A client arrives to the clinic after spending the day at the beach. She reports extreme pain and the nurse observes red skin on her face and upper body. There are no blisters present. What degree of burn has the client suffered?

First degree

Second degree

Third degree

This burn cannot be classified

Answer and Explanation

The Correct Answer is A

Choice A Reason: This is correct because first degree burns are superficial burns that affect only the outer layer of the skin, called the epidermis. First degree burns cause redness, pain, and mild swelling, but no blisters or scarring. They usually heal within a week.

Choice B Reason: This is incorrect because second degree burns are partial thickness burns that affect both the epidermis and the underlying layer of the skin, called the dermis. Second degree burns cause blisters, severe pain, and possible infection. They may take several weeks to heal and may leave scars.

Choice C Reason: This is incorrect because third degree burns are full thickness burns that destroy all layers of the skin and may damage the underlying tissues, such as muscles, nerves, or bones. Third degree burns cause charred or white skin, numbness, and shock. They require skin grafting and may cause permanent disability or death.

Choice D Reason: This is incorrect because this burn can be classified according to the depth and extent of the skin damage. The classification of burns helps to determine the appropriate treatment and prognosis for the client.

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Correct Answer is C

Explanation

Choice A Reason: This choice is incorrect. Inability to read is not a finding that the nurse should expect in a client who has meningitis, but rather a possible finding in a client who has a stroke or a brain tumor. Meningitis does not affect the language or cognitive functions, but rather the meninges or the membranes that cover the brain and spinal cord.

Choice B Reason: This choice is incorrect. Bruising around the eyes is not a finding that the nurse should expect in a client who has meningitis, but rather a possible finding in a client who has a basilar skull fracture or a head trauma. Meningitis does not cause bleeding or bruising, but rather inflammation and infection of the meninges.

Choice C Reason: This is the correct choice. A throbbing headache is a finding that the nurse should expect in a client who has meningitis, as it is one of the most common and characteristic symptoms. A throbbing headache is caused by increased intracranial pressure and irritation of the meninges due to inflammation and infection.

Choice D Reason: This choice is incorrect. A heart rate of 50 is not a finding that the nurse should expect in a client who has meningitis, but rather a possible finding in a client who has bradycardia or a slow heart rate. Meningitis does not affect the heart rate, but rather the temperature and blood pressure. The nurse should expect to see fever and hypotension in a client who has meningitis.

A. "I will incorporate foods rich in vitamin C in my diet." B. "I will receive injections into my eye." C. "My vision will slowly be restored after I start using the eye drops." D. "My vision will become progressively more blurry."

Correct Answer is C

Explanation

Choice A Reason: This is correct because incorporating foods rich in vitamin C in the diet can help prevent or delay macular degeneration. Vitamin C is an antioxidant that can protect the cells of the macula, which is the central part of the retina that is responsible for sharp and detailed vision, from oxidative stress and damage. The nurse should also advise the client to consume foods rich in other antioxidants, such as vitamin E, zinc, lutein, and zeaxanthin.

Choice B Reason: This is correct because receiving injections into the eye can help treat macular degeneration. Injections are a form of anti-vascular endothelial growth factor (anti-VEGF) therapy, which can block abnormal blood vessel growth and leakage in the macula that can cause vision loss. The nurse should explain to the client how often and how long they need to receive injections and what side effects or complications they may experience.

Choice C Reason: This is incorrect because vision will not be restored after using eye drops for macular degeneration. Eye drops are not a proven or effective treatment for macular degeneration, which is a chronic and progressive condition that causes irreversible vision loss. The nurse should reinforce education by informing the client that eye drops may only provide temporary relief of dryness or irritation, but they will not improve or restore vision.

Choice D Reason: This is correct because vision will become progressively more blurry with macular degeneration. Macular degeneration can cause blurred or distorted central vision, difficulty reading or recognizing faces, or dark spots in the visual field. The nurse should educate the client on how to cope with vision loss and use adaptive devices, such as magnifiers, large-print books, or voice-activated technology.

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A client arrives to the clinic after spending the day at the beach. She reports extreme pain and the nurse observes red skin on her face and upper body. There are no blisters present. What degree of burn has the client suffered?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has meningitis. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

A nurse provides education to a client recently diagnosed with macular degeneration. Which of the following statements made by the client requires reinforcement of education by the nurse?

Correct Answer is C

Explanation

An Asian family arrives with their newborn for a well visit. When assessing the infant, the nurse observes the following skin irregularity. What is the nurse's priority action?

A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate postoperative period for which most frequent complication of this type of surgery?

It is night time and a client who suffers from dementia is agitated and is having difficulty staying in his bed. Which of the following actions should the nurse take first?

A client diagnosed with contact dermatitis is receiving education from the nurse. Which of the following therapies will the nurse recommend to the client?

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for its presence?

A nurse is caring for a client following cataract surgery. Which of the following comments from the client should the nurse report to the client's provider?

After completing a neurological assessment, the nurse documents that the client is stuporous. Which of the following describes this level of consciousness?