The nurse is applying mafenide acetate (Sulfamylon), a sulfa antibiotic cream, to a client's lower extremity burn. Which assessment data would require immediate attention by the nurse?

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Skin Integrity NCLEX Questions Questions

Question 1 of 5

The nurse is applying mafenide acetate (Sulfamylon), a sulfa antibiotic cream, to a client's lower extremity burn. Which assessment data would require immediate attention by the nurse?

Correct Answer: C

Rationale: The ABG values indicate metabolic acidosis (low HCO3), a known side effect of mafenide acetate, requiring immediate attention to prevent further complications.

Question 2 of 5

The nurse is teaching a class on how to prevent Lyme disease. Which intervention should be included in the discussion?

Correct Answer: C

Rationale: Avoiding dense undergrowth reduces tick exposure, a primary prevention strategy for Lyme disease.

Question 3 of 5

The nurse has completed the teaching plan for the client diagnosed with psoriasis. Which statement indicates the need for further teaching?

Correct Answer: D

Rationale: Coal-tar products often stain clothing, so this statement shows a misunderstanding requiring further education.

Question 4 of 5

The ED nurse is caring for a client admitted with extensive, deep partial-thickness and full-thickness burns. Which intervention should the nurse implement first?

Correct Answer: D

Rationale: Airway status is the first priority in burn care due to the risk of inhalation injury.

Question 5 of 5

A client comes into contact with poison ivy. What is the recommended immediate treatment?

Correct Answer: B

Rationale: Showering helps remove the sap, decreasing the likelihood of irritation.

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