INTEGUMENTARY CHANGES
Why can smoking lead to heart
1. When planning care for a male client
with burns on the upper torso, which
nursing diagnosis should take
the highest priority?
Ineffective airway clearance related
to edema of the respiratory
passages
2. In a female client with burns on the
legs, which nursing intervention helps
prevent contractures?
Applying knee splints.
3. A male client comes to the physician’s
office for treatment of severe sunburn.
The nurse takes this opportunity to
discuss the importance of protecting
the skin from the sun’s damaging rays.
Which instruction would best prevent
skin damage?
“Apply sunscreen even on overcast
days.”
4. A female client is brought to the
emergency department with second-
and third-degree burns on the left arm,
left anterior leg, and anterior trunk.
Using the Rule of Nines, what is the
total body surface area that has been
burned? 36%
5. Which nursing intervention can help a
client maintain healthy skin?
Keep the client well hydrated.
6. A male client with psoriasis visits the
dermatology clinic. When inspecting
the affected areas, the nurse expects
to see which type of secondary lesion?
Scale
7. A female adult client with atopic
dermatitis is prescribed a potent
topical corticosteroid, to be covered
with an occlusive dressing. To address
a potential client problem associated
with this treatment, the nurse
formulates the nursing diagnosis of
Risk for injury. To complete the
nursing diagnosis statement, the nurse
should add which “related-to” phrase?
Related to percutaneous absorption
of the topical corticosteroid
8. A male client is diagnosed with primary
herpes genitalis. Which instruction
should the nurse provide?
“Apply acyclovir ointment to the
lesions every 3 hours, six times a
day for 7 days.”
9. Nurse Bea plans to administer
dexamethasone cream to a client who
has dermatitis over the anterior chest.
How should the nurse apply this
topical agent?
In long, even, outward, and
downward strokes in the direction
of hair growth.
10. A female client sees a dermatologist
for a skin problem. Later, the nurse
reviews the client’s chart and notes
that the chief complaint was intertrigo.
This term refers to which condition?
Irritation of opposing skin surfaces
caused by friction.
CARDIOVASCULAR CHANGES
1. Which of these is a cause of heart
disease?
Thickening of the inside of the
arteries.
2. What can happen if blood flow in an
artery is blocked or greatly restricted?
The heart and brain can be
permanently damaged if they don't
receive the blood they need. When
this occurs in the heart, it is known
as a heart attack (acute myocardial
infarction). When this occurs in the
brain, it is known as a stroke
(cerebrovascular accident).
3. Three risk factors for heart disease
can't be controlled. Which of these are
they? Age, sex, heredity.
4.
disease? Smoking also makes it
more likely for blood clots to form.
5. How much exercise each week is
recommended to help prevent heart
disease? 150 minutes on average.
6. Drinking a moderate amount of alcohol
is considered safe for your heart. What
can happen if you drink more?
Too much alcohol can damage the
liver and heart, lead to high blood
pressure, raise triglycerides, and
increase weight.
7. Which of these is a classic symptom of
a heart attack?
Call 911 right away if you or
someone you're with has these
symptoms. According to the AHA,
chest pain or discomfort is the most
common symptom of a heart attack
for adults. Nausea and vomiting,
back or jaw pain, and especially
shortness of breath may be more
likely in adults with a vagina than in
adults with a penis. Don't hesitate to
get help. The problems need to
treated right away.
8. Your risk for heart disease rises if your
body mass index (BMI) is more than
24.9. Why?
A BMI of 25 or higher means that
you are overweight. A BMI of 30 or
higher means that you are obese.
Losing weight may help you prevent
heart disease, stroke, and diabetes.
Besides helping your heart, staying
at a healthy weight has many other
benefits.
9. What is considered "high blood
pressure"?
You have high blood pressure when
your blood pressure is 130/80
mmHg on several separate
occasions. Blood pressure can be
 normal, elevated, or stage 1 or
stage 2 high blood pressure:
MUSCOSKELETAL CHANGES
1. With aging, certain changes occur in
the musculoskeletal system. Which of
the following changes may lead to
osteoarthritis? Thinning of the
cartilage in joints
2. Sarcopenia is a condition that begins
around age 30, progresses throughout
a person's life, and causes
decreased strength. Which of the
following best describes the cause of
sarcopenia?
The number and size of muscle
fibers gradually decrease.
3. A client comes to the emergency
department reporting pain in the right
leg. When obtaining the history, the
nurse learns that the client has a
history of obesity and hypertension.
Based on this information the nurse
anticipates the client having which
musculoskeletal disorder?
Degenerative joint disease
4. During a routine physical examination
on a 75-year-old female client, a nurse
notes that the client is 5 feet, 3/8
inches (1.6 m) tall. The client states,
"How is that possible? I was always 5
feet and 1/2 inches (1.7 m) tall." Which
statement is the best response by the
nurse?
After menopause, the body's bone
density declines, resulting in a
gradual loss of height."
5. To ensure safe postoperative care of a
client after a total hip arthroplasty,
which actions are most appropriate for
the nurse to perform? Select all that
apply.
Limit movements resulting in
internal rotation and adduction of
the affected hip.
Teach the client not to cross their 12. When admitting a client with a
legs. fractured extremity, the nurse should
6. Which of the following instructions first assess:
regarding body mechanics would be The area distal to the fracture.
most appropriate for helping a client to 13. A client undergoes a total hip
avoid back injury? replacement. Which statement made
Avoid prolonged sitting and by the client indicates to the nurse that
standing the client requires further teaching?
7. A client has been diagnosed with I don't know if I'll be able to get off
osteoporosis after a bone density test that low toilet seat at home by
and is asking what has caused it. myself."
Discussion of risk factors would 14. Which discharge instruction should a
include which of the following? nurse give a client who's had surgery
Heavy smoking, sedentary lifestyle, to repair a hip fracture?
and high intake of carbonated "Don't flex your hip more than 90
drinks. degrees, don't cross your legs, and
8. A nurse is teaching a female client have someone help you put your
about preventing osteoporosis. Which shoes on."
teaching point is correct? 15. The nurse should plan to use an
The recommended daily allowance abduction pillow (or splint) after a total
of calcium may be found in a wide hip replacement to:
variety of foods. Prevent dislocation of the
9. After instructing a 40-year-old woman prosthesis
about osteoporosis after menopause,
the nurse determines that the client
needs further instruction when the
makes which client statement?
"Women of African descent are at
the greatest risk for osteoporosis."
10. A nurse is caring for a client with a
spinal cord injury. The client is
experiencing blurred vision and has a
blood pressure of 204/102 mm Hg.
What should the nurse do first?
Check the client's bladder for
distention.
11. A nurse suspects that a client with a
recent fracture has compartment
syndrome. Assessment findings may
include:
Inability to perform active
movement and pain with passive
movement.