposure to moisture from urinary incontinence. This condition is known as which of the following? a. Maceration b. Ecchymosis c. Dehiscence d. Necrosis

a. maceration

which of the following pieces of equipment would allow the nurse to change a dressing without having to use tape? a. montgomery straps b. saline c. gauze d. waterproof pad

a. montgomery straps

Which disease is manifested by large vesicles that coalesce and rupture? a. pemphigus b. discoid lupus erythematosus c. lichen planus d. scleroderma

a. pemphigus

A client who has been confined to a hospital bed for the past 2 weeks complains of sores on the buttocks. On examination, the nurse quickly determines that the sores are caused by unrelieved compression of the skin that has resulted in damage to underlying tissues. This client exhibiting signs of which of the following conditions? a. pressure ulcers b. jaundice c. ecchymosis d. ischemia

a. pressure ulcers

The nurse is caring for a client who has a deep wound and whose saline-moistened wound dressing has been changed every 12 hours. While removing the old dressing, the nurse notes that the packing material is dry and adheres to the wound bed. Which of the following modifications is most appropriate? a. reduce the time interval between dressing changes b. discontinue application of saline-moistened packing and apply hydrocolloid dressing c. assure that the packing material is completely saturated when placed in wound d. use less packing material

a. reduce the time interval between dressing changes

Choose the correct match of the skin condition and its usual location: a. scabies—fingers, wrists, waist b. impetigo—legs, feet c. pediculosis humanus corporis—scalp d. seborrheic keratosis—feet , hands

a. scabies—fingers, wrists, waist

A nurse gives a 13-year old client an ice bag to place over her sprained ankle. How long should the nurse have the client apply the bag before removing it? a. 25 minutes b. 20 minutes c. 15 minutes d. 10 minutes

b. 20 minutes

Why do secondary infections frequently develop in pruritic lesions? a. loss of protective sebum b. entry of resident flora while scratching the lesion c. blockage of sebaceous glands d. increased sweat production

b. entry of resident flora while scratching the lesion

What causes the pruritus associated with scabies? a. an allergic reaction to the causative microbe b. mites burrowing into the epidermis and their feces c. bleeding and injected toxin from bites d. neurotoxins secreted by mites

b. mites burrowing into the epidermis and their feces

Choose the best description of the typical lesion of impetigo: a. large red painful nodule filled with purulent exudates b. small vesicles that rupture to produce a crusty brown pruritic mass c. red, swollen painful areas often with projecting red streaks d. firm raised papules that may have a rough surface and may be painful

b. small vesicles that rupture to produce a crusty brown pruritic mass

the nurse notes an area of tissue injury on the client's sacral region. The wound is a shallow, open ulcer with a red-pink wound bed and partial-thickness loss of dermis. Which of the following is the correct name of this wound? a. stage III pressure ulcer b. stage II pressure ulcer c. stage I pressure ulcer d. stage IV pressure ulcer

b. stage II rationale: stage II is defined as partial thickness loss of dermis presenting as shallow, open ulcer with red pink wound bed

Which of the following is a common effect of a type I hypersensitivity response to ingested substances? a. contact dermatitis b. urticaria c. discoid lupus erythematosus d. psoriasis

b. urticaria

A client is burned through all the dermis with only a few epidermal appendages intact. This burn is classified as: A. First degree B. Superficial partial-thickness C. Deep partial-thickness D. Third Degree

c. Deep partial-thickness

A nurse is caring for a client who will be undergoing removal of the gall bladder. Which type of drain should the nurse expect the surgeon to place in the client's common bile duct to drain bile while the surgical site is healing? a. jackson-pratt drain b. penrose drain c. T-tube drain d. hemovac drain

c. T-tube drain

Which of the following statements apply to impetigo? a. Lesions usually appear on the hands and arms. b. The cause is usually a virus. c. The infection is highly contagious. d. Scar tissue is common following infection.

c. The infection is highly contagious.

What change occurs in the skin with psoriasis? a. recurrent hypersensitivity reactions b. autoimmune response c. increased mitosis and shedding of epithelium d. basal cell degeneration

c. increased mitosis and shedding of epithelium

A surgeon is placing a hollow, open ended rubber tube in a client with an abscess. One end is in the abscess and the other passes through a hole in the skin. what type of drain is it? a. hemovac b. jackson-pratt c. penrose d. T-tube

c. penrose drain

Tinea capitis is an infection involving the: a. trunk b. feet c. scalp d. nails

c. scalp

What is a raised, thin-walled lesion containing clear fluid called? a. papule b. pustule c. vesicle d. macule

c. vesicle

Which of the following statements regarding acute necrotizing fasciitis is TRUE? a. Infection is localized in a small area of the epidermis. b. It is usually caused by S. aureus. c. Spontaneous recovery usually occurs in 48 hours. d. Infection rapidly causes extensive tissue necrosis and toxic shock.

d. Infection rapidly causes extensive tissue necrosis and toxic shock.

the nurse is caring for a client who recently had surgery. The nurse understands that it is customary for which of the following people to perform the initial postoperative dressing change? a. client b. nurse c. nursing assistant d. surgeon

d. Surgeon

The nurse is preparing to measure the depth of a client's tunneled wound. Which of the following implements should the nurse use to measure the depth accurately? a. a sterile tongue blade lubricated with water soluble gel b. an otic curette c. a small plastic ruler d. a sterile, flexible applicator moistened with saline

d. a sterile, flexible applicator moistened with saline

Which of the following best describes the typical lesion of psoriasis? a. purplish papules b. firm raised pruritic nodules c. moist red vesicles d. silvery plaques on an erythematous base

d. silvery plaques on an erythematous base

The nurse is removing a client;s dressing and encounters resistance while removing tape from the clients skin. Which of the following strategies to remove tape is the most appropriate? a. grasp the tape firmly and remove it with a quick, decisive pull b. squeeze a moderate amount of water-soluble gel along the edges of the dressing and then gently pull the tape away from the skin c. Saturate the tape with sterile normal saline solution; wait 10 to 20 minutes, then re-attempt removal d. use a silicon-based adhesive remover

d. use a silicon-based adhesive remover

You are applying a saline-moistened dressing to a client's wound. The client asks, "wouldn't it be better to let my wound dry out so a scab can form?" which of the following responses is most appropriate? a. this wound is too large for a scab to form over it, so a moist dressing is the best alternative b. allowing a scab to form would prevent us from observing the wound for signs of infection c. you may be correct. I will check with your PCP d. Wounds heal better when a moist wound bed is maintained

d. wounds heal better when a moist wound bed is maintianed

The acute care nurse is caring for a client whose large surgical wound is healing by secondary intention. The client asks, "why is my wound still open? WIll it ever heal?" which of the following responses by the nurse is appropriate? a. your surgeon may not have been skilled enough to close such a large wound, but it will eventually heal b. as soon as the infection clears, your surgeon will staple the wound closed c. if less scar tissue is essential, wounds are allowed to heal slowly through a process called secondary intention d. your wound will heal slowly as granulation tissue forms and fills the wound

d. your wound will heal slowly as granulation tissue forms and fills the wound

Acute burn injury results in _____ shock.

hypovolemic

A client with an undiagnosed lesion on the back of his right hand is concerned about the possibility of skin cancer. When the client asks what the most serious type of skin cancer is, the nurse responds based on the knowledge that most malignant tumors are -basal cell carcinomas. -melanomas. -angiomas. -squamous cell carcinomas.

melanomas. Melanomas are malignant neoplasms with atypical melanocytes in both the epidermis and the dermis (and sometimes the subcutaneous cells). It is the most lethal type of skin cancer, often causing metastases in bone, liver, lungs, spleen, the central nervous system, and lymph nodes.

Blistering of the skin occurs in _____ burns.

superficial second-degree

A client is being discharged after surgical excision of a malignant melanoma. Which statement indicates to the nurse an understanding of the danger of ultraviolet light? •"I'll skip application of sunscreen on cloudy days." •"I'll keep a tee shirt on when I go sailing so I don't get sunburned." •"I'll reapply my sunscreen every 2 hours when I'm out in the sun." •"I'll use a sunscreen with a solar protection factor of at least 10 when I'm in the sun."

•"I'll reapply my sunscreen every 2 hours when I'm out in the sun." Even water-resistant sunscreens should be reapplied at least every 2 hr after swimming or during prolonged sun exposure.

A nurse teaches a wheelchair bound client to reduce the risk of pressure ulcer formation by instructing the client to do which of the following? •"Move between the bed and the wheelchair every 2 hours." •"Make sure that your personal assistant massages your skin daily." •"Be certain to eat a diet that is high in both fiber and fluids." •"Shift your weight in the wheelchair every 15 minutes."

•"Shift your weight in the wheelchair every 15 minutes." This response addresses the safety issue of the risk of pressure ulcers. Pressure ulcers, wounds that develop due to prolonged pressure on a particular point on the body, are most likely to develop if the client does not shift position frequently.

A nurse on a surgical unit is caring for four clients with healing wounds. Which of the four clients' wounds should the nurse anticipate will heal by primary intention? •Deep partial-thickness burn •Stage III pressure ulcer •Gastroplasty incision •Dehisced sternal wound

•Gastroplasty incision Wound closure occurs by primary intention (surgical closure), secondary intention (left open to close by the reparative process), and tertiary closure (left open and surgically closed at a later date). With primary intention, a clean wound is closed mechanically, leaving well approximated edges and minimal scarring. A surgical incision is an example of a wound that heals by primary intention.

When assessing a bedridden client admitted from home, the nurse notes a shallow crater in the epidermis of the client's sacral area. The nurse documents the presence of a pressure ulcer, noting that it is stage •IV. •I. •III. •II.

•II. With a stage II ulcer, there is partial-thickness skin loss involving the epidermis and the dermis. The ulcer is visible and superficial and may appear as an abrasion, blister, or shallow crater. Edema persists, and the ulcer may become infected. The client may report pain, and there may be a small amount of drainage.

A client is admitted for treatment of a malignant melanoma of the left upper leg. Initially, the nurse plans to prepare the client for which of the following? •Cryosurgery •External radiation therapy •Regional chemotherapy •Surgical excision

•Surgical excision The therapeutic approach to malignant melanoma depends on the level of invasion and the depth of the lesion. Surgical excision is the treatment of choice for small, superficial lesions. Deeper lesions require wide local excision, after which skin grafting may be needed.

A nurse is caring for a client who sustained a thermal burn 4 days ago. Most of the burns are superficial partial-thickness and deep partial-thickness, but there are large areas of full-thickness burns as well. Which assessment finding should the nurse report to the client's provider? •Edema in the burned extremities •Temperature of 39.1º C (102.4º F) •Severe pain at the burn sites •Urine output of 30 mL/hr

•Temperature of 39.1º C (102.4º F) Sepsis is a critical problem post-burn. Initially, burn wounds are relatively pathogen-free. On approximately the third post-burn day, early colonization of the wound surface by gram-positive organisms changes to predominantly gram-negative opportunistic organisms, particularly Pseudomonas aeruginosa. An elevated temperature could indicate the need for an antibiotic and should be reported to the client's provider.

A nurse is bathing a client with burn injuries in a hydrotherapy tub. The nurse limits the client's hydrotherapy sessions to no more than 30 min to •minimize bleeding. •prevent cross contamination. •minimize sodium loss. •prevent hyperthermia.

•minimize sodium loss. Water used in the hydrotherapy tubs is hypotonic. Prolonged periods of immersion increase the client's risk of sodium loss.

The nurse has provided instructions to a client regarding the use of tretinoin. Which statement made by the client indicates the need for further instruction? 1. "I must apply it to wet to damp skin." 2. "Optimal results will be seen after 6 weeks." 3. "I will wash my hands thoroughly after applying the medication." 4. "I will cleanse the skin thoroughly before applying the medication."

1. "I must apply it to wet to damp skin."

The school nurse has provided instructions regarding the use of permethrin rinse to the parents of children diagnosed with pediculosis capitis (head lice). Which statement by one of the parents indicates a need for further instruction? 1. "It is applied to the hair and then shampooed out." 2. "The hair should not be shampooed for 24 hours after treatment." 3. "The permethrin rinse can be obtained over the counter in a local pharmacy." 4. "It is applied to the hair after shampooing, left on for 10 minutes, and then rinsed out."

1. "It is applied to the hair and then shampooed out."

Coal tar has been prescribed for the client with psoriasis, and the nurse provides instructions to the client regarding this treatment. Which statement by the client indicates a need for further instruction? 1. "The medication can cause diarrhea." 2. "The medication can cause phototoxicity." 3. "The medication has an unpleasant odor." 4. "The medication can stain the skin and hair."

1. "The medication can cause diarrhea."

A client with muscle aches and a diagnosis of rheumatism has been given a prescription for capsaicin topical cream. The nurse determines that the client understands the use of the medication if the client makes which statement? 1. "The medication will act as a local analgesic." 2. "The medication acts by decreasing muscle spasms." 3. "The medication will cause redness, flaking, and the skin to peel." 4. "A heating pad should be put on the area after applying the medication."

1. "The medication will act as a local analgesic."

Lindane is prescribed. The nurse reviews the client's record, knowing that this medication therapy would be contraindicated in which client? 1. A child 2. A young adult 3. An older client 4. A middle-aged client

1. A child

A burn-injured client is receiving treatments of topical mafenide acetate to the site of injury. The nurse should monitor the client for which systemic effect that can occur from the use of this medication? 1. Acidosis 2. Alkalosis 3. Hypotension 4. Hypertension

1. Acidosis

Which clients can safely receive lindane? Select all that apply. 1. An 89-year-old client with dementia 2. A 32-year-old client with renal stones 3. A 6-year-old child with a fractured arm 4. A 42-year-old woman with osteoporosis 5. A 52-year-old man with hypertension and high cholesterol

1. An 89-year-old client with dementia 2. A 32-year-old client with renal stones 4. A 42-year-old woman with osteoporosis 5. A 52-year-old man with hypertension and high cholesterol

The nurse is applying a topical corticosteroid to a client with eczema. The nurse should apply the medication to which body area? Select all that apply. 1. Back 2. Axilla 3. Eyelids 4. Soles of the feet 5. Palms of the hands

1. Back 4. Soles of the feet 5. Palms of the hands

A burn client is receiving treatments of topical mafenide acetate to the site of injury. The nurse monitors the client, knowing that which finding indicates that a systemic effect has occurred? 1. Hyperventilation 2. Elevated blood pressure 3. Local rash at the burn site 4. Local pain at the burn site

1. Hyperventilation

Sodium hypochlorite solution is prescribed for a client with a wound on the left foot that is draining purulent material. Which action should the nurse plan to take? 1. Irrigate the wound with the solution. 2. Soak the foot in the solution for 20 minutes daily. 3. Place the solution in the wound, and cover with an occlusive dressing. 4. Soak a sterile dressing with the solution, and pack the dressing into the wound.

1. Irrigate the wound with the solution.

The clinic nurse is performing an admission assessment on a client and notes that the client is taking azelaic acid. The nurse determines that which client complaint may be associated with use of this medication? 1. Itching 2. Euphoria 3. Drowsiness 4. Frequent urination

1. Itching

A client is prescribed mupirocin intranasally twice daily. The nurse correlates this prescription with the client's medical record and expects to note which result specifically related to the indication for this medication? 1. Positive methicillin-resistant Staphylococcus aureas (MRSA) by polymerase chain reaction (PCR) 2. Positive MRSA in a surgical wound site on the abdomen 3. Positive streptococci in the blood and an elevated lactic acid level 4. Positive vancomycin-resistant enterococci (VRE) in the urine for the client with a urinary catheter

1. Positive methicillin-resistant Staphylococcus aureas (MRSA) by polymerase chain reaction (PCR)

A client with an infected leg wound that is draining purulent material has a prescription for sodium hypochlorite to be used in the care of the wound. The nurse should implement which action while using this solution? 1. Rinse off immediately following irrigation. 2. Pour onto sterile sponges, and pack in wound. 3. Let the solution run freely over normal skin tissue. 4. Use each bottle of solution for 2 weeks before replacing.

1. Rinse off immediately following irrigation.

Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which finding indicates the presence of systemic toxicity from this medication? 1. Tinnitus 2. Diarrhea 3. Constipation 4. Decreased respirations

1. Tinnitus

a.Scald burns b.Contact burns c.Flame burns d.Electrical burns e.Chemical burns 1. Involve flammable liquids such as gasoline 2. Caused by hot grease 3. Results from direct contact with high- and low-voltage current 4. Corrosive agent 5. Cigarette burns and curling irons

1. ANS: C 2. ANS: A 3. ANS: D 4. ANS: E 5. ANS: B

a.Cardiogenic shock b.Hypovolemic shock c.Neurogenic shock d.Anaphylactic shock e.Septic shock 1.Follows infection 2.Follows widespread hypersensitivity reaction 3.Follows myocardial infarction 4.Follows major burns 5.Follows parasympathetic stimulation

1. ANS: E 2. ANS: D 3. ANS: A 4. ANS: B 5. ANS: C

The emergency department nurse is caring for a client who has sustained chemical burns to the esophagus after ingestion of lye. The nurse reviews the health care provider's prescriptions and should plan to question which prescription? 1. Gastric lavage 2. Intravenous (IV) fluid therapy 3. Nothing by mouth (NPO) status 4. Preparation for laboratory studies

1. Gastric lavage

1. Hyperventilation

A client who is being evaluated for thermal burn injuries to the arms and legs complains of thirst and asks the nurse for a drink. Which action by the nurse is most appropriate? 1. Keep the client on NPO status. 2. Allow the client to have full liquids. 3. Give the client small glasses of clear liquids. 4. Order the client a full meal tray with extra liquids.

1. Keep the client on NPO status.

The nurse is developing a nursing care plan for a client with a circumferential burn injury of the right arm. What is the nurse's priority action? 1. Monitor the radial pulse every hour. 2. Keep the extremity in a dependent position. 3. Document any changes that occur in the pulse. 4. Place pressure dressings and wraps around the burn sites.

1. Monitor the radial pulse every hour.

The industrial nurse is providing instructions to a group of employees regarding care to a client in the event of a chemical burn injury. The nurse instructs the employees that which is the first consideration in immediate care? 1. Removing all clothing, including gloves, shoes, and any undergarments 2. Determining the antidote for the chemical and placing the antidote on the burn site 3. Leaving all clothing in place until the client is brought to the emergency department 4. Lavaging the skin with water and avoiding brushing powdered chemicals off the clothing

1. Removing all clothing, including gloves, shoes, and any undergarments

The nurse is preparing to care for a burn client scheduled for an escharotomy procedure being performed for a third-degree circumferential arm burn. The nurse understands that which finding is the anticipated therapeutic outcome of the escharotomy? 1. Return of distal pulses 2. Brisk bleeding from the site 3. Decreasing edema formation 4. Formation of granulation tissue

1. Return of distal pulses

Minoxidil is prescribed for a client to treat hair loss. The nurse provides instructions to the client regarding the application of the medication. Which statement by the client indicates that teaching is effective? 1. "I will apply the prescribed amount of solution at bedtime." 2. "I will apply the prescribed amount of solution twice a day." 3. "I will apply the prescribed amount of solution 4 times a day." 4. "I will apply the prescribed amount of solution 3 times a day."

2. "I will apply the prescribed amount of solution twice a day."

Minoxidil is prescribed for a client to treat hair loss. The client asks the nurse if the hair will continue to grow when the medication is stopped. What is the appropriate nursing response? 1. "The hair will continue to grow." 2. "Newly gained hair is lost in 3 to 4 months." 3. "I'm not sure—you need to ask your health care provider." 4. "It depends on how long you have been taking the medication."

2. "Newly gained hair is lost in 3 to 4 months."

Topical azelaic acid is prescribed for a client, and the clinic nurse provides instructions regarding the use of this medication. Which statement by the client indicates a need for further instruction? 1. "I need to apply the medication twice daily." 2. "The medication is used to treat my eczema." 3. "I need to massage a thin film gently into the affected area." 4. "I need to wash and dry my skin before I apply the medication."

2. "The medication is used to treat my eczema."

The health care provider has prescribed a topical antiinflammatory cream for a client with a muscular sprain. The nurse provides instructions to the client regarding the medication. Which statement by the client indicates an understanding of this prescribed treatment? 1. "The medication is addicting." 2. "The medication will act as a local anesthetic." 3. "I will apply a heating pad to the area after applying the medication." 4. "The medication may make me sleepy but will stop the muscle spasms."

2. "The medication will act as a local anesthetic."

A topical corticosteroid is prescribed for an infant with dermatitis in the gluteal area. The nurse provides instructions to the mother regarding the use of the medication. Which statement by the mother indicates an understanding of the use of the medication? 1. "I should not rub the medication into the skin." 2. "The medication will help relieve the inflammation." 3. "I need to apply the medication in a thick layer to protect the skin." 4. "I should protect the area by covering it with a diaper and plastic pants."

2. "The medication will help relieve the inflammation."

A client has been given diphenhydramine as a topical agent for allergic dermatitis. The nurse should instruct the client to observe for which intended medication effect? 1. Nighttime sedation 2. A decrease in urticaria 3. Healing of burned tissue 4. Resolution of ecchymosis

2. A decrease in urticaria

A hydrocolloid dressing is prescribed for a client with a leg ulcer. The home health nurse is preparing a plan of care for the client and should appropriately document which intervention? 1. Change the hydrocolloid dressing daily. 2. Change the hydrocolloid dressing every 3 to 5 days. 3. Apply the hydrocolloid dressing over a dry, sterile dressing. 4. Apply the hydrocolloid dressing over a normal saline-soaked dressing.

2. Change the hydrocolloid dressing every 3 to 5 days.

A client with a burn injury is applying mafenide acetate cream to the wound. The client calls the health care provider's (HCP's) office and tells the nurse that the medication is uncomfortable and is causing a burning sensation. The nurse should instruct the client to take which action? 1. Discontinue the medication. 2. Continue with the treatment, as this is expected. 3. Apply a thinner film than prescribed to the burn site. 4. Come to the office to see the HCP immediately.

2. Continue with the treatment, as this is expected.

An ambulatory care client with allergic dermatitis has been given a prescription for a tube of diphenhydramine 1% to use as a topical agent. The nurse determines that the medication was effective if which finding was noted? 1. Nighttime sedation 2. Decrease in urticaria 3. Absence of ecchymosis 4. Healing of burned tissue

2. Decrease in urticaria

A child with severe seborrheic dermatitis is receiving treatments of topical corticosteroid applied over an extensive area of the body, followed by the application of an occlusive dressing. The nurse should monitor the child closely, knowing that which systemic effect can occur as a result of this treatment? 1. Local infection 2. Growth retardation 3. Thinning of the skin 4. Adrenal hyperactivity

2. Growth retardation

Tetracycline is prescribed for a client with severe acne. The nurse instructs the client regarding the importance of reporting which finding if it occurs? 1. Sunburn 2. Persistent diarrhea 3. Epigastric burning 4. Abdominal cramping

2. Persistent diarrhea

2. Rash

Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed? 1. Potassium level 2. Triglyceride level 3. Hemoglobin A1C 4. Total cholesterol level

2. Triglyceride level

The nurse caring for a child who sustained a burn injury plans care based on which pediatric considerations associated with this injury? Select all that apply. 1. Scarring is less severe in a child than in an adult. 2. A delay in growth may occur after a burn injury. 3. An immature immune system presents an increased risk of infection for infants and young children. 4. Fluid resuscitation is unnecessary unless the burned area is more than 25% of the total body surface area. 5. The lower proportion of body fluid to body mass in a child increases the risk of cardiovascular problems. 6. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.

2. A delay in growth may occur after a burn injury. 3. An immature immune system presents an increased risk of infection for infants and young children. 6. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.

A client is diagnosed with a full-thickness burn. What should the nurse anticipate will be used for final coverage of the client's burn wound? 1. Biobrane 2. Autograft 3. Homograft 4. Xenograft

2. Autograft

A client who previously suffered a burn injury now exhibits a keloid at the burn site. The nurse plans care, knowing that this lesion is caused by hypertrophy of which part of the dermis? 1. Nerves 2. Collagen 3. Vasculature 4. Subcutaneous tissue

2. Collagen

A client is admitted to the hospital emergency department after receiving a burn injury in a house fire. The skin on the client's trunk is tan, dry, and hard. It is edematous but not very painful. The nurse determines that this client's burn should be classified as which type? 1. Superficial 2. Full-thickness 3. Deep partial-thickness 4. Partial-thickness superficial

2. Full-thickness

Which finding indicates a burn client is adequately fluid resuscitated? 1. Disorientation to time only 2. Heart rate of 95 beats/minute 3. +1 palpable peripheral pulses 4. Urine output of 30 mL over the last 2 hours

2. Heart rate of 95 beats/minute

The nurse is planning care for a client who suffered a burn injury and has a negative self-image related to keloid formation at the burn site. The keloid formation is indicative of which condition? 1. Nerve damage 2. Hypertrophy of collagen fibers 3. Compromised circulation at the burn site 4. Increase in subcutaneous tissue at the burn site

2. Hypertrophy of collagen fibers

The nurse is planning care for a client returning from the operating room after having an autograft applied to the right lower extremity. Which nursing intervention is focused on promoting graft "take"? 1. Monitor temperature every 4 hours. 2. Leave the dressing intact for 3 to 5 days. 3. Maintain the right lower extremity in a dependent position. 4. Apply an ice pack to the site to decrease edema formation.

2. Leave the dressing intact for 3 to 5 days.

The nurse has developed a nursing care plan for a client with a burn injury to implement during the emergent phase. Which priority intervention should the nurse include in the plan of care? 1. Monitor vital signs every 4 hours. 2. Monitor mental status every hour. 3. Monitor intake and output every shift. 4. Obtain and record weight every other day.

2. Monitor mental status every hour.

A client is seen in the ambulatory care clinic for a superficial burn to the arm. On assessing the skin at the burn injury, what will the nurse observe? 1. White color 2. Pink or red color 3. Weeping blisters 4. Insensitivity to pain and cold

2. Pink or red color

The nurse is administering fluids intravenously as prescribed to a client who sustained superficial partial-thickness burn injuries of the back and legs. In evaluating the adequacy of fluid resuscitation, the nurse understands that which assessment would provide the most reliable indicator for determining the adequacy? 1. Vital signs 2. Urine output 3. Mental status 4. Peripheral pulses

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