ATI RN
NCLEX Skin Integrity Questions Questions
Question 1 of 5
The healthcare provider prescribes an indwelling urinary catheter for a client with urinary retention. Which intervention, along with strict aseptic technique, will decrease the risk of infection for this procedure?
Correct Answer: C
Rationale: Correct Answer: C - Using an anesthetic lubricating gel during insertion Rationale: Using an anesthetic lubricating gel during catheter insertion helps to reduce discomfort and trauma to the urethral mucosa, decreasing the risk of infection. This gel also helps to facilitate a smoother insertion process, reducing the chances of introducing pathogens into the urethra. Strict aseptic technique is important to prevent infection but using the lubricating gel specifically addresses the risk of trauma and discomfort during catheterization. Incorrect Choices: A: Irrigating the catheter with sterile saline on a daily basis - While irrigation with sterile saline is important for maintaining catheter patency, it does not directly decrease the risk of infection during catheter insertion. B: Instructing the client to void around the catheter - This does not address the risk of infection during catheter insertion; it is important for proper catheter care post-insertion. D: Inflating the balloon while the catheter is in
Question 2 of 5
When examining an older patient in the home, the home health nurse notices irregular patterns of bruising at different stages of healing on the patient’s body. Which action should the nurse take first?
Correct Answer: C
Rationale: Step 1: Talking with the patient alone allows for open communication and assessment of the situation. Step 2: Asking about the bruising can provide insight into the cause, such as potential abuse or neglect. Step 3: It is essential to gather information directly from the patient to ensure their safety and well-being. Step 4: This action prioritizes the patient's autonomy and right to disclose information. It also demonstrates a patient-centered approach. Summary: Option C is correct because it focuses on communication and assessment to address potential safety concerns. Options A and B address fall prevention, which is not the immediate concern. Option D jumps to radiographs without understanding the situation.
Question 3 of 5
Which information should the nurse include when teaching patients about decreasing the risk for sun damage to the skin?
Correct Answer: B
Rationale: The correct answer is B: Try to stay out of the direct sun between the hours of 10 AM and 2 PM. This is correct because UV radiation is strongest during these hours, so avoiding direct sun exposure at this time can significantly reduce the risk of sun damage. Choice A is incorrect because an SPF of at least 30 is recommended for adequate protection. Choice C is incorrect because water-resistant sunscreens may provide some protection but should be reapplied after swimming. Choice D is incorrect as increasing sun exposure can lead to skin damage rather than decrease the risk.
Question 4 of 5
A patient with atopic dermatitis has been using a high-potency topical corticosteroid ointment for several weeks. The nurse should assess for which adverse effect?
Correct Answer: A
Rationale: The correct answer is A: Thinning of the affected skin. High-potency topical corticosteroids can lead to skin atrophy, causing thinning of the skin with prolonged use. This adverse effect is important to assess for as it can increase the risk of skin fragility and potential for skin tears or bruising. Choice B: Alopecia of the affected areas is not typically associated with the use of topical corticosteroids, so it is an incorrect choice. Choice C: Dryness and scaling are common symptoms of atopic dermatitis itself, not directly caused by the corticosteroid ointment, making this choice incorrect. Choice D: Reddish-brown skin discoloration is not a common adverse effect of topical corticosteroids and is not typically seen with their use, making this choice incorrect.
Question 5 of 5
The nurse instructs a patient about application of corticosteroid cream to an area of contact dermatitis on the right leg. Which patient action indicates that further teaching is needed?
Correct Answer: C
Rationale: The correct answer is C because applying a thick layer of corticosteroid cream can lead to overuse and potential side effects such as skin thinning. The appropriate amount of cream should be applied thinly and evenly to the affected area. Choice A is correct as taking a tepid bath can help cleanse the area before application. Choice B is correct as spreading the cream in a downward motion can prevent further irritation. Choice D is incorrect as covering the area with a dressing is not recommended for corticosteroid cream application, as it can lead to increased absorption and potential side effects.