Nokea
The client is receiving UV light treatments for psoriasis along with methoxsalen, a photosensitizing agent. What precaution should be followed the first day after treatment?
- A. Wear ultraviolet B-protective sunglasses.
- B. Avoid applying skin ointments and lotions.
- C. Check for elevated temperature every 4 hours.
- D. Stop treatments if skin redness or erythema occurs.
Correct Answer: A
Rationale: Treatment with methoxsalen (Uvadex) enhances sensitivity of the eyes to sunlight. Sunglasses that provide UVB protection need to be worn for at least 24 hours following treatments. Skin ointments may be prescribed. Temperature monitoring is not needed. Redness and erythema are normal responses.
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Which statement by the client diagnosed with chickenpox indicates that the client understands the teaching?
- A. I should put rubbing alcohol on the lesions twice a day.'
- B. I should not scratch myself if at all possible. It might lead to scarring.'
- C. I can go to work when my lesions have all disappeared.'
- D. I need to take all my antibiotics no matter how I feel.'
Correct Answer: B
Rationale: Avoiding scratching prevents scarring and infection in chickenpox. Alcohol is harmful, contagiousness persists post-lesions, and antibiotics are not used.
The nurse is caring for several clients who have burns. Which of the following persons with burns has the poorest prognosis?
- A. A 20-year-old with second- and third-degree burns over 60% of the body
- B. An 80-year-old with second- and third-degree burns over 50% of the body
- C. A 35-year-old with second- and third-degree burns over 60% of the body
- D. A 2-year-old with second- and third-degree burns over 30% of the body
Correct Answer: B
Rationale: The 80-year-old with burns over 50% has the poorest prognosis due to age-related factors, such as reduced physiological reserve and difficulty managing fluid shifts, increasing mortality risk.
An electrician was wearing a glove that had a hole in it when he grabbed a 'hot' wire. His coworkers came to him immediately and called the rescue squad. When the industrial nurse reached him, the electric current had been shut off. What action should the nurse take initially?
- A. Dress the entrance and exit wounds
- B. Check respirations and pulse rate
- C. Remove clothing from the burned area
- D. Roll him in a blanket
Correct Answer: B
Rationale: Checking respirations and pulse rate is the initial action to assess for life-threatening complications, such as cardiac arrhythmias, common in electrical burns.
When a foreign body becomes embedded in a client's eye, which nursing action should be taken first before referring the client for emergency treatment?
- A. Remove the object with forceps.
- B. Ask the person to blink rapidly.
- C. Instill antibiotic ointment.
- D. Loosely patch both eyes.
Correct Answer: D
Rationale: Patching both eyes prevents eye movement, reducing further damage until emergency treatment is received.
The client had an allergic reaction to poison oak two (2) weeks ago. He has returned to the clinic with severe itching and weeping vesicles on the arms and legs. Which intervention should the nurse implement?
- A. Obtain a sample of the drainage for culture and sensitivities.
- B. Determine any allergic reactions to any medications taken recently.
- C. Inquire how the poison ivy/oak plants were destroyed.
- D. Assess for any temperature elevation since the last visit to the clinic.
Correct Answer: D
Rationale: Fever suggests secondary infection in persistent poison oak dermatitis, requiring assessment. Cultures, medication allergies, and plant destruction are secondary.