Nokea
A client is coming to the office to have a growth removed by the doctor. The client asks 'What does cryosurgery do to the growth?' What is the correct response by the nurse?
- A. Removes the entire growth
- B. Through the application of extreme cold, the tissue is destroyed.
- C. Freezes the growth, so the physician can remove it at the next appointment
- D. Lasers the growth off
Correct Answer: B
Rationale: Cryosurgery is the application of extreme cold to destroy tissue. The other statements are false.
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The nurse is caring for a client who has had emphysema for 10 years. When performing a fingernail assessment, what does the nurse anticipate the client's nails will be documented as?
- A. Concave
- B. Brittle
- C. Discolored
- D. Clubbing
Correct Answer: D
Rationale: Clubbing of the nails is evidenced by an angle greater than 160?° and suggests long-standing cardiopulmonary disease and chronic hypoxic states. Concave or 'spooning' may indicate iron-deficiency anemia. Discolored or brittle nails may result from other disorders or smoking.
Which of the following conditions is the cause of thickening of the nail?
- A. Fungal infection
- B. Long-standing pulmonary disease
- C. Myocardial infarction
- D. Iron-deficiency anemia
Correct Answer: A
Rationale: Long-standing poor circulation leads to nail thickening, especially of the lower extremities. Nails thicken when there is a fungal infection and poor circulation. Clubbing of the nails suggests a long-standing cardiopulmonary disease. Concave-shaped nails are a sign of iron-deficiency anemia. Myocardial infarction does not cause thickening of nails.
An older adult client is being seen in the dermatology clinic for lesions on the hands and forearm. The client is concerned about the possibility of having melanoma and wants to be evaluated. The nurse documents the lesions as small, brown lesions of the hands and forearms. What type of benign lesions are these characteristic of?
- A. Senile keratoses
- B. Senile lentigines
- C. Melanoma
- D. Freckles
Correct Answer: B
Rationale: Small, brown, pigmented, benign lesions, known as liver spots or senile lentigines, form on the hands and forearms of older people. Small, yellow or brown, raised lesions called senile keratoses may appear on the face and trunk and are precancerous and require close observation. Melanoma is diagnosed by biopsy and generally has irregular borders and is dark in color.
The nurse is caring for a client in the long-term care facility who had been living at home and being cared for by a family member. The family member states having had a difficult time getting the client to eat or drink and that the client developed a 'bed sore.' The nurse observes a serous drainage covering the dressing and a 2x2 cm crater that is 0.5 cm deep. What stage does the nurse document this pressure sore as?
- A. Stage I
- B. Stage II
- C. Stage III
- D. Stage IV
Correct Answer: C
Rationale: Stage III pressure sores involve superficial skin impairment that progresses to a shallow crater extending to the subcutaneous tissue, often with serous drainage. Stage I is characterized by redness of intact skin. Stage II includes a blister or shallow break in the skin. Stage IV involves deep ulceration exposing muscle or bone.
The nurse is changing a brief for a client that has been incontinent of stool and observes an area over the left trochanter that is reddened and in the center of the area is a shallow skin tear. The nurse takes a picture of the wound for the chart. How will the nurse stage this wound?
- A. Stage I
- B. Stage II
- C. Stage III
- D. Stage IV
Correct Answer: B
Rationale: A stage II pressure sore is red and is accompanied by blistering or a shallow break in the skin, sometimes described as a skin tear. Stage I pressure sores are characterized by redness of intact skin. The reddened skin of a beginning pressure sore fails to resume its normal color, or blanch when pressure is relieved. Stage III has superficial skin impairment that progresses to a shallow crater that extends to the subcutaneous tissue. Stage IV has tissue damage that is deeply ulcerated, exposing muscle and sometimes bone.