ATI RN
NCLEX Practice Questions Skin Integrity and Wound Care Questions
Question 1 of 5
Necrosis of respiratory epithelial cells and shedding of serous and ciliated cells of the respiratory tract produce which common symptom of influenza?
Correct Answer: D
Rationale: The shedding of serous and ciliated cells in the respiratory tract leads to rhinorrhea, which is a common symptom of influenza. This process causes an increase in nasal secretions and results in a runny nose. Malaise (A) is a general feeling of discomfort, not directly related to shedding of respiratory cells. Coryza (B) refers to nasal congestion, not shedding of cells. Cough (C) is more commonly associated with irritation of the respiratory tract, not shedding of cells. Therefore, D is the correct answer.
Question 2 of 5
The nurse is caring for a client with pneumonia. Which intervention should the nurse include in this client's plan of care to promote effective airway clearance?
Correct Answer: A
Rationale: The correct answer is A because chest percussion helps loosen and mobilize secretions in the lungs, promoting effective airway clearance in pneumonia. It should be performed regularly to prevent mucus buildup. B: Administering the pneumococcal vaccine is important for preventing pneumonia but does not directly address airway clearance. C: Limiting fluid intake may lead to dehydration and thickening of secretions, worsening airway clearance. D: Smoking cessation education is important for overall lung health but does not directly address airway clearance in pneumonia.
Question 3 of 5
The nurse is providing teaching on preventing sepsis. Which should the nurse include as a major risk factor for the development of this health problem?
Correct Answer: C
Rationale: The correct answer is C: Undiagnosed urinary tract infection. UTI is a major risk factor for sepsis as it can lead to bacterial infection spreading to the bloodstream. This can result in systemic inflammation and organ dysfunction, which are characteristic of sepsis. Pneumococcal bacteria (choice A) and leukocytosis (choice B) are not risk factors but rather potential indicators of infection. Elevated temperature (choice D) may indicate infection, but it is not a specific risk factor for sepsis like an untreated UTI.
Question 4 of 5
The nurse is preparing to assess an older adult client admitted with tuberculosis. Which assessment finding does the nurse anticipate?
Correct Answer: C
Rationale: The correct answer is C: Cough. In tuberculosis, a persistent cough is a common symptom due to infection of the lungs. This is caused by the Mycobacterium tuberculosis bacteria affecting the respiratory system. Night sweats (A) are also common in tuberculosis but are not specific to this condition. Swollen lymph nodes (B) typically occur in other infections such as bacterial or viral illnesses. Hemoptysis (D), which is coughing up blood, is a severe symptom seen in advanced stages of tuberculosis but not an early assessment finding.
Question 5 of 5
The nurse in an urgent care center assesses a 40-year-old adult client who presents with a fever of 101.2°F and complaints of painful urination. What should the nurse ask to elicit further data that indicate cystitis?
Correct Answer: D
Rationale: The correct answer is D: "What color is your urine?" This question is essential to assess for cystitis because changes in urine color (such as cloudy or bloody urine) are common symptoms of this condition. Fever and painful urination are also typical symptoms of cystitis, so asking about urine color helps confirm the diagnosis. Choice A is incorrect because menopause symptoms are not relevant to the client's current presentation. Choice B is less pertinent as the duration of fever and presence of chills, while important, may not directly point to cystitis. Choice C is also less relevant as upper abdominal pain or cramping are not specific symptoms of cystitis.