Nokea
An older adult client is prescribed a topical antifungal medication to treat a skin infection. The client comes back to the clinic in 7 days and informs the nurse that the treatment was not effective. What does the nurse know can occur in the older adult client with topical drugs?
- A. Age-related changes to the skin could decrease the absorption of topical drugs.
- B. Older adult clients are often not compliant with medication administration.
- C. The drug absorption is increased and does not give the medication time to work on the skin infection.
- D. The bacteria may be resistant to the medication.
Correct Answer: A
Rationale: Age-related changes in topical drugs may be altered and therefore decrease the ability to absorb the topical antifungal cream. Older adults are no less compliant than any other age group. Drug absorption would be decreased. The skin infection is related to a fungus, not a bacterium.
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During a routine checkup, a nurse observes the client's skin to be tight and shiny. Which of the following is the correct indication of this sign?
- A. Sebum deficiency
- B. Fluid retention
- C. Dehydration
- D. Protein deficiency
Correct Answer: B
Rationale: Tight, shiny skin suggests fluid retention. Loose, dry skin may indicate dehydration. Tight, shiny skin does not suggest protein deficiency or sebum deficiency.
A client has a boil that is located in the left axillary area and is elevated with a raised border, and filled with pus. How would the nurse document this type of lesion?
- A. Macule
- B. Vesicle
- C. Pustule
- D. Cyst
Correct Answer: C
Rationale: A pustule has an elevated, raised border, filled with pus. A macule is a flat, round, colored lesion such as a freckle or rash. A vesicle is a lesion that is elevated, round, and filled with serum. A cyst is an encapsulated, round, fluid-filled or solid mass beneath the skin.
The nurse is assessing a client who is hospitalized for dehydration from persistent vomiting. How would the nurse assess that the client's skin turgor is related to the state of dehydration?
- A. When the nurse pinches up skin of the hand, there is rapid recoil.
- B. The client has wrinkles of the chest.
- C. The nurse grasps the skin over the sternum between the thumb and forefinger with slow recoil observed.
- D. The nurse grasps the skin over the sternum between the thumb and forefinger with rapid recoil observed.
Correct Answer: C
Rationale: Poor skin turgor, indicated by slow recoil when the skin over the sternum is pinched, suggests dehydration. Rapid recoil indicates normal hydration. Wrinkles on the chest are not a specific indicator of dehydration.
The nurse is performing a skin assessment on a client that is admitted to the hospital and observes an area over the left heel that is reddened but intact. How would the nurse stage this pressure sore?
- A. Stage I
- B. Stage II
- C. Stage III
- D. Stage IV
Correct Answer: A
Rationale: 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 II is the same as stage I but has a blister or shallow break in the skin. 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.
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.