NCLEX-PN
Integumentary NCLEX Questions Questions
Extract:
Question 1 of 5
The nurse is caring for a client who has developed stage IV pressure ulcers on the left trochanter and coccyx. Which collaborative problem has the highest priority?
Correct Answer: B
Rationale: Altered nutrition is critical in stage IV ulcers to support wound healing. Cognition, self-care, and coping are secondary in advanced wounds.
Question 2 of 5
When assessing a burn victim's skin the nurse notices the entire right and left upper extremities are red, moist, weeping, and blistered. How should the nurse document the degree and total body surface area (TBSA) burned?
Correct Answer: B
Rationale: Partial-thickness burns damage the dermis and epidermis, often resulting in loss of epidermis and/or blistering. Each entire upper extremity is blistered. Approximately 18% of the TBSA has a partial-thickness burn (9% TBSA per each upper extremity). This is not a first-degree burn—In a first-degree burn the skin may appear red but intact, no weeping, and no blistering. With full-thickness burns there would be loss of tissue and a black or white charred/waxy appearance to the remaining tissues.
Question 3 of 5
Which area of health teaching is essential when a female client is prescribed isotretinoin (Accutane)?
Correct Answer: B
Rationale: Isotretinoin is teratogenic, requiring strict pregnancy prevention.
Question 4 of 5
If the physician wants to check the client's intraocular pressure (IOP), which instrument should the nurse have available?
Correct Answer: B
Rationale: A tonometer measures intraocular pressure, essential for glaucoma assessment.
Question 5 of 5
The nurse is caring for a client with complaints of a rash and itching on the face for one (1) week. Which intervention should the nurse implement first?
Correct Answer: D
Rationale: Determining rash onset provides critical history for diagnosis. Hirsutism, Wood’s light, and OTC medication history are secondary.