ATI LPN
NCLEX Style Questions on Skin Integrity and Wound Care Questions
Question 1 of 5
What would the nurse dressing a necrotic pressure injury with a minimal exudate most likely use?
Correct Answer: A
Rationale: Hydrocolloid dressings are useful in necrotic wounds with little exudate. Alginate and hydrofiber dressings are used for wounds with copious exudate. Transparent film is not absorbent.
Question 2 of 5
A 75-year-old patient questions the nurse about vaccination to prevent shingles. Which response is most appropriate?
Correct Answer: C
Rationale: The vaccination should be considered by high-risk populations. About 50% of individuals over age 80 years will have the disease. The vaccination has been approved for use. The immunity provided is anticipated to last for 6 years.
Question 3 of 5
A nurse assesses a burn injury and determines that the client sustained a fullthickness fourth-degree burn if which of the following is noted at the site of injury?
Correct Answer: C
Rationale: Fourth-degree burns extend beyond the skin into underlying tissues (muscle, bone), often resulting in charring due to severe destruction.
Question 4 of 5
A nurse is assessing the operative site in a client who underwent a breast reconstruction. The nurse is inspecting the flap and the areola of the nipple and notes that the areola is a deep red color around the edge. The nurse takes which action first?
Correct Answer: D
Rationale: Deep red color may indicate vascular compromise or infection, requiring immediate physician evaluation.
Question 5 of 5
A nurse is performing a skin assessment of a client who is immobile and notes the presence of partial thickness skin loss of the upper layer of the skin in the sacral area. The nurse documents these findings as a:
Correct Answer: B
Rationale: Stage 2 pressure ulcers involve partial-thickness loss of the epidermis and/or dermis, as described.