Nokea
A patient is admitted to the intensive care unit with what is thought to be toxic epidermal necrolysis (TEN). When assessing the health history of the patient, the nurse would be alert to what precipitating factor?
- A. Recent heavy ultraviolet exposure
- B. Substandard hygienic conditions
- C. Recent administration of new medications
- D. Recent varicella infection
Correct Answer: C
Rationale: TEN is commonly triggered by medications, such as antibiotics or antiseizure drugs. UV exposure, hygiene, and varicella are not typical causes.
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A patient has just undergone surgery for malignant melanoma. Which of the following nursing actions should be prioritized?
- A. Maintain the patient on bed rest for the first 24 hours postoperative.
- B. Apply distraction techniques to relieve pain.
- C. Provide soft or liquid diet that is high in protein to assist with healing.
- D. Anticipate the need for, and administer, appropriate analgesic medications.
Correct Answer: D
Rationale: Analgesic administration is critical post-melanoma excision to manage pain from wide excision. Bed rest and modified diets are unnecessary, and distraction is secondary to analgesia.
A nurse is working with a family whose 5 year-old daughter has been diagnosed with impetigo. What educational intervention should the nurse include in this familys care?
- A. Ensuring that the family knows that impetigo is not contagious
- B. Teaching about the safe and effective use of topical corticosteroids
- C. Teaching about the importance of maintaining high standards of hygiene
- D. Ensuring that the family knows how to safely burst the childs vesicles
Correct Answer: C
Rationale: Impetigo is linked to poor hygiene, so teaching hygiene practices is key. It is contagious, corticosteroids are ineffective, and bursting vesicles is harmful.
A 65-year-old man presents at the clinic complaining of nodules on both legs. The man tells the nurse that his son, who is in medical school, encouraged him to seek prompt care and told him that the nodules are related to the fact that he is Jewish. What health problem should the nurse suspect?
- A. Stasis ulcers
- B. Bullous pemphigoid
- C. Psoriasis
- D. Classic Kaposis sarcoma
Correct Answer: D
Rationale: Classic Kaposis sarcoma, common in Jewish men aged 40-70, presents as nodules on the lower extremities. Stasis ulcers, bullous pemphigoid, and psoriasis have different presentations.
A patient comes to the clinic complaining of a red rash of small, fluid-filled blisters and is suspected of having herpes zoster. What presentation is most consistent with herpes zoster?
- A. Grouped vesicles occurring on lips and oral mucous membranes
- B. Grouped vesicles occurring on the genitalia
- C. Rough, fresh, or gray skin protrusions
- D. Grouped vesicles in linear patches along a dermatome
Correct Answer: D
Rationale: Herpes zoster presents as grouped vesicles along a dermatome due to dorsal root ganglia inflammation. Lip vesicles suggest herpes simplex type 1, genital vesicles suggest type 2, and rough protrusions indicate warts.
A nurse is caring for a patient who has been diagnosed with psoriasis. The nurse is creating an education plan for the patient. What information should be included in this plan?
- A. Use caution when taking nonprescription medications.
- B. Avoid public places until symptoms subside.
- C. Wash skin frequently to prevent infection.
- D. Liberally apply corticosteroids as needed.
Correct Answer: A
Rationale: Nonprescription medications may exacerbate psoriasis, so caution is needed. Psoriasis is not contagious, frequent washing can worsen scaling, and overuse of corticosteroids may cause skin atrophy.