A nurse is observing a newly licensed nurse perform focused data collection on a client who has developed a skin condition. Which of the following questions by the newly licensed nurse requires intervention by the nurse?

"How do you handle stress?"

"Does your skin condition keep you awake at night?"

"How does your skin condition make you feel about yourself?"

"Have you had any changes in your diet?"

Answer and Explanation

The Correct Answer is A

A. "How do you handle stress?" While stress may influence some skin conditions (e.g., psoriasis, eczema), this question is not directly related to a focused skin assessment and may be too vague or irrelevant.

B. "Does your skin condition keep you awake at night?" Skin conditions such as eczema or urticaria can cause pruritus, leading to sleep disturbances. This is a relevant question.

C. "How does your skin condition make you feel about yourself?" Skin conditions can affect body image and self-esteem, making this an important question for psychosocial assessment.

D. "Have you had any changes in your diet?" Certain food allergies or deficiencies can trigger dermatologic conditions (e.g., celiac disease, atopic dermatitis), making this question appropriate.

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Correct Answer is D

Explanation

A. Press the skin over the client's ankle bone. Skin over the bony prominences is not ideal for assessing turgor, as it may not accurately reflect dehydration.

B. Observe for non-blanching, pinpoint-size, red or purple spots on the skin of the abdomen. This describes petechiae, which is a sign of bleeding disorders, not hydration status.

C. Lightly palpate the skin using the fingertips. Palpation does not assess elasticity.

D. Grasp a fold of skin on the client's forearm or near the sternum. The best way to check for dehydration is by pinching the skin on the sternum or forearm and observing how quickly it returns to normal.

A. Maintenance of good posture B. Increased fiber and fluid in the diet C. Regular use of a laxative D. Regular use of glycerine suppositories

Correct Answer is B

Explanation

A. Maintenance of good posture. While good posture can promote better bowel motility, it is not a primary intervention for constipation.

B. Increased fiber and fluid in the diet. Increasing dietary fiber (whole grains, fruits, vegetables) and fluid intake softens stool and promotes regular bowel movements, making this the best recommendation.

C. Regular use of a laxative. Frequent use of stimulant laxatives can lead to dependence, making it an inappropriate first-line intervention.

D. Regular use of glycerin suppositories. Glycerin suppositories are used for occasional relief of constipation but are not recommended for routine use as they do not address the underlying cause.

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A nurse is observing a newly licensed nurse perform focused data collection on a client who has developed a skin condition. Which of the following questions by the newly licensed nurse requires intervention by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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