ATI LPN
NCLEX Skin Integrity Questions Questions
Question 1 of 5
A nurse's assessment of a patient's knee reveals edema, tenderness, muscle spasms, and ecchymosis. The patient states that 2 days ago he ran 10 miles and now it really hurts to stand up. The nurse should plan care based on the belief that the patient has experienced what?
Correct Answer: B
Rationale: A second-degree strain involves tearing of muscle fibers and is manifested by notable loss of load-bearing strength with accompanying edema, tenderness, muscle spasm, and ecchymosis. A first-degree strain reflects tearing of a few muscle fibers and is accompanied by minor edema, tenderness, and mild muscle spasm, without noticeable loss of function. However, this patient states a loss of function. A sprain normally involves twisting, which is inconsistent with the patient's overuse injury.
Question 2 of 5
The nurse notes that a patient's skin and hair are dry. Which function of the skin is most likely malfunctioning?
Correct Answer: C
Rationale: Dry skin and hair indicate a malfunction in the skin's protective function, which includes maintaining moisture.
Question 3 of 5
The nurse is assisting with the secondary survey of a patient with 50% total body surface area electrical burns. Which test would be a priority for this patient?
Correct Answer: D
Rationale: Electrical burns can cause cardiac arrhythmias due to current passing through the body, making a 12-lead ECG a priority to assess heart function.
Question 4 of 5
A patient is diagnosed with tinea corporis. Which medication should the nurse expect to be prescribed to treat this infection?
Correct Answer: B
Rationale: Topical terbinafine is a highly effective antifungal for tinea corporis, targeting the fungal cell membrane, and is commonly prescribed over the other options.
Question 5 of 5
The nurse sends 10 samples of body sites to assess an intensive care patient's Candida colonization index. Seven of the samples came back as being positive. What is this patient's colonization index?
Correct Answer: B
Rationale: The colonization index is calculated as the ratio of positive sites to total sites (7/10 = 0.7), indicating significant Candida presence.