NCLEX Review about Skin and Integumentary Disorders (41-45)

NCLEX Review about Skin and Integumentary Disorders

41. An emergency department nurse is caring for a client who has sustained chemical burns to the esophagus after ingestion of lye. The nurse reviews the physician's orders and plans to question an order for which of the following?

a) nothing by mouth (NPO) status
b) gastric lavage
c) intravenous fluid therapy
d) preparation for barium swallow

42. A home care nurse is visiting a client with a skin infection who is receiving amoxicillin (Amoxil) 500 mg every 8 hours. Which of the following would indicate to the nurse that the client is experiencing a frequent side effect related to the medication?

a) severe abdominal cramps
b) vaginal drainage
c) fever
d) severe watery diarrhea



43. A nurse is developing a plan of care for a client who is receiving amphotericin (Fungizone) intravenously to treat severe fungal infection of the skin. A main component of the plan of care is monitoring for adverse reactions related to the medication. Which of the following should the nurse include in a list of manifestations to watch for?

a) visual difficulties
b) increased urinary output
c) fatigue
d) confusion

44. A nurse is performing an assessment on a client being admitted to the nursing unit who has sustained an extensive burn injury involving greater than 25% of total body surface area (TBSA). In performing the assessment, the nurse knows that the maximum amount of edema that occurs from a burn normally is seen:

a) immediately after the injury
b) within 12 hours after the injury
c) between 18 and 24 hours after the injury
d) between 42 and 72 hours after the injury

45. A nursing instructor has just completed a lecture to nursing students regarding care of the client with a burn injury, and a major aspect of the lecture was care of the client at the scene of a fire. Which statement if made by a nursing student indicates a need for further instruction?

a) flames may be extinguished by rolling the client on the ground
b) flames may be smothered by the use of a blanket or another cover
c) flames should be doused with water
d) the client should be maintained in a standing position because the flames may spread to the other parts of the body






NCLEX Review about Skin and Integumentary Disorders:
ANSWERS AND RATIONALE

41) B

- The client who has sustained chemical burns to the esophagus is placed on NPO status, is given intravenous (IV) fluids for replacement and treatment of possible shock, and is prepared for esophagoscopy and barium swallow to determine the extent of damage. A nasogastric tube may be inserted, but gastric lavage and emesis are avoided to prevent further erosion of the mucosa by the irritating substances.

42) B

- Amoxicillin is a type of penicillin. Frequent side effects include gastrointestinal disturbances, headache, and oral or vaginal candidiasis (perineal itching). Less common but more harmful adverse reactions that can occur include superinfection, such as potentially fatal antibiotic-associated colitis, which results from altered bacterial balance. Symptoms and signs would include abdominal cramps, severe watery diarrhea, and fever.

43) A

- Amphotericin B is an antifungal. Adverse reactions include nephrotoxicity, which occurs commonly and is evidenced by decreased urine output. Cardiovascular toxicity (as evidenced by hypotension and ventricular fibrillation) and anaphylactic reaction occur rarely. Vision and hearing alterations, seizures, hepatic failure, and coagulation defects also may occur.

44) C

The maximum amount of edema in a client with a burn injury is seen between 18 and 24 hours after the injury. With adequate fluid resuscitation, the transmembrane potential is restored to normal within 24 to 36 hours after the burn. Options A, B, and D are incorrect.

45) D

The client should be placed or maintained in a supine position; otherwise; flames may spread to other parts of the body, causing more extensive injury. Flame burns may be extinguished by rolling the client on the ground, smothering the flames with a blanket or other cover, or dousing the flames with water.



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