A nurse is assessing a client who reports burning, stabbing pain on their right thorax. The nurse notes the presence of a unilateral vesicular rash following a dermatome. Based on these findings, which of the following is the most likely diagnosis?
Psoriasis
Herpes Zoster (Shingles)
Eczema
Contact Dermatitis
The Correct Answer is B
A. Psoriasis. Psoriasis presents as scaly, erythematous plaques with silvery-white scales, typically on the extensor surfaces of the body, rather than a unilateral vesicular rash.
B. Herpes Zoster (Shingles). Herpes zoster (shingles) is caused by reactivation of the varicella-zoster virus. It presents as a painful, unilateral vesicular rash along a dermatome, often accompanied by burning or stabbing pain.
C. Eczema. Eczema (atopic dermatitis) presents as dry, itchy, inflamed skin, usually in a chronic and relapsing pattern, rather than a vesicular rash following a dermatome.
D. Contact Dermatitis. Contact dermatitis presents as erythematous, pruritic, and sometimes vesicular lesions, but it is not limited to a single dermatome and typically occurs in areas of direct skin exposure to an allergen or irritant.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Increased oral temperature from 36.6° C (97.8° F) to 37° C (98.6° F). A slight temperature increase is expected post-injury due to normal inflammatory response and does not indicate a serious complication.
B. Increased heart rate from 68 to 72/min. This small increase in heart rate is not clinically significant and does not indicate a serious complication.
C. Increased respiratory rate from 18 to 44/min. A sudden increase in respiratory rate could indicate a fat embolism, a life-threatening complication associated with long bone fractures. Fat emboli can travel to the lungs, causing respiratory distress. Immediate intervention is required.
D. Increased blood pressure from 112/68 to 120/72 mm Hg. This small increase in blood pressure is not alarming and does not indicate a serious complication.
Correct Answer is C
Explanation
A. Deep Tissue Injury. Deep tissue injuries appear as intact or discolored skin (purple or maroon) due to underlying soft tissue damage. This wound is already open with slough, so it does not fit this category.
B. Stage III Pressure Ulcer. A Stage III pressure ulcer involves full-thickness skin loss with visible subcutaneous tissue, but the wound depth must be assessable. Since the slough covers the wound, the depth cannot be determined.
C. Unstageable Pressure Ulcer. An unstageable pressure ulcer is one where the base of the wound is covered with slough or eschar, preventing assessment of the full depth of tissue damage. Until the slough is removed, the stage cannot be determined.
D. Stage II Pressure Ulcer. A Stage II ulcer has partial-thickness skin loss with exposed dermis, often appearing as an open blister or shallow wound. The presence of thick slough suggests deeper involvement, making this an incorrect classification.
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