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SAUNDERS HESI MED SURG QUESTIONS WITH CORRECTLY SOLVED ANSWERS AND RATIONALE.
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SAUNDERS HESI MED SURG QUESTIONSWITH CORRECTLY SOLVED ANSWERS
AND RATIONALE.
The nurse is conducting a session about the principles of first aid and is
discussing the interventions for snakebite to an extremity. The nurse should
inform those attending the session that the first priority intervention in the
event of this occurrence is which action?
1. Immobilize the affected extremity.
2. Remove jewelry and constricting clothing from the victim.
3. Place the extremity in a position so that it is below the level of the heart.
4. Move the victim to a safe area away from the snake and encourage the
victim to rest. - Correct Answer-4
In the event of a snakebite, the first priority is to move the victim to a safe
area away from the snake and encourage the victim to rest to decrease
venom circulation. Next, jewelry and constricting clothing are removed
before swelling occurs. Immobilizing the extremity and maintaining the
extremity at the heart level would be done next; these actions limit the
spread of the venom. The victim is kept warm and calm. Stimulants such as
alcohol or caffeinated beverages are not given to the victim because these
products may speed the absorption of the venom. The victim should be
transported to an emergency facility as soon as possible.
A client calls the emergency department and tells the nurse that he came
directly into contact with poison ivy shrubs. The client tells the nurse that he
cannot see anything on the skin and asks the nurse what to do. The nurse
should make which response?
1. "Come to the emergency department."
2. "Apply calamine lotion immediately to the exposed skin areas."
3. "Take a shower immediately, lathering and rinsing several times."
4. "It is not necessary to do anything if you cannot see anything on your
skin." - Correct Answer-3
,When an individual comes in contact with a poison
ivy plant, the sap from the plant forms an invisible film on the human skin.
The client should be instructed to cleanse the area by showering
immediately and to lather the skin several times and rinse each time in
running water. Removing the poison ivy sap will decrease the likelihood of
irritation. Calamine lotion
may be one product recommended for use if dermatitis
develops. The client does not need to be seen in the emergency department
at this time.
A client is being admitted to the hospital for treatment of acute cellulitis of
the lower left leg. During the admission assessment, the nurse expects to
note which finding?
1. An inflammation of the epidermis only
2. A skin infection of the dermis and underlying hypodermis
3. An acute superficial infection of the dermis and lymphatics
4. An epidermal and lymphatic infection caused by Staphylococcus - Correct
Answer-2
Cellulitis is an infection of the dermis and underlying hypodermis that results
in deep red erythema without
sharp borders and spreads widely throughout tissue spaces. The skin is
erythematous, edematous, tender, and sometimes nodular. Erysipelas is an
acute, superficial, rapidly spreading inflammation of the dermis and
lymphatics. The infection is not superficial and extends deeper than the
epidermis.
The clinic nurse assesses the skin of a client with psoriasis after the client
has used a new topical treatment for 2 months. The nurse identifies which
characteristics as improvement in the manifestations of psoriasis? (SELECT
ALL THAT APPLY)
1. Presence of striae
2. Palpable radial pulses
3. Absence of any ecchymosis on the extremities
4. Thinner and decrease in the number of reddish papules
5. Scarce amount of silvery-white scaly patches on the arms - Correct
Answer-4, 5
,Psoriasis skin lesions include thick reddened papules or plaques covered by
silvery-white patches. A decrease in the severity of these skin lesions is
noted as an improvement. The presence of striae (stretch marks), palpable
pulses, or lack of ecchymosis is not related to psoriasis.
The clinic nurse notes that the health care provider has documented a
diagnosis of herpes zoster (shingles) in the client's chart. Based on an
understanding of the cause of this disorder, the nurse determines that this
definitive diagnosis was made by which diagnostic test?
1. Positive patch test
2. Positive culture results
3. Abnormal biopsy results
4. Wood's light examination indicative of infection - Correct Answer-2
With the classic presentation of herpes zoster, the
clinical examination is diagnostic. However, viral culture of the lesion
provides a definitive diagnosis. Herpes zoster (shingles) is caused by a
reactivation of the varicella-zoster virus, the virus that causes chickenpox. A
patch test is a skin test that involves the administration of an allergen to the
surface of the skin to identify specific allergies. A biopsy would provide a
cytological examination of tissue. In a Wood's light examination, the skin is
viewed under ultraviolet light to identify superficial infections of the skin.
A client returns to the clinic for follow-up treatment following a skin biopsy of
a suspicious lesion performed 1 week ago. The biopsy report indicates that
the lesion is a melanoma. The nurse understands that melanoma has which
characteristics? (SELECT ALL THAT APPLY.)
1. Lesion is painful to touch.
2. Lesion is highly metastatic.
3. Lesion is a nevus that has changes in color.
4. Skin under the lesion is reddened and warm to touch.
5. Lesion occurs in body area exposed to outdoor sunlight. - Correct Answer-
2, 3
Melanomas are pigmented malignant lesions originating in the melanin-
producing cells of the epidermis. Melanomas cause changes in a nevus
(mole), including color and borders. This skin cancer is highly metastatic, and
, a person's survival depends on early diagnosis and treatment. Melanomas
are not painful or accompanied by sign of inflammation. Although sun
exposure increases the risk of melanoma, lesions are most commonly found
on the upper back and legs and on
the soles and palms of persons with dark skin.
When assessing a lesion diagnosed as basal cell carcinoma, the nurse most
likely expects to note which findings? (SELECT ALL THAT APPLY.)
1. An irregularly shaped lesion
2. A small papule with a dry, rough scale
3. A firm, nodular lesion topped with crust
4. A pearly papule with a central crater and a waxy border
5. Location in the bald spot atop the head that is exposed to outdoor sunlight
- Correct Answer-4, 5
Basal cell carcinoma appears as a pearly papule with
a central crater and rolled waxy border. Exposure to ultraviolet sunlight is a
major risk factor. A melanoma is an irregularly shaped pigmented papule or
plaque with a red-, white-, or blue-toned color. Actinic keratosis, a
premalignant lesion, appears as a small macule or papule with a dry, rough,
adherent yellow or brown scale. Squamous cell carcinoma is a firm, nodular
lesion topped with a crust or a central area of ulceration.
A client arriving at the emergency department has experienced frostbite to
the right hand. Which finding would the nurse note on assessment of the
client's hand?
1. A pink, edematous hand
2. Fiery red skin with edema in the nail beds
3. Black fingertips surrounded by an erythematous rash
4. A white color to the skin, which is insensitive to touch - Correct Answer-4
Assessment findings in frostbite include a white or
blue color; the skin will be hard, cold, and insensitive to touch. As thawing
occurs, flushing of the skin, the development of blisters or blebs, or tissue
edema appears. Options 1, 2, and 3 are incorrect.
The evening nurse reviews the nursing documentation in a client's chart and
notes that the day nurse has documented that the client has a stage II
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