ATI RN
Skin Integrity and Wound Care NCLEX Questions Quizlet Questions
Question 1 of 5
Which finding supports the nurse's evaluation that an older adult client with sepsis has maintained a normal mental status?
Correct Answer: C
Rationale: The correct answer is C because a client responding appropriately to questions indicates a normal mental status. This response demonstrates intact cognitive function and ability to understand and communicate effectively. Choice A, agitation, suggests altered mental status. Choice B, a Glasgow coma score of 4, indicates severe impairment. Choice D, fixed and dilated pupils, can be a sign of neurological dysfunction, not necessarily a reflection of mental status. Therefore, choice C is the best indicator of maintaining a normal mental status in an older adult with sepsis.
Question 2 of 5
An occupational health nurse is screening a new employee in a long-term care facility for tuberculosis (TB). The employee questions why purified protein derivative (PPD) testing is done twice. Which is the most appropriate response by the nurse?
Correct Answer: D
Rationale: The correct answer is D because there is an increased risk of false-negative responses in individuals who work in long-term care facilities due to frequent exposure to TB. Conducting two PPD tests allows for a more accurate screening as the initial exposure may not trigger an immediate immune response detectable by the first test. By performing the second test, any delayed immune response can be captured, reducing the likelihood of missing an active TB infection. Option A is incorrect because the same PPD is used for both tests. Option B is incorrect as the rationale for repeating the PPD is not solely to verify the accuracy of the first test but to account for potential delayed immune responses. Option C is incorrect as the time frame for interpreting the PPD is standard and not the reason for performing two tests.
Question 3 of 5
The nurse for a urology clinic is planning an in-service about urinary infections for a group of novice nurses. Which statement should the nurse include in the presentation?
Correct Answer: C
Rationale: The correct answer is C because women typically require a shorter course of antibiotic therapy to manage urinary tract infections (UTIs) compared to men due to differences in anatomy and physiology. Women have a shorter urethra, making it easier for bacteria to travel up to the bladder, leading to a higher incidence of UTIs. Men are less likely to experience descending UTIs compared to women. Straight catheterization is not the only way to evaluate for UTIs as other methods like urinalysis and urine culture can also be used. The rate of UTIs is higher in women than men, so the statement that the rate of UTIs is similar between men and women (choice D) is incorrect.
Question 4 of 5
During assessment of the patient’s skin, the nurse observes a similar pattern of discrete, small, raised lesions on the left and right upper back areas. Which term should the nurse use to document the distribution of these lesions?
Correct Answer: B
Rationale: The correct term to document the distribution of lesions on the left and right upper back areas is "Symmetric" (Choice B). This term indicates that the lesions are evenly distributed on both sides of the body, mirroring each other in a balanced pattern. "Confluent" (Choice A) refers to lesions merging together, "Zosteriform" (Choice C) relates to lesions following a dermatomal pattern, and "Generalized" (Choice D) indicates widespread distribution across the body. In this case, the lesions appearing on both sides of the upper back in a similar pattern suggest symmetry, making "Symmetric" the most appropriate term.
Question 5 of 5
The health care provider diagnoses impetigo in a patient who has crusty vesicopustular lesions on the lower face. Which instructions should the nurse include in the teaching plan?
Correct Answer: A
Rationale: The correct answer is A: Clean the infected areas with soap and water. This is because impetigo is a bacterial skin infection that requires good hygiene to prevent spreading. Cleaning the infected areas with soap and water helps to remove bacteria and crusty discharge. Choice B is incorrect because alcohol-based cleansers can be too harsh and irritating to the skin, further aggravating the lesions. Choice C is also incorrect as antibiotic ointments are commonly used to treat impetigo by killing the bacteria causing the infection. Choice D is incorrect because using petroleum jelly may trap bacteria and moisture, worsening the infection. It is important to keep the affected areas clean and dry to promote healing.