Testbank Pharm Chapter 50
A female patient has begun using 2% minoxidil (Rogaine) to treat thinning of her hair. After several weeks of treatment, she reports minimal effectiveness but has noticed some improvement. The nurse will counsel her to perform which action? A. Continue to use the 2% minoxidil. B. Change to finasteride (Propecia). C. Discontinue the minoxidil. D. Increase to 5% minoxidil.
A
A nurse administers topical gentamicin sulfate (Garamycin) to a client's burn injury. Which laboratory value should the nurse monitor while the client is prescribed this therapy? A. Creatinine B. Red blood cells C. Sodium D. Magnesium
A
A nurse assesses a client who has a chronic skin disorder. Which finding indicates the client is effectively coping with the disorder? A. Clean hair and nails B. Poor eye contact C. Disheveled appearance D. Drapes a scarf over the face
A
A nurse assesses a client who has a chronic wound. The client states, "I do not clean the wound and change the dressing every day because it costs too much for supplies." How should the nurse respond? A. "You can use tap water instead of sterile saline to clean your wound." B. "If you don't clean the wound properly, you could end up in the hospital." C. "Sterile procedure is necessary to keep this wound from getting infected." D. "Good hand hygiene is the only thing that really matters with wound care."
A
A nurse assesses a client who has a lesion on the skin that is suspicious for skin cancer, as shown below: Which diagnostic test should the nurse anticipate being ordered for this client? A. Punch skin biopsy B. Viral cultures C. Wood's lamp examination D. Diascopy
A
A nurse assesses a client who has open lesions. Which action should the nurse take first? A. Put on gloves. B. Ask the client about his or her occupation. C. Assess the client's pain. D. Obtain vital signs.
A
A nurse assesses a client who has two skin lesions on his chest. Each lesion is the size of a nickel, flat, and darker in color than the client's skin. How should the nurse document these lesions? A. Two 2-cm hyperpigmented patches B. Two 1-inch erythematous plaques C. Two 2-mm pigmented papules D. Two 1-inch moles
A
A nurse assesses a client who is admitted with inflamed soft-tissue folds around the nail plates. Which question should the nurse ask to elicit useful information about the possible condition? A. "What do you do for a living?" B. "Are your nails professionally manicured?" C. "Do you have diabetes mellitus?" D. "Have you had a recent fungal infection?"
A
A nurse assesses an older adult client with the skin disorder shown below: How should the nurse document this finding? A. Petechiae Correct B. Ecchymoses C. Actinic lentigo D. Senile angiomas
A
A nurse assesses an older client who is scratching and rubbing white ridges on the skin between the fingers and on the wrists. Which action should the nurse take? A. Place the client in a single room. B. Administer an antihistamine. C. Assess the client's airway. D. Apply gloves to minimize friction.
A
A nurse cares for a client who has a deep wound that is being treated with a wet-to-damp dressing. Which intervention should the nurse include in this client's plan of care? A. Change the dressing every 6 hours. B. Assess the wound bed once a day. C. Change the dressing when it is saturated. D. Contact the provider when the dressing leaks.
A
A nurse cares for a client with burn injuries. Which intervention should the nurse implement to appropriately reduce the client's pain? A. Administer the prescribed intravenous morphine sulfate. B. Apply ice to skin around the burn wound for 20 minutes. C. Administer prescribed intramuscular ketorolac (Toradol). D. Decrease tactile stimulation near the burn injuries.
A
A nurse delegates hydrotherapy to an unlicensed assistive personnel (UAP). Which statement should the nurse include when delegating this activity? A. "Keep the water temperature constant when showering the client." B. "Assess the wound beds during the hydrotherapy treatment." C. "Apply a topical enzyme agent after bathing the client." D. "Use sterile saline to irrigate and clean the client's wounds."
A
A nurse prepares to discharge a client who has a wound and is prescribed home health care. Which information should the nurse include in the hand-off report to the home health nurse? A. Recent wound assessment, including size and appearance B. Insurance information for billing and coding purposes C. Complete health history and physical assessment findings D. Resources available to the client for wound care supplies
A
A nurse who manages client placements prepares to place four clients on a medical-surgical unit. Which client should be placed in isolation awaiting possible diagnosis of infection with methicillin-resistantStaphylococcus aureus (MRSA)? A. Client admitted from a nursing home with furuncles and folliculitis B. Client with a leg cut and other trauma from a motorcycle crash C. Client with a rash noticed after participating in sporting events D. Client transferred from intensive care with an elevated white blood cell count
A
A patient who has psoriasis is taking methoxsalen (Oxsoralen) to treat the condition along with receiving therapeutic ultraviolet A. The nurse notes burning and blistering of the patient's skin. Which action will the nurse take? A. Ask the patient about any recent exposure to sunlight. B. Explain to the patient that these signs mean the treatment is working. C. Report spread of the psoriasis to the patient's provider. D. Tell the patient to take the methoxsalen after the ultraviolet A treatment.
A
An emergency room nurse assesses a client who was rescued from a home fire. The client suddenly develops a loud, brassy cough. Which action should the nurse take first? A. Apply oxygen and continuous pulse oximetry. B. Provide small quantities of ice chips and sips of water. C. Request a prescription for an antitussive medication. D. Ask the respiratory therapist to provide humidified air.
A
The nurse assesses a client who has a severe burn injury. Which statement indicates the client understands the psychosocial impact of a severe burn injury? A. "It is normal to feel some depression." B. "I will go back to work immediately." C. "I will not feel anger about my situation." D. "Once I get home, things will be normal."
A
A nurse delegates care for a client who has open skin lesions. Which statements should the nurse include when delegating this client's hygiene care to an unlicensed assistive personnel (UAP)? (Select all that apply.) A. "Wash your hands before touching the client." B. "Wear gloves when bathing the client." C. "Assess skin for breakdown during the bath." D. "Apply lotion to lesions while the skin is wet." E. "Use a damp cloth to scrub the lesions."
A,B
A nurse manages wound care for clients on a medical-surgical unit. Which client wounds are paired with the appropriate treatments? (Select all that apply.) A. Client with a left heel ulcer with slight necrosis - Whirlpool treatments B. Client with an eschar-covered sacral ulcer - Surgical débridement C. Client with a sunburn and erythema - Soaking in warm water for 20 minutes D. Client with urticaria - Wet-to-dry dressing changes every 6 hours E. Client with a sacral ulcer with purulent drainage - Transparent film dressing
A,B
A nurse teaches a client to perform total skin self-examinations on a monthly basis. Which statements should the nurse include in this client's teaching? (Select all that apply.) A. "Look for asymmetry of shape and irregular borders." B. "Assess for color variation within each lesion." C. "Examine the distribution of lesions over a section of the body." D. "Monitor for edema or swelling of tissues." E. "Focus your assessment on skin areas that itch."
A,B
A nurse cares for older adult clients in a long-term acute care facility. Which interventions should the nurse implement to prevent skin breakdown in these clients? (Select all that apply.) A. Use a lift sheet when moving the client in bed. B. Avoid tape when applying dressings. C. Avoid whirlpool therapy. D. Use loose dressing on all wounds. E. Implement pressure-relieving devices.
A,B,E
A nurse plans care for a client who has a wound that is not healing. Which focused assessments should the nurse complete to develop the client's plan of care? (Select all that apply.) A. Height B. Allergies C. Alcohol use D. Prealbumin laboratory results E. Liver enzyme laboratory results
A,C,D
A nurse cares for a client who reports pain related to eczematous dermatitis. Which nonpharmacologic comfort measures should the nurse implement? (Select all that apply.) A. Cool, moist compresses B. Topical corticosteroids C. Heating pad D. Tepid bath with cornstarch E. Back rub with baby oil
A,D
Which factors indicate that a client's burn wounds are becoming infected? (Select all that apply.) A. Dry, crusty granulation tissue B. Elevated blood pressure C. Hypoglycemia D. Edema of the skin around the wound E. Tachycardia
A,D,E
A nurse plans care for a client who is immobile. Which interventions should the nurse include in this client's plan of care to prevent pressure sores? (Select all that apply.) A. Place a small pillow between bony surfaces. B. Elevate the head of the bed to 45 degrees. C. Limit fluids and proteins in the diet. D. Use a lift sheet to assist with re-positioning. E. Re-position the client who is in a chair every 2 hours. F. Keep the client's heels off the bed surfaces. G. Use a rubber ring to decrease sacral pressure when up in the chair.
A,D,F
A nurse assesses a client admitted with deep partial-thickness and full-thickness burns on the face, arms, and chest. Which assessment finding should alert the nurse to a potential complication? A. Partial pressure of arterial oxygen (PaO2) of 80 mm Hg B. Urine output of 20 mL/hr C. Productive cough with white pulmonary secretions D. Core temperature of 100.6° F (38° C)
B
A nurse assesses a client and identifies that the client has pallor conjunctivae. Which focused assessment should the nurse complete next? A. Partial thromboplastin time B. Hemoglobin and hematocrit C. Liver enzymes D. Basic metabolic panel
B
A nurse assesses a client who has psoriasis. Which action should the nurse take first? A. Don gloves and an isolation gown. B. Shake the client's hand and introduce self. C. Assess for signs and symptoms of infections. D. Ask the client if she might be pregnant.
B
A nurse assesses a wife who is caring for her husband. She has a Braden Scale score of 9. Which question should the nurse include in this assessment? A. "Do you have a bedpan at home?" B. "How are you coping with providing this care?" C. "What are you doing to prevent pediculosis?" D. "Are you sharing a bed with your husband?"
B
A nurse cares for a client with burn injuries from a house fire. The client is not consistently oriented and reports a headache. Which action should the nurse take? A. Increase the client's oxygen and obtain blood gases. B. Draw blood for a carboxyhemoglobin level. C. Increase the client's intravenous fluid rate. D. Perform a thorough Mini-Mental State Examination.
B
A nurse evaluates the following data in a client's chart: Admission Note Laboratory Results Wound Care Note 66-year-old male with a health history of a cerebral vascular accident and left-side paralysis White blood cell count: 8000/mm3 Prealbumin: 15.2 mg/dL Albumin: 4.2 mg/dL Lymphocyte count: 2000/mm3 Sacral ulcer - 4 cm × 2 cm × 1.5 cm Based on this information, which action should the nurse take? A. Perform a neuromuscular assessment. B. Request a dietary consult. C. Initiate Contact Precautions. D. Assess the client's vital signs.
B
A nurse evaluates the following data in a client's chart: Admission Note Prescriptions Wound Care 78-year-old male with a past medical history of atrial fibrillation is admitted with a chronic leg wound Warfarin sodium (Coumadin) Sotalol (Betapace) Vacuum-assisted wound closure (VAC) treatment to leg wound Based on this information, which action should the nurse take first? A. Assess the client's vital signs and initiate continuous telemetry monitoring. B. Contact the provider and express concerns related to the wound treatment prescribed. C. Consult the wound care nurse to apply the VAC device. D. Obtain a prescription for a low-fat, high-protein diet with vitamin supplements.
B
A nurse performs a skin screening for a client who has numerous skin lesions. Which lesion does the nurse evaluate first? A. Beige freckles on the backs of both hands B. Irregular blue mole with white specks on the lower leg C. Large cluster of pustules in the right axilla D. Thick, reddened papules covered by white scales
B
A nurse receives new prescriptions for a client with severe burn injuries who is receiving fluid resuscitation per the Parkland formula. The client's urine output continues to range from 0.2 to 0.25 mL/kg/hr. Which prescription should the nurse question? A. Increase intravenous fluids by 100 mL/hr. B. Administer furosemide (Lasix) 40 mg IV push. C. Continue to monitor urine output hourly. D. Draw blood for serum electrolytes STAT.
B
A patient has second- and third-degree burns, and the nurse is applying silver sulfadiazine (Silvadene) to the burns with each dressing change. The patient reports a burning sensation. The nurse understands that this is A. a hypersensitivity reaction to the medication. B. an expected adverse reaction to the medication. C. a sign of localized tissue infection. D. a sign of skin necrosis.
B
A patient who works outdoors has frequent contact dermatitis flares secondary to exposure to plant irritants. The patient asks the nurse how to minimize these episodes. The nurse will counsel this patient to perform which action? A. Apply topical glucocorticoid medication prior to exposure. B. Cleanse the skin immediately after any contact with plants C. Take systemic diphenhydramine (Benadryl) after being outdoors. D. Use calamine lotion prior to working outdoors.
B
After educating a caregiver of a home care client, a nurse assesses the caregiver's understanding. Which statement indicates that the caregiver needs additional education? A. "I can help him shift his position every hour when he sits in the chair." B. "If his tailbone is red and tender in the morning, I will massage it with baby oil." C. "Applying lotion to his arms and legs every evening will decrease dryness." D. "Drinking a nutritional supplement between meals will help maintain his weight.
B
After teaching a client who has psoriasis, a nurse assesses the client's understanding. Which statement indicates the client needs additional teaching? A. "At the next family reunion, I'm going to ask my relatives if they have psoriasis." B. "I have to make sure I keep my lesions covered, so I do not spread this to others." C. "I expect that these patches will get smaller when I lie out in the sun." D. "I should continue to use the cortisone ointment as the patches shrink and dry out."
B
After teaching a client who is at risk for the formation of pressure ulcers, a nurse assesses the client's understanding. Which dietary choice by the client indicates a good understanding of the teaching? A. Low-fat diet with whole grains and cereals and vitamin supplements B. High-protein diet with vitamins and mineral supplements C. Vegetarian diet with nutritional supplements and fish oil capsules D. Low-fat, low-cholesterol, high-fiber, low-carbohydrate diet
B
During skin inspection of a client, a nurse observes lesions with wavy borders that are widespread across the client's chest. Which descriptors should the nurse use to document these observations? A. Clustered and annular B. Linear and circinate C. Diffuse and serpiginous D. Coalesced and circumscribed
B
The nurse assists the provider to treat a patient who has warts with cantharidin (Cantharone). After the cantharidin is applied to the warts, the nurse will A. apply gauze dressings to the warts and secure them with tape. B. cover the warts with non-porous tape when the solution dries. C. prepare to assist the provider with cryotherapy to complete the procedure. D. treat the warts with Burrow's soaks and apply a wet-to-dry dressing.
B
The nurse is caring for a client with an acute burn injury. Which action should the nurse take to prevent infection by autocontamination? A. Use a disposable blood pressure cuff to avoid sharing with other clients. B. Change gloves between wound care on different parts of the client's body. C. Use the closed method of burn wound management for all wound care. D. Advocate for proper and consistent handwashing by all members of the staff.
B
While assessing a client's lower extremities, a nurse notices that one leg is pale and cooler to the touch. Which assessment should the nurse perform next? A. Ask about a family history of skin disorders. B. Palpate the client's pedal pulses bilaterally. C. Check for the presence of Homans' sign. D. Assess the client's skin for adequate skin turgor.
B
While assessing a client, a nurse detects a bluish tinge to the client's palms, soles, and mucous membranes. Which action should the nurse take next? A. Ask the client about current medications he or she is taking. B. Use pulse oximetry to assess the client's oxygen saturation. C. Auscultate the client's lung fields for adventitious sounds. D. Palpate the client's bilateral radial and pedal pulses.
B
A nurse prepares to admit a client who has herpes zoster. Which actions should the nurse take? (Select all that apply.) A. Prepare a room for reverse isolation. B. Assess staff for a history of or vaccination for chickenpox. C. Check the admission orders for analgesia. D. Choose a roommate who also is immune suppressed. E. Ensure that gloves are available in the room.
B,C,E
A nursing student is caring for a client with open-wound burns. Which nursing interventions does the nursing student provide for this client? (Select all that apply.) A. Provides cushions and rugs for comfort B. Performs frequent handwashing C. Places plants in the client's room D. Performs gloved dressing changes E. Uses disposable dishes
B,D,E
A nurse assesses a client who presents with an increase in psoriatic lesions. Which questions should the nurse ask to identify a possible trigger for worsening of this client's psoriatic lesions? (Select all that apply.) A. "Have you eaten a large amount of chocolate lately?" B. "Have you been under a lot of stress lately?" C. "Have you recently used a public shower?" D. "Have you been out of the country recently?" E. "Have you recently had any other health problems?" F. "Have you changed any medications recently?"
B,E,F
The nurse is providing teaching for an adolescent who has acne vulgaris. In addition to teaching about correct administration of the prescribed medications, the nurse will instruct this patient to A. apply topical vitamin D3. B. cleanse the skin gently several times a day. C. scrub the affected skin vigorously twice daily. D. take supplemental vitamin A.
B. cleanse the skin gently several times a day
A nurse assesses a client who has a burn injury. Which statement indicates the client has a positive perspective of his or her appearance? A. "I will allow my spouse to change my dressings." B. "I want to have surgical reconstruction." C. "I will bathe and dress before breakfast." D. "I have secured the pressure dressings as ordered."
C
A nurse assesses a young female client who is prescribed isotretinoin (Accutane). Which question should the nurse ask prior to starting this therapy? A. "Do you spend a great deal of time in the sun?" B. "Have you or any family members ever had skin cancer?" C. "Which method of contraception are you using?" D. "Do you drink alcoholic beverages?"
C
A nurse assesses clients on a medical-surgical unit. Which client is at greatest risk for pressure ulcer development? A. A 44-year-old prescribed IV antibiotics for pneumonia B. A 26-year-old who is bedridden with a fractured leg C. A 65-year-old with hemi-paralysis and incontinence D. A 78-year-old requiring assistance to ambulate with a walker
C
A nurse assesses clients on a medical-surgical unit. Which client should the nurse evaluate for a wound infection? A. Client with blood cultures pending B. Client who has thin, serous wound drainage C. Client with a white blood cell count of 23,000/mm3 D. Client whose wound has decreased in size
C
A nurse cares for a client who has facial burns. The client asks, "Will I ever look the same?" How should the nurse respond? A. "With reconstructive surgery, you can look the same." B. "We can remove the scars with the use of a pressure dressing." C. "You will not look exactly the same but cosmetic surgery will help." D. "You shouldn't start worrying about your appearance right now."
C
A nurse cares for a client who is prescribed vancomycin (Vancocin) 500 mg IV every 6 hours for a methicillin-resistant Staphylococcus aureus (MRSA) infection. Which action should the nurse take? A. Administer it over 30 minutes using an IV pump. B. Give the client diphenhydramine (Benadryl) before the drug. C. Assess the IV site at least every 2 hours for thrombophlebitis. D. Ensure that The client has increased oral intake during therapy.
C
A nurse cares for a client with a burn injury who presents with drooling and difficulty swallowing. Which action should the nurse take first? A. Assess the level of consciousness and pupillary reactions. B. Ascertain the time food or liquid was last consumed. C. Auscultate breath sounds over the trachea and bronchi. D. Measure abdominal girth and auscultate bowel sounds.
C
A nurse cares for an older adult client who has a chronic skin disorder. The client states, "I have not been to church in several weeks because of the discoloration of my skin." How should the nurse respond? A. "I will consult the chaplain to provide you with spiritual support." B. "You do not need to go to church; God is everywhere." C. "Tell me more about your concerns related to your skin." D. "Religious people are nonjudgmental and will accept you."
C
A nurse prepares to administer intravenous cimetidine (Tagamet) to a client who has a new burn injury. The client asks, "Why am I taking this medication?" How should the nurse respond? A. "Tagamet stimulates intestinal movement so you can eat more." B. "It improves fluid retention, which helps prevent hypovolemic shock." C. "It helps prevent stomach ulcers, which are common after burns." D. "Tagamet protects the kidney from damage caused by dehydration."
C
A nurse reviews the following data in the chart of a client with burn injuries: Admission Notes Wound Assessment 36-year-old female with bilateral leg burns NKDA Health history of asthma and seasonal allergies Bilateral leg burns present with a white and leather-like appearance. No blisters or bleeding present. Client rates pain 2/10 on a scale of 0-10. Based on the data provided, how should the nurse categorize this client's injuries? A. Partial-thickness deep B. Partial-thickness superficial C. Full thickness D. Superficial
C
A nurse reviews the laboratory results for a client who was burned 24 hours ago. Which laboratory result should the nurse report to the health care provider immediately? A. Arterial pH: 7.32 B. Hematocrit: 52% C. Serum potassium: 6.5 mEq/L D. Serum sodium: 131 mEq/L
C
A nurse teaches a client being treated for a full-thickness burn. Which statement should the nurse include in this client's discharge teaching? A. "You should change the batteries in your smoke detector once a year." B. "Join a program that assists burn clients to reintegration into the community." C. "I will demonstrate how to change your wound dressing for you and your family." D. "Let me tell you about the many options available to you for reconstructive surgery."
C
A nurse uses the rule of nines to assess a client with burn injuries to the entire back region and left arm. How should the nurse document the percentage of the client's body that sustained burns? A. 9% B. 18% C. 27% D. 36%
C
A patient who has extensive second- and third-degree burns will use mafenide acetate (Sulfamylon) to treat the burns. What is an important aspect of care for this patient? A. Assess for fluid overload. B. Explain that this medication will decrease pain. C. Monitor the patient's electrolytes. D. Teach the patient how to use sterile technique at home.
C
After assessing an older adult client with a burn wound, the nurse documents the findings as follows: Vital Signs Laboratory Results Wound Assessment Heart rate: 110 beats/min Blood pressure: 112/68 mm Hg Respiratory rate: 20 breaths/min Oxygen saturation: 94% Pain: 3/10 Red blood cell count: 5,000,000/mm3 White blood cell count: 10,000/mm3 Platelet count: 200,000/mm3 Left chest burn wound, 3 cm × 2.5 cm × 0.5 cm, wound bed pale, surrounding tissues with edema present Based on the documented data, which action should the nurse take next? A. Assess the client's skin for signs of adequate perfusion. B. Calculate intake and output ratio for the last 24 hours. C. Prepare to obtain blood and wound cultures. D. Place the client in an isolation room.
C
After teaching a client who expressed concern about a rash located beneath her breast, a nurse assesses the client's understanding. Which statement indicates the client has a good understanding of this condition? A. "This rash is probably due to fluid overload." B. "I need to wash this daily with antibacterial soap." C. "I can use powder to keep this area dry." D. "I will schedule a mammogram as soon as I can."
C
The nurse is teaching a female patient who will begin taking isotretinoin (Amnesteem) to treat severe cystic acne. Which statement by the patient indicates understanding of the teaching? A. "I may get a 3-month supply of the medication with each refill." B. "I must abstain from intercourse while taking this drug." C. "I should avoid strenuous exercise when I am taking this medication." D. "I should take a vitamin A supplement while I am taking the medication."
C
The nurse teaches burn prevention to a community group. Which statement by a member of the group should cause the nurse the greatest concern? A. "I get my chimney swept every other year." B. "My hot water heater is set at 120 degrees." C. "Sometimes I wake up at night and smoke." D. "I use a space heater when it gets below zero."
C
When transferring a client into a chair, a nurse notices that the pressure-relieving mattress overlay has deep imprints of the client's buttocks, heels, and scapulae. Which action should the nurse take next? A. Turn the mattress overlay to the opposite side. B. Do nothing because this is an expected occurrence. C. Apply a different pressure-relieving device. D. Reinforce the overlay with extra cushions.
C
A nurse assesses a client who has burn injuries and notes crackles in bilateral lung bases, a respiratory rate of 40 breaths/min, and a productive cough with blood-tinged sputum. Which action should the nurse take next? A. Administer furosemide (Lasix). B. Perform chest physiotherapy. C. Document and reassess in an hour. D. Place the client in an upright position
D
A nurse assesses bilateral wheezes in a client with burn injuries inside the mouth. Four hours later the wheezing is no longer heard. Which action should the nurse take? A. Document the findings and reassess in 1 hour. B. Loosen any constrictive dressings on the chest. C. Raise the head of the bed to a semi-Fowler's position. D. Gather appropriate equipment and prepare for an emergency airway.
D
A nurse cares for a client who has burn injuries. The client's wife asks, "When will his high risk for infection decrease?" How should the nurse respond? A. "When the antibiotic therapy is complete." B. "As soon as his albumin levels return to normal." C. "Once we complete the fluid resuscitation process." D. "When all of his burn wounds have closed."
D
A nurse cares for clients who have various skin infections. Which infection is paired with the correct pharmacologic treatment? A. Viral infection - Clindamycin (Cleocin) B. Bacterial infection - Acyclovir (Zovirax) C. Yeast infection - Linezolid (Zyvox) D. Fungal infection - Ketoconazole (Nizoral)
D
A nurse is caring for a client who has a pressure ulcer on the right ankle. Which action should the nurse take first? A. Draw blood for albumin, prealbumin, and total protein. B. Prepare for and assist with obtaining a wound culture. C. Place the client in bed and instruct the client to elevate the foot. D. Assess the right leg for pulses, skin color, and temperature.
D
A nurse teaches a client who has very dry skin. Which statement should the nurse include in this client's education? A. "Use lots of moisturizer several times a day to minimize dryness." B. "Take a cold shower instead of soaking in the bathtub." C. "Use antimicrobial soap to avoid infection of cracked skin." D. "After you bathe, put lotion on before your skin is totally dry."
D
A patient reports localized itching after contact with a new brand of laundry detergent. The nurse will suggest that the patient contact the provider to discuss treatment with which product? A. Calamine lotion B. Systemic glucocorticoid C. Topical diphenhydramine D. Topical glucocorticoid
D
A patient who has psoriasis will begin taking etanercept (Enbrel). The nurse will ensure that which laboratory test is performed prior to initiating treatment with this drug? A. Complete blood count (CBC) with differential B. CD4 and T-cell count C. Serum pregnancy test D. Tuberculin test
D
After teaching a client how to care for a furuncle in the axilla, a nurse assesses the client's understanding. Which statement indicates the client correctly understands the teaching? A. "I'll apply cortisone cream to reduce the inflammation." B. "I'll apply a clean dressing after squeezing out the pus." C. "I'll keep my arm down at my side to prevent spread." D. "I'll cleanse the area prior to applying antibiotic cream."
D
An adolescent patient is preparing to take a summer job as a landscaper and asks the nurse about insect repellants and sunscreens. Which statement by the nurse is correct? A. Apply sunscreen prior to applying insect repellants containing DEET. B. Apply sunscreen containing PABA 30 minutes prior to sun exposure. C. Most sunscreens block both UVB and UVA radiation. D. Reapply sunscreen every 2 hours if sweating occurs.
D
The nurse is teaching a group of adolescents about sun protection. What information will the nurse include when teaching this group? A. Effective sunscreens guard against melanoma and basal cell carcinoma. B. SPF numbers indicate UVB protection, and UVA protection is assumed for all products. C. SPF ratings are proportional to the amount of UVB radiation that they block. D. Sunscreen products of all SPF ratings will protect for 2 hours if not exposed to moisture.
D
The registered nurse assigns a client who has an open burn wound to a licensed practical nurse (LPN). Which instruction should the nurse provide to the LPN when assigning this client? A. "Administer the prescribed tetanus toxoid vaccine." B. "Assess the client's wounds for signs of infection." C. "Encourage the client to breathe deeply every hour." D. "Wash your hands on entering the client's room."
D
A nurse assesses an older adult's skin. Which findings require immediate referral? (Select all that apply.) A. Excessive moisture under axilla B. Increased hair thinning C. Increased presence of fungal toenails D. Lesion with various colors E. Spider veins on legs F. Asymmetric 6-mm dark lesion on forehead
D, F
A patient reports using benzoyl peroxide 2.5% for acne but doesn't feel that it is working. The nurse notes papules and nodules on the patient's face, neck, and back, consistent with moderate acne vulgaris. The nurse will counsel this patient to ask the provider about A. adding isotretinoin (Amnesteem) to the treatment regimen. B. increasing the benzoyl peroxide to a 5% solution. C. taking systemic antibiotics until symptoms improve. D. using benzoyl peroxide 10% and a topical antibiotic.
D. Using benzoyl peroxide 10% and a topical antibiotic
An emergency room nurse cares for a client admitted with a 50% burn injury at 10:00 this morning. The client weighs 90 kg. Using the Parkland formula, calculate the rate at which the nurse should infuse intravenous fluid resuscitation when started at noon. (Record your answer using a whole number.) _____ mL/hr
This was the correct response: 1500 mL/hr The Parkland formula is 4 mL/kg/% total body surface area burn. This client needs 18,000 mL of fluid during the first 24 hours postburn. Half of the calculated fluid replacement needs to be administered during the first 8 hours after injury, and half during the next 16 hours. This client was burned at 10:00 AM, and fluid was not started until noon. Therefore, 9000 mL must be infused over the next 6 hours at a rate of 1500 mL/hr to meet the criteria of receiving half the calculated dose during the first 8 postburn hours.
An emergency room nurse implements fluid replacement for a client with severe burn injuries. The provider prescribes a liter of 0.9% normal saline to infuse over 1 hour and 30 minutes via gravity tubing with a drip factor of 30 drops/mL. At what rate should the nurse administer the infusion? (Record your answer using a whole number and rounding to the nearest drop.) ____ drops/min
This was the correct response: 333 drops/min 1000 mL divided by 90 minutes, then multiplied by 30 drops, equals 333 drops/min.
