A nurse is collecting data from a client who reports finding a new skin lesion. Which of the following actions is the nurse's priority?
Document the client's history of skin allergies.
Photograph the lesion for the client's medical record.
Identify when the client first noticed the lesion.
Instruct the client on the use of daily sunscreen products.
The Correct Answer is C
A. Document the client's history of skin allergies: While important for the client's overall care, documenting the history of skin allergies is not the priority when assessing a new skin lesion.
B. Photograph the lesion for the client's medical record: Documenting the appearance of the lesion is important for the client's medical record, but it is not the priority when initially assessing the lesion.
C. Identify when the client first noticed the lesion: The priority is to gather information about the onset and characteristics of the lesion to determine its potential severity and urgency of intervention.
D. Instruct the client on the use of daily sunscreen products: While sun protection is important for skin health, it is not the priority when assessing a new skin lesion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Swelling, tenderness, and purulent drainage around the wound are classic signs of a wound infection. Swelling and tenderness indicate inflammation, while purulent drainage (pus) suggests the presence of infection.
B. Urticaria and itching around the wound are more indicative of an allergic reaction or hypersensitivity rather than a wound infection.
C. Serosanguineous drainage (clear to blood-tinged fluid) is a normal finding in the early stages of wound healing and does not necessarily indicate infection.
D. Brown crusting over the wound may indicate the formation of an eschar, which can occur in wounds undergoing healing, particularly in wounds with necrotic tissue. It is not necessarily indicative of infection unless accompanied by other signs such as erythema, warmth, or purulent drainage.
Correct Answer is ["7"]
Explanation
Dosage required / Dosage strength = Volume to administer
1. Identify the required dose: 350 mg.
2. Identify the available medication strength: 250 mg of amoxicillin in every 5 mL.
3. Set up the equation using the formula: 350 mg / 250 mg = Volume to administer / 5 mL.
4. Solve for the volume to administer: (350 mg / 250 mg) x 5 mL = 7 mL.
Therefore, the nurse should administer 7 mL
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