Nokea
The school nurse recognizes the signs of scabies when a child displays which symptom?
- A. small fluid-filled blisters that sting when scratched.
- B. dry scaly patches in body creases that itch.
- C. wavy threadlike lines on the body and pruritus.
- D. cluster of papular lesions with pruritus.
Correct Answer: C
Rationale: Scabies is manifested by brown threadlike lines on the body, especially the hands, anus, and body folds. Pruritus is severe. Scabies is not characterized by blisters, dry patches or popular lesions.
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Several residents in a long term care facility have been diagnosed with herpes zoster. Which resident will require the closest observation for development of complications?
- A. A resident who is sexually active
- B. A resident recovering from a hip fracture
- C. A resident with dementia who requires assistance eating.
- D. A resident who is undergoing chemotherapy for breast cancer
Correct Answer: D
Rationale: The resident who is undergoing chemotherapy is likely to develop a low white blood cell count, and is at the highest risk of complications such as disseminated herpes zoster or severe skin infection from the irritated skin at the lesion sites. A resident who is sexually active is not necessarily at high risk of complications of herpes zoster, (shingles). Neither the resident recovering from a hip fracture or the resident with dementia are as high a risk as the resident undergoing chemotherapy.
The nurse is caring for a 26-year-old patient who was burned 72 hours ago. The patient has partial-thickness burns to 24% of the body surface area and begins to excrete large amounts of urine. Which action should the nurse take?
- A. Increase the IV rate and monitor for burn shock.
- B. Monitor for signs of seizure activity.
- C. Assess for signs of fluid overload.
- D. Raise the foot of the bed and apply blankets.
Correct Answer: C
Rationale: As the blood volume increases, the cardiac output increases to increase renal perfusion. The result includes diuresis. However, a great risk for the patient includes fluid overload because of the rapid movement of fluid back into the intravascular space. Burn shock occurs from hypovolemia in the first 72 hours of a burn injury. Seizures are not associated with the burn injury. Raising the foot of the bed would not be of value in this situation.
Which action will the nurse take when administering a therapeutic bath to a patient who has severe pruritus from contact dermatitis?
- A. Use Burow's solution to help promote healing.
- B. Rub the skin briskly to decrease pruritus.
- C. Limit bathing to three times a week.
- D. Ensure that bath area is at least 85 degrees and dehumidified.
Correct Answer: A
Rationale: Pruritus is responsible for most of the discomfort. Wet dressings and using Burow's solution help promote the healing process. Rubbing the skin would increase pruritis. Give daily baths with an application to cleanse the skin. A cool environment with increased humidity decreases the pruritus.
A school nurse assesses a child who has an erythematous circular patch of vesicles on her scalp with alopecia and report spain and pruritus. For which reason will 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. The Woods lamp does not dry out lesions, reduce pruritus or kill fungus.
A patient, age 37, sustained partial- and full-thickness burns to 26% of the body surface area. When would the greatest fluid loss resulting from the burns occur?
- A. Within 12 hours after burn trauma
- B. 24 to 36 hours after burn trauma
- C. 36 to 48 hours after burn trauma
- D. 48 to 72 hours after burn trauma
Correct Answer: A
Rationale: In a burn injury, usually the greatest fluid loss occurs within the first 12 hours.