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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Document preview page 1

2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 1

Document preview content for 2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions)

2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions)

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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 1 preview image1NURS618SaundersMedSurgSkinIntegumentaryRevisedSaundersMed-SurgSkinIntegumentary1.Aclientcallstheemergencydepartmentandtellsthenursethathecamedirectlyintocontactwithpoisonivyshrubs.Theclienttellsthenursethathecannotseeanythingontheskinandasksthenursewhattodo.Thenurseshouldmakewhichresponse?1."Cometotheemergencydepartment."2."Applycalamine lotion immediately to theexposed skin areas."3."Takeashowerimmediately,latheringandrinsingseveraltimes."4."Itisnotnecessarytodoanythingifyoucannotseeanythingonyourskin."Answer:3."Takeashowerimmediately,latheringandrinsingseveraltimes."Rationale:
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 2 preview image
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 3 preview image2When an individualcomesin contactwith apoisonivyplant,the sapfromtheplant formsaninvisible filmon thehuman skin.The clientshouldbeinstructedtocleansetheareabyshoweringimmediatelyandtolathertheskinseveraltimesandrinseeachtimeinrunningwater.Removingthepoisonivy sap willdecrease thelikelihood ofirritation.Calaminelotionmaybeoneproductrecommendedforuseifdermatitisdevelops.Theclientdoesnotneedtobeseenintheemergencydepartmentatthistime.2.Aclientisbeingadmittedtothehospitalfortreatmentofacutecellulitisofthelowerleftleg.Duringtheadmissionassessment,thenurseexpectstonotewhichfinding?1.Aninflammationoftheepidermisonly2.Askininfectionofthedermisandunderlyinghypodermis3.Anacutesuperficialinfectionofthedermisandlymphatics4.AnepidermalandlymphaticinfectioncausedbyStaphylococcusAnswer:2.AskininfectionofthedermisandunderlyinghypodermisRationale:Cellulitisisaninfectionofthedermisandunderlyinghypodermisthatresultsinadeeprederythemawithoutsharpbordersandspreadswidelythroughouttissuespaces.Theskiniserythematous,edematous,tender,and
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 4 preview image3sometimesnodular.Erysipelasisanacute,superficial,rapidlyspreadinginflammationofthedermisandlymphatics.Theinfectionisnotsuperficialandextendsdeeperthantheepidermis.3.Theclinicnurseassessestheskinofaclientwithpsoriasisaftertheclienthasusedanewtopicaltreatmentfor2months.Thenurseidentifieswhichcharacteristicsasimprovementinthemanifestationsofpsoriasis?Selectallthatapply.1.Presenceofstriae2.Palpableradialpulses3.Absenceofanyecchymosisontheextremities4.Thinneranddecreaseinnumberofreddishpapules5.Scarceamountofsilvery-whitescalypatchesonthearmsAnswers:4.Thinneranddecreaseinnumberofreddishpapules5.Scarceamountofsilvery-whitescalypatchesonthearmsRationale:Psoriasisskinlesionsincludethickreddenedpapulesorplaquescoveredbysilvery-whitepatches.Adecreaseintheseverityoftheseskinlesionsisnotedasanimprovement.Thepresenceofstriae(stretchmarks),palpablepulses,orlackofecchymosisisnotrelatedtopsoriasis.
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 5 preview image44.Theclinicnursenotesthatthehealthcareproviderhasdocumentedadiagnosisofherpeszoster(shingles)intheclient'schart.Basedonanunderstandingofthecauseofthisdisorder,thenursedeterminesthatthisdefinitivediagnosiswasmadebywhichdiagnostictest?1.Positivepatchtest2.Positivecultureresults3.Abnormalbiopsyresults4.Wood'slightexaminationindicativeofinfectionAnswer:2.PositivecultureresultsRationale:Withtheclassicpresentationofherpeszoster,theclinicalexaminationisdiagnostic.However,aviralcultureofthelesionprovidesthedefinitivediagnosis.Herpeszoster(shingles)iscausedbyareactivationofthevaricella-zostervirus,thevirusthatcauseschickenpox.Apatchtestisaskintestthatinvolvestheadministrationofanallergentothesurfaceoftheskintoidentifyspecificallergies.Abiopsywouldprovideacytologicalexaminationoftissue.InaWood'slightexamination,theskinisviewedunderultravioletlighttoidentifysuperficialinfectionsoftheskin.
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 6 preview image55.Aclientreturnstotheclinicforfollow-uptreatmentfollowingaskinbiopsyofasuspiciouslesionperformed1weekago.Thebiopsyreportindicatesthatthelesionisamelanoma.Thenurseunderstandsthatmelanomahaswhich characteristics?Selectallthatapply.1.Lesion is painful totouch.2.Lesionishighlymetastatic.3.Lesionisanevusthathaschangesincolor.4.Skinunderthelesionisreddenedandwarmtotouch.5.Lesionoccursinbodyareaexposedtooutdoorsunlight.Answers:2.Lesionishighlymetastatic.3.Lesionisanevusthathaschangesincolor.Rationale:Melanomas are pigmented malignant lesions originating in the melanin-producingcellsoftheepidermis.Melanomascausechangesinanevus(mole),includingcolorandborders.Thisskincancerishighlymetastatic,andaperson'ssurvivaldependsonearlydiagnosisandtreatment.Melanomasarenotpainfuloraccompaniedbysignofinflammation.Althoughsunexposureincreasestheriskofmelanoma,lesionsaremostcommonlyfoundontheupper backandlegsandonthesolesandpalmsofpersonswithdarkskin.
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 7 preview image67. A client arriving at the emergency department has experienced frostbiteto the right hand. Which finding would the nurse note on assessment of theclient'shand?1.Apink,edematoushand2.Fieryredskinwithedemainthenailbeds3.Blackfingertipssurroundedbyanerythematousrash4.Awhitecolortotheskin,whichisinsensitivetotouchAnswer:4.Awhitecolortotheskin,whichisinsensitivetotouchRationale:Assessmentfindingsinfrostbiteincludeawhiteorbluecolor;theskinwillbehard,cold,andinsensitivetotouch.Asthawingoccurs,flushingoftheskin,thedevelopmentofblistersorblebs,ortissueedemaappears.Options1,2,and3areincorrect.8.Theeveningnursereviewsthenursingdocumentationinaclient'schartandnotesthatthedaynursehasdocumentedthattheclienthasastageIIpressureulcerinthesacralarea.Whichfindingwouldthenurseexpecttonoteonassessmentoftheclient'ssacralarea?1.Intactskin
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 8 preview image72.Full-thicknessskinloss3.Exposedbone,tendon,or muscle4.Partial-thicknessskinlossofthedermisAnswer:4.Partial-thicknessskinlossofthedermisRationale:InastageIIpressureulcer,theskinisnotintact.Partial-thicknessskinlossofthedermishasoccurred.Itpresentsasashallowopenulcerwithared-pinkwoundbed,withoutslough.Itmayalsopresentasanintactoropen/rupturedserum-filledblister.Theskin isintact instage I.Full-thicknessskinlossoccursinstageIII.Exposedbone,tendon,ormuscleispresentinstageIV.9.An adultclient wasburnedinan explosion.The burninitiallyaffectedtheclient'sentireface(anteriorhalfofthehead)andtheupperhalfoftheanteriortorso,andtherewerecircumferentialburnstothelowerhalfofbotharms.Theclient'sclothescaughtonfire,andtheclientran,causingsubsequentburninjuriestotheposteriorsurfaceoftheheadandtheupperhalfoftheposteriortorso.Usingtheruleofnines,whatwouldbetheextentoftheburninjury?1.18%
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 9 preview image82.24%3.36%4.48%Answer:3.36%Rationale:Accordingtotheruleofnines,withtheinitialburn,theanteriorhalfoftheheadequals4.5%,theupperhalfoftheanteriortorsoequals9%,andthelowerhalfofbotharmsequals9%.Thesubsequentburnincludedtheposteriorhalfofthehead,equaling4.5%,andtheupperhalfofposteriortorso,equaling9%.Thistotals36%.10.Thenurseispreparingtocareforaburnclientscheduledforanescharotomyprocedurebeingperformedforathird-degreecircumferentialarmburn.Thenurseunderstandsthatwhichfindingistheanticipatedtherapeuticoutcomeoftheescharotomy?1.Returnofdistalpulses2.Briskbleedingfromthesite3.Decreasingedemaformation4.Formationofgranulationtissue
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 10 preview image9Answer:1.ReturnofdistalpulsesRationale:Escharotomiesareperformedtorelievethecompartmentsyndromethatcanoccurwhenedemaformsundernondistensibleescharinacircumferentialthird-degreeburn.Theescharotomyreleasesthetourniquet-likecompressionaroundthearm.Escharotomiesareperformedthroughavasculareschartosubcutaneousfat.Althoughbleedingmayoccurfromthesite,itisconsideredacomplicationratherthanananticipatedtherapeuticoutcome.Usually,directpressurewithabulkydressingandelevationcontrolthebleeding,butoccasionallyanarteryisdamagedandmayrequireligation.Escharotomydoesnotaffecttheformationofedema.Formationofgranulationtissueisnottheintentofanescharotomy.11.Thenurseiscaringforaclientwhosustainedsuperficialpartial-thicknessburnsontheanteriorlowerlegsandanteriorthorax.Whichfindingdoesthenurseexpecttonoteduringtheresuscitation/emergentphaseoftheburninjury?1.Decreasedheartrate2.Increasedurinaryoutput3.Increasedbloodpressure4.Elevatedhematocritlevels
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 11 preview image10Answer:4.ElevatedhematocritlevelsRationale:Theresuscitation/emergentphase beginsatthe timeofinjuryandendswiththerestorationofcapillarypermeability,usuallyat48to72hoursfollowingtheinjury.Duringtheresuscitation/emergentphase,thehematocritlevelincreasestoabovenormalbecauseofhemoconcentrationfromthelargefluidshifts.Hematocritlevelsof50%to55%(0.50to0.55)areexpectedduringthefirst24hoursafterinjury,withreturntonormalby36hoursafter injury.Initially,bloodisshuntedawayfromthekidneysandrenalperfusionandglomerularfiltrationaredecreased,resultinginlowurineoutput.Theburnclientispronetohypovolemiaandthebodyattemptstocompensate byincreasedpulserateand lowered blood pressure. Pulseratesaretypicallyhigherthannormal,andthebloodpressureisdecreasedasaresultofthelargefluidshifts.12.Thenurseisadministeringfluidsintravenouslyasprescribedtoaclientwhosustainedsuperficialpartial-thicknessburninjuriesofthebackandlegs.Inevaluatingtheadequacyoffluidresuscitation,thenurseunderstandsthatwhichassessmentwouldprovidethemostreliableindicatorfordeterminingtheadequacy?
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 12 preview image111.Vitalsigns2.Urineoutput3.Mentalstatus4.PeripheralpulsesAnswer:2.UrineoutputRationale:Successfuloradequatefluidresuscitationintheclientissignaledbystablevitalsigns,adequateurineoutput,palpableperipheralpulses,andclearsensorium.However, themostreliableindicatorfordeterminingadequacyoffluidresuscitation,especiallyinaclientwithburns,istheurineoutput.Foranadult,thehourlyurinevolumeshouldbe30to50mL.13.Thenurseiscaringforaclientfollowinganautograftandgraftingtoaburnwoundontherightknee.Whatwouldthenurseanticipatetobeprescribedfortheclient?1.Out-of-bedactivities2.Bathroomprivileges3.Immobilization oftheaffected leg4.PlacingtheaffectedleginadependentpositionAnswer:
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 13 preview image123.ImmobilizationoftheaffectedlegRationale:Autograftsplacedoverjointsoronthelowerextremitiesaftersurgeryoftenare elevated andimmobilizedfor3 to7days.This periodofimmobilizationallowstheautografttimetoadheretothewoundbed.Gettingoutofbed,goingtothebathroom,andplacingthegraftedlegdependentwouldputstressonthegraftedwound.14.Thehealtheducationnurseprovidesinstructionstoagroupofclientsregardingmeasuresthatwillassistinpreventingskincancer.Whichinstructionsshouldthenurseprovide?Selectallthatapply.1.Sunscreenshouldbeappliedevery8hours.2.Usesunscreenwhenparticipatinginoutdooractivities.3.Wearahat,opaqueclothing,andsunglasseswheninthesun.4.Avoidsunexposureinthelateafternoonandearlyeveninghours.5.Examineyourbodymonthly forany lesionsthatmaybesuspicious.Answers:2.Usesunscreenwhenparticipatinginoutdooractivities.3.Wearahat,opaqueclothing,andsunglasseswheninthesun.5.Examineyourbodymonthlyforanylesionsthatmaybesuspicious.
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 14 preview image13Rationale:Theclientshouldbeinstructedtoavoidsunexposurebetweenthehoursofbrightestsunlight:10a.m.and4p.m.Sunscreen,ahat,opaqueclothing,andsunglassesshouldbewornforoutdooractivities.Theclientshouldbeinstructedtoexaminethebodymonthlyfortheappearanceofanycancerousoranyprecancerouslesions.Sunscreenshouldbereappliedevery2to3hoursandafterswimmingorsweating;otherwise,thedurationofprotectionisreduced.27.Thecommunityhealthnurseisvisitingahomelessshelterandisassessingtheclientsintheshelterforthepresenceofscabies.Whichassessmentfindingshouldthenurseexpecttonoteifscabiesispresent?1.Brown-redmaculeswithscales2.Pustulesonthetrunkofthebody3.Whitepatchesnotedontheelbowsandknees4.MultiplestraightorwavythreadlikelinesunderneaththeskinAnswer:4.MultiplestraightorwavythreadlikelinesunderneaththeskinRationale:
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 15 preview image14Scabiescanbeidentifiedbythemultiplestraightorwavythreadlikelinesbeneaththeskin.Theskinlesionsarecausedbythefemale,whichburrowsbeneaththeskintolayitseggs.Theeggshatchinafewdays,andthebabymitesfindtheirwaytotheskinsurface,wheretheymateandcompletethelifecycle.Options1,2,and3arenotcharacteristicsofscabies.29.Thenurseisconcernedaboutpotentialskinintegrityproblemsforanunconsciousclient.Whichinterventionswouldbemostappropriatetoincludeintheplanofcareforthisclient?Selectallthatapply.1.Repositionevery2hours.2.Useabedcradleasindicated.3.Applyprotectivepadstoheelsandelbows.4.Adda smallamountof alcoholto thedailybath water.5.Provideperinealcareevery8hoursandafterincontinence.Answers:1.Repositionevery2hours.2.Useabedcradleasindicated.3.Applyprotectivepadstoheelsandelbows.5.Provideperinealcareevery8hoursandafterincontinence.Rationale:
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2020 NURS618 Saunders Medical Surgical Skin Integumentary Revised Question With Answers (115 Solved Questions) - Page 16 preview image15Unconsciousclientsarecompletelyimmobile,havinglosttheprotectivereflexestoshiftbodyweight.Itisuptothenursetominimizetheriskofprolongedpressurethatcouldcauseskinischemiaandbreakdown.Thisisaccomplishedbyrepositioningtheclientevery2hours.Useofabedcradlecanprotecttheclient'stoesfrombreakdownduetoweightfromlinens.Protectivepadscanbeappliedtotheheelsandelbowstoreducefrictionandshear.Appropriateperinealcareisessentialtokeepwasteproductsfromexcoriatingtheskin.Thenursecanreduceskindrynessandirritationbyaddingasuperfattysolution(suchasbabyoilorcastilesoap)tothedailybathwater.Dryingagentssuchasalcoholareavoidedbecausedryskincancrackandbreakdown.30.Theemergencydepartmentnurseiscaringforaclientwhohassustainedchemicalburnstotheesophagusafteringestionoflye.Thenursereviewsthehealthcareprovider'sprescriptionsandshouldplantoquestionwhichprescription?1.Gastriclavage2.Intravenous(IV)fluidtherapy3.Nothingbymouth(NPO)status4.PreparationforlaboratorystudiesAnswer:1.Gastriclavage
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University
Walden University
Course
NURS 618
Subject
Medicine

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