ATI RN
Skin Integrity and Wound Care Questions Questions
Question 1 of 5
The provider has ordered fluid administration for a pediatric client with pneumonia. The client weighs 81.6 lb (37 kg). The nurse should expect to administer ________ mL of fluid per day for this client.
Correct Answer: A
Rationale: To calculate fluid administration for a pediatric client, use the formula: 100 mL/kg for the first 10 kg, 50 mL/kg for the next 10 kg, and 20 mL/kg for each kg above 20 kg. For a 37 kg client, the calculation is: (10 kg x 100 mL) + (10 kg x 50 mL) + (7 kg x 20 mL) = 1840 mL/day (Answer A). This is the correct answer because it follows the appropriate formula based on the client's weight. Choices B, C, and D are incorrect as they do not follow the correct calculation method for fluid administration based on weight.
Question 2 of 5
The nurse is providing teaching to parents about urinary tract infections (UTIs) in preschool children. The nurse should inform the parents that which of the following are common symptoms of UTI in this age group? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A: Urinary urgency. In preschool children, common symptoms of UTI include urinary urgency due to the irritation of the bladder lining by the infection. Elevated blood pressure is not a common symptom of UTI in this age group. Dysuria, or painful urination, can also be a symptom but is less common in preschool children. Fever is a common symptom of UTI, but it is not specific to this age group as it can occur in various infections. Therefore, the most specific and common symptom of UTI in preschool children is urinary urgency.
Question 3 of 5
The nurse is caring for a client who is admitted to the unit with tuberculosis (TB). Which type of isolation room is most appropriate?
Correct Answer: B
Rationale: The correct answer is B: Isolation room with an anteroom and negative airflow. This is appropriate for TB as it prevents contaminated air from escaping the room, reducing the risk of transmission. Negative airflow ensures air flows into the room, capturing and containing infectious particles. A: Positive airflow would allow contaminated air to escape. C: Normal airflow may not contain infectious particles effectively. D: Normal airflow could lead to potential spread of TB outside the room.
Question 4 of 5
Which integumentary assessment data from an older patient admitted with bacterial pneumonia is of concern to the nurse?
Correct Answer: C
Rationale: The correct answer is C because skin wrinkling with tenting on both hands in an older patient with bacterial pneumonia is concerning for dehydration. Dehydration can exacerbate the pneumonia and lead to complications. Skin turgor is a key indicator of hydration status. Brown macules, allergic rashes, longitudinal nail ridges, and sparse scalp hair are not directly related to dehydration or bacterial pneumonia in this context. Brown macules may be age-related skin changes, allergic rashes indicate hypersensitivity reactions, longitudinal nail ridges can be a normal part of aging, and sparse scalp hair could be due to various factors unrelated to the pneumonia.
Question 5 of 5
Which abnormality on the skin of an older patient is the priority to discuss immediately with the health care provider?
Correct Answer: C
Rationale: The correct answer is C, petechiae on the chest and abdomen. Petechiae are small pinpoint hemorrhages that can indicate a serious underlying medical condition such as thrombocytopenia or a bleeding disorder. It is important to discuss this immediately with the healthcare provider to determine the cause and initiate appropriate treatment. A: Dry, scaly patches on the face are likely related to skin issues and can be addressed during a routine dermatology visit. B: Numerous varicosities on both legs are common in older individuals and usually do not require urgent attention unless causing pain or other complications. D: Small dilated blood vessels on the face are typically cosmetic concerns and not urgent unless they are causing discomfort or affecting vision.