A nurse is observing a newly licensed nurse who is performing a focused skin assessment on a client who reports a skin condition. Which of the following questions by the newly licensed nurse requires intervention?
Have you had any changes in your diet?
How do you handle stress?
How does your skin condition make you feel?
Does your skin condition keep you awake at night?
None
None
The Correct Answer is B
Choice A reason:
Asking about dietary changes is relevant to a skin assessment, as diet can influence skin health. However, this question does not require intervention unless the dietary changes are directly related to the skin condition. If the client has been advised to follow a specific diet for their skin condition, then the nurse should ensure compliance with that diet.
Choice B reason:
This question shifts the focus from the skin condition’s characteristics and impact to general coping mechanisms. It does not help determine the lesion’s symptoms, triggers, or functional effects, and thus does not align with a targeted skin assessment framework, requiring intervention.
Choice C reason:
Exploring how the skin issue affects the client’s feelings reveals psychosocial stressors and the emotional burden of living with a visible condition. This insight supports holistic care planning, adherence strategies, and therapeutic rapport.
Choice D reason:
Sleep disturbances can be a consequence of skin conditions, especially if they involve itching or pain. This question is pertinent to the assessment and does not require intervention. The information gathered can help in formulating a comprehensive care plan that addresses the client's comfort and sleep quality.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
While the white blood cell (WBC) count is important in assessing the immune system's ability to fight infection, a WBC of 5,000/mm³ is within the normal range (4,500 to 11,000 WBCs/mm³). Therefore, it is not the most critical value for a nurse to prioritize in the care of an HIV patient.
Choice B reason:
A platelet count of 150,000/mm³ is also within the normal range (150,000 to 450,000 platelets/mm³). Although thrombocytopenia can occur in HIV, this value does not indicate an immediate concern for the nurse to prioritize.
Choice C reason:
A positive Western blot test confirms the presence of HIV antibodies, which is indicative of HIV infection. However, this is a diagnostic result rather than a laboratory value that reflects the current status of the patient's immune function or disease progression.
Choice D reason:
The CD4-T-cell count is a critical laboratory value for assessing the immune function of a patient with HIV. A count of 180 cells/mm³ is below the normal range of 500 to 1,200 cells/mm³ and indicates a significantly weakened immune system, placing the patient at risk for opportunistic infections. This value is a priority as it guides treatment decisions and the need for prophylaxis against opportunistic infections.
Correct Answer is ["A","B","C"]
Explanation
Acetaminophen is commonly used for pain relief in osteoarthritis. It is recommended for clients who have mild to moderate pain. It does not reduce inflammation but can be effective in managing pain without the gastrointestinal side effects associated with NSAIDs.
Choice B reason:
Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that is specifically a COX-2 inhibitor. It is used to reduce pain and inflammation in osteoarthritis. Celecoxib can be a good option for those who need an anti-inflammatory and may have a lower risk of gastrointestinal bleeding compared to other NSAIDs.
Choice C reason:
Ibuprofen, another NSAID, is effective in reducing the inflammation and pain associated with osteoarthritis. It is available over the counter and can be used for short-term pain management, but it should be used cautiously due to potential side effects, including gastrointestinal bleeding and cardiovascular risks.
Choice D reason:
Cyclobenzaprine is a muscle relaxant and is not typically used as a first-line treatment for osteoarthritis. It may be prescribed in cases where muscle spasms are present, but it does not directly address the joint pain or inflammation caused by osteoarthritis.
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