ATI LPN
NCLEX Practice Questions Skin Integrity and Wound Care Questions
Question 1 of 5
The nurse is completing an assessment of the patient's skin's integrity. Which assessment is the priority?
Correct Answer: A
Rationale: Pressure points , per the flashcards, are priority, as bony prominences are ulcer-prone. Breath , bowel , and pulse sounds inform overall status, not skin. Nurses inspect these first, making this the correct priority.
Question 2 of 5
The nurse is caring for a patient who is immobile and is at risk for skin impairment. The plan of care includes turning the patient. Which is the best method for repositioning the patient?
Correct Answer: B
Rationale: Lifting with a transfer device , per the flashcards, avoids shear and friction, protecting skin during repositioning. Supine 30-degree isn't ideal lateral is better. Elevating 45 degrees increases shear. Sliding damages skin. This method ensures safety, making it the correct choice.
Question 3 of 5
The patient has a risk for skin impairment and has a 15 on the Braden Scale upon admission. The nurse has implemented interventions. Upon reassessment, which Braden score will be the best sign that the risk for skin breakdown is removed?
Correct Answer: D
Rationale: A Braden score of 23 , per the flashcards, is perfect, indicating no risk across all subscales. From 15 (moderate risk), 12 and 13 are worse. 20 is improved but not optimal. This score confirms success, making it the correct sign.
Question 4 of 5
The nurse is discussing the importance of regular exercise with a client diagnosed with hypertension. The client responds, 'I just don't have the time for exercise.' The nurse determines that the client has which time orientation?
Correct Answer: B
Rationale: Time orientation affects health behavior. A present time orientation , per cultural frameworks, prioritizes now over future benefits (e.g., exercise for hypertension), as the client focuses on immediate constraints. Past orientation clings to tradition. Future orientation plans ahead. Lack of orientation isn't a standard term. Nurses adjust education to this mindset, making it the correct orientation.
Question 5 of 5
A nurse is caring for a client from a different cultural background who is experiencing chronic pain. The nurse asks the client, 'Mr. Smith, I would like to understand how you generally manage pain or if you have any preferences for pain management. Could you please share with me any cultural practices or approaches that you or your family find helpful in managing pain?' The nurse's approach is most closely aligned with which of the following models?
Correct Answer: B
Rationale: Leininger's theory focuses on culturally congruent care, exploring practices like pain management preferences, as in this question. Giger and Davidhizar assesses six phenomena (e.g., communication), less specific here. Purnell is broader. Peplau is relational, not cultural. This aligns with Leininger's emphasis, making it the correct model.