NCLEX Chapte
A client arrives at the emergency department and has experienced frostbite to the right hand. What would the nurse expect to find when inspecting the client's hand?
A white color of the skin which is insensitive to touch
The nurse reinforces instructions to a group of clients regarding measures that will assist with the prevention of skin cancer. Which statement by a client indicates the need for further teaching?
" I need to avoid sun exposure before 10:00 am and after 4:00pm."
The client arrives at the emergency department after a burn injury that occurred in their home basement and an inhalation injury is suspected. Which would the nurse anticipate as being prescribed for the client?
100% oxygen via a tight-fitting, nonrebreather face mask
The nurse, employed in a long-term care facility, is planning the clinical assignments for the day. The nurse prepares the assignment and would not assign which staff member to the client with a diagnosis of herpes zoster?
An unlicensed assistive personnel who has never had chickenpox
The nurse is caring for a client with circumferential burns of both legs. Which leg position is appropriate for this type of a burn?
Elevation above the level of the heart
The evening nurse, reviews the nursing documentation in the client's chart and notes that the day nurse has documented that the client has a stage 2 pressure injury in the sacral area. What would the nurse expect to find when checking the client's sacral area?
Partial-thickness skin loss of the epidermis
The nurse is assigned to care for a client with herpes zoster. Based on an understanding of the cause of this disorder, the nurse determines that this definitive diagnosis was made by which diagnostic test?
Positive culture results
The nurse inspects the skin of a client who is suspected of having psoriasis. Which finding would the nurse note if this disorder is present?
Silvery-white scaly lesions
The nurse is caring for a client who has just been admitted to the nursing unit after receiving flame burns to the face and chest. The nurse notes a hoarse cough, and the client is expectorating sputum with black flecks. The client suddenly becomes restless and his color is becoming dusky. Based on this data, which interpretation would the nurse make?
The burn has probably caused laryngeal edema, which has occluded the airway
Which would be the anticipated therapeutic out come of an escharotomy procedure performed for a circumferential arm burn?
The return of distal pulses
The nurse is assisting with caring for a client who is receiving intravenous fluids and who has sustained full-thickness burn injuries of the back and legs. The nurse understands that which would provide the most reliable indicator for determining the adequacy of the fluid resuscitation?
Urine output
The nurse is told that an assigned client is suspected of having methicillin-resistant Staphylococcus aureus (MRSA). Which precautions must the nurse institute during the care of the client?
Wear a gown and gloves
