Integumentary/Burns Board Vitals Questions
A nurse is caring for an adolescent client who has burn wounds on her face and hands. Which of the following statements by the client indicates that she has adapted to her changed body image? A. "May I go with my family to the visitor's lounge?" B. "I'll see my friends when I get home." C. "My dad is coming to visit. Can you fix my hair for me?" D. "I told my cousins I'm in protective isolation."
A. "May I go with my family to the visitor's lounge?"
A nurse is teaching the parent of a 2-month-old infant who has seborrheic dermatitis of the scalp. Which of the following instructions should the nurse include in the teaching? A. "You can use petrolatum to help soften and remove patches from the infant's scalp" B. "When patches are present, you should keep your infant away from others" C. "You should avoid brushing your infant's scalp until the fontanelles have closed" D. "When patches are present, it indicates that your infant has a systemic infection"
A. "You can use petrolatum to help soften and remove patches from the infant's scalp"
Which type of wound would most likely heal by primary intention? A. A wound with a low risk of infection B. A wound that has a long healing time C. A wound with excessive drainage D. A wound that would be closed later
A. A wound with a low risk of infection
A nurse is providing teaching to a client who has a new prescription for corticosteroid cream to treat mild psoriasis. Which of the following instructions should the nurse include? (select all that apply.) A. Apply thin layer of medication to damp skin B. Apply five times daily C. Apply gloves before putting on medication D. Avoid applying in skin folds E. It is unnecessary to notify the provider if redness or pain increases after medication use
A. Apply thin layer of medication to damp skin C. Apply gloves before putting on medication D. Avoid applying in skin folds
A registered nurse is performing a sterile dressing change when a nursing assistant reports that a client who is postoperative hip replacement asked when he would be receiving his as-needed pain medication, as he anticipates pain when his current medication "wears off." What is the correct action by the RN? A. Ask the nursing assistant to tell the client he will be there shortly B. Direct the nursing assistant to take the postop client's vital signs C. Interrupt the dressing change to administer the pain medication to the postop client D. Ask the nursing assistant to find out how the client writes the pain on a scale of 1 to 10
A. Ask the nursing assistant to tell the client he will be there shortly
A nurse is teaching a client who has extensive deep partial- and full-thickness burns and requires a topical antimicrobial medication. The goal of this medication therapy is to reduce which of the following outcomes? A. Bacterial growth B. Scarring C. Skin graft size D. Pain
A. Bacterial growth
A nurse is collecting data on a toddler who has eczema. What findings would the nurse expect? (Select all that apply) A. Generalized disruption of lesions B. Papules C. Ecchymosis in flexural areas D. Intense itching E. Keratosis pilaris
A. Generalized disruption of lesions B. Papules D. Intense itching
A nurse in a provider's office is assessing a client's skin lesions. The nurse notes that the lesions are 0.5 cm (0.20 in) in size, elevated, and solid with distinct borders. The nurse should document these findings as which of the following skin lesions? A. Papules B. Macules C. Wheals D. Vesicles
A. Papules
A nurse is reviewing the lab values for a client who has a stage 3 pressure ulcer. The nurse should identify that which of the following laboratory findings can delay wound healing? A. Prealbumin 14mg/dL B. Hemoglobin 16 g/dL C. WBC 8,000/mm3 D. aPTT 32 seconds
A. Prealbumin 14mg/dL
A nurse in the emergency department is assessing a child who has a laceration to the thigh following a motor-vehicle crash. The nurse should recognize that which of the following factors can delay would healing? (Select all that apply). A. Vitamin B1 deficiency B. Low hemoglobin C. Use of anti-inflammatory medications D. Active occlusive dressing E. Use of corticosteroids
A. Vitamin B1 deficiency B. Low hemoglobin C. Use of anti-inflammatory medications E. Use of corticosteroids
Which of the following clients should take priority for the assigned nurse? A. A client who has normal saline (NS) infusing at 100 mL/hr with 300 mL NS remaining in the bag B. A client scheduled for discharge soon who has swelling at the IV site C. A client who is DNR with a peripheral IV line in place for 90 hours D. A client who has a saline lock in place and an IV saline flush scheduled now
B. A client scheduled for discharge soon who has swelling at the IV site
A nurse in a provider's office is caring for a client who has a new diagnosis of herpes zoster. The nurse should anticipate a prescription for which of the following medications? A. Zoster vaccine B. Acyclovir C. Amoxicillin D. Infliximab
B. Acyclovir
A nurse is reviewing the plan of care for an infant who has diaper dermatitis. Which of the following interventions should the nurse except to be included in the plan of care? A. Apply talcum powder with every diaper change B. Allow the buttocks to air dry C. Use cloth diapers until the rash is gone D. Use a hair dryer on the lowest setting to the dry skin
B. Allow the buttocks to air dry
Which of the following measures should be included in client teaching to prevent transmission of scabies? A. Keep body areas lubricated. B. Avoid sexual contact with infected people. C. Avoid sun exposure between 10 am and 4 pm. D. Look for eggs (nits) on hairs about ¼" from the scalp or skin.
B. Avoid sexual contact with infected people.
A nurse in an emergency department is assessing a client who has extensive burns, including on her face. Which of the following assessments should the nurse perform first? A. Estimation of burn injury B. Characteristics of the cough and sputum C. Extent of peripheral edema D. Amount of urine output
B. Characteristics of the cough and sputum
A nurse in an emergency department is assessing a client who has extensive burns, including on her face. Which of the following assessments should the nurse preform first? A. Estimation of burn injury B. Characteristics of the cough and sputum C. Extent of peripheral edema D. Amount of urine output
B. Characteristics of the cough and sputum
A nurse is caring for an adolescent who has a superficial partial thickness burn to the thigh. Which of the following actions should the nurse take? A. Prepare the adolescent for transport to a burn facility B. Cleanse the affected area with tepid water C. Scrub the affected area using a soft bristle brush D. Administer morphine sulfate
B. Cleanse the affected area with tepid water
A nurse is teaching a group of clients about skin cancer. The nurse should explain that basal cell carcinoma originates from which of the following tissues? A. Subcutaneous B. Epidermis C. Dermis D. Stratum corneum
B. Epidermis
Which of the following risk factors are part of the Braden Scale for predicting pressure score risk? (Select all that apply) A. Muscle strength B. Fiction and shear C. Gender D. ROM E. Nutrition
B. Fiction and shear E. Nutrition
A nurse is applying a wound dressing to a client's stage 3 pressure ulcer. Which of the following dressing options are correctly matched to the wound stage? (Select all that apply.) A. Skin sealant for red granulating wound B. Hydrocolloid for red granulating wound C. Barrier ointment for red granulating wound D. Thin hydrocolloid for moderate exudates E. Hydrocolloid for deep granulation F. Alginate for deep granulation
B. Hydrocolloid for red granulating wound D. Thin hydrocolloid for moderate exudates F. Alginate for deep granulation
A nurse is caring for a client who has a prescription for silver sulfadiazine cream to be applied to her burn wounds. The nurse should evaluate the client for which of the following laboratory findings? A. Hyponatremia B. Leukopenia C. Hyperchloremia D. Elevated BUN
B. Leukopenia
A community health nurse is teaching a group of clients about malignant melanoma. Which of the following traits places a client at risk for developing malignant melanoma? A. Brown eyes B. Light skin C. Black hair D. Dark skin
B. Light skin
A nurse is caring for a client who has a lesion on the back of his right hand. The client asks the nurse which type of skin cancer is the most serious. Which of the following responses by the nurse is appropriate? A. Basal cell carcinoma B. Melanoma C. Actinic keratosis D. Squamous cell carcinoma
B. Melanoma
A nurse is caring for a client whose wounds are covered with a heterograft dressing. In response to the client's questions about the dressing, the nurse explains that it is obtained from which of the following sources? A. Cadaver skin B. Pig skin C. Amniotic membranes D. Beef collagen
B. Pig skin
A nurse is caring for a client who was just admitted to the ED with a severe burn injury. Which of the following orders would the nurse question for this client? A. Water B. Potassium C. Lactated Ringers D. Plasma expanders
B. Potassium
A nurse is caring for a male client with extensive 2nd and 3rd degree burn injuries. Which of the following laboratory values should be reported immediately to the healthcare provider? A. Glucose of 200mg/dl B. Potassium of 6.1mEq/L C. Hemoglobin of 19g/dL D. Hematocrit of 55%
B. Potassium of 6.1mEq/L
A nurse is providing teaching for a client who has impetigo. Which of the following information should the nurse include? A. Keep an occlusive dressing over the lesion until they are healed B. Remove the crust on the lesion prior to applying the topical medication C. Impetigo does not spread to others D. Wear soft cotton gloves while sleeping
B. Remove the crust on the lesion prior to applying the topical medication
A nurse is caring for a child with a diagnosis of ringworm. Which of the following does the nurse expect to find on assessment? A. Intestinal bleeding and iron deficiency anemia B. Scaly erythematous with central clearing and pruritus C. Anal itching that worsens at night D. Fatty stools and weight loss
B. Scaly erythematous with central clearing and pruritus
A nurse is caring for a child who is postoperative following ventriculoperitoneal (VP) shunt placement. Which of the following positions should the nurse place the child? A. Knee-chest B. Semi-Fowler's C. Prone D. Supine
B. Semi-Fowler's
Which of the following lifestyle factors may have the largest impact on the development of foot wounds in diabetics? A. Caffeine intake B. Smoking C. Decrease intake of potassium D. Moderate exercise
B. Smoking
A nurse is evaluating the laboratory values of a client who is in the resuscitation phase following a major burn. Which of the following laboratory findings should the nurse expect? A. Hemoglobin 10 g/dL B. Sodium 132 mEq/L C. Albumin 3.6 g/dL D. Potassium 4.0 mEq/dL
B. Sodium 132 mEq/L
A nurse is caring for a client who presents with a large, blistered burn from hot water. The area is reddened and painful with mild edema. Which of the following depth classification should the nurse use to document this burn? A. Superficial thickness B. Superficial partial thickness C. Deep partial thickness D. Full thickness
B. Superficial partial thickness
A charge nurse is evaluating client care performed by a newly licensed nurse who is caring for a client who has shingles with multiple skin lesions. Which of the following actions by the nurse licensed nurse requires intervention by the charge nurse? A. The nurse wears an N95 respirator mask B. The nurse admits another client to the client's double room C. The nurse uses alcohol-based hand sanitizer after removing gloves D. The nurse wears a gown when bathing the client
B. The nurse admits another client to the client's double room
A charge nurse is providing education to staff about skin care in the elderly client. The nurse will review all of the following changes associated with the normal aging process, EXCEPT: A. The amount of fat & water begins to decrease, resulting in loss of turgor B. The outer layer of skin sloughs off and is replaced with new cells every few days C. The vascularity of the skin decreases, resulting in lowered ability to regulate body temperature D. Collagen beings to lose its elasticity
B. The outer layer of skin sloughs off and is replaced with new cells every few days
A charge nurse is providing education to staff about skin care in the elderly client. The nurse will review all of the following changes associated with the normal aging process, EXCEPT: A. The amount of fat and water begin to decrease, resulting in loss of turgor B. The outer layer of skin sloughs off and is replaced with new cells every few days C. The vascularity of the skin decreases, resulting in lowered ability to regulate body temperature D. Collagen begins to lose its elasticity and strength
B. The outer layer of skin sloughs off and is replaced with new cells every few days
A nurse is caring for a client with an infected abdominal incision from an open cholecystectomy. Which of the following actions is correct when performing a dressing change for this client? A. Use sterile gloves, a gown, and a face shield when removing the soiled dressing? B. Wear clean gloves when removing the soiled dressing and sterile gloves to place the new dressing? C. Use clean gloves when removing the soiled dressing and replacing the new dressing? D. Use clean gloves only when placing the new dressing?
B. Wear clean gloves when removing the soiled dressing and sterile gloves to place the new dressing?
A nurse is providing discharge instructions to a client who had a skin biopsy and has sutures in place. Which of the following client statements should indicate to the nurse that the teaching was effective? A. "I can expect redness around the site for 5 days." B. "I will most likely have a fever for the first few days." C. "I should apply an antibiotic ointment to the area." D. "I will make a return appointment in 2 days for removal of my sutures."
C. "I should apply an antibiotic ointment to the area."
A nurse should understand the different types of isolation precautions necessary to prevent transmission of infection in a health care facility. For which of the following clients would contact precautions be indicated? A. 19-year-old client with tuberculosis B. Five-year-old client diagnosed with acute bronchitis C. 43-year-old client who has MRSA D. 25-year-old client with community acquired bacterial pneumonia
C. 43-year-old client who has MRSA
A nurse is planning care for a child who has tinea pedis. Which of the following actions should the nurse include in the plan of care? A. Treat infected house pets B. Use selenium sulfide shampoo C. Apply a topical antifungal cream D. Use moist, warm compresses
C. Apply a topical antifungal cream
A nurse is caring for a client who has an infected traumatic wound. The provider has ordered a culture and the sensitivity test of the purulent wound drainage, which of the following will be determined by the sensitivity test? A. Severity of the condition B. Type of pathogen C. Appropriate antibiotic therapy D. Condition of the immune system
C. Appropriate antibiotic therapy
A nurse is teaching a group of young adult clients about health promotion techniques to reduce the risk of skin cancer. Which of the following instructions should the nurse include? A. Apply a broad-spectrum sunscreen 5 min before sun exposure B. Wear a sun visor instead of a hat when outside in the sun C. Avoid exposure to the midday sun D. Use a tanning booth instead of sunbathing outdoors
C. Avoid exposure to the midday sun
A nurse is providing education to a client with severe cystic acne vulgaris who has a new prescription for isotretinoin (Accutane). Which of the following information needs to be provided to the client? (Select all that apply) A. Take medication one hour prior to a meal B. Take vitamin A supplements C. Avoid prolonged sun exposure D. Night vision may worsen E. Safe in pregnancy
C. Avoid prolonged sun exposure D. Night vision may worsen
A nurse is caring for a client with a Spica cast. Which interventions includes proper skin care? (Select all that apply) A. Cover the peri area to provide privacy B. Assess pulse and sensation in distal extremities Q12 hours. C. Check exposed areas for redness and irritation D. Inspect the inside edges of the cast to look for extra pieces of cast material E. Provide regular sponge baths
C. Check exposed areas for redness and irritation D. Inspect the inside edges of the cast to look for extra pieces of cast material E. Provide regular sponge baths
A nurse in a dermatology clinic is using the ABCDE method while screening several skin lesions for skin cancer on a client. Which of the following findings should the nurse report to the provider? A. Symmetric shape B. Border regularity C. Color variation within a lesion D. Diameter >4 mm
C. Color variation within a lesion
A nurse is providing teaching to a client with a new ostomy site. Which of the following will the nurse include in teaching about cleaning the ostomy site. A. Use an oil-base cleanser to ride the site of accumulated drainage B. Swab the site with isoproyl alcohol before applying the drainage bag C. Ensure that the skin is dry before applying the drainage bag D. If dryness or cracked skin develops, apply Vaseline to moisturize the area
C. Ensure that the skin is dry before applying the drainage bag
A nurse is caring for a school-age child who has a severe burn. Which of the following actions should the nurse take? A. Initiate a high-protein, low-calorie diet B. Expose affected area to the air C. Establish an airway D. Implement contact isolation
C. Establish an airway
While performing daily peritoneal dialysis and catheter exit cite care with the mother of a child with chronic renal failure, the importance of which of the following is most important to emphasize to the mother? A. Applying the occlusive dressing after cleaning the site B. Changing the dressing when the peritoneal space is dry C. Examining the area while cleaning if for any sign of infection D. Pulling on the catheter to hold it taught while cleaning the skin
C. Examining the area while cleaning if for any sign of infection
A nurse is screening a client for skin cancer. When teaching the client about skin cancer risk, which of the following risk factors should the nurse include? A. Cigarette smoking B. Low-fiber diet C. Excessive exposure to ultraviolet light D. Human papillomavirus
C. Excessive exposure to ultraviolet light
A nurse is caring for a client who has sustained full-thickness burns on the arms, face, neck, and shoulders and is in the resuscitation phase. The nurse notes that the client's voice has become hoarse with a brassy cough and drooling. The nurse should identify these findings as indications that the client has which of the following? A. Pulmonary edema B. Bacterial pneumonia C. Inhalation injury D. Carbon monoxide poisoning
C. Inhalation injury
What is an example of a skin lesion commonly seen in older adults? A. Impetigo B. Atopic dermatitis C. Lentigines D. Tinea pedis
C. Lentigines
A nurse is caring for a client who has full-thickness burns covering 63% of her body and smoke inhalation. Which of the following nursing actions is the top priority? A. Monitor intake and output B. Administer antibiotics C. Monitor respiratory status D. Encourage fluid and food loss
C. Monitor respiratory status
A nurse is assessing a client who has a stage 2 pressure ulcer. The nurse should expect which of the following findings? A. Exposed bone B. Nonblanchable erythema C. Partial-thickness skin loss D. Necrotic subcutaneous tissue
C. Partial-thickness skin loss
A nurse is admitting a client who is scheduled for operative repair of a tibial plateau fracture. Which of the following items in the client's history is most likely to impede healing? A. BMI of 28 B. Drinking 1 beer most evenings C. Peripheral arterial disease D. Family history of diabetes
C. Peripheral arterial disease
A Nurse is collecting data from an adolescent who has scabies. Which of the following locations of the nurse expect to find the lesions? A. Hair shaft B. Thigh C. Popliteal folds D. Nailbeds
C. Popliteal folds
A nurse is caring for a 45 year old postoperative client who underwent surgery 1 day ago. The nurse inspects the suture line, which is slightly red with mild swelling. The wound is not tender or warm. Which of the following is the most appropriate nursing action? A. Report findings to the nurse supervisor B. Notify the surgeon C. Recognize normal findings and document D. Document findings as early signs of infection
C. Recognize normal findings and document
Which of the following statements should be included in education on the prevention of skin cancer? A. Sunscreen is not necessary on a cloudy or overcast day B. Waterproof sunscreen does not require reapplication after swimming C. Sunscreen should be applied 30 minutes before participating in an outdoor activity D. A broad-spectrum sunscreen of SPF 50 should be used before outdoor activities E. People of African descent do not require sunscreen
C. Sunscreen should be applied 30 minutes before participating in an outdoor activity
A nurse on a surgical unit is caring for 4 clients who have healing wounds. Which of the following wounds should the nurse expect to heal by primary intention? A. Partial-thickness burn B. Stage III pressure ulcer C. Surgical incision D. Dehisced sternal wound
C. Surgical incision
Which of the following is considered an abnormal finding when assessing a client skin? A. Moisture under the axilla B. Slightly cool hand temperature C. Tenting of the skin D. Thick skin on the soles of the feet
C. Tenting of the skin
A nurse is assessing the skin of a client who has frostbite. The client has small blisters that contain blood, and the skin of the affected area does not blanch. The nurse should classify this injury as which of the following? A. First-degree frostbite B. Second-degree frostbite C. Third-degree D. Fourth-degree frostbite
C. Third-degree
A nurse is teaching the guardian of a school-age child who has pediculosis capitis. Which of the following instructions should the nurse include in the teaching? A. Apply mayonnaise to the affected area at night B. Treat all household pets C. Use an over-the-counter medication 1% permethrin D. Hire professional exterminators to eradicate the insects
C. Use an over-the-counter medication 1% permethrin
A nurse is caring for a client who has a large wound healing by secondary intention. The nurse should inform the client that, in addition to protein, which of the following nutrients promotes wound healing? A. Vitamin B1 B. Calcium C. Vitamin C D. Potassium
C. Vitamin C
A nurse is providing discharge teaching to a client who is post-op day 3 after an open cholecystectomy. When providing discharge teaching about wound care, which of the following will the nurse advise the client may indicate a wound infection? A. Serous drainage from the incision B. Increased fatigue when performing daily activities. C. Warmth and erythema at the wound site D. Pink skin at the incision
C. Warmth and erythema at the wound site
A nurse is caring for a child with ringworm. When reinforcing teaching to the child's parents, which statement indicates an understanding of the teaching? A. "My child's ringworm infection must be eradicated from the entire body with systemic treatment." B. "I should apply antifungal cream to my child's entire body." C. "The ringworm must be eradicated since it is a dangerous condition." D. "Handwashing is important for preventing the spread between humans and pets."
D. "Handwashing is important for preventing the spread between humans and pets."
A nurse is providing teaching to a client who is wheelchair-bound and his caregiver about ways to reduce the risk of pressure ulcer formation. Which of the following instructions should the nurse include? A. "Move between the bed and the wheelchair once every 2 hours." B. "Make sure that your caregiver massages your skin daily." C. "Use a rubber ring when sitting at the bedside." D. "Shift your weight in the wheelchair every 15 minutes."
D. "Shift your weight in the wheelchair every 15 minutes."
A 75-year-old client is assessed by a home health nurse 10 days after undergoing major abdominal surgery. The client is tearful and complains of difficulty concentrating. Which of the following is the most appropriate response by the nurse? A. "Depression is a common occurrence after major surgery, but these problems can be treated with an antidepressant by your health care provider." B. How is your appetite? C. "You will begin to feel better in a week or so." D. "Symptoms like this occur commonly after major surgery. They may last up to 4-6 weeks as you heal from your surgery and begin to feel normal again."
D. "Symptoms like this occur commonly after major surgery. They may last up to 4-6 weeks as you heal from your surgery and begin to feel normal again."
A nurse is caring for four clients on an orthopedic unit. The nurse should identify that which of the following clients is at greatest risk for skin breakdown? A. An adolescent who has a cervical fracture and is in a halo brace B. A young adult client who has a femur fracture and is in skeletal balanced suspension traction C. A middle adult client who has a fractured ankle and a lower leg cast D. An older adult client who has a hip fracture and is in Buck's traction
D. An older adult client who has a hip fracture and is in Buck's traction
You are caring for a client who has been NPO since surgery 24 hours ago. The surgeon has ordered the client's diet to be advanced as tolerated. What should you offer this client to eat as his first meal after discontinuation of NPO status? A. Chicken broth, cranberry juice, and sherbet B. Chicken broth, cranberry juice, and Italian ice or pudding C. Beef broth, ginger ale, and pudding D. Beef broth, gelatin, and citrus soda
D. Beef broth, gelatin, and citrus soda
A nurse in a provider's office is teaching an adolescent who has severe cystic acne and a new prescription for isotretinoin. The nurse should instruct the adolescent that which of the following adverse effects is the priority to report to the provider? A. Dry skin B. Headache C. Decreased night vision D. Feelings of isolation
D. Feelings of isolation
Which of the following is an example of a skin macule? A. Wart B. Elevated nevus C. Blister D. Freckle
D. Freckle
A nurse is assessing a client who is bedridden and was admitted from home. The nurse notes a shallow crater in the epidermis of the client's sacral area. The nurse should document that the client has a pressure ulcer at which of the following stages? A. IV B. I C. III D. II
D. II
A nurse is planning care for a client who is on bedrest and is at risk for the development of pressure ulcers. Which of the following interventions should the nurse include in the plan? A. Elevate the head of the client's bed to a 45 degree angle B. Apply powder to the skin to decrease areas of moisture C. Position the client when lying laterally on the trochanter D. Instruct the client to shift weight 10 to 15 degrees every 30 min
D. Instruct the client to shift weight 10 to 15 degrees every 30 min
A nurse is assessing a client who has lesions on his skin. Which of the following findings is a clinical manifestation of malignant melanoma? A. Rough, dry, scaly skin B. Firm nodule with crusting C. Pearly papule with ulcerated center D. Irregularly shaped lesion with blue tones
D. Irregularly shaped lesion with blue tones
A client with bilateral varicose veins of the lower extremities questions the nurse about the brownish discoloration of his lower legs. The best response by the nurse is: This is probably the result of: A. Inadequate arterial blood supply B. Delayed healing of tissues after an injury C. Increased production of melanin in the area D. Leakage of red blood cells through the vascular wall
D. Leakage of red blood cells through the vascular wall
A nurse is caring for an obese client postoperatively who has an abdominal incision that is healing poorly. After the client complains of coughing forcefully, the nurse notes protrusion of the intestine through the surgical wound. Which of the following is the priority action? A. Take the client's vital signs B. Cover the wound with a dry sterile towel C. Using a sterile towel, the organs back into the body cavity D. Place the client in the low Fowler's position
D. Place the client in the low Fowler's position
Which intervention is appropriate for a client with impaired skin integrity? A. Limit chair-sitting to 4 hours at a time B. Break blisters and cover with gauze C. Encourage food intake to 4000 calories a day D. Promote ambulation when client is able
D. Promote ambulation when client is able
A nurse is assessing a client's wound and notes that there is a small amount of yellow drainage that is watery in consistency. This drainage is most likely described as: A. Sanguineous B. Purulent C. Serosanguinous D. Serous
D. Serous
A nurse is irrigating a surgical wound. Which of the following solutions will the nurse use to irrigate the wound? A. Hydrogen peroxide B. Povidone-iodine solution C. Chlorhexidine D. Sterile 0.9 NS
D. Sterile 0.9 NS
A nurse is planning care for a client who has been admitted for treatment of a malignant melanoma of the upper leg without metastasis. The nurse should plan to prepare the client for which of the following procedures? A. Curettage B. External radiation therapy C. Regional chemotherapy D. Surgical excision
D. Surgical excision
A nurse is planning care for a client who has been admitted for the treatment of a malignant melanoma of the upper leg without metastasis. The nurse should plan to prepare the client for which of the following procedures? A. Curettage B. External radiation therapy C. Regional chemotherapy D. Surgical incision
D. Surgical incision
A nurse is assessing a client who sustained superficial partial-thickness and deep partial-thickness burns 72hrs ago. Which of the following findings should the nurse report to the provider? A. Edema in the burned extremities B. Severe pain at the burn sites C. Urine output of 30ml/hr D. Temperature of 39.1°C (102.4°F)
D. Temperature of 39.1°C (102.4°F)
A nurse is conducting discharge teaching about foot care for a client who has diabetes mellitus. Which of the following instructions should the nurse include? A. Wear nylon socks with shoes every day B. Trim toenails by rounding the edges of the nail C. Apply lotion between the toes after bathing D. Test water temperature with the wrist
D. Test water temperature with the wrist
A nurse is planning care for a client with a nursing diagnosis of impaired physical mobility related to prolonged bedrest. Which is the most appropriate nursing intervention for this diagnosis? A. Keep lower you know side rails down and the bed in an elevated position B. Avoid turning the patient prone while in bed C. Encourage liquid intake of 1000 ML per day, unless contraindicated D. Turn and reposition every two hours, or more often as needed
D. Turn and reposition every two hours, or more often as needed
The on-call provider receives a call from a patient who states that she was out hiking and walked through a patch of poison ivy, which made direct contact with her lower legs. She states that her skin looks normal, and she has no pain or rash at this time. She asks the provider what she should do now. The provider should tell her to do which of the following right away? A. Apply a cool compress B. Come to the emergency room C. Do nothing since there is no rash or pain D. Wash with soap and rinse with water several times
D. Wash with soap and rinse with water several times
