ATI LPN
Integumentary System Multiple Choice Questions and Answers Questions
Question 1 of 5
The school nurse is completing spinal screenings. Which data require a referral to an HCP?
Correct Answer: D
Rationale: The correct answer is D because having one arm lower than the other while bending over at the waist can indicate potential spinal curvature or scoliosis, requiring further evaluation by a healthcare professional. This asymmetry suggests a possible spinal abnormality that needs medical attention. A, B, and C are incorrect: A: Bilateral arm lengthening while bending over is a normal finding during spinal screenings. B: A deformity that resolves when the head is raised is likely a postural issue and does not necessarily indicate a spinal problem. C: Equal spacing of the arms and body at the waist is a normal finding and not indicative of spinal issues.
Question 2 of 5
Which intervention is appropriate for the nurse to delegate to the unlicensed assistive personnel (UAP) when caring for the female client experiencing acute pain?
Correct Answer: B
Rationale: The correct answer is B. Applying an ice pack is a non-invasive intervention that can help alleviate acute pain. It does not require specialized medical knowledge and can be safely delegated to the UAP. Here's the rationale: 1) Ice pack application is a basic skill that falls within the scope of practice for UAPs. 2) Ice packs can help reduce inflammation and numb the area, providing pain relief. 3) It is a simple and low-risk intervention that does not require clinical judgment. Choices A, C, and D involve handling medications and assessing pain management, which are beyond the UAP's scope of practice and require nursing expertise.
Question 3 of 5
The client diagnosed with chronic otitis media is scheduled for a mastoidectomy. Which discharge teaching should the nurse discuss with the client?
Correct Answer: D
Rationale: The correct answer is D: Do not allow water to enter the ear for six (6) weeks. This instruction is essential post-mastoidectomy to prevent infection and promote healing. Water exposure can introduce bacteria, leading to complications. Option A is incorrect as the Valsalva maneuver should be avoided to prevent pressure changes in the ear. Option B is incorrect as hearing can improve after mastoidectomy. Option C is incorrect as ophthalmic drops are not indicated for ear care.
Question 4 of 5
The elderly client is complaining of abdominal discomfort. Which scientific rationale should the nurse remember when addressing an elderly client's perception of pain?
Correct Answer: C
Rationale: The correct answer is C because as people age, their reaction to painful stimuli may decrease due to changes in the nervous system. This is important for nurses to consider when assessing and managing pain in elderly clients. Choice A is incorrect as elderly clients may have different pain perceptions compared to other age groups. Choice B is incorrect as not all elderly clients require more pain medication. Choice D is incorrect as the Wong scale is not specifically recommended for elderly clients.
Question 5 of 5
The nurse is admitting a client diagnosed with primary adrenal cortex insufficiency (Addison's disease). Which clinical manifestations should the nurse expect to assess?
Correct Answer: C
Rationale: The correct answer is C: Bronze pigmentation, hypotension, and anorexia. Primary adrenal cortex insufficiency (Addison's disease) is characterized by decreased production of cortisol and aldosterone. Bronze pigmentation is due to increased melanocyte-stimulating hormone. Hypotension is a result of aldosterone deficiency leading to sodium and water loss. Anorexia can occur due to decreased cortisol levels affecting glucose metabolism. A: Moon face, buffalo hump, and hyperglycemia are manifestations of Cushing's syndrome, which is excessive cortisol production. B: Hirsutism, fever, and irritability are not typical manifestations of Addison's disease. D: Tachycardia, bulging eyes, and goiter are signs of hyperthyroidism, not adrenal insufficiency.