A client newly diagnosed with eczema tells the clinic nurse of using a heat lamp to dry the fluid-filled blisters localized in the left antecubital area. How should the nurse respond?
Encourage the application of topical corticosteroids to eczema.
Explain the use of chemical debridement to reduce blistering.
Remind the client to restrict the use of heat to 15 to 20 minutes.
Provide a sling so the left arm can be extended and elevated.
The Correct Answer is A
Choice A reason: Topical corticosteroids reduce eczema’s inflammation by inhibiting cytokines, alleviating antecubital vesicles. Heat lamps dry skin, worsening irritation and cracking. Encouraging steroids addresses the inflammatory pathophysiology, promoting healing, making this the most effective response for managing eczema and correcting harmful self-treatment.
Choice B reason: Chemical debridement is for necrotic tissue, not eczema’s inflammatory vesicles. Heat lamps exacerbate dryness, but debridement does not address immune-mediated inflammation. Corticosteroids target the cytokine-driven process, making debridement inappropriate for eczema’s pathophysiology, which requires anti-inflammatory treatment.
Choice C reason: Restricting heat to 15–20 minutes does not mitigate harm, as heat dries eczema lesions, disrupting the skin barrier and increasing infection risk. Corticosteroids reduce inflammation, addressing vesicles. Heat worsens epidermal damage, making this response ineffective compared to targeting the inflammatory cause.
Choice D reason: A sling for arm elevation is irrelevant for localized eczema, an inflammatory dermatitis, not edema requiring elevation. Heat lamps aggravate dryness, and corticosteroids treat inflammation, addressing immune-mediated pathology more effectively than positional changes, which do not impact eczema’s skin symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Administering an IV narcotic masks pain without addressing its cause. Pain at the PCI site may indicate hematoma or arterial injury, common post-PCI due to vessel trauma and tirofiban’s antiplatelet effects. Assessing the site identifies bleeding, critical to prevent complications like hemorrhage before providing analgesia.
Choice B reason: Adjusting the compression device without assessment risks worsening a hematoma, as excessive pressure impairs flow, while insufficient pressure fails to control bleeding. Tirofiban increases bleeding risk. Assessing for hematoma ensures proper management, preventing vascular complications, making adjustment premature without confirming the pain’s cause.
Choice C reason: Turning to a left side-lying position does not address PCI site pain, potentially from hematoma or arterial injury. Post-PCI, supine positioning minimizes site stress. Assessing for hematoma, exacerbated by tirofiban’s anticoagulation, is critical to detect bleeding, preventing complications like retroperitoneal hemorrhage over positional changes.
Choice D reason: Assessing the femoral PCI site for hematoma is essential, as pain may indicate bleeding, common post-PCI with tirofiban’s platelet inhibition. Hematoma can compress vessels, causing ischemia or rupture, requiring urgent intervention like compression or surgery. This addresses the pathophysiological risk, ensuring vascular stability and patient safety.
Correct Answer is A
Explanation
Choice A reason: Persistent pain after Herpes zoster suggests postherpetic neuralgia (PHN), a neuropathic condition from varicella-zoster virus damaging sensory nerves. Assessing pain intensity, location, and characteristics guides treatment with analgesics or anticonvulsants like gabapentin. This step differentiates PHN from other causes, ensuring targeted therapy to alleviate nerve pain and improve quality of life.
Choice B reason: Checking shingles vaccination status is irrelevant for current pain, as the client already had Herpes zoster. Vaccination prevents initial infection but does not treat PHN, which results from nerve damage during active infection. Pain assessment is critical to address neuropathic symptoms caused by viral-induced sensory nerve dysfunction, making this less urgent.
Choice C reason: A mental status exam evaluates cognition but is not indicated for PHN, a physiological condition from nerve damage, not a cognitive issue. Pain is neuropathic, driven by damaged sensory neurons, not psychological factors. Assessing pain directly addresses the client’s complaint, guiding treatment for nerve-related discomfort, making this action inappropriate.
Choice D reason: Teaching about phantom pain is incorrect, as phantom pain occurs post-amputation, not after shingles. PHN involves persistent nerve pain in the affected dermatome due to viral nerve damage. Misdiagnosing this could delay proper management, as pain assessment is needed to confirm PHN and initiate therapies like gabapentin, not phantom pain education.
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