ATI RN
NCLEX Questions on Skin Integrity and Wound Care Questions
Question 1 of 5
Which medication information will the nurse identify as a potential risk to a patient’s musculoskeletal system?
Correct Answer: C
Rationale: The correct answer is C because oral corticosteroids, used to treat severe asthma, can lead to musculoskeletal issues like osteoporosis and muscle weakness. Corticosteroids can decrease bone density and increase the risk of fractures. A: Taking multivitamins and calcium supplements promotes bone health. B: Hormone replacement therapy does not directly impact the musculoskeletal system. D: NSAIDs are not typically associated with musculoskeletal risks unless used in high doses for prolonged periods.
Question 2 of 5
A patient has a long-arm plaster cast applied for fracture immobilization. Until the cast has completely dried, the nurse should
Correct Answer: B
Rationale: The correct answer is B: avoid handling the cast using fingertips. This is because handling the cast while it is still wet can deform or break it, leading to improper immobilization. It is crucial to allow the cast to dry completely to ensure proper support and healing of the fracture. Keeping the arm in a dependent position (choice A) is not necessary for the drying process. Placing gauze around the cast edge (choice C) may interfere with the drying process and cause uneven drying. Covering the cast with a blanket (choice D) may trap moisture and prolong the drying time, leading to potential complications.
Question 3 of 5
After the health care provider recommends amputation for a patient who has nonhealing ischemic foot ulcers, the patient tells the nurse that he would rather die than have an amputation. Which response by the nurse is best?
Correct Answer: C
Rationale: The correct answer is C because it demonstrates active listening and allows the nurse to assess the patient's understanding and concerns about the treatment options. By asking the patient to share what they know, the nurse can address any misconceptions, provide additional information, and involve the patient in decision-making. Choice A is incorrect because it dismisses the patient's feelings and does not address the patient's concerns. Choice B is incorrect because it assumes the patient will be open to using a foot prosthesis without exploring the patient's preferences further. Choice D is incorrect because it does not address the patient's need for information and support in making an informed decision about their treatment options.
Question 4 of 5
After being hospitalized for 3 days with a right femur fracture, a patient suddenly develops shortness of breath and tachypnea. The patient tells the nurse, 'I feel like I am going to die!' Which action should the nurse take first?
Correct Answer: B
Rationale: The correct action for the nurse to take first is to administer prescribed PRN O2 at 4 L/min (Choice B). This is the correct choice because the patient is showing signs of respiratory distress, which could indicate a pulmonary embolism, a potentially life-threatening complication following a femur fracture. Administering oxygen can help improve oxygenation and stabilize the patient's condition. It is essential to address the immediate physiological need for oxygen before taking further action. Staying with the patient and offering reassurance (Choice A) may be important but addressing the respiratory distress is the priority. Checking the patient's legs for swelling or tenderness (Choice C) may help in assessing for a potential deep vein thrombosis, but it is not the most urgent action in this scenario. Notifying the health care provider (Choice D) can be done after stabilizing the patient's condition with oxygen.
Question 5 of 5
A patient is admitted to the emergency department with a left femur fracture. Which information obtained by the nurse is most important to report to the health care provider?
Correct Answer: C
Rationale: The correct answer is C: Slow capillary refill of the left foot. This is the most important information to report because it indicates potential compromised blood flow to the affected limb, which can lead to serious complications like ischemia and tissue damage. The priority in managing a femur fracture is to ensure adequate blood supply to prevent further damage. Choice A (Ecchymosis) is important but not as urgent as compromised circulation. Choice B (Severe pain) is expected with a femur fracture and can be managed with pain medication. Choice D (Outward pointing toes) is a concerning sign but does not directly indicate compromised circulation like slow capillary refill does.