SAUNDERS COMPREHENSIVE REVIEW FOR NCLEX 3 - 2020 | SAUNDERS COMPREHENSIVE REVIEW FOR NCLEX

SAUNDERS COMPREHENSIVE REVIEW FOR NCLEX THREE 1000+ Questions and answers 1) The nurse performs an assessment on a client admitted with contact dermatitis. Which signs and symptoms should the nurse look for?  Lesions with well-defined geometric margins 2) The nurse is providing home care instructions to the client who just had surgery for squamous cell carcinoma. The nurse provides follow-up teaching and explains to the client to watch for which characteristics of this type of skin carcinoma?  Firm, nodular lesion topped with a crust or with a central area of ulceration 3) The nurse is teaching the client about risk factors for skin cancer. Which statements by the client indicate that teaching was successful? Select all that apply.  "I have to avoid excessive exposure to sunlight."  "I am at higher risk for skin cancer because my mother had one." 4) The nurse is assessing a dark-skinned client for signs of anemia. The nurse should focus the assessment on which structures? Select all that apply.  Lips  Conjunctiva  Mucous membranes 5) The nurse is providing teaching to a client who will undergo chemotherapy for cancer, and alopecia is expected from the chemotherapeutic agent. Which statement made by the client indicates a need for further teaching?  "I can't believe my hair loss will be permanent." 6) The nurse is caring for a client with full-thickness circumferential burns of the entire trunk of the body. Which finding suggests that an escharotomy may be necessary?  High pressure alarm keeps sounding on the ventilator 7) A client with chloasma is extremely stressed about the change in her facial appearance. Which integumentary change observed by the nurse is consistent with this problem?  Blotchy brown macules across the cheeks and forehead 8) The nurse is planning care for a client who suffered a burn injury and has a negative self-image related to keloid formation at the burn site. The keloid formation is indicative of which condition?  Hypertrophy of collagen fibers 9) The nurse observes the client's sacrum and notes the following. How will the nurse document this in the client's medical record? Refer to figure. View Figure  Stage IV pressure ulcer 10) A client recently diagnosed with chronic kidney disease requiring hemodialysis has an arteriovenous fistula for access. The client asks the nurse what complications can occur with the access site. What complications should the nurse inform the client about? Select all that apply.  Hepatitis  Infection 11) The nurse has completed discharge teaching for a client who was admitted for reticular skin lesions. Which statement by the client indicates understanding of the discharge instructions?  "I need to assess my skin for lesions that appear net-like." 12) A client exhibits erythema of the skin. The nurse plans care, knowing that which factors are responsible for this finding? Select all that apply.  Fever  Vasodilation  Inflammation  Excessively high environmental temperature 13) An older client's physical examination reveals the presence of a fiery star-shaped marking with a circular, solid center. The nurse recognizes that these findings, which are caused by capillary radiations extending from the central arterial body, are representative of which lesions?  Spider angioma 14) An older client is lying in a supine position. The nurse understands that the client is at least risk for skin breakdown in which body area?  Greater trochanter 15) In planning care for the client with psoriasis, the nurse understands that which represents a priority client problem?  Altered body image 16) The nurse is performing an admission assessment on a client diagnosed with paronychia. The nurse should plan to assess which part of the integumentary system first?  Nails 17) A client exhibits a purplish bruise to the skin after a fall. The nurse would document this finding in the health record most accurately using which term?  Ecchymosis 18) A client is diagnosed with a full-thickness burn. What should the nurse anticipate will be used for final coverage of the client's burn wound?  Autograft 19) The nurse is providing instructions to a client with psoriasis who will be receiving ultraviolet (UV) light therapy. Which statement would be most appropriate for the nurse to include in the client's instructions?  "You will need to wear dark eye goggles during the treatment." 20) The nurse in the surgical care center will be assisting the health care provider to perform a punch biopsy of a client's skin lesion. Which interventions should be included in the preprocedure plan of care? Select all that apply.  Obtain an informed consent.  Prepare to apply direct pressure to the biopsy site after the procedure.  Tell the client that a small piece of tissue will be removed for examination. 21) The nurse is developing a teaching plan for a group of adolescents regarding the causes of acne. The nurse develops the plan based on which characteristics associated with acne? Select all that apply.  The exact cause of acne is unknown.  Acne requires active treatment for control until it resolves.  Oily skin and a genetic predisposition may be contributing factors for acne.  The types of lesions in acne include comedones (open and closed), pustules, papules, and nodules. 22) The nurse is reviewing the health care records of clients scheduled to be seen at a health care clinic. The nurse determines that which client is at the greatest risk for development of an integumentary disorder?  An outdoor construction worker 23) A client scheduled for a skin biopsy is concerned and asks the nurse how painful the procedure is. Which statement is the appropriate response by the nurse?  "The local anesthetic may cause a burning or stinging sensation." 24) The nurse is preparing a client for punch biopsy. What should the nurse do to prepare for this procedure?  Ensure that the consent form has been signed. 25) The nurse prepares to assist a health care provider who is examining a client's skin with a Wood's light. Which step should the nurse include in the plan for this procedure?  Darken the room for the examination. 26) The nurse prepares to treat a client with frostbite of the toes. Which action should the nurse anticipate will be prescribed for this condition?  Rapid and continuous rewarming of the toes in a warm water bath until flushing of the skin occurs 27) The presence of which finding leads the home health nurse to suspect infestation of a client with scabies?  Multiple straight or wavy, threadlike lines beneath the skin 28) The nurse suspects herpes zoster (shingles) when which assessment finding is noted?  Clustered skin vesicles 29) Ultraviolet (UV) light therapy is prescribed as a component of the treatment plan for a client with psoriasis, and the nurse provides instructions to the client regarding the treatment. Which statement by the client indicates a need for further instruction?  "The UV light treatments are given on consecutive days." 30) The nurse prepares to care for a client with acute cellulitis of the lower leg. The nurse anticipates that which interventions will be prescribed for the client? Select all that apply.  Antibiotic therapy  Warm compresses to the affected area 31) Which individuals are most likely to be at risk for development of psoriasis? Select all that apply.  A woman experiencing menopause  A client with a family history of the disorder  An individual who has experienced a significant amount of emotional distress 32) A 60-kg client has sustained third-degree burns over 40% of the body. Using the Parkland (Baxter) formula, the minimum fluid requirements are which during the first 24 hours after the burn?  9600 mL of lactated Ringer's solution - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -972) Isoniazid is prescribed for a child with human immunodeficiency virus (HIV) infection who has a positive tuberculin skin test result. The mother of the child asks the nurse how long the child will need to take the medication. For how long should the nurse tell the mother the medication will need to be taken?  12 months 973) A client with an exacerbation of chronic obstructive pulmonary disease (COPD) has been on oral glucocorticoids and is currently being weaned to triamcinolone by inhalation. The nurse determines that the client understands the potential adverse effects to watch for during this medication change when the client states the need to report which signs and symptoms?  Anorexia, nausea, weakness, and fatigue 974) A client diagnosed with active tuberculosis has been prescribed a combination of isoniazid and rifampin for treatment. The nurse teaches the client to perform which action?  Take both medications together once a day. 975) A client with tuberculosis receiving cycloserine orally twice daily must have blood drawn in 1 week to measure the serum concentration of the medication. The nurse prepares the client for this test by providing which information to the client?  Take the morning dose and have the blood drawn 2 hours after taking the dose. 976) A client with a documented exposure to tuberculosis is on medication therapy with isoniazid. The nurse is monitoring laboratory results and determines that which laboratory value indicates the need for follow-up?  Aspartate aminotransferase (AST) 55 U/L (55 U/L 977) A client has begun a course of therapy with rifampin. The home care nurse instructs the client on which measure due to an anticipated side effect?  Wear dark clothing to avoid staining. 978) A client is taking a prescribed course of therapy with ethambutol. The home health nurse assesses the client at each home visit for which adverse effect of this medication?  Visual disturbances 979) The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving theophylline. The nurse monitors the serum theophylline level and concludes that the medication dosage may need to be increased if which value is noted?  5 mg/mL (20 mcmol/L) 980) The nurse is administering a dose of morphine sulfate to a client via an epidural catheter after nephrectomy. Before administering the medication, what should the nurse plan to do?  Ensure that naloxone is readily available. 981) A client has been given a prescription for benzonatate. Which observation should the nurse look for to evaluate the effectiveness of the medication?  Calming the client's persistent cough 982) A client has begun using a methylxanthine bronchodilator. What beverage should the nurse plan to teach the client to avoid while taking this medication?  Coffee 983) A client taking albuterol by inhalation cannot cough up secretions. What should the nurse suggest that the client do to assist in expectoration of secretions?  Drink increased amounts of fluids every day. 984) A client who has been receiving theophylline by the intravenous (IV) route has the medication prescription changed to an immediate-release oral form of the medication. After discontinuing the IV medication, when should the nurse schedule the first dose of the oral medication?  4 hours after discontinuing the IV form 985) A client has been taking pyrazinamide for 6 months. The nurse determines that the medication is effective if which cultures yield a negative result?  Sputum 986) A client with a prescription to take theophylline daily has been given medication instructions by the nurse. What statement by the client indicates the need for further education regarding the prescription?  "I will take the daily dose at bedtime." 987) A client with tuberculosis (TB) has a prescription for rifampin. What instruction should the nurse include in the client's teaching plan?  Wearing glasses instead of soft contact lenses will be necessary. 988) Cromolyn sodium is prescribed for the client with allergic asthma. What goal does the nurse expect to achieve by administration of this medication?  Inhibition of the release of mediators from mast cells after exposure to an antigen 989) A client has been taking pyrazinamide for 1 month. The client asks the nurse whether the therapy is due to be terminated soon. The nurse determines that the medication probably will be continued based on a positive finding in which report?  Sputum culture 990) A client has a prescription to take guaifenesin. The nurse should conclude that the client understands the most effective use of this medication if the client states that they need to take which action?  Take the tablet with a full glass of water. 991) The nurse is preparing to administer albuterol to a client. Which parameters should the nurse assess before and during therapy?  Lung sounds and presence of dyspnea 992) A home care nurse has observed a client self-administer a dose of an adrenergic bronchodilator via metered-dose inhaler. Within a short time, the client begins to wheeze loudly. The nurse understands that this is the result of which occurrence?  Paradoxical bronchospasm, which must be reported to the health care provider (HCP) 993) A client receiving oral theophylline is due to have a theophylline level drawn. The nurse should question the client to ensure that the client has not ingested which substance before the blood sample is drawn?  Coffee 994) The nurse has administered a dose of salmeterol to a client. The client develops a generalized rash and urticaria, and the eyelids begin to swell. Which action should the nurse take?  Call the health care provider (HCP) immediately. 995) A client taking rifampin reports, "My urine has blood in it." When the nurse assesses the urine, it is brown. Which is the nurse's best action?  Chart the finding as a normal response to the rifampin. 996) A clinic nurse is assessing a client who has been on isoniazid for 6 months. Which client complaint should most concern the nurse?  Difficulty tying shoes 997) The client questions the nurse as to why the health care provider switched the usual prescription from a metered-dose inhaler (MDI) to a dry powder inhaler (DPI). The nurse should respond correctly by providing which facts? Select all that apply.  Dry powder inhalers pose no environmental risks.  Dry powder inhalers deliver more medication to the lungs.  Dry powder inhalers require less hand-to-lung coordination. 998) Which statement made by a client taking montelukast indicates the need for further teaching?  "I will take the medication when I first notice I am having trouble breathing." 999) When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instruction is needed when the client makes which statement?  "I use my corticosteroid inhaler each time I feel short of breath." 1000) Which are risk factors for chronic obstructive pulmonary disease (COPD)? Select all that apply.  Cigarette smoking  Genetic risk factor  Environmental factors  Alpha-1 antitrypsin (AAT) deficiency 1001) Which is the nurse's priority assessment for monitoring for adverse effects for the client taking isoniazid?  Urine color