The nurse is caring for a patient who has suffered a stroke and has residual mobility problems. The patient is at risk for skin impairment. Which initial actions should the nurse take to decrease this risk?

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NCLEX Skin Integrity Questions Questions

Question 1 of 5

The nurse is caring for a patient who has suffered a stroke and has residual mobility problems. The patient is at risk for skin impairment. Which initial actions should the nurse take to decrease this risk?

Correct Answer: A

Rationale: Use gentle cleansers, and thoroughly dry the skin' is the initial action. Nonionic surfactants e.g., pH 5.5 prevent breakdown e.g., 50% less risk unlike 'therapeutic bed' , secondary e.g., later cost. 'Absorbent pads' are last-resort e.g., controversial. 'Moisture-holding products' harm e.g., maceration. A nurse cleans e.g., Dry post-wash' per basic care, a physiological priority. The text starts with skin hygiene, making the correct, first step.

Question 2 of 5

Which layer of the skin contains cells that are undergoing mitosis?

Correct Answer: D

Rationale: Stratum basale' has mitotic cells, per ProProfs. The deepest layer e.g., 0.05 mm it renews skin e.g., 10 cells/day unlike 'granulosum' , dying e.g., granules. 'Corneum' is dead e.g., outer 0.02 mm. 'Spinosum' matures e.g., less division. A scientist tracks e.g., Basale birth' per 28-day cycle, a physiological must. The quiz links mitosis to basale, making the correct, dividing layer.

Question 3 of 5

A nurse documents a closed wound on a patient chart. Which of the following is an example of a closed wound?

Correct Answer: B

Rationale: Ecchymosis' is a closed wound. Bruising e.g., 3 cm purple keeps skin intact e.g., blood beneath unlike 'abrasion' , scraped e.g., open. 'Incision' cuts e.g., surgical, open. 'Puncture' pierces e.g., 1 mm deep, open. A nurse charts e.g., Bruise, no break' per 80% closed type, a physiological call. The text defines closed as unbroken, making the correct, intact example.

Question 4 of 5

A nurse assesses an area of pale white skin over a patient's coccyx. After turning the patient on her side, the skin becomes red and feels warm. What should the nurse do about these assessments?

Correct Answer: B

Rationale: Recognize that this is ischemia, followed by reactive hyperemia' fits. Pale e.g., <15 mmHg then red/warm e.g., blood rush is normal e.g., 5 min unlike 'report ulcer' , premature e.g., no break. 'Document ulcer' and 'interventions' overreact e.g., not yet. A nurse observes e.g., Temp flush' per circulation shift, a physiological sign. The text defines this, making the correct, accurate response.

Question 5 of 5

Of the many topics that may be taught to patients or caregivers about home wound care, which one is the most significant in preventing wound infections?

Correct Answer: C

Rationale: Thorough hand hygiene' prevents infections most. Hands e.g., 10 bacteria spread 90% risk unlike 'medications' , treatment e.g., not prevention. 'Food, fluids' heals indirect. 'Sleep' supports e.g., not primary. A nurse teaches e.g., Wash first' per 80% reduction, a physiological must. The text prioritizes hygiene, making the correct, top topic.

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