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31. The client scheduled for a skin biopsy is concerned and asks the nurse how painful the procedure is. The appropriate response by the nurse is:
a) there is no pain associated with this procedure
b) the local anesthesia may cause a burning or stinging sensation
c) a preoperative medication will be given so you will be sleeping and will not feel any pain
d) there is some pain, but the physician will prescribe an opioid analgesic following the procedure
32. The nurse prepares to assist the physician to examine the client's skin with a Wood light. The nurse includes which of the following in the plan for this procedure?
a) prepare a local anesthetic
b) obtain an informed consent
c) darken the room for the examination
d) shave the skin and scrub with povidine-iodine solution
33. The home health nurse visits a client suspected of having scabies. Which of the following precautions will the nurse institute during the assessment of the client?
a) wear gloves only
b) wear a mask and gloves
c) wear a gown and gloves
d) avoid touching the client's home furnishings
34. A client is undergoing fluid replacement after being burned on 20% of her body 12 hours ago. The nursing assessment reveals a blood pressure of 90/50 mm Hg, a pulse rate of 110 beats/min, and a urine output of 20 ml over the past hour. The nurse reports the findings to the physician and anticipates which of the following orders to be prescribed?
a) transfusing 1 unit of packed red blood cells
b) administering a diuretic to increase urine output
c) changing the IV lactated ringer's solution to one that contains dextrose in water
d) increasing the amount of IV lactated ringer's solution administered per hour
35. A client whose treatment included an amniotic membrane graft after a full-thickness burn injury is seen in the burn rehabilitation clinic. The client has been fitted for a pressure garment. Which statement best indicates that the client understands the purpose of the pressure garment?
a) this garment will take the place of exercise
b) this garment can be removed when it feels itchy
c) this garment will decrease the swelling in my arms and hands
d) this garment can be removed at bedtime and reapplied in the morning
ANSWERS AND RATIONALE
31) B
- Depending on the size and location of the lesion, a biopsy is usually a quick and almost painless procedure. The most common source of pain is the initial local anesthetic, which can produce a burning or stinging sensation. Preoperative medication is not necessary with this procedure.
32) C
- Examination of the skin under a Wood’s light is always carried out in a darkened room. This is a noninvasive examination; therefore, an informed consent is not required. A hand-held long-wavelength ultraviolet light or Wood’s light is used. The skin does not need to be shaved, and a local anesthetic is not necessary. Areas of blue-green or red fluorescence are associated with certain skin infections. The procedure is painless.
33) C
- The Centers for Disease Control and Prevention (CDC) recommends wearing gowns and gloves for close contact with a person infested with scabies. Masks are not necessary. Transmission via clothing and other inanimate objects is uncommon. Scabies usually is transmitted from person to person by direct skin contact. All contacts that the client has had should be treated at the same time.
34) D
- Fluid management during the first 24 hours following a burn injury generally includes the infusion of a balanced salt solution, usually lactated Ringer’s solution. Fluid resuscitation is determined by urine output and hourly urine output should be at least 30 mL/hr. The client’s urine output is indicative of insufficient fluid resuscitation, which places the client at risk for inadequate perfusion of the brain, heart, kidneys, and other body organs. Therefore, the physician would prescribe an increase in the amount of IV lactated Ringer’s solution administered per hour. Administering a diuretic would not correct the problem because it would not replace needed fluid. Diuretics promote the removal of the circulating volume, thereby further compromising the inadequate tissue perfusion. Dextrose in water is an isotonic solution and an isotonic solution maintains fluid balance. This type of solution may be administered after the first 24 hours following the burn injury, depending on the client’s physiological needs. Blood replacement is not consistent with fluid therapy for burn injuries.
35) C
- The rationale for the use of a pressure garment includes decreasing venous stasis, to prevent edema in areas of poor lymphatic circulation. Pressure garments also aid in preventing contractures. For maximum effectiveness, the garment should be worn 23 hours each day. Itchiness and warmth may occur under the garment and the client may require encouragement to keep the garment on. The client needs to continue to ambulate and actively perform range-of-motion exercises.
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Online Nursing Practice Test about Skin Disorder (1-5)
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