A newly graduated RN is in the third week of orientation to the medical-surgical unit. Which client is best for you, as charge nurse, to assign to the new graduate?

Correct Answer: A

Rationale: The correct answer is A because a patient with periorbital cellulitis requires close monitoring and immediate intervention due to the risk of complications such as vision loss or intracranial involvement. This assignment will provide the new graduate with an opportunity to develop critical thinking skills and prioritize care for a potentially unstable patient. Choice B is incorrect because a patient needing discharge instructions after skin grafts is usually stable and may not require acute interventions, making it less suitable for a new graduate. Choice C is incorrect because a dressing change for a stage 3 pressure ulcer post-hydrotherapy is a routine procedure that may not challenge the new graduate's critical thinking skills or require immediate interventions. Choice D is incorrect as teaching before a punch biopsy is important but not as time-sensitive or critical compared to managing a patient with periorbital cellulitis.

Correct Answer: C

Rationale: The correct answer is C: Wash hands before and after applying a topical medication. This is crucial to prevent the spread of infection as proper hand hygiene reduces the risk of introducing harmful bacteria to the wound. Cold wet soaks (A) do not address hand hygiene and may not be effective in preventing infection. Proper disposal of soiled material (B) is important but not the most critical action for preventing infection. The use of an antiseptic solution (D) is helpful, but without proper hand hygiene, the risk of spreading infection remains high.

Correct Answer: B

Rationale: The correct answer is B because growing cultured skin is indeed time-consuming. Cultured skin requires a significant amount of time for cells to proliferate and form a suitable skin graft. This process can take several weeks to months, thus delaying treatment for patients in need of immediate skin repair. A: Pigmentation mismatch is not a disadvantage as it can be managed with techniques like pigmentation matching. C: The risk of infection can be minimized through proper sterile techniques during the culturing process. D: The risk of rejection can be reduced by using the patient's own cells to grow the cultured skin, making rejection less likely.

Correct Answer: A

Rationale: The correct answer is A because malignant melanomas typically present as non-keratotic and soft lesions. Choice B is correct as melanomas arise from melanocytes. Choice C is correct as melanoma has a high mortality rate. Choice D is correct as melanomas often have irregular color and asymmetric shape.

Correct Answer: B

Rationale: The correct answer is B: Warty, irregular papules or plaques. Seborrheic keratosis is a common benign skin growth characterized by warty, raised, and often brown or black lesions. These growths have a stuck-on appearance and may be smooth or rough. They are not associated with white patchy yeast infections (choice A), excessive turnover of epithelial cells (choice C), or deep inflammation of subcutaneous tissue (choice D). The key characteristics of seborrheic keratosis are the warty and irregular nature of the lesions, which differentiate it from other skin conditions.