Nokea
Assuming the following solutions are available, which one is best for the school nurse to use at this time?
- A. Tap water
- B. Sodium bicarbonate
- C. Mammalise
- D. Magnesium sulfate
Correct Answer: C
Rationale: Mammalise (likely a typo for a sterile saline solution) is the safest and most effective for eye irrigation to flush out chemicals without causing further irritation.
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A 28-year-old man received severe burns of the chest, abdomen, back, legs, and hands when the house caught fire. In the emergency room, a nasogastric tube was inserted, and the client was ordered NPO. What is the primary reason for the nurse to keep this client NPO?
- A. To prevent the deadly complication of aspiration
- B. To make the client more comfortable
- C. To help prevent paralytic ileus
- D. To help prevent excessive fluid loss
Correct Answer: C
Rationale: Severe burns predispose clients to paralytic ileus due to stress and fluid shifts, so keeping the client NPO prevents complications until bowel function returns.
The client sustained partial- and full-thickness burns to the anterior left and right arms, anterior chest and abdominal area, and anterior left leg. Using the Rule of Nines, what is the estimated extent of this injury that the nurse should document? % (Record your answer as a whole number.)
- A. 36
Correct Answer: A
Rationale: According to the Rule of Nines, this client sustained injuries on about 36% of the body surface: right arm is 4.5%; left arm is 4.5%; left leg is 9%; anterior chest and abdomen are 18%.
The client receives treatment for uncomplicated lower-extremity cellulitis. The nurse notes improvement in the client's condition when which observation is noted on assessment?
- A. Decreased swelling in the lower extremity
- B. Strong dorsalis pedis pulses felt bilaterally
- C. Increased erythema in the lower extremity
- D. White blood cell (WBC) count 14,000/mm3
Correct Answer: A
Rationale: Cellulitis is an infection with diffuse inflammation occurring in the tissue just under the skin. Observing a decrease in swelling is evidence of improvement. Circulation is not involved with cellulitis, so pedal pulses are unaffected. Increased erythema indicates worsening. A WBC of 14,000/mm3 is elevated, indicating infection.
Which information about pruritus should the nurse include? Select all that apply.
- A. Cool environments increase itching.
- B. Use of soap increases itching.
- C. Use hot water to rinse off soap.
- D. Apply mild skin lotion for hydration.
- E. Blot gently, but completely dry the skin.
Correct Answer: B,D,E
Rationale: Soap, mild lotion, and gentle drying reduce pruritus. Cool environments decrease itching, and hot water worsens it.
The client is complaining of burning, stabbing pain that radiates around the left rib cage area. The nurse cannot find any type of skin abnormality. Which action should the nurse implement?
- A. Transfer the client to the ED for a cardiac work-up.
- B. Inform the client that the nurse can’t see anything.
- C. Administer a nonnarcotic analgesic to the client.
- D. Ask the client if he or she has ever had chickenpox.
Correct Answer: D
Rationale: Burning pain along dermatomes without visible lesions suggests early herpes zoster, linked to prior chickenpox. Cardiac work-up, dismissal, or analgesics are premature.