Nokea
Several residents in a long term care facility have been diagnosed with herpes zoster. Which resident will require the closest observation for development of complications?
- A. A resident who is sexually active
- B. A resident recovering from a hip fracture
- C. A resident with dementia who requires assistance eating.
- D. A resident who is undergoing chemotherapy for breast cancer
Correct Answer: D
Rationale: The resident who is undergoing chemotherapy is likely to develop a low white blood cell count, and is at the highest risk of complications such as disseminated herpes zoster or severe skin infection from the irritated skin at the lesion sites. A resident who is sexually active is not necessarily at high risk of complications of herpes zoster, (shingles). Neither the resident recovering from a hip fracture or the resident with dementia are as high a risk as the resident undergoing chemotherapy.
You may also like to solve these questions
A school nurse assesses a child who has an erythematous circular patch of vesicles on her scalp with alopecia and report spain and pruritus. For which reason will the nurse use a Woods lamp?
- A. To dry out the lesions.
- B. To reduce the pruritus.
- C. To kill the fungus.
- D. To cause fluorescence of the infected hairs.
Correct Answer: D
Rationale: Tinea capitis is commonly known as ringworm of the scalp. Microsporum audouinii is the major fungal pathogen. The use of the diagnostic Woods lamp causes the infected hairs to turn a brilliant blue green. The Woods lamp does not dry out lesions, reduce pruritus or kill fungus.
Two weeks after a severe burn of over 20% of the body, the patient vomits bright red blood. Which condition is most likely?
- A. Curling ulcer
- B. Paralytic ileus
- C. Ruptured colon
- D. Gastritis
Correct Answer: A
Rationale: Curling ulcer is a duodenal ulcer that develops 8 to 14 days after severe burns on the surface of the body. The first sign is usually vomiting of bright red blood. Paralytic ileus involves the small intestine becoming immobile, characterized by absent bowel sounds. A ruptured colon would cause internal bleeding, and possibly rectal bleeding. Gastritis would not cause bright red bleeding.
When providing the open method of treatment for a patient who is 52 years old with burns to the lower extremities, which does the nurse expect to see included in the nursing plan?
- A. Change the dressing using good medical asepsis.
- B. Provide an analgesic immediately after the dressing change.
- C. Perform circulation checks every 2 to 4 hours.
- D. Keep the room temperature at 85°F (29.4°C) to prevent chilling.
Correct Answer: D
Rationale: Chilling may be controlled by keeping the room temperature at 85°F (29.4°C). The open method of burn injury treatment does not involve dressings; the wound is left undressed. Strict surgical protocol is observed and analgesia should be given before the treatment. Circulation is not restricted if the wound area is left open.
A patient developed a severe contact dermatitis of the hands, arms, and lower legs after spending an afternoon picking strawberries. The patient states that the itching is severe and cannot keep from scratching. Which instruction will be helpful in managing the pruritus?
- A. Use cool, wet dressings and baths to promote vasoconstriction.
- B. Trim the fingernails short to prevent skin damage from scratching.
- C. Expose the areas to the sun to promote drying and healing of the lesions.
- D. Wear cotton gloves and cover all other affected areas with clothing to prevent environmental irritation.
Correct Answer: A
Rationale: Wet dressings and using Burow's solution help promote the healing process. Cold compresses may be applied to decrease circulation to the area (vasoconstriction). Short nails prevent skin damage, but not pruritus. Exposing the areas to the sun will not manage pruritus. Wearing cotton gloves may prevent environmental irritation, but will not help the existing pruritis.
Melanocytes give rise to the pigment melanin, which is responsible for skin color. Where can the melanocytes be found?
- A. Dermis
- B. Superficial fascia
- C. Epidermis
- D. Loose connective tissue
Correct Answer: C
Rationale: A layer in the epidermis contains highly specialized cells called melanocytes.