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36. When caring for a client with extensive burns, the nurse anticipates that pain medication will be administered via which route?
a) oral
b) intravenous
c) intramuscular
d) subcutaneous
37. The nurse is caring for a client following an autograft and grafting to a burn wound on the right knee. Which of the following would the nurse anticipate to be prescribed for the client?
a) out of bed
b) bathroom privileges
c) immobilization of the affected leg
d) placing the affected leg in a dependent position
38. A community health nurse is visiting a homeless shelter and is assessing the clients in the shelter for the presence of scabies. Which assessment finding would the nurse expect to note if scabies is present?
a) multiple straight or wavy thread-like lines underneath the skin
b) white patches noted on the elbows and knees
c) pustules on the trunk of the body
d) brown red macules with scales
39. A nurse is providing instructions to the client with psoriasis who will be receiving ultraviolent light (UVL) therapy. Which of the following statements would be appropriate for the nurse to include in the instructions for this client?
a) each treatment will last at least 30 minutes
b) your entire body will be exposed to the light treatment
c) you will need to wear cotton clothes during the treatment
d) you will need to wear goggles during the treatment
40. A nurse in the ambulatory care unit is providing home care instructions to a client after cryotherapy for the treatment of malignant skin lesions. Which of the following statements would be appropriate for the nurse to include in the home care instructions for this client?
a) clean the site with alcohol three times a day
b) avoid showering or taking baths until seen by the physician in 1 week
c) apply a warm damp wash cloth if discomfort occurs
d) apply ice to the site to prevent swelling
ANSWERS AND RATIONALE
36) B
- An extensive burn injury causes impairment of muscle and subcutaneous tissue. Additionally, the gastrointestinal tract has decreased perfusion related to the burn injury. Medications administered by mouth, intramuscularly, or subcutaneously are not absorbed consistently as a result of the burn injury. The client may not experience pain relief from these routes of administration and may also receive a sudden bolus of medication at some point after administration, when fluid shifts occur. Therefore, options A, C, and D are incorrect.
37) C
- Autografts placed over joints or on the lower extremities often are elevated and immobilized following surgery for 3 to 7 days. This period of immobilization allows the autograft time to adhere and attach to the wound bed. Options A, B, and D are incorrect.
38) A
- Scabies can be identified by the multiple straight or wavy thread-like lines beneath the skin. The skin lesions are caused by the female, which burrows beneath the skin to lay its eggs. The eggs hatch in a few days, and the baby mites find their way to the skin surface, where they mate and complete the life cycle. Options B, C, and D are not characteristics of scabies.
39) D
- Safety precautions are required during UVL therapy. Most UVL therapies require the person to stand in a light treatment chamber for up to a maximum of 15 minutes. The client will not wear clothing on the body parts to be exposed and will expose only those areas requiring treatment to the UVL. Protective goggles are required to prevent exposure of the eyes to the UVL. The face also is shielded with a loosely applied cloth if it is unaffected by the psoriasis. Direct contact with the light bulbs for the treatment should be avoided, to prevent burning of the skin.
40) C
- Cryotherapy involves the local application of liquid nitrogen to the lesion that causes cell death and tissue destruction. Tissue freezing is followed in 1 to 2 days by hemorrhagic blister formation. The nurse instructs the client to clean the site with hydrogen peroxide to prevent secondary infection. A topical antibiotic also may be prescribed. Alcohol would cause irritation to the skin. There is no reason for the client to avoid showering or bathing. The application of a warm, damp wash cloth intermittently to the site will provide relief of any discomfort. Ice is not applied to the site.
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Online Nursing Practice Test about Skin Disorder (1-5)
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