Integumentary System

A client is diagnosed as having cancer of the breast and is admitted to the hospital for a lumpectomy to be followed by radiation. While being admitted to ambulatory surgery by the nurse, the client has tears in her eyes and her chin is quivering. In a shaky voice the client says, "I can't believe this is happening." What is the nurse's best response?

"This must be a very scary time for you."

A client is hospitalized with pressure ulcers. Which task could be delegated to an unlicensed nursing professional (UNP)? Select all that apply.

-Empty wound drainage containers. -Report changes in wound appearance.

Which skin infection experienced by a client is treated with an intralesional injection?

Alopecia areata

A client who is being provided palliative care for melanoma complains of severe pain at the lesion sites on his lower leg. Which action by the nurse is most appropriate in this situation?

Applying warm, moist dressings to the lesions

A person on the beach sustains a deep partial-thickness burn because of a severe sunburn. What is the best first aid measure that a nurse should instruct the person to apply before seeking health care?

Cool, moist towels

A client is admitted to the hospital for the medical management of burns over 18% of the body's surface. What should the nurse teach the client to help manage pain during dressing changes?

Deep breathing exercises

A client with a parotid tumor and enlarged lymph nodes in the neck is undergoing radiation therapy on an outpatient basis. For what physiological response to the radiation should the nurse assess the client during the return visit to the radiology department?

Dysphagia

A client has a fracture of the tibia, and a cast is applied. Which action will the nurse take?

Elevate the affected leg above the level of the heart.

A female client arrives in the emergency department with partial-thickness burns on the chest, abdomen, and leg. What is the priority nursing intervention?

Evaluate for inhalation injury

A farmer seeks medical care for a large crusty patch of skin on the cheek. The client states that even after using different remedies, it still bleeds easily and has not gotten better. From the client's history, the nurse suspects skin cancer because the major precipitating factor associated with skin cancer is what?

Exposure to radiation

A client with scleroderma complains of numbness and tingling in the hands followed by blanching of the fingers. The nurse concludes that the client has Raynaud's phenomenon, a condition commonly associated with scleroderma. The nurse plans to advise the client to do what?

Keep the hands warm by wearing gloves

During a physical assessment, the nurse notes cutaneous fibromas and Lisch nodules (yellow elevations) on a client's irises. What genetic condition might this client have?

Neurofibromatosis

When changing a postoperative client's dressing, the nurse is careful not to introduce microorganisms into the incision. What type of asepsis includes this principle?

Surgical asepsis

Which topical immunomodulator is used to treat a client with atopic dermatitis?

Tacrolimus

During an admission assessment the nurse discovers that a client has a stage 1 pressure ulcer. Which is the priority nursing action?

Turn and reposition the client every 2 hours.

A nurse is caring for a client with full-thickness burns of the anterior trunk and thigh. During the first two to three days after the burn to monitor fluid balance, what is it important for the nurse to assess?

Urinary output every hour

The nurse is caring for a client with a closed soft tissue injury. How will the nurse describe this injury?

As a contusion