Nokea
The nurse is assisting the patient to select foods from the menu that will promote wound healing. Which statement indicates the nurse's knowledge of nutritional goals?
- A. "Avoid foods that have saturated fats. Fats interfere with the ability of the burn wound to heal.?"
- B. "Choose foods that are high in protein
- C. such as meat
- D. eggs
Correct Answer: B
Rationale: Nutritional therapy must be instituted immediately after burn injury to meet the high metabolic demands of the body. Oral diets should be high in calories and high in protein to meet the demands of the body.
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Which specific touch receptor picks up deep pressure and vibrations?
- A. Meissner's corpuscles
- B. Pacinian corpuscles
- C. Merkel's disks
- D. Free nerve endings
Correct Answer: B
Rationale: Pacinian corpuscles are located in the dermis and detect deep pressure and vibrations.
Which of the following statements are true regarding Bowen's disease?
- A. This appears as a very slowly growing red, scaly plaque
- B. It represents a basal cell carcinoma in situ
- C. Microscopically the basal layer is intact
- D. Treatment is by adequate excision
Correct Answer: A
Rationale: Bowen's disease presents as a slow-growing red, scaly plaque and represents squamous cell carcinoma in situ.
The nurse differentiates the various types of dermatitis. Which characteristic best describes atopic dermatitis?
- A. Cell-mediated immunity resulting in inflammatory response
- B. Erythema and pruritus with scaling associated with phlebitis
- C. Scaly lesions on scalp, ear canals, and eyebrows
- D. Mast cell-stimulated release of histamine
Correct Answer: D
Rationale: Atopic dermatitis involves mast cell histamine release, leading to allergic-type skin reactions.
Based on the documented data of an older adult with a burn wound showing signs of local infection, which action should the nurse take next?
- A. Assess the client's skin for signs of adequate perfusion.
- B. Calculate intake and output ratio for the last 24 hours.
- C. Prepare to obtain blood and wound cultures.
- D. Place the client in an isolation room.
Correct Answer: C
Rationale: Signs of local infection in an older adult require cultures to assess for systemic infection.
A school nurse assesses a child who has an erythematous circular patch of vesicles on her scalp with alopecia and complains of pain and pruritus. Why would 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.