The nurse caring for a patient with repeated episodes of contact dermatitis is providing instruction to prevent future episodes.
Which information should the nurse include?

Avoid cosmetics with fragrance.

Wash skin in very hot water.

Wear gloves during the day.

Use a fabric softener.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Fragrances in cosmetics and personal care products are common causes of allergic contact dermatitis. These are often complex mixtures of chemical allergens that can trigger a T-cell mediated immune response, leading to a delayed-type hypersensitivity reaction. Avoiding products containing these known irritants is a key preventative strategy to reduce the frequency and severity of future episodes.

Choice B rationale

Washing the skin with very hot water is detrimental to the skin's barrier function. Hot water strips the skin of its natural oils (sebum), leading to excessive dryness and micro-fissures. This compromised skin barrier makes the skin more permeable to allergens and irritants, exacerbating existing dermatitis and increasing susceptibility to future episodes. The skin should be cleansed with lukewarm water.

Choice C rationale

Wearing gloves constantly, especially those made of latex or vinyl, can create a moist environment that traps sweat and irritants, leading to maceration and irritation of the skin. This can worsen existing dermatitis and potentially cause a new form of contact dermatitis. Gloves should only be worn for specific tasks and for limited periods to prevent this moisture-induced skin damage.

Choice D rationale

Fabric softeners often contain chemicals and fragrances that are known contact allergens and irritants. These substances can remain in the clothing fibers after washing and come into direct contact with the skin, triggering a hypersensitivity reaction. Therefore, the nurse should advise against using fabric softeners to reduce exposure to potential allergens and prevent future episodes of contact dermatitis.

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Correct Answer is A

Explanation

Choice A rationale

A PaCO2 of 72 mmHg indicates severe hypercapnia and respiratory acidosis, which is a significant sign of impending or actual respiratory failure. The oxygen saturation of 84% signifies severe hypoxemia. Intubation and mechanical ventilation are necessary to provide positive pressure ventilation, which can override the patient's respiratory muscle fatigue, improve alveolar ventilation, and correct the life-threatening hypercapnia and hypoxemia. This approach provides precise control over tidal volume and respiratory rate.

Choice B rationale

A nonrebreather mask can deliver high concentrations of oxygen, typically 60-90%, and is suitable for patients with severe hypoxemia. However, it does not provide ventilatory support. Since this patient has severe hypercapnia with a PaCO2 of 72 mmHg, they are retaining carbon dioxide due to inadequate ventilation. A nonrebreather mask will not correct this ventilatory failure; it will only increase the inspired oxygen fraction.

Choice C rationale

A Venturi mask delivers a precise, fixed concentration of oxygen, such as 35%, which is useful for patients with chronic obstructive pulmonary disease (COPD) to avoid suppressing their hypoxic drive. However, a 35% concentration is insufficient for a patient with a saturation of 84% and severe hypoxemia. Furthermore, this method does not provide the ventilatory support needed to address the patient's severe hypercapnia and respiratory acidosis.

Choice D rationale

An oxygen cannula at 6 L/min provides a low-flow oxygen delivery, typically yielding an FiO2 of around 44% at this flow rate. This is an inappropriate choice for a patient with a saturation of 84% and severe hypoxemia, as it cannot deliver a high enough concentration of oxygen to significantly improve their oxygenation. It also fails to provide the ventilatory support needed to correct the severe hypercapnia. *.

A. Flail chest. B. Tension pneumothorax. C. Simple pneumothorax. D. Hemothorax.

Correct Answer is D

Explanation

Choice A rationale

Flail chest is the paradoxical movement of a section of the chest wall, caused by multiple rib fractures in two or more places. It is characterized by paradoxical chest wall motion, where the injured segment moves in during inspiration and out during expiration. While it is a severe chest injury, it does not typically involve a large accumulation of blood in the pleural space, which is the defining characteristic mentioned in the patient's presentation.

Choice B rationale

A tension pneumothorax is a life-threatening condition where air enters the pleural space but cannot exit, causing a rapid increase in intrathoracic pressure. This leads to tracheal deviation, hypotension, and profound respiratory distress. While it can cause a collapsed lung and dyspnea, the defining characteristic is air trapping, not blood accumulation in the pleural space, making this diagnosis inconsistent with the patient's specific presentation of hemothorax.

Choice C rationale

A simple pneumothorax is the presence of air in the pleural space, causing the lung to collapse, but without the one-way valve effect seen in a tension pneumothorax. It presents with dyspnea and asymmetrical chest expansion. While it causes a collapsed lung, the defining feature of this patient's case is the presence of a blood accumulation in the pleural space, which is not a hallmark of a simple pneumothorax.

Choice D rationale

A hemothorax is a medical condition characterized by the accumulation of blood in the pleural cavity, which is the space between the lungs and the chest wall. The presence of a collapsed lung, blood accumulation in the pleural space, dyspnea, and asymmetrical chest expansion directly corresponds to the classic presentation of a hemothorax. This diagnosis accurately and completely accounts for all the symptoms described in the patient's clinical scenario. .

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The nurse caring for a patient with repeated episodes of contact dermatitis is providing instruction to prevent future episodes. Which information should the nurse include?

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Naxlex Comprehensive Predictor Exams

A patient diagnosed with pulmonary edema has a PaCO2 of 72 mmHg and an oxygen saturation of 84%. What method of oxygen delivery would best meet the needs of this patient?

Correct Answer is A

Explanation

A patient in the emergency department has dyspnea, asymmetrical chest expansion, and an oxygen saturation of 90%. A chest X-ray shows a collapsed lung and blood accumulation in the pleural space. What is the correct diagnosis?

Correct Answer is D

Explanation

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The nurse caring for a patient with repeated episodes of contact dermatitis is providing instruction to prevent future episodes.
Which information should the nurse include?