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The nurse is caring for a male client diagnosed with folliculitis barbae. Which information should the nurse teach to prevent a reoccurrence?
- A. Tell the client to not shave the face.
- B. Instruct the client to rub on astringent aftershave lotion.
- C. Recommend the client apply hot packs for 20 minutes before shaving.
- D. Teach the client to use an antibacterial soap on the face.
Correct Answer: D
Rationale: Antibacterial soap reduces bacterial load, preventing folliculitis barbae. Not shaving is impractical, astringents irritate, and hot packs are less effective.
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Which nursing interventions should be included for the client who has full-thickness and deep partial-thickness burns to 50% of the body? Select all that apply.
- A. Perform meticulous hand hygiene.
- B. Use sterile gloves for wound care.
- C. Wear gown and mask during procedures.
- D. Change central lines once a week.
- E. Administer antibiotics as prescribed.
Correct Answer: A,B,C,E
Rationale: Hand hygiene, sterile gloves, gown/mask, and antibiotics prevent infection in extensive burns. Weekly central line changes are not standard; daily assessment is preferred.
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.
The female client admitted for an unrelated diagnosis asks the nurse to check her back because 'it itches all the time in that one spot.' When the nurse assesses the client’s back, the nurse notes an irregular-shaped lesion with some scabbed-over areas surrounding the lesion. Which action should the nurse implement first?
- A. Notify the HCP to check the lesion on rounds.
- B. Measure the lesion and note the color.
- C. Apply lotion to the lesion.
- D. Instruct the client to make sure the HCP checks the lesion.
Correct Answer: B
Rationale: Measuring and documenting the lesion provides baseline data for HCP evaluation. Notification, lotion, or client instruction are secondary.
The nurse is obtaining a preoperative health history on the client scheduled for revision of facial scars. Which client comment indicates an increased risk for a poor cosmetic outcome?
- A. I haven't had anything to eat or drink since 10 pm last night.
- B. I'm nervous about surgery; what if the surgery doesn't work?
- C. My high blood pressure is controlled with lisinopril.
- D. I plan to continue taking diclofenac for pain control.
Correct Answer: D
Rationale: Diclofenac (Voltaren) is an NSAID; increased bleeding tendency and increased sensitivity to sunlight are side effects that may inhibit achieving optimal cosmetic outcomes. Fasting is standard practice. Nervousness does not affect cosmetic outcomes. Controlled hypertension poses no significant risk.
The nurse is caring for the client with a split-thickness skin graft taken from the thigh to cover a burn on the back. Which intervention should the nurse expect to implement to help reduce the risk of infection at the donor and graft site?
- A. Obtain serial wound cultures of the donor site.
- B. Eliminate plants and flowers in the client's room.
- C. Use clean technique for all wound care procedures.
- D. Administer a continual low dosage of an IV antibiotic.
Correct Answer: B
Rationale: Pseudomonas has been found in plants and flowers, which may be a source of wound infection. Wound cultures are used to confirm an infection but do not prevent one. Sterile technique, not clean technique, would eliminate additional sources of infection. Continual low-dosage antibiotic infusions would not be effective due to increased metabolism in burn clients.