med surg dermatology
a nurse is assessing a client who is bedridden and was admited 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
II
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
acyclovir
a nurse is caring for a client who has burn injuries on his trunk. the nurse is explaining what to expect from the prescribed hydrotherapy. which of the following statements by the client indicates an understanding of the teaching a. i will be on a special shower table b. the water temperature will be very cool to ease my pain---warm c. the nurse will use a firm-bristled brush to remove loose skin----use soft washcloths or gauze d. the nurse will use scissors to open small blister---open only large blister
i will be on a special shower table
a nurse is caring for a client who has regular occupational exposure to sunlight and present for evaluation of several skin lesions. which of the following findings should alert the nurse to the possibility of malignant melanoma?
an irregularly shaped brown lesion with light blue areas on the neck
a nurse is teaching a group of young adult client about health promotion techniques to reduce the risk of the skin cancer. which of the following instructions should the nurse include? a. apply a broad spectrum sunscreen 5 min before sun exposure---15min b. wear a sun visor instead of a hat when outside in the sun----hat c. avoid exposure to the midday sun d. use a tanning booth instead of sunbathing outdoors
avoid exposure to the midday sun
a nurse in a dermatology clinic is using the ABCDE method while screening skin lesions for skin cancer on a client. which of the following findings should the nurse report the provider a. symmetric shape-----assymetric b. border regularity ---border irregularity c. color variation within a lesion d. diameter > 4mm----6
color variation within a lesion
a community health nurse is teaching a group of client about melanoma. which of the following characteristics of lesions associated with melanoma should the nurse include in the teaching a. one solid color b. symmetrical shape c. < 6mm in diameter d. irregular border
irregular border
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. scaring c. skin graft size d. pain
bacterial growth
a nurse in an emergency department is assessing a client who has extensive burns, including on the face. which of the following assessment 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
characteristics of the cough and sputum
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
epidermis
a nurse in the emergency department is caring for a client who has snake bite on her arm. which of the following interventions should the nurse implement a. immobilize the limb at the level of the heart b. apply a tourniquet to the affected limb c. use a sterile scapula to incise the wound d. apply ice to the skin over the snakebite wound
immobilize the limb at the level of the heart
a nurse is planning care for a client who has deep partial thickness and full-thickness thermal burns over 40% of his total body surface and is in the acute phase of burn injury. which of the following interventions should the nurse include in the plan? a. initiate range of motion exercises b. use clean technique to provide wound care c. place the client on a low-protein diet d. maintain the client on bed rest
initiate range of motion exercises
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
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
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 is appropriate a. basal cell carcinoma b. melanoma c. actinic keratosis d. squamous cell carcinoma
melanoma
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 intake
monitor respiratory status
a nurse in a provider's office is assessing a client 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
papules
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 (homographs) b. pig skin c. amniotic membrane d. beef collagen
pig skin
a nurse is providing teaching to a client who is wheelchair bounds 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 hr b. make sure that your caregiver massages your skin daily c. use a rubber ring when sitting on the bedside d. shift your weight in the wheelchair every 15 min
shift your weight in the wheelchair every 15 min
a nurse is evaluating the laboratory values of a client who is in the resuscitation phase following laboratory findings should the nurse expect? a. hemoglobin 10g/ dl b. sodium 132 mEq/dL c. albumin 3.6 g/dl d. potassium 4.0 mEq/dl
sodium 132 mEq/dL
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 ---resistant to radiatn c. regional chemotherapy d. surgical excision
surgical excision
a nurse on a surgical unit is caring for 4 client who have healing wounds. which of the following wound should the nurse expect to heal by primary intention.(closed wound) a. partial-thickness burn b. stage III pressure ulcer c. surgical incision d. dehisced sternal wound
surgical incision
a nurse is assessing a client who sustained superficial partial-thickness and deep partial-thickness burns 72 hr 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 (102.4)
temperature of 39. 1 (102.4)
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 edge of the nail c. apply lotion between the toes after bathing d. test water temperature with the wrist
test water temperature with the wrist
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--reddened and waxy b. second-degree frostbite---large, fluid-filled blister c. third-degree frostbite d. fourth-degree frostbite--frozen skin, muscle and bone affected
third-degree frostbite
a nurse is providing discharge instructions to a client who is postoperative following surgical excision of basal cell carcinoma. which of the following findings should the nurse include as an indication of a mole's potential malignancy a. ulceration b. blanching of surrounding skin c. dimpling d. fading of color
ulceration, bleeding, exudation
a nurse is caring for a client who has a large wound healing by secondary intension. the nurse should inform the client that which of the following nutrients in addition to protein promotes wound healing a. vitamin BI B. calcium c. vit c d. potassium
vit c
a nurse is screening a client for skin caner. when teaching the client about skin cancer risk, which of the following risk factors should the nurse include a. cigarette smoking---lung b. low-fiber diet--colorectal c. excessive exposure to ultraviolet light d. human papillomavirus---cervical
excessive exposure to ultraviolet light
a nurse is assessing the abdominal incision of a client who is 3 days postoperative. the incision is slightly edematous and pink with crusting on the edges and is draining serosanguineous assessments describes the incision? a. the incision is showing early signs of infection b. the incision is showing early signs of dehiscence c. the incision is showing signs of healing without complications d. the incision is showing signs of developing a fistula
he incision is showing signs of healing without complications
a nurse is assessing a client who has a lesion on his skin. which of the following findings is a clinical manifestation of malignant melanoma? a. rough, dry, scaly lesion b. firm nodule with crusting (cell carcinoma) c. pearly papule with ulcerated center (carcinoma) d. irregularly shaped lesion with blues tones
irregularly shaped lesion with blues tones