Nokea
A nurse cares for clients who have various skin infections. Which infection is paired with the correct pharmacologic treatment?
- A. Viral infection: Clindamycin (Cleocin)
- B. Bacterial infection: Acyclovir (Zovirax)
- C. Yeast infection: Linezolid (Zyvox)
- D. Fungal infection: Ketoconazole (Nizoral)
Correct Answer: D
Rationale: Ketoconazole is an antifungal medication appropriate for fungal infections. Clindamycin and Linezolid are antibiotics used for bacterial infections, and Acyclovir is an antiviral drug used for viral infections.
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A nurse prepares to admit a client who has herpes zoster. Which actions should the nurse take? (Select all that apply.)
- A. Prepare a room for reverse isolation.
- B. Assess staff for a history of or vaccination for chickenpox.
- C. Check the admission orders for analgesia.
- D. Choose a roommate who also is immune suppressed.
- E. Ensure that gloves are available in the room.
Correct Answer: B,C,E
Rationale: Herpes zoster (shingles) is caused by reactivation of the varicella zoster virus, and staff without immunity to chickenpox are at risk. Analgesia is necessary due to the painful nature of shingles. Gloves and hand hygiene prevent spread, but reverse isolation is not required. An immune-suppressed roommate should be avoided to prevent infection transmission.
A nurse is caring for a client who has a pressure ulcer on the right ankle. Which action should the nurse take first?
- A. Draw blood for albumin, prealbumin, and total protein.
- B. Prepare for and assist with obtaining a wound culture.
- C. Place the client in bed and instruct the client to elevate the foot.
- D. Assess the right leg for pulses, skin color, and temperature.
Correct Answer: D
Rationale: A client with an ulcer on the foot should be assessed for interruption in arterial flow to the area. This begins with the assessment of pulses and color and temperature of the skin. The nurse can also assess for pulses noninvasively with a Doppler flowmeter if unable to palpate with fingers. Tests to determine nutritional status and risk assessment would be completed after the initial assessment is done. Wound cultures are done after it has been determined that drainage, odor, and other risks for infection are present. Elevation of the foot is appropriate after assessment of arterial flow to the area.
A nurse cares for a client who reports pain related to eczematous dermatitis. Which nonpharmacologic comfort measures should the nurse implement? (Select all that apply.)
- A. Cool, moist compresses
- B. Topical corticosteroids
- C. Heating pad
- D. Tepid bath with cornstarch
- E. Back rub with baby oil
Correct Answer: A,D
Rationale: Cool, moist compresses and tepid baths with cornstarch reduce inflammation and help debride crusts in eczematous dermatitis. Topical corticosteroids are pharmacologic, and heating pads or baby oil may increase inflammation and discomfort.
A nurse assesses clients on a medical-surgical unit. Which client is at greatest risk for pressure ulcer development?
- A. A 44-year-old prescribed IV antibiotics for pneumonia
- B. A 26-year-old who is bedridden with a fractured leg
- C. A 65-year-old with hemiplegia and incontinence
- D. A 78-year-old requiring assistance to ambulate with a walker
Correct Answer: C
Rationale: Being immobile and being incontinent are two significant risk factors for the development of pressure ulcers. The client with pneumonia does not have specific risk factors. The young client who has a fractured leg and the client who needs assistance with ambulation might be at moderate risk if they do not move about much, but having two risk factors makes the 65-year-old the person at highest risk.
After educating a caregiver of a home care client, a nurse assesses the caregivers understanding. Which statement indicates that the caregiver needs additional education?
- A. I can help him shift his position every hour when he sits in the chair.
- B. If his tailbone is red and tender in the morning, I will massage it with baby oil.
- C. Applying lotion to his arms and legs every evening will decrease dryness.
- D. Drinking a nutritional supplement between meals will help maintain his weight.
Correct Answer: B
Rationale: Massage of reddened areas over bony prominences such as the coccyx, or tailbone, is contraindicated because the pressure of the massage can cause damage to the skin and subcutaneous tissue layers. The other statements are appropriate for the care of a client at home.