Medical | Surgical and Nursing Management of Patients with burns | Breast Disorders | Integumentary Disorders | Mock Test | Staff Nurse | Guides Academy

Medical, surgical and nursing management of patients with burns, breast disorders, integumentary disorders

Time: 15:00

A patient is admitted with severe burns to the face, neck, and chest. The nurse notes singed nasal hairs and a hoarse voice. What is the highest priority nursing action?

[a] Starting two large-bore IV lines for fluid resuscitation.

[b] Preparing for immediate endotracheal intubation.

[c] Covering the burn wounds with sterile dressings.

[d] Administering a tetanus toxoid injection.

A nurse is caring for a patient one day after a left-sided modified radical mastectomy with axillary lymph node dissection. Which nursing intervention is essential to prevent complications on the affected side?

[a] Keeping the left arm in a dependent position to promote blood flow.

[b] Taking the blood pressure on the left arm to ensure accuracy.

[c] Placing a sign above the bed: "NO BP, VENIPUNCTURES, or INJECTIONS on the left arm."

[d] Applying a warm compress to the left axilla to reduce swelling.

A patient presents with well-demarcated, erythematous plaques covered with silvery-white scales on the elbows and knees. This is a classic clinical feature of which integumentary disorder?

[a] Atopic dermatitis (Eczema).

[b] Cellulitis.

[c] Herpes Zoster.

[d] Psoriasis vulgaris.

The Parkland (Baxter) formula is used in the management of burn patients to calculate:

[a] The percentage of total body surface area (TBSA) burned.

[b] The amount of intravenous fluid resuscitation required in the first 24 hours.

[c] The required daily caloric intake for wound healing.

[d] The appropriate dose of opioid analgesics for pain control.

What is the primary purpose of an escharotomy procedure for a patient with a full-thickness circumferential burn of the arm?

[a] To remove dead tissue and prevent infection.

[b] To prepare the wound bed for skin grafting.

[c] To relieve pressure and restore distal circulation.

[d] To decrease pain in the affected limb.

A young woman is diagnosed with a fibroadenoma of the breast. The nurse should explain that this type of breast mass is typically:

[a] Painful and associated with the menstrual cycle.

[b] A precancerous lesion that requires immediate excision.

[c] A fluid-filled sac that can be aspirated.

[d] A firm, rubbery, mobile, and non-cancerous lump.

A patient is diagnosed with Herpes Zoster (shingles). The nurse expects the rash to have which characteristic presentation?

[a] A scattered, itchy rash all over the body.

[b] A unilateral, vesicular rash that follows a single dermatome.

[c] A circular rash with a central clearing, like a bull's-eye.

[d] Thick, silvery scales on a red base.

According to the Rule of Nines for an adult, what is the estimated Total Body Surface Area (TBSA) percentage for burns covering the entire front of the trunk and the entire right arm?

[a] 18%.

[b] 36%.

[c] 27%.

[d] 45%.

A nurse is caring for a patient with a Jackson-Pratt (JP) drain following a lumpectomy. The nurse's responsibility includes:

[a] Irrigating the drain with sterile saline every 4 hours.

[b] Keeping the bulb fully expanded to allow for drainage.

[c] Disconnecting the drain to allow the patient to ambulate.

[d] Emptying the drain and compressing the bulb to re-establish suction.

A nurse assesses a pressure ulcer on a patient's sacrum that presents as a deep crater with full-thickness skin loss and visible subcutaneous fat, but no exposed bone or muscle. This ulcer would be staged as:

[a] Stage I.

[b] Stage II.

[c] Stage III.

[d] Unstageable.

The most significant and potentially life-threatening complication during the emergent (resuscitative) phase of burn injury is:

[a] Sepsis.

[b] Contractures.

[c] Hypovolemic shock.

[d] Paralytic ileus.

A woman with fibrocystic breast changes asks the nurse for dietary advice to help manage symptoms. The nurse should suggest limiting the intake of:

[a] Dairy products.

[b] Caffeine.

[c] Green leafy vegetables.

[d] Citrus fruits.

A patient is diagnosed with cellulitis of the lower leg. Which nursing intervention is a priority?

[a] Applying a heating pad to the affected area.

[b] Elevating the affected leg above the level of the heart.

[c] Encouraging vigorous exercise to improve circulation.

[d] Massaging the affected area to reduce edema.

During the acute phase of burn management, the nurse should prioritize monitoring for which major complication?

[a] Dehydration.

[b] Infection and sepsis.

[c] Hypothermia.

[d] Acute pain.

A patient is being treated with topical corticosteroids for atopic dermatitis. What is a key patient education point regarding the use of these medications?

[a] "Apply the cream to the entire body daily to prevent new lesions."

[b] "This medication can be shared with family members who have a rash."

[c] "Apply a thin layer only to the affected areas as prescribed."

[d] "You should stop the medication as soon as the itching subsides."

The ABCDE mnemonic is a tool used to assess skin lesions for signs of which type of skin cancer?

[a] Basal Cell Carcinoma.

[b] Squamous Cell Carcinoma.

[c] Malignant Melanoma.

[d] Actinic Keratosis.

A nurse is planning nutritional support for a patient with major burns. The diet should be:

[a] Low in protein and low in calories to reduce metabolic stress.

[b] High in fat and low in carbohydrates.

[c] High in protein and high in calories to support wound healing.

[d] Restricted in fluids to prevent edema.

Which surgical procedure involves the removal of the entire breast, nipple-areolar complex, and axillary lymph nodes, but preserves the pectoralis major muscle?

[a] Lumpectomy.

[b] Simple mastectomy.

[c] Modified radical mastectomy.

[d] Radical mastectomy.

A patient develops Stevens-Johnson Syndrome (SJS) after taking a new medication. The nursing care for this patient is most similar to the care of a patient with:

[a] Congestive heart failure.

[b] A severe asthma attack.

[c] A major burn injury.

[d] A spinal cord injury.

What is the primary purpose of applying pressure garments during the rehabilitative phase of burn care?

[a] To protect the new skin from infection.

[b] To keep the skin warm and promote comfort.

[c] To absorb excess wound drainage.

[d] To reduce hypertrophic scarring and contractures.

A patient is prescribed acyclovir for a severe outbreak of genital herpes. The nurse explains that the primary goal of this antiviral medication is to:

[a] Cure the herpes infection completely.

[b] Prevent future transmission of the virus to partners.

[c] Decrease the severity and duration of the current outbreak.

[d] Provide lifelong immunity against the virus.

A patient is admitted after a chemical burn to the arm. What is the immediate, priority nursing action?

[a] Apply a neutralizing agent to the chemical.

[b] Cover the arm with a dry, sterile dressing.

[c] Lavage the area with copious amounts of running water.

[d] Assess the patient's airway, breathing, and circulation.

A patient who had a lumpectomy with sentinel lymph node biopsy asks the nurse what the benefit of a sentinel node biopsy is. The best response is:

[a] "It guarantees that the cancer will not recur."

[b] "It helps determine if cancer has spread to the lymph nodes with less risk of lymphedema than a full axillary dissection."

[c] "It is a way to deliver radiation directly to the lymph nodes."

[d] "It removes all the lymph nodes in the axilla to prevent spread."

A patient has a skin lesion that is described as a "pearly papule with a central ulceration and telangiectasias." This description is most characteristic of:

[a] Basal Cell Carcinoma.

[b] Squamous Cell Carcinoma.

[c] Malignant Melanoma.

[d] A cherry angioma.

Post-herpetic neuralgia is a potential complication of Herpes Zoster (shingles). Nursing management for this condition primarily focuses on:

[a] Administering antiviral medications.

[b] Applying wet-to-dry dressings.

[c] Surgical removal of the affected nerves.

[d] Pain management with analgesics and adjuvant medications.