ATI RN
NCLEX Questions Skin Integrity and Wound Care Questions
Question 1 of 5
The nurse is caring for a client who is being discharged following abdominal surgery with an incision. Which instruction is most important for the nurse to teach this client regarding wound healing?
Correct Answer: D
Rationale: The correct answer is D because it emphasizes the importance of monitoring for signs of infection, such as swelling, warmth, or tenderness, which are crucial in detecting complications early. This instruction ensures prompt medical intervention if needed, promoting proper wound healing. A: Thoroughly irrigating the wound with hydrogen peroxide once a day can be too harsh and may delay healing by damaging healthy tissue. B: Applying a lubricating lotion to the edges of the wound may not address infection risk or proper wound care. C: Adding more fruits and vegetables to the diet is beneficial for overall health but not directly related to wound healing or preventing complications.
Question 2 of 5
On which region of the body would the nurse most expect to observe erysipelas?
Correct Answer: B
Rationale: The correct answer is B: Ankles. Erysipelas is a bacterial skin infection typically caused by Streptococcus bacteria. The lower extremities, especially the ankles, are common sites for erysipelas due to factors like compromised circulation and skin trauma increasing susceptibility. Erysipelas presents with well-defined, raised, and erythematous patches on the skin, commonly seen on the lower legs and ankles. The infection usually affects the superficial layers of the skin and subcutaneous tissues, leading to characteristic symptoms such as warmth, pain, and swelling in the affected area. Choices A, C, and D are incorrect as erysipelas typically occurs on the lower extremities rather than the abdomen, neck, or back.
Question 3 of 5
The nurse is assessing a client who presents with purulent drainage and crusting of the eye. The nurse should recognize that these findings are most consistent with which type of infection?
Correct Answer: C
Rationale: The correct answer is C: Bacterial conjunctivitis. Purulent drainage and crusting of the eye are indicative of a bacterial infection. Bacterial conjunctivitis typically presents with these symptoms due to the bacterial presence causing inflammation and discharge. Viral conjunctivitis (A) may have watery discharge, while allergic conjunctivitis (B) is characterized by itching and clear discharge. Fungal conjunctivitis (D) is rare and usually presents with a slow onset and may involve a white patch on the eye.
Question 4 of 5
Which oral antiviral drug that is commonly prescribed for influenza A and B works by preventing the release of newly formed virus?
Correct Answer: C
Rationale: The correct answer is C: Oseltamivir (Tamiflu). Oseltamivir is a neuraminidase inhibitor, which works by preventing the release of newly formed virus particles from infected cells. This stops the spread of the virus in the body. Rimantadine and Amantadine (choices A and D) are M2 ion channel blockers that prevent the virus from entering the host cell. Zanamivir (choice B) is also a neuraminidase inhibitor like Oseltamivir, but it is administered via inhalation instead of orally. Therefore, the correct choice is Oseltamivir as it targets the release of newly formed virus particles, distinguishing it from the other options.
Question 5 of 5
A toddler with otitis media is prescribed amoxicillin clavulanate 250 mg/5 mL three times daily by mouth for 10 days. What should the nurse teach the mother about this medication?
Correct Answer: B
Rationale: The correct answer is B: Give the antibiotic for the full 10 days as prescribed. The rationale is as follows: 1. Amoxicillin clavulanate is used to treat otitis media, and completing the full course is crucial to ensure the infection is completely eradicated. 2. Stopping the antibiotic prematurely can lead to antibiotic resistance and treatment failure. 3. Using a household teaspoon (Choice C) is inaccurate and can result in incorrect dosing. 4. Administering a loading dose (Choice D) is not necessary for this medication.