Nursing Exam Practice - Lecture Notes

Question 1: Severe Burn and Hypovolemia

• Earliest Indicator: Increased heart rate (Answer: A)
• Rationale: The body compensates for reduced blood volume by increasing heart rate to maintain cardiac output.

Question 2: Psoriasis Patient Education

• Need for Further Teaching: Expecting to be completely cured (Answer: C)
• Rationale: Psoriasis is a chronic autoimmune disease that can be managed but not cured.

Question 3: Acne Medication

• Avoid Pregnancy: Isotretinoin (Answer: B)
• Rationale: Isotretinoin has significant teratogenic effects; a risk management program is required.

Question 4: Suspected Melanoma

• Expected Finding: Mole with irregular borders and varying colors (Answer: B)
• Rationale: Melanoma is characterized by asymmetry, irregular borders, color variation, and evolving nature.

Question 5: Leg Ulcer Wound Care

• Essential Information: Use antibiotic ointment and a moist dressing (Answer: C)
• Rationale: Moist environments promote faster healing and less pain, prevent infection.

Question 6: Skin Cancer History

• Recommendation: Limit sun exposure between 10:00 a.m. and 4:00 p.m. (Answer: A)
• Rationale: UV rays are strongest during these hours; tanning beds should also be avoided.

Question 7: Non-Blanchable Redness

• Appropriate Action: Document as a stage I pressure injury (Answer: A)
• Rationale: Indicates a stage I pressure injury; documentation and intervention are necessary.

Question 8: Basal Cell Carcinoma

• Suspect Characteristic: Small flesh-colored papule with pearly appearance (Answer: B)
• Rationale: Basal cell carcinoma often presents as a small, flesh-colored pearly nodule.

Question 9: Cellulitis Diagnosis

• Consistent Finding: Warm, red swollen area with diffuse borders (Answer: B)
• Rationale: Cellulitis typically presents as a warm, red swollen area with diffuse borders.

Question 10: Scabies Treatment

• Essential Instruction: Wash all bedding and clothing in hot water (Answer: A)
• Rationale: Washing items in hot water prevents reinfestation and controls the spread of mites.

Question 11: Atopic Dermatitis (Eczema)

• Need for Further Teaching: Scratching lesions to remove dead skin (Answer: D)
• Rationale: Scratching exacerbates eczema and can lead to skin damage and infection.

Question 12: Suspected Frostbite

• Typical Finding: White or yellowish waxy skin (Answer: B)
• Rationale: Frostbite is characterized by white or yellowish waxy skin; immediate rewarming is necessary.

Question 13: Pressure Ulcer Care

• Appropriate Statement: Use saline to clean wound and apply a moist dressing (Answer: C)
• Rationale: Cleaning with saline and applying a moist dressing promotes healing.

Question 14: Herpes Zoster (Shingles)

• Appropriate Instruction: Keep rash covered to prevent transmission (Answer: C)
• Rationale: Herpes zoster can spread; covering the rash helps prevent transmission.

Question 15: Severe Acne Dietary Recommendation

• Dietary Change: Limit dairy products and high-glycemic foods (Answer: D)
• Rationale: Some studies suggest these foods can exacerbate acne.

Question 16: Severe Sunburn Management

• Initial Intervention: Encourage increased fluid intake (Answer: B)
• Rationale: Hydration prevents dehydration in severe sunburn cases.

Question 17: Colostomy Stoma Care

• Need for Further Teaching: It's normal for the stoma to bleed a little (Answer: C)
• Rationale: Regular bleeding should be reported as it may indicate trauma or irritation.

Question 18: Venostasis Ulcers

• Important Instruction: Wear compression stockings during the day (Answer: C)
• Rationale: Compression stockings improve venous return, prevent fluid accumulation.

Question 19: Isotretinoin Precautions

• Essential Instruction: Limit exposure to direct sunlight (Answer: A)
• Rationale: Isotretinoin increases skin sensitivity to sunlight.

Question 20: Impetigo Diagnosis

• Common Finding: Thick crusted yellow lesions (Answer: B)
• Rationale: Impetigo presents as vesicles that rupture and form thick, honey-colored crust.

Question 21: Post-Operative Skin Graft Care

• Important Action: Keep graft site elevated (Answer: B)
• Rationale: Elevation reduces edema, promotes venous return.

Question 22: Malignant Melanoma Biopsy

• Accurate Explanation: Remove entire lesion and surrounding skin (Answer: B)
• Rationale: Excisional biopsy helps in diagnosis and staging.

Question 23: Allergic Reaction (Urticaria)

• Priority Intervention: Administer prescribed antihistamine (Answer: B)
• Rationale: Antihistamines address the underlying allergic reaction.

Question 24: Scleroderma

• Expected Finding: Hard thickened skin (Answer: B)
• Rationale: Characterized by skin that becomes hard and thickened.

Question 25: Preventing Candidal Infections

• Understanding Indicated: Dry skin thoroughly after bathing (Answer: C)
• Rationale: Drying skin prevents conditions that promote candidal infections.