integumentary

A nurse is making a presentation on skin cancer prevention with special focus on melanoma at a community health forum. Which statements should the nurse include? Select all that apply. 1. Apply a broad-spectrum sunscreen, minimum SPF 15, before and during outdoor sports 2. Apply sunscreen immediately before participating in outdoor activities 3. Reapply sunscreen after swimming even if using waterproof sunscreen earlier 4. Serious sunburns can still occur on cloudy, overcast days 5. Use of tanning beds for 15 minutes or less will provide a base tan less likely to burn

1.3.4

A 24-year-old female client has been prescribed isotretinoin for severe nodulocystic acne that has been resistant to other therapies. Which instruction is most important for the nurse to reinforce with this client? 1. "Apply lubricating eye drops when wearing contacts." 2. "Swallow capsules whole." 3. "Use sunscreen routinely." 4. "Use 2 forms of contraception."

4

A client is brought to the emergency department after sustaining third-degree burns over 50% of the body. Which solution is the best choice for fluid resuscitation in this client? 1. 0.45% normal saline 2. 5% dextrose in 0.9% normal saline (D5NS) 3. 5% dextrose in water (D5W) 4. Lactated Ringer's solution

4

A parent calls the nursing triage line during the evening. The parent says that a 7-year-old was found playing in an area with poison ivy and asks what to do. Which is the most important instruction to give the parent? 1. Apply cool, wet compresses for itching 2. Apply topical cortisone ointment to the area 3. Discourage the child from scratching the area 4. Wash the skin where the contact occurred

4

The nurse is caring for a client in the intensive care unit who suffered partial-thickness burns to 36% of the body. During the first 24 hours, the nurse would anticipate which of the following assessments? 1. Hemoglobin 10.2 g/dL (102 g/L) 2. Hyperactive bowel sounds 3. Serum sodium 152 mEq/L (152 mmol/L) 4. Tall, peaked T waves on ECG

4

The parent of a 6-year-old calls the nurse and reports that the child was playing outside in the snow and the child's feet now appear red and swollen. What is the best response by the nurse? 1. "Bring the child to the health care provider's (HCP) office immediately." 2. "Give your child something warm to drink." 3. "Massage the child's feet gently until they warm up." 4. "Place the child's feet in warm water immediately."

4

What is the priority when caring for a 6-month-old diagnosed with atopic dermatitis? 1. Encouraging use of humidifier 2. Exploration of family feelings 3. Instruction regarding hypoallergenic diet 4. Prevention of scratching

4

The nurse is beginning intravenous (IV) resuscitation therapy for a client weighing 85 kg (187 lb) with visible second- and third-degree burns covering 40% of his body. Using the Parkland Formula, enter the amount of fluid in liters needed during the first 8 hours of IV fluid resuscitation. Record your answer using 1 decimal place.

6.8L

A client arrives at the emergency department after being rescued from a burning building. Both arms and the entire chest are covered with dry, leathery, charred skin that does not blanch. What is the priority for the client's care? 1. Administration of IV lactated Ringer's 2. Antibiotic administration 3. Incision through the burned tissue (escharotomy) 4. IV administration of analgesics

1

A client who suffered a burn injury has received fluid resuscitation and is now diuresing, indicating the end of the emergency phase. Which prescription is the highest priority at this time? 1. Administer enteral feedings at the return of bowel sounds 2. Assist the client in activities of daily living as tolerated 3. Contact the client's religious advisor for spiritual support 4. Educate the client's family about dressings and medications

1

The nurse is providing discharge teaching for a client who suffered full-thickness burns. Which statement by the client demonstrates a need for further instruction on the rehabilitation phase of a burn injury? 1. "I should avoid using lotion to prevent infection." 2. "I should perform range-of-motion exercises daily." 3. "I will avoid direct sun exposure for at least 3 months." 4. "I will wear pressure garments to minimize scars."

1

A 2-year-old is diagnosed with atopic dermatitis (eczema). Which instructions should the nurse teach the parents? Select all that apply. 1. Apply emollient immediately after a bath 2. Dress child in wool pajamas 3. Give tepid baths with mild soap 4. Keep child's nails well-trimmed 5. Thoroughly rub the skin dry after baths

1,3,4

The nurse is conducting an educational community outreach program on melanoma screening. Which statement by a resident would indicate the need for further education? 1. Abrupt changes in the size or color of a mole are warning signs. 2. All new growths and pigmentations must be biopsied to rule out cancer. 3. Melanoma can occur as any color. 4. Melanoma does not always occur as a new mole.

2

When caring for a client with severe burns, the nurse can expect to administer pain medication via which route? 1. Intramuscular 2. Intravenous 3. Oral 4. Subcutaneous

2

An adult client was severely burned in a warehouse accident. The client has second-degree burns on the right leg and right arm as well as the back. Using the rule of nines, the nurse estimates the percentage of the client's burns as which of these options? 1. 25% 2. 32% 3. 45% 4. 50%

3

The nurse cares for a client admitted with severe burns who is now on fluid resuscitation therapy. Which assessment findings would best indicate that fluid resuscitation has been successful? 1. Heart rate 89/min, blood pressure 99/52 mm Hg 2. Potassium decrease from 5.7 mEq/L to 5.0 mEq/L (5.7 mmol/L to 5.0 mmol/L) 3. Urine output 31 mL/hr, respirations 20/min 4. Weight gain of 2.2 lbs (1 kg) in last 8 hours and palpable pulses

3

For which client is it most important for the nurse to provide teaching on ways to prevent the spread of the condition? 1. Client with eczema on upper torso 2. Client with oral candidiasis 3. Client with psoriasis on hands 4. Client with tinea corporis

4

The nurse is caring for an adult client who has sustained partial-thickness burns to all anterior body surfaces below the neck. Using the rule of nines, calculate the percentage of total body surface area affected. Record your answer using a whole number. Answer: (%)

46%

The unlicensed assistive personnel (UAP) reports finding a reddened area on a client's sacrum during a bath. What is the nurse's priority action?

perform an assessment on client's skin

A nurse is caring for a client admitted to the intensive care unit for toxic epidermal necrolysis. Which interventions should be included in this client's care plan? Select all that apply. 1. Administer prescribed eye lubricants on schedule 2. Apply sterile, moist dressings and ointments to denuded areas of skin 3. Implement reverse isolation precautions and strict aseptic technique 4. Keep room temperature warm to prevent shivering 5. Provide gentle massage as needed to relieve pain

1,2,3,4

The health care provider has just prescribed tetracycline for an adolescent with acne vulgaris. The client takes oral contraceptive pills. The clinic nurse should educate the teen about which topics? Select all that apply. 1. Not taking tetracycline with dairy products 2. Taking tetracycline at bedtime 3. Taking tetracycline with food 4. Using additional contraceptive techniques 5. Using sunblock

1,4,5

An obese client with diabetes who had a bowel resection 5 days ago says, "I felt like I split open when I was coughing." On assessment, the nurse notes that the incision edges are separated and a loop of bowel is protruding through the wound. Which nursing actions would be appropriate? Select all that apply. 1. Administer one oral tablet of oxycodone prescribed PRN for pain 2. Assess a full set of vital signs 3. Cover the viscera with sterile dressings saturated in normal saline (NS) solution 4. Notify the health care provider (HCP) immediately 5. Place the client in low Fowler's position with knees slightly flexed

2,3,4,5

A child's arm is burned from accidentally spilling boiling water on it, and the parent calls the clinic. The nearest emergency department is an hour away. Which instructions would be appropriate to give the parent? Select all that apply. 1. "Apply antibiotic ointment to any open skin." 2. "Briefly soak the arm with cool water." 3. "Cover the area with a clean, dry cloth." 4. "Place ice on the arm to relieve pain." 5. "Remove clothing, if not stuck to skin, around the burn."

2,3,5