You have prepared a care plan for an elderly client living in an LTC facility who has candidiasis in the skin folds of the abdomen and groin. Which intervention is best for you, as the nurse manager, to delegate to an LPN working in the facility?

Correct Answer: A

Rationale: In this scenario, the best intervention to delegate to an LPN for an elderly client with candidiasis in skin folds is option A, which is to apply nystatin (Mycostatin) powder to the area 3 times daily. This is the correct answer because nystatin is an antifungal medication specifically used to treat candidiasis, effectively targeting the root cause of the infection. Option B, cleaning skin folds every 8 hours with mild soap and drying thoroughly, is important for maintaining hygiene but does not directly address the fungal infection. Option C, evaluating the need for further antifungal treatment weekly, involves making clinical judgments that require a higher level of expertise than an LPN possesses. Option D, assessing for ongoing risk factors for skin breakdown and infection, is important but does not provide a direct treatment for the current candidiasis infection. It's crucial to educate healthcare professionals on appropriate delegation based on their scope of practice and competency levels. LPNs have the skills to apply topical medications like nystatin under the supervision of a registered nurse or healthcare provider, making option A the most suitable task to delegate in this situation. Understanding delegation principles is essential for effective teamwork and patient care coordination in healthcare settings.

Correct Answer: D

Rationale: The correct answer is D) Turn and reposition the client frequently. This is the most appropriate action because blanching of the skin indicates impaired circulation, which can lead to pressure ulcers or bedsores in clients who are bedridden. Turning and repositioning the client helps to relieve pressure on specific areas of the body, improving circulation and reducing the risk of skin breakdown. Option A) Massage bony areas is incorrect because massaging areas with compromised circulation can further damage the skin and tissues, increasing the risk of pressure ulcers. Option B) Using a moisturizing skin cleanser is not the most appropriate action in this scenario as it does not directly address the issue of pressure relief and prevention of pressure ulcers. Option C) Padding body areas may provide some comfort but does not address the underlying issue of pressure relief and prevention of pressure ulcers. In an educational context, it is crucial for nurses and healthcare providers to understand the importance of skin integrity in clients who are immobile. Proper positioning, turning, and repositioning are essential to prevent pressure ulcers, maintain skin health, and overall promote the well-being of bedridden clients. It is vital for healthcare professionals to be knowledgeable about effective strategies to prevent complications associated with immobility.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Encourage the client to join a psoriasis support group. This option is the most appropriate because it focuses on addressing the client's emotional distress and provides a sense of community and understanding. Psoriasis is a chronic condition without a known cure, so emotional support and coping strategies are essential for individuals living with it. By joining a support group, the client can connect with others facing similar challenges, share experiences, and learn effective ways to manage the condition. Option B) Recommend dermabrasion is incorrect because dermabrasion is a cosmetic procedure that involves removing the top layer of skin and is not a suitable treatment for psoriasis. Option C) Apply anthralin is incorrect because anthralin is a topical medication used to treat psoriasis symptoms, such as slowing down skin cell growth and reducing inflammation, but it does not address the client's emotional distress or help them accept their condition. Option D) Recommend a skin graft is incorrect as it is a surgical procedure used for specific cases like severe burns or injuries, not for treating psoriasis. In an educational context, it is crucial for healthcare providers to not only focus on the physical aspects of a condition but also address the emotional and psychological impact on patients. Encouraging patients to seek support from others who understand their situation can significantly improve their quality of life and ability to cope with chronic conditions like psoriasis. It is important for nurses to be empathetic, supportive, and provide holistic care to meet the needs of the whole patient.

Correct Answer: C

Rationale: In the context of extensive burns, grafting of skin is the most effective intervention in minimizing the risk of morbidity and mortality after fluid resuscitation. Skin grafting helps to cover and protect the wounded area, promote healing, prevent infection, and reduce fluid loss. This intervention plays a crucial role in restoring the skin's barrier function and aiding in the overall recovery process for burn patients. Providing the client with antibiotics (Option A) may be necessary if there is an infection present but it is not the primary intervention to minimize risk post-fluid resuscitation. Addressing the client's depression (Option B) is important for holistic care but is not directly related to minimizing risks post-fluid resuscitation for burns. Monitoring electrolyte balance (Option D) is important in burn patients but skin grafting takes precedence in minimizing morbidity and mortality. In an educational context, understanding the priority interventions in burn care is crucial for healthcare providers. Skin grafting is a fundamental aspect of burn treatment and is essential for improving outcomes in patients with extensive burns. Educating healthcare professionals on the significance of timely and appropriate interventions post-fluid resuscitation can lead to better patient outcomes and quality of care in burn management.

Correct Answer: A

Rationale: The correct answer to the question is A) Actinic keratosis. Actinic keratosis presents with keratotic and firm lesions on the skin, often found in sun-exposed areas. It is considered a precursor lesion to squamous cell carcinoma, a type of skin cancer. Topical fluorouracil (5-FU) is a common treatment for actinic keratosis as it works to selectively target and destroy abnormal skin cells. Option B) Basal cell carcinoma is a type of skin cancer that presents differently from actinic keratosis. It typically appears as a pearly or waxy bump on the skin and rarely progresses to squamous cell carcinoma. Option C) Malignant melanoma is a different type of skin cancer that arises from melanocytes. It is characterized by the development of atypical moles or pigmented lesions on the skin, unlike the keratotic lesions seen in actinic keratosis. Option D) Squamous cell carcinoma is a type of skin cancer that may develop from actinic keratosis but is not the correct answer to the question. It typically presents as a red, scaly patch or a firm, rapidly growing nodule on the skin. Understanding skin conditions and their characteristics is crucial for healthcare professionals, especially dermatologists and primary care providers. Recognizing the features of different skin conditions helps in accurate diagnosis, appropriate treatment selection, and patient education on preventive measures. This question reinforces the importance of differentiating between various skin lesions and understanding their implications for patient care.