A nurse is caring for a client with an electrical burn. The client states that since the wound on the skin is small, the burn must not be too bad. Which of the following is the best response by the nurse?
Electrical burns can have small amounts of skin damage, but more extensive damage beneath the skin.
Electrical burns commonly cause reddened/purplish skin without blistering.
Electrical burns typically are minor.
Electrical burns usually cause much more skin damage than what can be seen on your skin.
The Correct Answer is A
A. Electrical burns can have small amounts of skin damage, but more extensive damage beneath the skin.
This response is the best choice because it educates the client about the potential for deeper tissue damage associated with electrical burns. It acknowledges that while the burn on the skin may appear small, the damage underneath could be more extensive, affecting muscles, nerves, and blood vessels.
B. Electrical burns commonly cause reddened/purplish skin without blistering.
This statement is not the best response because it focuses solely on the appearance of the skin without addressing the potential for deeper tissue damage. While it is true that electrical burns can present with reddened or purplish skin without blistering, this response does not provide comprehensive information about the nature and severity of electrical burns.
C. Electrical burns typically are minor.
This response is incorrect because it downplays the seriousness of electrical burns. While some electrical burns may indeed be minor, others can cause significant tissue damage and complications. It's important for the nurse to educate the client about the range of severity that electrical burns can present.
D. Electrical burns usually cause much more skin damage than what can be seen on your skin.
This statement is partially accurate but does not provide as much information as choice A. While it acknowledges that electrical burns can cause more damage than what is visible on the skin's surface, it doesn't emphasize the potential for deeper tissue damage as effectively as choice A does.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
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A. How many people live in your home?
This question pertains to social and environmental factors but is not directly related to assessing skin inflammation on the chest. While social factors can impact overall health, such as stress levels or exposure to infectious agents, the number of people living in the client's home is unlikely to be directly related to a new skin inflammation unless there are specific circumstances, such as sharing personal care products or close contact with others who have similar skin issues.
B. Did you have a recent exposure to irritants?
This question is highly relevant to assessing a new skin inflammation on the chest. Exposure to irritants or allergens can trigger or worsen skin conditions, such as contact dermatitis or allergic reactions. By asking about recent exposure to potential irritants like new detergents, soaps, fabrics, chemicals, or environmental factors, the nurse can gather important information to identify possible triggers for the skin inflammation.
C. Is nausea associated with your rash?
Nausea is typically not directly associated with a skin rash or inflammation unless there is a systemic condition or allergic reaction causing both symptoms. While it's important to assess for any systemic signs or symptoms that may be related to the skin condition, such as fever or malaise, specifically asking about nausea may not provide relevant information about the skin inflammation on the chest.
D. What is your body mass index?
Body mass index (BMI) is a measure of body weight relative to height and is not directly related to assessing a new skin inflammation on the chest. While obesity or changes in body weight can sometimes contribute to skin issues, such as friction-related dermatitis or hormonal changes affecting skin health, BMI alone is not a primary assessment parameter for localized skin conditions unless there are specific concerns related to weight-related skin problems.
Correct Answer is B
Explanation
A. Melanoma:
Melanoma is a type of skin cancer that arises from melanocytes, the cells that produce pigment (melanin) in the skin. Melanoma lesions are typically irregularly shaped, often asymmetrical, with varying shades of color (brown, black, tan, red, blue). They may have an uneven border and can evolve over time. Melanomas can be raised but are not typically described as indurated (firm) and shiny. They are also more commonly associated with changes in color, size, and shape.
B. Keloid:
A keloid is an abnormal overgrowth of scar tissue that extends beyond the boundaries of the original wound or incision site. Keloids are characterized by their raised appearance, firm or indurated texture, and shiny surface compared to the surrounding skin. They may also be darker than the surrounding skin due to increased collagen deposition. Keloids can develop months after an injury or surgery and are more common in individuals with darker skin tones, such as African Americans.
C. Nevus:
A nevus, commonly known as a mole or birthmark, is a benign growth of melanocytes or other skin cells. Nevus lesions can vary in appearance but are often flat or slightly raised, with a uniform color (brown, black, tan, or flesh-colored). They are usually not described as indurated or shiny. Nevus lesions can be present at birth (congenital nevus) or develop later in life (acquired nevus).
D. Angioma:
Angiomas are benign tumors that originate from blood vessels or lymphatic vessels. They can present as red or purplish raised lesions on the skin. Angiomas are typically not described as indurated or shiny. Common types of angiomas include cherry angiomas (small, red papules) and spider angiomas (red, spider-like lesions with central vessels).
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