ATI LPN
NCLEX Skin Integrity Questions Questions
Question 1 of 5
Which intervention should the nurse include when conducting an in-service on caring for elderly clients addressing normal developmental sensory changes?
Correct Answer: A
Rationale: Open curtains increase light, aiding vision in elderly clients with age-related visual decline, such as presbyopia or cataracts.
Question 2 of 5
The nurse is admitting a client to the neurological intensive care unit who is postoperative transsphenoidal hypophysectomy. Which data warrant immediate intervention?
Correct Answer: B
Rationale: High output vs. low intake suggests diabetes insipidus, a common post-hypophysectomy complication requiring immediate fluid replacement.
Question 3 of 5
The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles and the nurse suspects pulmonary edema. Which intervention is the priority?
Correct Answer: A
Rationale: Oxygen is the priority in pulmonary edema to correct hypoxemia. Originally multi-select, restructured to single-answer focusing on the most immediate need.
Question 4 of 5
An external insulin pump is prescribed for a client with diabetes mellitus. When the client asks the nurse about the functioning of the pump, the nurse bases the response on which information about the pump?
Correct Answer: D
Rationale: An insulin pump provides a small continuous dose of short-duration (rapid- or short-acting) insulin subcutaneously throughout the day and night. The client can self-administer an additional bolus dose from the pump before each meal as needed. Short-duration insulin is used in an insulin pump. An external pump is not attached surgically to the pancreas.
Question 5 of 5
A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client?
Correct Answer: C
Rationale: Respiratory distress is the priority post-thyroidectomy due to potential airway obstruction from swelling or hematoma, a life-threatening complication requiring immediate attention.