A nurse is providing first aid for a client who has a minor burn on one hand. Which of the following actions should the nurse take? (Select all that apply.)

Apply ice to the larger blisters.

Administer ibuprofen for pain.

Maintain skin integrity over the blisters.

Run cool water over the affected area.

Allow the affected area to remain open to air.

Answer and Explanation

Correct Answer : D,E

Running cool water over the affected area will help to decrease pain and prevent further tissue damage. Allowing the affected area to remain open to air will help to promote healing and prevent infection.

A. "Apply ice to the larger blisters" is an incorrect answer because applying ice can cause further damage to the skin and delay healing.

B. "Administer ibuprofen for pain" is an incorrect answer because the nurse cannot administer medications without a physician's order.

C. "Maintain skin integrity over the blisters" is an incorrect answer because maintaining skin integrity over the blisters can cause further damage and delay healing.

Explanation: The nurse should run cool water over the affected area and allow it to remain open to the air to promote healing and prevent infection. Applying ice or medication without a physician's order can cause further damage and delay healing.

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Correct Answer is D

Explanation

Palpable area of induration, greater than 10 mm (0.4 in) in diameter. This indicates a positive tuberculin skin test (TST) reaction for a person with no known risk factors for TB infection. A positive TST reaction means that the person has been infected with Mycobacterium tuberculosis, the bacterium that causes TB disease, and needs further testing to confirm the diagnosis and rule out active TB disease.

The other choices are not correct because:

- Choice A. Nonpalpable area of redness, less than 5 mm (0.2 in) in diameter. This indicates a negative TST reaction for any person, regardless of their risk factors for TB infection. A negative TST reaction means that the person has not been infected with Mycobacterium tuberculosis or has a very low level of immune response to the bacterium.

- Choice B. Area of ecchymosis, greater than 12 mm (0.5 in) in diameter. This indicates a bruise or bleeding under the skin, not a TST reaction. Ecchymosis is not caused by the injection of tuberculin purified protein derivative (PPD) into the skin, but by trauma or injury to the blood vessels.

- Choice C. Tenderness at the injection site. This indicates a mild local reaction to the injection of tuberculin PPD into the skin, not a TST reaction. Tenderness is not measured in millimeters of induration (firm swelling), which is the standard way of reading TST results.

A. "I should consume fish once per week." B. "With a BMI of 30, I should focus on maintaining my current weight." C. "I should consume no more than 2,000 milligrams of sodium per day." D. "I should exercise for 30 minutes three times per week."

Correct Answer is C

Explanation

"I should consume no more than 2,000 milligrams of sodium per day." This is an appropriate statement because consuming too much sodium is associated with an increased risk for hypertension.

Choice A is not correct because there is not enough evidence to support the idea that consuming fish once per week can prevent hypertension.

Choice B is not correct because maintaining a healthy weight is important, but is not as directly related to preventing hypertension as reducing sodium intake.

Choice D is not correct because exercising 30 minutes three times per week is not enough to prevent hypertension.

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A nurse is providing first aid for a client who has a minor burn on one hand. Which of the following actions should the nurse take? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with care for a client who received a tuberculin skin test 72 hr ago. When collecting data from the test site, which of the following findings indicates a need for further testing?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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