Nokea
Which action is most appropriate to include in the postoperative care plan when a client has skin grafts?
- A. Minimize movement to prevent graft disruption.
- B. Change the dressing over the graft every 8 hours.
- C. Reinforce the graft dressing if drainage occurs.
- D. Apply wet soaks to the graft every 4 hours.
Correct Answer: A
Rationale: Minimizing movement ensures graft adherence and healing.
You may also like to solve these questions
After instilling medication into the client's ear, which nursing instruction is most appropriate?
- A. Keep your head tilted for 5 minutes.
- B. Pack a cotton ball tightly in your ear.
- C. Do not blow your nose for at least 1 hour.
- D. Wipe the excess medication from the ear.
Correct Answer: A
Rationale: Keeping the head tilted allows the medication to stay in contact with the ear canal.
A young man has extensive burns on the front and back of the chest. His treatment includes the use of Sulfamylon to the burned areas. How should the nurse apply this medication?
- A. With a sterile, gloved hand
- B. With a sterile applicator
- C. With sterile 4x4's
- D. By aerosol spray
Correct Answer: C
Rationale: Sulfamylon is applied using sterile 4x4 gauze pads to ensure even coverage and maintain sterility while minimizing pain.
Which health teaching information is most appropriate for a client with a herpes simplex virus type 1 infection?
- A. Apply petroleum jelly to the lesions to prevent spreading the virus to adjacent areas.
- B. Use good personal hygiene to prevent spreading the virus to other body parts.
- C. Avoid using soap and water on open lesions.
- D. Remove the scabs daily by soaking with hot compresses.
Correct Answer: B
Rationale: Good hygiene prevents viral spread to other areas.
The client with the condition illustrated is prescribed adapalene topical daily to the affected areas. Which information should the nurse exclude when planning client education?
- A. The client has acne vulgaris, an inflammatory disease involving the sebaceous glands of the skin characterized by papules or pustules or comedones.
- B. Adapalene should be applied once daily in the evening.
- C. Exposing the back to the sun after adapalene (Differin) is applied.
- D. Only a thin film of adapalene should be applied.
Correct Answer: C
Rationale: The nurse should exclude exposing the back to the sun after adapalene (Differin) is applied. This increases the risk for sunburn. Adapalene should also not be applied to sunburned areas. The client has acne vulgaris. Adapalene should be applied once daily in the evening with a thin film.
Which information provided by the nurse will best prepare the client for the caloric test?
- A. Cold water and warm water will be instilled into each of the ears.
- B. You will wear earphones through which sounds are transmitted.
- C. The room will be darkened, and scalp electrodes will be attached to the head.
- D. Your blood will be drawn from a vein and examined microscopically.
Correct Answer: A
Rationale: The caloric test involves instilling water to assess vestibular function.