Nokea
A woman who has herpes simplex 1 (HSV1) around the mouth and nose asks the nurse if she can give the sores to her husband. What should the nurse include when answering this client?
- A. Herpes simplex 1 (HSV1) is a fever blister and is not contagious.
- B. She should not kiss her husband or anyone else because it can be transmitted to susceptible persons.
- C. Fever blisters are seen only in persons who have fevers.
- D. The virus is transmitted through coughing and sneezing.
Correct Answer: B
Rationale: HSV1 is contagious and can be transmitted through direct contact, such as kissing, especially during active outbreaks.
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The health department nurse is caring for the client who has leprosy (Hansen’s disease). Which assessment data indicate the client is experiencing a complication of the disease?
- A. Elevated temperature at night.
- B. Brownish-black discoloration to the skin.
- C. Reduced skin sensation in the lesions.
- D. A high count of mycobacteria in the culture.
Correct Answer: C
Rationale: Reduced sensation in lesions indicates nerve damage, a leprosy complication. Night fevers, discoloration, and bacterial load are less specific.
What images will a client with macular degeneration most likely describe seeing?
- A. Objects that are close to the face
- B. Objects that are clear distance
- C. Objects that are in outer peripheral fields
- D. Objects that are in the central field of vision
Correct Answer: C
Rationale: Macular degeneration spares peripheral vision, affecting central vision.
The long-term care nurse has received the a.m. shift report. Which client should the nurse assess first?
- A. The client who has not had a bowel movement today.
- B. The client who needs the indwelling catheter changed.
- C. The client with periorbital skin lesions.
- D. The client with a stage I pressure ulcer.
Correct Answer: C
Rationale: Periorbital skin lesions (e.g., herpes zoster ophthalmicus) risk eye complications, requiring urgent assessment. Constipation, catheter changes, and stage I ulcers are less acute.
The client diagnosed with stage IV infected pressure ulcers on the coccyx is scheduled for a fecal diversion operation. The nurse knows that client teaching has been effective when the client makes which statement?
- A. This surgery will create a skin flap to cover my wounds.'
- B. This surgery will get all the old black tissue out of the wound so it can heal.'
- C. The surgery is important to allow oxygen to get to the tissue for healing to occur.'
- D. Stool will come out an opening in my abdomen so it won’t get in the sore.'
Correct Answer: D
Rationale: Fecal diversion (colostomy) prevents stool contamination of coccyx ulcers, aiding healing. Skin flaps, debridement, and oxygen delivery are unrelated to this surgery.
The wound care nurse documented a client’s pressure ulcers on admission as 3.3 cm × 4 cm stage II on the coccyx. Which information would alert the nurse that the client’s pressure ulcer is getting worse?
- A. The skin is not broken and is 2.5 cm × 3.5 cm with erythema that does not blanch.
- B. There is a 3.2-cm × 4.1-cm blister that is red and drains occasionally.
- C. The skin covering the coccyx is intact but the client complains of pain in the area.
- D. The coccyx wound extends to the subcutaneous layer and there is drainage.
Correct Answer: D
Rationale: Extension to the subcutaneous layer with drainage indicates progression to stage III or IV, worsening the ulcer. Smaller size, blisters, or pain are less severe.