The nurse in a healthcare provider's (HCP's) office is reassessing a patient's skin and making a comparison with the information from the patient's last visit. For which reason does the nurse focus on any changes noted in the patient's skin?

Skin lesions are seen as solid predictors of the general health state.

The patient's psychological health is best predicted by the skin.

Detection of skin cancer is the only reason to assess the client's skin.

The skin is a good communicator regarding the client's overall health.

Answer and Explanation

The Correct Answer is D

A.   Skin lesions are seen as solid predictors of the general health state: While skin lesions can provide valuable information about a patient's health, they are not the only indicator. Changes in the skin can indicate various health conditions, not just lesions.
B.   The patient's psychological health is best predicted by the skin: While changes in the skin can sometimes be associated with psychological health conditions, they are not the sole predictors. Psychological health is assessed through a comprehensive evaluation, including observation, interview, and assessment tools.
C.   Detection of skin cancer is the only reason to assess the client's skin: While skin cancer detection is an important aspect of skin assessment, it is not the only reason. Skin assessment provides valuable information about overall health, hydration status, circulation, and potential systemic conditions.
D.   The skin is a good communicator regarding the client's overall health: The skin can provide valuable clues about a patient's overall health status. Changes in skin color, texture, moisture, and integrity can indicate underlying health conditions, nutritional deficiencies, circulation problems, or systemic diseases. Therefore, focusing on any changes noted in the patient's skin is essential for comprehensive assessment and early detection of potential health issues.

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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.

A. Perform hand hygiene before, during, and after direct contact with the client B. Encourage the client to consume a diet high in protein C. Change the client's bed linens each day D. Place the client in a room with positive pressure airflow

Correct Answer is A

Explanation

A. Perform hand hygiene before, during, and after direct contact with the client: Hand hygiene is one of the most effective strategies to interrupt the transmission of infections. It helps prevent the spread of pathogens from one person to another, reducing the risk of healthcare-associated infections.
B. Encourage the client to consume a diet high in protein: While proper nutrition is important for overall health and immune function, it does not directly address the transmission of the client's infection.

C. Change the client's bed linens each day: Changing bed linens regularly is important for maintaining cleanliness and comfort but is not sufficient to interrupt the transmission of infection.

D. Place the client in a room with positive pressure airflow: Positive pressure airflow rooms are typically used for patients with compromised immune systems to protect them from airborne pathogens. This strategy is not applicable for all types of infections and may not be necessary for every client with an infection.

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The nurse in a healthcare provider's (HCP's) office is reassessing a patient's skin and making a comparison with the information from the patient's last visit. For which reason does the nurse focus on any changes noted in the patient's skin?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from four clients who have wounds. The nurse should recognize that which of the following clients has a manifestation of a wound infection?

Correct Answer is A

Explanation

A nurse is caring for a client who has an infection. The nurse should use which of the following strategies to interrupt the transmission of the client's infection?

Correct Answer is A

Explanation

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