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After teaching a client how to care for a furuncle in the axilla, a nurse assesses the clients understanding. Which statement indicates the client correctly understands the teaching?
- A. I'll apply cortisone cream to reduce the inflammation.
- B. I'll apply a clean dressing after squeezing out the pus.
- C. I'll keep my arm down at my side to prevent spread.
- D. I'll cleanse the area prior to applying antibiotic cream.
Correct Answer: D
Rationale: Cleansing and topical antibiotics can eliminate the infection. Warm compresses enhance comfort and open the lesion, allowing better penetration of the topical antibiotic. Cortisone cream reduces the inflammatory response but increases the infection process. Squeezing the lesion may introduce infection to deeper tissues and cause folliculitis. Keeping the arm down increases moisture in the area and promotes bacterial growth.
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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.
A nurse teaches a client who has very dry skin. Which statement should the nurse include in this clients education?
- A. Use lots of moisturizer several times a day to minimize dryness.
- B. Take a cold shower instead of soaking in the bathtub.
- C. Use antimicrobial soap to avoid infection of cracked skin.
- D. After you bathe, put lotion on before your skin is totally dry.
Correct Answer: D
Rationale: The client should bathe in warm water for at least 20 minutes and then apply lotion immediately because this will keep the moisturizer in the skin. Just using moisturizer will not be as helpful because the moisturizer is not what dehydrates the skin, it is the water. Bathing in warm water will rehydrate skin more effectively than a cold shower, and antimicrobial soaps are actually more drying than other kinds of soap.
A nurse assesses clients on a medical-surgical unit. Which client should the nurse evaluate for a wound infection?
- A. Client with blood cultures pending
- B. Client who has thin, serous wound drainage
- C. Client with a white blood cell count of 23,000/mm^3
- D. Client transferred from intensive care with an elevated white blood cell count
Correct Answer: C
Rationale: An elevated white blood cell count, such as 23,000/mm^3, indicates a potential infection. The nurse should evaluate this client for signs of a wound infection, as an elevated white blood cell count is a strong indicator of an infectious process.
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.
After teaching a client who is at risk for the formation of pressure ulcers, a nurse assesses the clients understanding. Which dietary choice by the client indicates a good understanding of the teaching?
- A. Low-fat diet with whole grains and cereals and vitamin supplements
- B. High-protein diet with vitamins and mineral supplements
- C. Vegetarian diet with nutritional supplements and fish oil capsules
- D. Low-fat, low-cholesterol, high-fiber, low-carbohydrate diet
Correct Answer: B
Rationale: The preferred diet is high in protein to assist in wound healing and prevention of new wounds. Fat is also needed to ensure formation of cell membranes, so any of the options with low fat would not be good choices. A vegetarian diet would not provide fat and high levels of protein.