Nokea
The nurse is caring for a client who has had emphysema for 10 years. When performing a fingernail assessment, what does the nurse anticipate the client's nails will be documented as?
- A. Concave
- B. Brittle
- C. Discolored
- D. Clubbing
Correct Answer: D
Rationale: Clubbing of the nails is evidenced by an angle greater than 160?° and suggests long-standing cardiopulmonary disease and chronic hypoxic states. Concave or 'spooning' may indicate iron-deficiency anemia. Discolored or brittle nails may result from other disorders or smoking.
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The nurse is applying a cool compress to the forehead of a client with an elevated temperature. This is an example of what type of heat loss?
- A. Radiation
- B. Evaporation
- C. Conduction
- D. Convection
Correct Answer: C
Rationale: Conduction is the transfer of heat through direct contact. Radiation is the transfer of surface heat in the environment. Evaporation is the loss of moisture or water. Convection is the transfer of heat by means of currents of liquids or gases in which warm air molecules move away from the body.
An older adult client is being seen in the dermatology clinic for lesions on the hands and forearm. The client is concerned about the possibility of having melanoma and wants to be evaluated. The nurse documents the lesions as small, brown lesions of the hands and forearms. What type of benign lesions are these characteristic of?
- A. Senile keratoses
- B. Senile lentigines
- C. Melanoma
- D. Freckles
Correct Answer: B
Rationale: Small, brown, pigmented, benign lesions, known as liver spots or senile lentigines, form on the hands and forearms of older people. Small, yellow or brown, raised lesions called senile keratoses may appear on the face and trunk and are precancerous and require close observation. Melanoma is diagnosed by biopsy and generally has irregular borders and is dark in color.
A client has a rash on the arm that has been treated with an antibiotic without eradicating the rash. What type of examination using ultraviolet light can be used to determine if the rash is a fungal rash?
- A. Skin biopsy
- B. Fungal culture
- C. Potassium hydroxide test
- D. A Wood light examination
Correct Answer: D
Rationale: A Wood light is also known as a black light and is a handheld device that can identify certain fungal infections that fluoresce under long-wave ultraviolet light. In a darkened room, when a physician or nurse aims the light at a lesion caused by a fungus that fluoresces, the lesion emits a blue-green color. It is the only test that uses a light; the others use skin scrapings.
A client has a wart on the left knee but wants to try an over-the-counter medication to dissolve the wart. What type of solution would the nurse educate the client about?
- A. Antiseborrheic agents
- B. Antihistamine
- C. Antiseptics
- D. Keratolytics
Correct Answer: D
Rationale: Keratolytics dissolve thickened, cornified skin such as warts, corns, and calluses. Their action causes the treated area to soften and swell, facilitating removal. Antiseborrheic agents are applied to the scalp or incorporated into shampooing products to control dandruff. Antihistamines are used to relieve itching. An antiseptic would be used to reduce bacteria on the arm.
The nurse observes a client's fingernails have a concave shape. What laboratory studies should the nurse review?
- A. Hemoglobin and hematocrit
- B. Arterial blood gases
- C. BUN and creatinine
- D. Glucose level
Correct Answer: A
Rationale: Normal nails appear slightly convex with a 160?° angle between the nail base and the skin. Concave-shaped nails, referred to as 'spooning' because of their characteristic appearance, are a sign of iron-deficiency anemia. ABGs, BUN and creatinine, and glucose levels are not related to this shape of nail.