Which of the following patients are at highest risk for developing a skin injury caused by shearing?
A patient who is lying on wrinkled sheets.
A patient who is pulled up in the bed by the nurse
A patient who is frequently incontinent.
A patient who is noted to have slough tissue
The Correct Answer is B
A. A patient who is lying on wrinkled sheets: Wrinkled sheets can cause pressure injuries, but they do not directly lead to shearing.
B. A patient who is pulled up in the bed by the nurse: Shearing occurs when the skin remains in place while underlying tissues move, often when a patient is dragged up in bed instead of lifted. This can damage skin layers and underlying tissues.
C. A patient who is frequently incontinent: Incontinence increases the risk of moisture-associated skin damage and pressure injuries but is not directly related to shearing.
D. A patient who is noted to have slough tissue: The presence of slough (dead tissue in a wound) indicates existing tissue damage but does not suggest an increased risk of shearing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Determine the dose per administration:
- 1000 mg ÷ 250 mg/capsule = 4 capsules per dose
Calculate the total per day:
- Since the order is every 12 hours, the medication is given twice a day
- 4 capsules per dose × 2 doses per day = 8 capsules per day
Correct Answer is ["B","D"]
Explanation
A. Schedule an in-person appointment with the provider for the next month: This does not address the challenge of frequent travel or accessibility.
B. Setting up a telehealth visit for the patient: Telehealth reduces travel burdens and allows for frequent monitoring without unnecessary trips.
C. Assist the patient in arranging for transportation to and from the appointment: Assisting the patient in arranging transportation can be beneficial, but telehealth visits offer a more sustainable solution for frequent appointments
D. Ensure that the patient has access to their patient portal: A patient portal allows for easy communication with providers, medication refills, and appointment scheduling.
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