ATI LPN
Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017)
Chapter 60 : Assessment of Integumentary Function Questions
Question 1 of 5
A nurse is doing a shift assessment on a group of patients after first taking report. An elderly patient is having her second dose of IV antibiotics for a diagnosis of pneumonia. The nurse notices a new rash on the patients chest. The nurse should ask what priority question regarding the presence of a reddened rash?
Correct Answer: B
Rationale: A new rash during antibiotic therapy suggests a possible allergic reaction, which could be life-threatening. Assessing for allergies is the priority over timing, sensation, or pain.
Question 2 of 5
A gerontologic nurse is teaching a group of nursing students about integumentary changes that occur in older adults. How should these students best integrate these changes into care planning?
Correct Answer: B
Rationale: Aging causes thinning at the dermis-epidermis junction, increasing the risk of shearing injuries. Moisturizers are beneficial for dry skin, ice packs can be used with caution, and sweat accumulation is not a concern in older adults.
Question 3 of 5
A patient is diagnosed with atrial fibrillation and the physician orders Coumadin (warfarin). For what skin lesion should the nurse monitor this patient?
Correct Answer: B
Rationale: Ecchymosis, or bruising, is a risk with anticoagulants like warfarin due to blood extravasation. Ulcers, scars, and erosions are not directly associated with anticoagulant use.
Question 4 of 5
A new patient has come to the dermatology clinic to be assessed for a reddened rash on his abdomen. What diagnostic test would most likely be ordered to identify the causative allergen?
Correct Answer: C
Rationale: Patch testing identifies allergens causing contact dermatitis. Skin scrapings are for fungal infections, biopsies rule out malignancy, and Tzanck smears diagnose blistering conditions.
Question 5 of 5
A patient with a suspected malignant melanoma is referred to the dermatology clinic. The nurse knows to facilitate what diagnostic test to rule out a skin malignancy?
Correct Answer: B
Rationale: A skin biopsy is used to diagnose or rule out skin malignancies like melanoma. Tzanck smears diagnose blistering conditions, patch testing identifies allergens, and skin scrapings detect fungal infections.