ATI LPN
Integumentary System Test Questions Questions
Question 1 of 5
Which of the following manifestations would the nurse expect to see with a client who has had previous knee surgery who suffered a surgical infection with signs of systemic manifestations?
Correct Answer: A
Rationale: The client is post-surgical repair of the knee. The nurse should be able to distinguish between local reactions and systemic reactions. An elevated WBC and 10 % bands are indicative of an infection. Vital sign changes typically associated with an infection include an elevation in temperature and tachycardia. Local manifestations include erythema, warmth, pain, edema, and functional impairment, whereas systemic manifestations include elevated temperature above 100.4°F, pulse greater than 90min, respiratory rate greater than 20, and WBC greater than 12,000 mm³ or 10 % bands.
Question 2 of 5
When assessing a 75-year-old client, which findings would require immediate action by the nurse? A statement about:
Correct Answer: D
Rationale: Frequent falls indicate significant vision changes (e.g., macular degeneration or depth perception issues) requiring immediate action to prevent injury and preserve vision.
Question 3 of 5
The client who has been experiencing the clinical manifestations associated with menopause voices an interest in using alternative and complementary therapies to manage them. What initial response by the nurse is indicated?
Correct Answer: C
Rationale: The nurse should collect data on the client's interests in alternative therapies, which many women use successfully, to tailor education appropriately.
Question 4 of 5
After teaching a client who expressed concern about a rash located beneath her breast, a nurse assesses the client's understanding. Which statement indicates the client has a good understanding of this condition?
Correct Answer: C
Rationale: Rashes limited to skinfold areas (e.g., on the axillae, beneath the breasts, in the groin) may reflect problems related to excessive moisture. The client needs to keep the area dry; one option is to use powder. Good hygiene is important, but the rash does not need an antibacterial soap. Fluid overload and breast cancer are not related to rashes in skinfolds.
Question 5 of 5
A nurse assesses an older client who is scratching and rubbing white ridges on the skin between the fingers and on the wrists. Which action should the nurse take?
Correct Answer: A
Rationale: The client's presentation is most likely scabies, a contagious mite infestation, requiring isolation in a single room.