Which finding, obtained during a skin assessment, should the school nurse report to the healthcare provider?

Multiple maculopapular pustules over forehead and chin on an adolescent.

Bilateral patellar abrasions with eschar formation on a preschool-aged child.

Red, swollen, painful nodule located on upper back on a school-aged boy.

Small, white flecks on the hair shafts throughout scalp on a school-aged girl.

Answer and Explanation

The Correct Answer is A

A.   Multiple maculopapular pustules over the forehead and chin are suggestive of acne vulgaris or possibly another dermatologic condition that may require medical intervention. If the pustules are widespread or persistent, it should be reported for further evaluation.
B.   Bilateral patellar abrasions with eschar formation are common in children and are usually non- threatening unless there are signs of infection. This finding may not require immediate reporting unless the condition worsens.
C.   A red, swollen, painful nodule on the upper back is likely a boil or abscess, but it’s important to consider the overall presentation and if there is a risk for systemic infection. This may not need immediate reporting unless symptoms worsen.
D.   Small, white flecks on the hair shafts indicate possible head lice, which, while needing treatment,
doesn’t require immediate reporting unless there is a larger health concern associated with it.

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Correct Answer is ["A","C"]

Explanation

WRIST - ABLE TO BEND WRIST BACK TOWARD FOREARM:

Abduction

Abduction refers to the movement of a body part away from the body's midline. This movement is typically used for fingers, arms, or legs, but not for the wrist. Therefore, this choice is incorrect for the wrist's range of motion.

Flexion

Flexion refers to the bending of a joint that reduces the angle between two body parts. For the wrist, flexion would involve bending the wrist forward, toward the palm of the hand. Since the patient is able to bend the wrist backward (toward the forearm), this is not the correct choice.

Extension

Extension refers to straightening a joint, which increases the angle between the body parts. For the wrist, extension is the movement where the hand moves away from the palm (backward toward the forearm). This is the correct choice because the patient is able to bend the wrist back toward the forearm, which is extension.

Adduction

Adduction refers to the movement of a body part toward the body's midline. This is not relevant to the wrist, so it is an incorrect option.

SHOULDER - UNABLE TO MOVE THE ARM AWAY FROM THE BODY:

Extension

Extension refers to the movement that straightens a joint, increasing the angle between two parts of the body. For the shoulder, this would involve moving the arm behind the body, and it's not the movement of the arm away from the body, so this is not the correct choice.

Adduction

Adduction refers to moving a body part toward the midline of the body. For the shoulder, this would involve moving the arm closer to the body. This does not correspond to the action of moving the arm away from the body, so this is not the correct choice either.

Flexion

Flexion refers to the bending of a joint that decreases the angle between two body parts. For the shoulder, this would involve raising the arm forward, not moving it away from the body. This is not the correct choice for the described movement.

Abduction

Abduction refers to the movement of a body part away from the midline of the body. In this case, the shoulder movement of moving the arm away from the body is abduction. Since the client is unable to move the arm away from the body (i.e., is experiencing weakness or limited ROM), the shoulder’s range of motion has a restriction in abduction.

A. Hematoma. B. Vesicle. C. Ecchymosis. D. Petechiae.

Correct Answer is D

Explanation

A. A hematoma refers to a collection of blood outside of blood vessels, typically resulting in a bruise or swelling. The description of round, flat, pinpoint red spots does not suggest this type of injury.
B. Vesicles are small fluid-filled blisters, which do not match the description of the pinpoint red spots. Vesicles would be more elevated and contain fluid.
C. Ecchymosis refers to a bruise, or large, irregular areas of discoloration caused by blood leaking into the tissues. The description of pinpoint red spots suggests petechiae, not ecchymosis.
D. Petechiae are small, round, flat, pinpoint red or purple spots that occur when small blood vessels (capillaries) break under the skin. This is the most appropriate description for the observed finding, particularly in the context of trauma from intimate partner violence.

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Which finding, obtained during a skin assessment, should the school nurse report to the healthcare provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","C"]

Explanation

The nurse is performing a head-to-toe physical examination on a known victim of intimate partner violence. The visual exam reveals several round, flat, pinpoint, red spots. How should the nurse document this finding?

Correct Answer is D

Explanation

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