As charge nurse in a long-term-care (LTC) facility, you are developing a care plan for a client with a stage 3 pressure ulcer located over the sacrum. Which nursing intervention is most appropriate to delegate to an LPN who works as a team leader in the facility?

Correct Answer: D

Rationale: The correct answer is D: Inspect and document the appearance of the ulcer daily. Delegating this task to an LPN is appropriate as it involves routine monitoring and documentation of the pressure ulcer, which is within the scope of practice for an LPN. By inspecting and documenting the ulcer daily, the LPN can track any changes in the ulcer's appearance, such as signs of infection or healing progress, and report this information to the charge nurse or healthcare provider. This helps in ensuring proper wound care and timely intervention. Choice A (Choosing the type of dressing) involves making a clinical decision that requires a higher level of assessment and expertise, typically done by an RN or wound care specialist. Choice B (Using the Norton scale for assessment) involves a comprehensive assessment of risk factors, which is more suitable for an RN. Choice C (Assisting the client to change position) involves direct client care and should be done by a nursing assistant under the supervision of an RN or LPN.

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: Infection of the wound. Skin impairment can lead to an open wound, making it susceptible to bacterial invasion and infection. Bacteria can enter the wound, leading to inflammation and potential complications. Purulent leakage (choice A) is a symptom of infection, not a direct consequence of skin impairment. Itching (choice B) is a common symptom of skin irritation but not a direct consequence of skin impairment. Pain (choice D) can be a result of skin impairment but is not as directly linked to the consequences of an infected wound. Ultimately, infection of the wound is the most critical consequence of skin impairment due to the potential for serious complications and delayed healing.

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.