While the nurse is assessing the client hospitalized with recurrent lower-extremity cellulitis, the client states, 'I have athlete's foot; do you want to check it?' The nurse concludes that this information is significant for what reason?
- A. Cellulitis is commonly caused by a similar fungal infection.
- B. Both infections should resolve with topical fungicide therapy.
- C. Painful neuralgia can occur after the cellulitis infection has resolved.
- D. The skin disruption with tinea pedis may be the cause of the cellulitis.
Correct Answer: D
Rationale: Cellulitis is an infection with diffuse inflammation occurring in the tissue just under the skin. Chronic athlete's foot causes minute breaks in the skin, allowing bacteria on the skin to enter the tissue and cause the infectious process. Cellulitis is caused by a bacterial infection, not fungal. Cellulitis requires antibiotics, not fungicides. Neuralgia is associated with herpes zoster, not cellulitis.
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The nurse is developing a plan of care for a client diagnosed with left-sided paralysis secondary to a right-sided cerebrovascular accident (stroke). Which should be included in the interventions?
- A. Use a pillow to keep the heels off the bed when supine.
- B. Order a low air-loss therapy bed immediately.
- C. Prepare to insert a nasogastric feeding tube.
- D. Order an occupational therapy consult for strength training.
Correct Answer: A
Rationale: Heel elevation prevents pressure ulcers in paralyzed clients. Low air-loss beds require HCP orders, NG tubes are premature, and OT is for rehabilitation, not immediate care.
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 nurse is working with clients in an aesthetic surgery center. Which intervention should the nurse implement for a client undergoing a chemical peel?
- A. Teach the client to expect extreme swelling after the procedure.
- B. Apply the chemical mixture directly to skin after the face is cleansed.
- C. Administer general anesthesia to the client prior to the procedure.
- D. Explain that there will be no pain or discomfort during the procedure.
Correct Answer: B
Rationale: Applying the chemical post-cleansing ensures efficacy and safety. Extreme swelling is not typical, general anesthesia is unnecessary, and mild discomfort is expected.
The nurse in a dermatology clinic is taking the history of a client. Which questions should the nurse ask the client? Select all that apply.
- A. When did you first notice the skin problem?
- B. What cosmetics or skin products do you use?
- C. Have you experienced any loss of sensation?
- D. What is your current and previous occupation?
- E. Do you experience any itching, burning, or tingling?
Correct Answer: A,B,C,D,E
Rationale: All listed questions assess onset, triggers, symptoms, and occupational exposures, critical for dermatologic history.
Of the following information provided by the client to the nurse, which factor is most likely to cause a retinal detachment?
- A. The client is younger than age 40.
- B. The client fell and struck the head.
- C. The client has multiple allergies.
- D. The client is being treated for glaucoma.
Correct Answer: B
Rationale: Trauma, such as a head injury, is a common cause of retinal detachment.
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