Nokea
The school nurse is discussing impetigo with the teachers in an elementary school. One of the teachers asks the nurse, 'How can I prevent getting impetigo?' Which statement would be the most appropriate response?
- A. Wash your hands after using the bathroom.'
- B. Do not touch any affected areas without gloves.'
- C. Apply a topical antibiotic to your hands.'
- D. Keep the child with impetigo isolated in the room.'
Correct Answer: B
Rationale: Avoiding contact with impetigo lesions without gloves prevents transmission. Handwashing is general, topical antibiotics are for treatment, and isolation is excessive.
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Which plan best promotes a blind client's feeling of self-reliance when eating?
- A. Help the client locate food by comparing its placement to clock positions.
- B. Ask a hospital volunteer to feed the client so the client does not have to ask for help.
- C. Order foods that can be sipped from containers rather than eaten with utensils.
- D. Ask the dietary department to serve the client's food on paper plates and in cups.
Correct Answer: A
Rationale: Using clock positions empowers the client to eat independently by orienting them to food placement.
Which laboratory test should the nurse monitor to identify an allergic reaction for the client diagnosed with contact dermatitis?
- A. IgA.
- B. IgD.
- C. IgE.
- D. IgG.
Correct Answer: C
Rationale: IgE mediates allergic reactions, elevated in contact dermatitis. IgA, IgD, and IgG are less relevant.
On inspecting the client's eye, the nurse will note which symptom of conjunctivitis in addition to erythema?
- A. Dried drainage along the eyelid
- B. Lack of pupil response to light
- C. Bulging of the eye from the orbit
- D. Loss of moisture on the cornea
Correct Answer: A
Rationale: Conjunctivitis often presents with dried, crusty drainage along the eyelid.
The experienced nurse is observing the new nurse administer medications. Which actions by the new nurse require the experienced nurse to intervene? Select all that apply.
- A. Applies tretinoin to an open wound on the face of the client with acne
- B. Withholds isotretinoin until the client's pregnancy status is known
- C. Withholds fluorouracil because the client's papules of actinic keratosis are worse
- D. Waits two hours after the client bathes and uses lotion to apply tacrolimus
- E. Tells the client taking acitretin for psoriasis to prevent pregnancy for a year
Correct Answer: A,C,E
Rationale: Tretinoin (Retin-A) should not be applied to open wounds; the experienced nurse should intervene. Actinic keratosis treatment using fluorouracil (Carac) causes the affected area to become worse before getting better; the medication should not be withheld. When taking acitretin (Soriatane), the client should not become pregnant for three years following treatment. Withholding isotretinoin until pregnancy status is known is appropriate. Waiting two hours to apply tacrolimus after lotion is correct.
The ED nurse is caring for a client admitted with extensive, deep partial-thickness and full-thickness burns. Which interventions should the nurse implement? List in order of priority.
- A. Estimate the amount of burned area using the rule of nines.
- B. Insert two (2) 18-gauge catheters and begin fluid replacement.
- C. Apply sterile saline dressings to the burned areas.
- D. Determine the client’s airway status.
- E. Administer morphine sulfate, IV.
Correct Answer: D,B,E,A,C
Rationale: Priority: 1) Airway status (ABCs); 2) IV catheters/fluids (prevent shock); 3) Morphine (pain control); 4) Rule of nines (guide resuscitation); 5) Sterile dressings (infection prevention).