ATI LPN
Skin Integrity NCLEX Questions Questions
Question 1 of 5
Most of the deaths from burn trauma in the emergent phase that require a referral to a burn center result from:
Correct Answer: C
Rationale: Hypovolemic shock is frequently lethal in the emergent period of a severe burn because of the transfer of fluids into the interstitial tissue from the circulating volume.
Question 2 of 5
While bathing a patient, the nurse assesses a red, unblanchable area on the coccyx. Which type of dressing should the nurse apply?
Correct Answer: A
Rationale: A transparent film for a stage I pressure ulcer will protect it from shearing injury and will retain moisture. A hydrocolloid dressing would be appropriate for a larger, more advanced pressure ulcer. There is no discharge in a stage I pressure ulcer, making absorbent and wet-to-dry dressing options inappropriate.
Question 3 of 5
The nurse describes several types of burn treatment. Which statement best describes an escharotomy?
Correct Answer: A
Rationale: An escharotomy is an incision to relieve pressure and improve circulation in constricted burn areas.
Question 4 of 5
A nurse is reviewing the nursing care plan for a client for whom a stage 4 decubiti ulcer has been documented. Which of the following would the nurse expect to note on assessment of the client?
Correct Answer: D
Rationale: Stage 4 pressure ulcers involve full-thickness tissue loss extending into muscle, bone, or supporting structures.
Question 5 of 5
The client with acquired immunodeficiency syndrome (AIDS) is suspected of having cutaneous Kaposi's sarcoma. The nurse prepares the client for which test that will confirm the presence of this type of sarcoma?
Correct Answer: C
Rationale: A punch biopsy of the lesion confirms Kaposi's sarcoma by histologically identifying spindle cells and vascular structures.