ATI LPN
NCLEX Skin Integrity Questions Questions
Question 1 of 5
Which intervention should the nurse implement for a client diagnosed with a full-thickness burn over 38% of the body admitted to the burn unit 4 hours after the fire, with an HCP order for Ringer's lactate 450 mL/hour?
Correct Answer: B
Rationale: The nurse should administer the IV fluid as prescribed and infuse it via a pump to ensure accurate delivery. Fluid resuscitation formulas specify large volumes (50% in the first 8 hours, 50% over the next 16 hours) for burns over 20% TBSA, making 450 mL/hour appropriate. Questioning the order or limiting to 200 mL/hour is incorrect, and verification with another nurse is unnecessary.
Question 2 of 5
The client has been applying a topical hydrocortisone cream to dry, rough skin for more than 2 years. Which data should the nurse assess in the client?
Correct Answer: C
Rationale: Prolonged topical steroid use causes skin atrophy (thinning, striae, purpura). Systemic effects like adrenal insufficiency or Cushing's features (buffalo hump, moon face) are unlikely, and glucose isn't directly affected.
Question 3 of 5
Which type of capillary hemangioma is described by the following: these are found on the trunk of middle-aged and elderly subjects. They are bright red aggregates of dilated capillaries, which can be emptied by pressing on them with the tip of a pencil. They are of no significance
Correct Answer: C
Rationale: Campbell de Morgan spots are insignificant vascular lesions found on the trunk.
Question 4 of 5
There is no cure for eczema so treatment aims to:
Correct Answer: B
Rationale: The main goal of eczema treatment is to control or ease symptoms since there is no cure.
Question 5 of 5
The nurse is caring for four clients on a medical-surgical unit. Which client should the nurse see initially?
Correct Answer: A
Rationale: The nurse must decide which client should be seen on the initial rounds of the day. The nurse must remember that the first client to be seen should be the client who needs the attention of the nurse initially. A client with hepatitis A does experience diarrhea, but diarrhea for the last 24 hours could cause the client to have a problem with dehydration and experience a state of fluid volume deficit.