A nurse is assessing a female client who has pneumonia. The nurse should identify which of the following findings increases the client's risk of skin breakdown?

Receiving bronchodilator medication

Weight loss of 2.8 kg (6.2 b)

Hemoglobin 17 g/dl (12 to 16 g/dL)

Wearing an oxygen device

Answer and Explanation

The Correct Answer is B

Indicates an increased risk of skin breakdown. This is because significant weight loss can lead to muscle wasting and reduced subcutaneous tissue, making the skin more vulnerable.

Bronchodilators, hemoglobin level and oxygen device do not relate directly to skin breakdown

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Correct Answer is C

Explanation

C. Mannitol is a osmotic diuretic that is commonly used in the management of increased intracranial pressure (ICP) following a head injury. It works by drawing fluid out of brain tissue and into the bloodstream, thereby reducing cerebral edema and lowering ICP.
A. Chlorpromazine is an antipsychotic medication that does not have direct effects on reducing ICP and is not commonly used in this clinical scenario.
B. Dobutamine is a medication primarily used for increasing cardiac output in patients with heart failure or shock.
D. Propranolol is a beta-blocker medication commonly used to treat conditions such as hypertension, angina, and certain cardiac arrhythmias.

A. Loss of hearing B. Muscle wasting C. Paresthesia D. Changes in vision

Correct Answer is C

Explanation

C. Paresthesia, or abnormal sensations like tingling, numbness, or burning, is a common neurological manifestation of pernicious anemia due to damage to the peripheral nerves caused by vitamin B12 deficiency. Paresthesia can affect balance and coordination, increasing the risk of falls and injuries, and thus posing a risk to the client's safety.
A. Loss of hearing is not typically associated with pernicious anemia.
B. Muscle wasting is not a typical manifestation of pernicious anemia. However, weakness and fatigue are common symptoms due to anemia resulting from decreased oxygen-carrying capacity of the blood.

D. While changes in vision can impact the client's safety, they are not as directly associated with pernicious anemia as paresthesia, which affects mobility and balance.

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A nurse is assessing a female client who has pneumonia. The nurse should identify which of the following findings increases the client's risk of skin breakdown?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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