As charge nurse, you are observing a newly hired RN. Which action by the new RN requires your most immediate action?

Correct Answer: B

Rationale: In this scenario, the most immediate action required is option B) Administration of tetracycline with a glass of milk to a client with cellulitis. The rationale behind this choice is that tetracycline should not be administered with dairy products like milk, as calcium in milk can interfere with the absorption of tetracycline, reducing its effectiveness. Option A is incorrect because obtaining an anaerobic culture of a superficial partial-thickness arm burn is a standard procedure for assessing infection, but it does not pose an immediate risk to the client. Option C is incorrect because debriding a deep partial-thickness burn wound using wet-to-dry dressings is a common practice in wound care, although there may be more optimal methods available. Option D is incorrect as teaching a newly admitted burn client about the use of pressure garments is an important aspect of burn care but does not pose an immediate risk to the client's health. In an educational context, this question highlights the importance of medication administration knowledge, understanding drug-food interactions, and the significance of timely interventions in nursing practice to ensure patient safety and optimal outcomes. Nurses need to be vigilant in their medication administration practices to prevent adverse reactions and ensure the effectiveness of treatment.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Encourage the client to join a psoriasis support group. This option is the most appropriate because it focuses on addressing the client's emotional distress and provides a sense of community and understanding. Psoriasis is a chronic condition without a known cure, so emotional support and coping strategies are essential for individuals living with it. By joining a support group, the client can connect with others facing similar challenges, share experiences, and learn effective ways to manage the condition. Option B) Recommend dermabrasion is incorrect because dermabrasion is a cosmetic procedure that involves removing the top layer of skin and is not a suitable treatment for psoriasis. Option C) Apply anthralin is incorrect because anthralin is a topical medication used to treat psoriasis symptoms, such as slowing down skin cell growth and reducing inflammation, but it does not address the client's emotional distress or help them accept their condition. Option D) Recommend a skin graft is incorrect as it is a surgical procedure used for specific cases like severe burns or injuries, not for treating psoriasis. In an educational context, it is crucial for healthcare providers to not only focus on the physical aspects of a condition but also address the emotional and psychological impact on patients. Encouraging patients to seek support from others who understand their situation can significantly improve their quality of life and ability to cope with chronic conditions like psoriasis. It is important for nurses to be empathetic, supportive, and provide holistic care to meet the needs of the whole patient.

Correct Answer: C

Rationale: In the context of extensive burns, grafting of skin is the most effective intervention in minimizing the risk of morbidity and mortality after fluid resuscitation. Skin grafting helps to cover and protect the wounded area, promote healing, prevent infection, and reduce fluid loss. This intervention plays a crucial role in restoring the skin's barrier function and aiding in the overall recovery process for burn patients. Providing the client with antibiotics (Option A) may be necessary if there is an infection present but it is not the primary intervention to minimize risk post-fluid resuscitation. Addressing the client's depression (Option B) is important for holistic care but is not directly related to minimizing risks post-fluid resuscitation for burns. Monitoring electrolyte balance (Option D) is important in burn patients but skin grafting takes precedence in minimizing morbidity and mortality. In an educational context, understanding the priority interventions in burn care is crucial for healthcare providers. Skin grafting is a fundamental aspect of burn treatment and is essential for improving outcomes in patients with extensive burns. Educating healthcare professionals on the significance of timely and appropriate interventions post-fluid resuscitation can lead to better patient outcomes and quality of care in burn management.

Correct Answer: A

Rationale: The correct answer to the question is A) Actinic keratosis. Actinic keratosis presents with keratotic and firm lesions on the skin, often found in sun-exposed areas. It is considered a precursor lesion to squamous cell carcinoma, a type of skin cancer. Topical fluorouracil (5-FU) is a common treatment for actinic keratosis as it works to selectively target and destroy abnormal skin cells. Option B) Basal cell carcinoma is a type of skin cancer that presents differently from actinic keratosis. It typically appears as a pearly or waxy bump on the skin and rarely progresses to squamous cell carcinoma. Option C) Malignant melanoma is a different type of skin cancer that arises from melanocytes. It is characterized by the development of atypical moles or pigmented lesions on the skin, unlike the keratotic lesions seen in actinic keratosis. Option D) Squamous cell carcinoma is a type of skin cancer that may develop from actinic keratosis but is not the correct answer to the question. It typically presents as a red, scaly patch or a firm, rapidly growing nodule on the skin. Understanding skin conditions and their characteristics is crucial for healthcare professionals, especially dermatologists and primary care providers. Recognizing the features of different skin conditions helps in accurate diagnosis, appropriate treatment selection, and patient education on preventive measures. This question reinforces the importance of differentiating between various skin lesions and understanding their implications for patient care.

Correct Answer: B

Rationale: The correct answer is B) Lentigo. In immunosuppressed patients, skin conditions that are more common are those caused by opportunistic infections or viral reactivations due to the compromised immune system. Lentigo, a benign pigmented lesion, is not directly related to immune suppression. A) Malignancies such as Kaposi sarcoma are common in immunosuppressed patients, particularly those with HIV/AIDS or post-organ transplant due to the weakened immune response allowing for the proliferation of cancerous cells. C) Candidiasis, a fungal infection caused by Candida species, is more prevalent in immunosuppressed individuals as the weakened immune system cannot effectively combat the overgrowth of this fungus on the skin. D) Herpes zoster, caused by the reactivation of the varicella-zoster virus, is also more common in immunosuppressed patients due to their compromised immune function, which allows the virus to reactivate and cause the characteristic painful rash. Understanding the skin conditions that are more common in immunosuppressed patients is crucial for healthcare providers to recognize and effectively manage these conditions in this vulnerable population. This knowledge helps in timely diagnosis, appropriate treatment, and overall better care for patients with compromised immune systems.