Integumentary Practice Questions 05292014

Front 1

A suspected outbreak of anthrax has been transmitted by skin exposure. A client is admitted to the ED with lesions on the hands. The physician prescribes antibiotics and sends the client home. What should the RN instruct the client to do? (Select all that appy.)
a. Take the prescribed antibiotics for 60 days.
b. Avoid contact with other members of the family during the treatment period.
c. Wear a mask for 60 days.
d. Expect the skin lesions to clear up within 1-2 wks.
e. Wash hands frequently.

Back 1

a. Take the prescribed antibiotics for 60 days.
d. Expect the skin lesions to clear up within 1-2 wks.
e. Wash hands frequently.

Front 2

A child has beed prescribed diphenhydramine hydrochloride (Benadryl) to help control the itching from atopic dermatitis. The RN should instruct the parents to report: (Select all that apply.)
a. weight loss.
b. drowsiness.
c. thickened bronchial secretions.
d. upset stomach.
e. bradycardia.

Back 2

b. drowsiness.
c. thickened bronchial secretions.
d. upset stomach.

Front 3

An occupational RN is called to treat an employee who experienced a finger injury on a piece of equipment. When the RN arrives, it is discovered that the finger tip was cut off at the first digit and is bleeding profusely. What should be the RN's first action?
a. Elevate the extremity above the level of the heart.
b. Apply pressure to the radial artery of that extremity to decrease bleeding.
c. Apply direct pressure to the finger with a clean, dry cloth.
d. Apply a tourniquet at the bicept of the affected limb.

Back 3

c. Apply direct pressure to the finger with a clean, dry cloth.

Front 4

A RN is caring for a client with a postoperative wound evisceration. Which action should the RN perform first?
a. Calm the client, as the client is very upset and crying.
b. Cover the protruding internal organs with sterile gauze, moistened with sterile saline solution.
c. Push the protruding organs back into the abdominal cavity.
d. Request that the client remain on bedrest until the HCP is notified.

Back 4

b. Cover the protruding internal organs with sterile gauze, moistened with sterile saline solution.

Front 5

A RN is providing teaching to a client about skin cancer. Which of the following should the RN explain are risk factors for skin cancer? (Select all that apply.)
a. Increasing age.
b. Exposure to chemical pollutants.
c. Long-term exposure to the sun.
d. Increased pigmentation.
e. Genetics.
f. Immunosuppression.

Back 5

a. Increasing age.
b. Exposure to chemical pollutants.
c. Long-term exposure to the sun.
e. Genetics.
f. Immunosuppression.

Front 6

The RN is developing a program on skin cncer prevention for a community group. Which of the following should be included in the program? (Select all that apply.)
a. Purchase sunscreen containing benzophenones to block UVA and UVB rays.
b. Use sunscreen with a minimum of 15 sun protection factor (SPF).
c. Obtain genetic screening to identify risk of melanoma.
d. Apply sunscreen only on sunny days, especially between 1000 and 1400.
e. Have a pigmented lesion biopsied by shaving if it looks suspicious.
f. Rub baby oil to lubricate the skin before going out in the sun.

Back 6

a. Purchase sunscreen containing benzophenones to block UVA and UVB rays.
b. Use sunscreen with a minimum of 15 sun protection factor (SPF).

Front 7

During the emergent stage of burn management for a client with burns of 30% of the body the RN should assess the client for which of the following? (Select all that apply.)
a. Hyponatremia.
b. Hyperkalemia.
c. Hypoglycemia.
d. Increased hematocrit.
e. "Fever spikes".

Back 7

b. Hyperkalemia.
d. Increased hematocrit.
e. "Fever spikes".

Front 8

A 17 yof with severe nodular acne is considering treatment with isotretinoin (Accutane). Prior to beginning the medication, the RN explains that the client will be required to:
a. enroll in a risk mgmt plan.
b. Have proof of a mental health evaluation.
c. Begin an effective form of birth control.
d. Temporarily give up sports.

Back 8

a. enroll in a risk mgmt plan.

Front 9

A client presents to the ED with symptoms of cough, H/A, and generalized aches and pains. Upon assessment, the RN documents a temperature of 101.5F (38.6C) and a red, irritating rash on the arms, legs, and upper chest. SHe aslo notes that the client takes eight different medications each day. What nursing diagnosis is the priority for this client?
a. Impaired physical mobility.
b. Impaired tissue integrity.
c. Impaired thermoregulation.
d. Ineffective therapeutic regimen mgmt.

Back 9

b. Impaired tissue integrity.

Front 10

A 35 yo client is brought to the the ED with second and third degree burns over 15% of the body. Admission VS are BP 100/50, HR 130, RR 26. Which nursing interventions are appropriate for this client. (Select all that apply.)
a. Clean the burns with hydrogen peroxide.
b. Cover the burns with saline soaked towels.
c. Begin an IV infusion of LR.
d. Place ice directly on the burn areas.
e. Administer 6mg of IV Morphine.
f. Administer tetanjus prophylaxis, as ordered.

Back 10

c. Begin an IV infusion of LR.
e. Administer 6mg of IV Morphine.
f. Administer tetanjus prophylaxis, as ordered.

Front 11

A well-nourished client is admitted with a stasis ulcer. The RN assesses the ulcer and finds excavation of the skin surface as a result of sloughing of inflammatory necrotic tissue. The MD has ordered the ulcer to be flushed with a fibrinolytic agent. Which of the following goals are appropriate for this client? (Select all that appy.)
a. Increase oxygen to the tissues.
b. Prevent direct trauma to the ulcer.
c. Improve nutrition.
d. Prevent infection.
e. Reduce pain.

Back 11

a. Increase oxygen to the tissues.
b. Prevent direct trauma to the ulcer.
d. Prevent infection.
e. Reduce pain.

Front 12

A client returns from the OR with a partial-thickness skin graft on his left arm. The donor tissue was taken from his left hip. In planning his immediate post-op care, which interventions should the RN include? (Select all that apply.)
a. Change the dressing at the graft site every 8 hrs.
b. Elevate the left arm and provide complete rest of the grafted area.
c. Administer pain medication every 4 hrs as ordered for pain in the donor site.
d. Perform ROM exercises to the left arm every 4 hrs.
e. Monitor the pulse in the left arm every 4 hrs.
f. Encourage the client to ambulate as desired on the first post-op day.

Back 12

b. Elevate the left arm and provide complete rest of the grafted area.
c. Administer pain medication every 4 hrs as ordered for pain in the donor site.
e. Monitor the pulse in the left arm every 4 hrs.

Front 13

Following a small-bowel resection, a client develops fever and anemia. The surface surrounding the surgical wound is warm to the touch and necrotizing fasciitis is suspected. Another manifestation that suggests necrotizing fasciitis is:
a. erythema.
b. leukocytosis.
c. pressure like pain.
d. swelling.

Back 13

c. pressure like pain.

Front 14

The RN is assessing an 80 yo client who has scald burns on both hands and forearms (first and second degree burns on 10% of BSA). What should the RN do first?
a. Clean the wounds with warm water.
b. Apply antibiotic cream.
c. Refer the client to a burn center.
d. Cover the burns with a sterile dressing.

Back 14

c. Refer the client to a burn center.

Front 15

Which of the following interventions is recommended protocol for all clients who are at risk for pressure sore development?
a. Identify at-risk clients on admission to the health care facility.
b. Place at-risk clients on an every 2-hour turning schedule.
c. Automatically place clients in specialty beds.
d. Provide at-risk clients with a high-protein, high-carb diet.

Back 15

a. Identify at-risk clients on admission to the health care facility.

Front 16

A client is diagnosed with gonorrhea. When teaching the client about the disease, the RN should include which instruction?
a. "Avoid sexual intercourse until you've completed treatment, which takes 2-3 months."
b. "Wash your hands thoroughly to avoid transferring the infection to your eyes."
c. "If you have intercourse before treatment ends, tell sexual partners of your status and have them wash well after intercourse."
d. "If you don't get treatment, you may develop meningitis and suffer widespread CNS damage."

Back 16

b. "Wash your hands thoroughly to avoid transferring the infection to your eyes."

Front 17

Using the Parkland formula, calculate the hourly rate of fluid replacement with LR solution during the first 8 hrs for a client weighing 75kg with TBSA burn of 40%.
a. 750
b. 123
c. 4
d. 100

Back 17

a. 750
75 x 40 x 4 = 12,000
12000 divided by 2 = 6000 (half fluid is given if first 8 hrs.
6000 divided by 8 = 750

Front 18

A stage II pressure ulcer is characterized by:
a. redness in the involved area.
b. muscle sspasms in the involved area.
c. pain in the involved area.
d. tissue necrosis in the involved area.

Back 18

c. pain in the involved area.

Front 19

Which nursing interventions are effective in preventing pressure ulcers? (Select all that apply.)
a. Clean the skin with warm water and a mild cleaning agent; then apply a moisturizer.
b. When turning the client, slide and avoid lifting him/her.
c. Avoid raising the HOB more than 90 degrees.
d. Turn and reposition the client every 1-2 hrs unless contracindicated.
e. If the client uses a w/c, seat him or her on a rubber or plastic doughnut.
f. Use pillows to position the client and increase comfort.

Back 19

a. Clean the skin with warm water and a mild cleaning agent; then apply a moisturizer.
d. Turn and reposition the client every 1-2 hrs unless contracindicated.
f. Use pillows to position the client and increase comfort.

Front 20

A client is receiving sulfonamide cream as topical treatment for burns. When reviewing the daily laboratory tests, the RN notices that the client's WCH count has decreased. The RN reviews the data and determines that:
a. it is normal to have this response from immunosuppression.
b. this is normal; an increased WBC would be a concern.
c. this is abnormal; the MD needs to be alerted.
d. the WBC count should be observed over several days to look for a trend.

Back 20

c. this is abnormal; the MD needs to be alerted.

Front 21

Which of the following clients with burns will most likely requie an ETT. A client who:
a. electrical burns of the hands and arms causing arrhythmias.
b. thermal burns to the head, face, and airway reuslting in hypoxia.
c. chemical burns to the chest and abdomen.
d. seconhand smoke inhalation.

Back 21

b. thermal burns to the head, face, and airway reuslting in hypoxia.

Front 22

The RN assesses the client's burned right arm and notes increasing edema, absence of a radial pulse, and decreased sensation in finger tips. The RN should:
a. document findings and recheck in 1 hr.
b. elevate the extremity on a pillow.
c. notify the MD immediately.
d. implement passive ROM exercises.

Back 22

c. notify the MD immediately.