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Skin/Pressure Ulcer NCLEX Practice Questions from Lippincott, and Saunders Questions And Answers 2022

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Skin/Pressure Ulcer NCLEX Practice Questions from Lippincott, and Saunders Questions And Answers 2022 Multiple Choice Identify the choice that best completes the statement or answers the question.... 1. The evening nurse reviews the nursing documentation in a client’s chart and notes that the day nurse has documented that the client has a stage II pressure ulcer in the sacral area. Which finding would the nurse expect to note on assessment of the client’s sacral area? a. Intact Skin c. Exposed bone, tendon, or muscle b. Full-thickness skin loss d. Partial-thickness skin loss of the dermis 2. Which of the following is an appropriate nursing intervention for a client at risk for developing a pressure ulcer? a. Massaging over the reddened area to improve circulation b. Positioning the HOB at a 45 degree angle to improve tissue perfusion c. Using hot, soapy water for pericare d. Repositioning a bedfast client at least every two hours 3. Which of the following diagnostic tests is most relevant for assessing the risk of developing a pressure ulcer for a 73 year old client with no health issues? a. White blood cells c. Red blood cells b. Serum albumin d. Serum potassium 4. Which of the following clients would least likely be at risk for developing skin breakdown? a. An incontinent client c. A client with decreased sensory perception b. A client with nutritional deficiencies d. A client who is unable to move about and is confined to bed 5. The nurse is reviewing the health care record of a male clients scheduled to be seen at the health care clinic. The nurse determines that which of the following individuals is at greatest risk for development of an integumentary disorder? a. An adolescent c. A physical education teacher b. An older female d. An outdoor construction worker 6. The nurse is teaching a female client with a leg ulcer about tissue repair and wound healing. Which of the following statements by the client indicates effective teaching? a. “I’ll limit my intake of protein” c. “My foot should feel cold” b. “I’ll make sure that the bandage is wrapped tightly” d. “I’ll eat plenty of fruits and vegetables” 7. A nurse is reviewing the nursing care plan for a client for whom a stage 4 pressure ulcer has been documented. Which of the following would the nurse expect to note on the client assessment? a. A reddened area that returns to normal skin color after 15 to 20 minutes of pressure relief c. An area in which the top layer of skin is missing b. Intact skin d. A deep ulcer that extends into muscle and bone 8. A nurse notes documentation of stage 3 pressure ulcer in a client’s record. Which of the following would the nurse expect to note on client assessment? a. A deep ulcer that extends into muscle and bone c. An area in which the top layer of skin is missing Continues... [Show More]

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