ATI LPN
Skin Integrity NCLEX Questions Questions
Question 1 of 5
An emergency room nurse cares for a client admitted with a 50% burn injury at 10:00 this morning. The client weighs 90 kg. Using the Parkland formula, calculate the rate at which the nurse should infuse intravenous fluid resuscitation when started at noon.
Correct Answer: B
Rationale: Using the Parkland formula (4 mL/kg/% burn), 18,000 mL is needed in 24 hours; half (9000 mL) in the first 8 hours. Starting at noon, 9000 mL over 6 hours is 1500 mL/hr.
Question 2 of 5
The nurse is applying mafenide acetate (Sulfamylon), a sulfa antibiotic cream, to a client's lower extremity burn. Which assessment data would require immediate attention by the nurse?
Correct Answer: C
Rationale: The ABG values indicate metabolic acidosis (low HCO3), a known side effect of mafenide acetate, requiring immediate attention to prevent further complications.
Question 3 of 5
The female client admitted for an unrelated diagnosis asks the nurse to check her back because 'it itches all the time in that one spot.' When the nurse assesses the client's back, the nurse notes an irregular-shaped lesion with some scabbed-over areas surrounding the lesion. Which action should the nurse implement first?
Correct Answer: B
Rationale: Measuring and documenting the lesion provides objective data for further evaluation, the first step in assessment.
Question 4 of 5
The nurse is teaching a class on how to prevent Lyme disease. Which intervention should be included in the discussion?
Correct Answer: C
Rationale: Avoiding dense undergrowth reduces tick exposure, a primary prevention strategy for Lyme disease.
Question 5 of 5
The nurse has completed the teaching plan for the client diagnosed with psoriasis. Which statement indicates the need for further teaching?
Correct Answer: D
Rationale: Coal-tar products often stain clothing, so this statement shows a misunderstanding requiring further education.