A nurse is preparing to perform a wound debridement procedure for a patient with a necrotic wound. What action should the nurse prioritize to minimize patient discomfort during the procedure?

Correct Answer: A

Rationale: Administering systemic analgesia, such as pain medications or anesthesia, before the wound debridement procedure is the most effective way to minimize patient discomfort. These medications will help manage and reduce the pain experienced by the patient during the procedure, making it more tolerable for them. Topical anesthetic cream may provide some localized relief but may not be sufficient for significant pain management during a wound debridement procedure. Using sharp debridement techniques or performing the procedure quickly may help reduce manipulation or duration, respectively, but these actions alone may not adequately address the patient's pain and discomfort. Administering systemic analgesia ensures that the patient's overall pain is managed, promoting a more comfortable and successful wound debridement procedure.

Correct Answer: B

Rationale: The presentation of a pruritic rash with linear streaks and small, fluid-filled blisters following exposure to poison ivy is characteristic of allergic contact dermatitis. Poison ivy contains an oil called urushiol, which is known to cause this type of skin reaction in individuals who are sensitive to it. The linear streaks are often a result of the plant brushing against the skin. Pemphigus vulgaris is an autoimmune condition characterized by the formation of intraepidermal blisters, typically not associated with linear streaks or exposure to irritants like poison ivy. Bullous pemphigoid is characterized by subepidermal blisters, and herpes zoster presents with a painful rash following reactivation of the varicella-zoster virus in a dermatomal pattern, not typically in linear streaks.

Correct Answer: A

Rationale: The presentation described in the question is characteristic of tinea versicolor, a fungal skin infection caused by Malassezia furfur. The hypopigmented macules with fine scaling are often seen on the trunk and proximal extremities, particularly in areas that are more prone to sebum production. Patients with tinea versicolor may have a history of sun exposure and outdoor activities as the organism responsible for the infection thrives in warm, humid environments. Treatment typically involves the use of topical antifungal agents such as ketoconazole or selenium sulfide.

Correct Answer: A

Rationale: Molluscum contagiosum is a viral skin infection caused by the poxvirus. It typically presents as multiple, flesh-colored, dome-shaped papules with a central umbilication (dimple or depression in the center) on the skin. These lesions are often found on the trunk and extremities and can persist for several months. Molluscum contagiosum is commonly seen in children but can also occur in adults, especially those with weakened immune systems. The lesions are usually asymptomatic but can become inflamed or itchy in some cases. Treatment options include observation, topical therapies, cryotherapy, or curettage.

Correct Answer: B

Rationale: Acute otitis media is the most likely condition responsible for this presentation. The sudden onset of severe, unilateral ear pain, diminished hearing, and purulent otorrhea are classic symptoms of acute otitis media. Otoscopic examination revealing a bulging, erythematous tympanic membrane with obscured landmarks further supports the diagnosis. The bulging of the tympanic membrane is due to the accumulation of fluid and pus behind it, causing the characteristic appearance. Treatment typically involves antibiotics to help clear the infection and relieve symptoms. If left untreated, acute otitis media can lead to complications such as perforation of the eardrum or mastoiditis.