Burns and Skin Cancer Dynamic Quizzing Practice

a nurse is planning to administer fluids to a client who has 25% total body surface area burns. The patient has no prior medical history. Which of the following IV fluids is contraindicated for this patient.

0.45% sodium chloride (1/2 NS)

this is a hypotonic solution and is contraindicated for clients to have burns since hypotonic fluids have an osmolarity value of less than 270 mOsm/L which is less than the expected reference range of the osmolarity value for plasma and body fluids of 285 to 295. mOsm/L. Administering a hypotonic solution to this client can cause third spacing of fluid.

A nurse is caring for a patient who has a lesion on the back of his right hand. The patient asks the nurse which type of skin cancer is the most serious, which of the following responses by the nurse is appropriate.

Melanoma

melanomas are malignant neoplasm with atypical melanocytes in the epidermis, the dermis, and sometimes the subcutaneous cells. Which is the most lethal type of skin cancer, often causing metastasis in the bone, liver, lungs, spleen, CNS and lymph nodes.

A nurse is evaluating lab values of a client who is in the resuscitation phase following a major burn. Which of the following lab values should the nurse expect

sodium 132 mEq/L

The nurse shouldn’t anticipate a low sodium because sodium is trapped in interstitial space

A nurse is assessing a patient who has a lesion on his skin, which of the following findings is a clinical manifestation of a malignant melanoma

Irregularly shaped lesion with blue tones

Malignant melanomas are a regularly shaped and can be blue red or white and color. They often occur on the clients upper back and lower legs.

A nurse is planning care for a patient who has been admitted for the treatment of a malignant melanoma of the upper leg without metastasis. The nurse should plan to prepare the client for which of the following procedures.

surgical excision

A nurse is caring for a patient who has a prescription for silver sulfadiazine cream to be applied to her Berlin. The nurse should evaluate the patient for which of the following lab findings.

Leukopenia

transient leukopenia is an adverse effect of this medication

A nurse and a dermatology clinic is using the ACDE method while screening several skin lesions for skin cancer on our client. Which of the following findings should the nurse report to the provider?

Color variation within lesion

A nurse is trained for an adolescent client who has burn rooms on her face and hands. Which of the following statements by the client indicates that she has adapted to her changed body image.

May I go with my family to the visitors lounge?

This statement demonstrates a positive self since the client is asking to visit with her family in a public setting

A nurse is teaching a group of clients about skin cancer, the nurse should explain that basal cell carcinoma or originates from which of the following tissues

Epidermis

Basal cell carcinoma originates from the epidermal layer of his skin. It is the most common form of skin cancer.

A nurse is teaching a group of young adults about health promotion techniques to reduce the risk of skin cancer which of the following instructions should the nurse include

Avoid exposure to the midday sun

The nurse should instruct clients to avoid skin exposure to the sun, especially during the midday hours of 10 to 4 PM when the sun are the strongest

A nurse in an emergency department is assessing a client who has extensive burns, including on her face. Which of the following assessment should the nurse perform first.

Characteristics of a cough and sputum

A client who has burns to the faces at risk for pulmonary injury, and the development of a brassy cough can indicate an impending loss of airway

A nurse is assessing a patient who has sustained superficial partial thickness and deep partial thickness burns 72 hours ago. Which of the following findings should the nurse report to the provider?

Temperature of 39.1°C or 102.4°F

an elevated temperature is an indication of infection, and the nurse should report this to the provider. Sepsis is a critical finding following a major burn injury on approximately the third day, following the injury, early colonization of the wound surface by gram-negative organism changes to predominantly gram-positive opportunistic organisms.

my nurse came for a patient who has full thickness burns covering 63% of her body and smoke inhalation. Which of the following nursing actions is the top priority

Monitor respiratory status

Smoke inhalation most likely include a thermal injury to the tracheal bronchial tree. Edema from the inflammatory response to heat can obstruct the airway endotracheal intubation may become necessary to maintain a patent airway

nurse planning care for a client who has deep partial thickness and full thickness thermal burns over 40% of his total body surface and is in the acute phase of burn injury. Which of the following intervention show the nursing including this plan

Initiate range of motion exercise exercises

The nurse should begin, performing active and passive range of motion, exercise exercises with the client to maintain mobility and prevent contractures

a nurse is caring for a client who has burnt injuries on his trunk. The nurse is explaining what to expect from the prescribed hydrotherapy, which of the following statements by the client indicates an understanding of the teaching.

I will be on a special shower table

The special shower table facilitates examination and debridement of the wound during hydrotherapy. An advantage of using the shower technique as opposed to a tub bath is that the water can be kept at a constant temperature. There is also a lower risk of wound infection.

a nurse is caring for a client whose wounds are covered with a heterograft dressing. He responds to the client’s questions about the dressing. The nurse explained that it is obtained from which of the following resources.

Pig skin

heterografts (xenografts) are obtained from an animal

A nurse is screaming for a client who has irregular occupational exposure to sunlight and presents for evaluation of several skin lesions. Which of the following should alert the nurse to the possibility of malignant melanoma.

an irregularly shaped brown lesion with light blue areas on the neck

A nurse is providing discharge instructions to a patient who is postop, following surgical excision of a basal cell carcinoma. Which of the following of the nurse include as an indication of a moles, potential malignancy.

Ulceration

Ulceration, bleeding and exudation or indication of a mole potential malignancy. Increasing size is also a warning