The clinic health care worker notices that a client has a fungal infection on her nails that looks like the fungus is digesting the nail keratin. The nail appears opaque and white in color. The client states she has had this for years. The health care worker suspects the client has:

Correct Answer: C

Rationale: The correct answer is C: Onychomycosis. This is a fungal infection of the nail caused by dermatophytes, yeasts, or molds. In this case, the description of the nail appearing opaque and white, with the fungus appearing to digest the keratin, is consistent with onychomycosis. The fact that the client has had this for years also aligns with the chronic nature of onychomycosis. Explanation for why other choices are incorrect: A: Candidiasis is a fungal infection caused by Candida species, typically affecting mucous membranes or skin folds, not nails. B: Cellulitis is a bacterial infection involving the deeper layers of the skin, not related to fungal nail infections. D: Tinea corporis is a fungal infection of the skin, commonly known as ringworm, not specific to nails.

Correct Answer: A

Rationale: The correct answer is A because malignant melanoma is indeed a very rapid growing and aggressive cancer. This information is crucial for the client to understand the seriousness of the diagnosis and the need for prompt and aggressive treatment. Explanation of why other choices are incorrect: B: This cancer usually extends wide and deep but rarely metastasize - This statement is incorrect because malignant melanoma is known to have a high potential for metastasis. C: This cancer is mainly contained to the head and neck area - This statement is incorrect because melanoma can occur on any part of the body, not just limited to the head and neck. D: Your cancer has grown into the deep tissues and quite likely into lymph nodes (stage 3B) - While this choice provides some accurate information about the staging of the cancer, it does not fully address the client's question about the nature of malignant melanoma.

Correct Answer: D

Rationale: Skin tear risk spikes with age and fragility, making 'a 72-year-old female taking a steroid for rheumatoid arthritis' most vulnerable. Steroids thin skin e.g., 20% dermal loss in 6 months per Baranoski and Ayello (2004), and her age adds rete ridge flattening e.g., 70% tear rate. , '22-year-old post-hernia,' has resilient skin e.g., 1 mm thick, tears <5% despite surgery. , '37-year-old with fracture,' risks bruising e.g., not tears skin still elastic. , '64-year-old post-cataract,' is older e.g., 30% risk but mobile, no steroids. The 72-year-old's immobility e.g., RA stiffness plus prednisone (e.g., 10 mg daily) doubles tear odds, a nurse's red flag for padding. Unlike younger, thicker skin or less medicated elders, her profile per *Wound Care Essentials* peaks risk, making the correct, highest-risk patient.

Correct Answer: D

Rationale: For a dirty puncture wound, '10 years' since last tetanus toxoid triggers a booster, per Potter's *Essentials*. CDC guidelines mandate e.g., after 10 years, immunity wanes (e.g., 50% antibody drop) unlike '1 year' , too soon e.g., still protective. '3 years' and '5 years' apply to cleaner wounds e.g., not this risk. A nurse asks e.g., Last shot 2012?' if over 10 (e.g., 2025 now), injects, reducing tetanus odds (e.g., 1/1000 to near zero). Potter stresses this for dirty trauma, a health promotion must. is the correct, evidence-based cutoff.

Correct Answer: D

Rationale: To culture a wound, 'gently swab the center after irrigating with sterile saline' is correct, per Potter's *Essentials*. Irrigation e.g., 10 mL saline cleans debris, ensuring accurate swab e.g., 90% pathogen catch unlike 'drainage bag' , contaminated e.g., old fluid. 'Edge' misses e.g., surface bacteria, not core. 'Dressing' taints e.g., external bugs. A nurse swabs e.g., Clean center' per infection control (e.g., CLSI standards), a safety must. Potter stresses sterile technique, making the correct, precise method.