A client requires a full-thickness graft to cover a chronic wound. How is the donor site selected?

The largest area of the body without hair is selected.

Any area that is not normally visible can be used.

An area matching the color and texture of the skin at the surgical site is selected.

An area matching the sensory capability of the skin at the surgical site is selected.

Answer and Explanation

The Correct Answer is C

Choice A rationale

The largest area of the body without hair is not selected as it is not necessary for the graft to be hairless. The primary concern is matching the color and texture, not the absence of hair.

Choice B rationale

Any area that is not normally visible is not ideal as visibility is not the primary concern. The donor site needs to match the surgical site in color and texture to ensure a natural appearance.

Choice C rationale

An area matching the color and texture of the skin at the surgical site is selected to ensure the graft blends well with the surrounding skin and appears natural once healed.

Choice D rationale

An area matching the sensory capability of the skin at the surgical site is not typically a concern in graft selection. The focus is on the appearance and integration of the graft.

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Correct Answer is A

Explanation

Choice A rationale

Administering systemic antibiotics is essential to treat the underlying bacterial infection causing severe impetigo. This intervention helps reduce infection spread and promotes healing.

Choice B rationale

Placing mitts on the client's hands may prevent scratching, which can worsen impetigo, but it is not the primary treatment for the infection itself. Antibiotic therapy is more crucial.

Choice C rationale

Continuing antibiotics for 21 days is not a standard duration for impetigo treatment. The treatment duration typically ranges from 7 to 10 days, depending on the severity and response to treatment.

Choice D rationale

Topical antibiotics are used for mild cases of impetigo. For severe impetigo, systemic antibiotics are more appropriate and effective in managing the infection.

A. Scoliosis. B. Lordosis. C. Kyphosis. D. Dowager's hump. E. Dowager's hump.

Correct Answer is B

Explanation

Choice A rationale

Scoliosis refers to a lateral curvature of the spine, not an exaggeration of the lumbar spine curve, which is characterized by lordosis.

Choice B rationale

Lordosis is an exaggerated inward curve of the lumbar spine, often referred to as swayback. This condition is identified by the nurse as the client presents with an exaggerated lumbar curve.

Choice C rationale

Kyphosis describes an excessive outward curvature of the thoracic spine, resulting in a hunched back, not the lumbar spine.

Choice D rationale

Dowager's hump is a term commonly associated with kyphosis, characterized by a pronounced curvature of the upper back, not the lumbar region.

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A client requires a full-thickness graft to cover a chronic wound. How is the donor site selected?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When caring for a client with severe impetigo, the nurse should include which intervention in the care plan?

Correct Answer is A

Explanation

The client presents with an exaggeration of the lumbar spine curve. How does the nurse interpret this finding?

Correct Answer is B

Explanation

The nurse assesses two new wounds located on a client's right and left buttocks. Which intervention for wound management would the nurse employ? Select all that apply.

A client is being treated for prolonged diarrhea. Which foods should the nurse encourage the client to consume?

A nurse is assessing a client with impetigo. The nurse would most likely observe which of the following?

A newly admitted client has gained weight steadily over the past 2 years and the nurse recognizes the need for a nutritional assessment. What assessment parameters should the nurse include? Select all that apply.

During the skin assessment of a client, the nurse observes a skin lesion that is elevated, round, and filled with serum. Identify the type of lesion.

A nurse is planning discharge education for a client who underwent a cervical discectomy. What strategies would the nurse assess that would aid in planning discharge teaching?

A client is being tested for a gag reflex. When the nurse places the tongue blade to the back of the throat, there is no response elicited. What dysfunction does the nurse determine the client has?