You are acting as a preceptor for a newly hired graduate nurse. The graduate has been assigned to care for a client with a Stage III pressure ulcer. The graduate nurse voices questions about infections and pressure ulcers.
Which of the following statements should be included in your response?
A) Topical antibiotic therapy is used for long-term prophylactic pressure ulcer management.
B) Silver sulfadiazine is the antimicrobial of choice for wounds with high bacterial counts.
C) Nanocrystalline silver dressings are effective against gram-positive bacteria.
D) Caution must be used with cadexomer iodine dressings, as they have been shown to disrupt granulation activity.
Question 2Which interventions should the nurse perform when an older patient reports a change in hearing? Standard Text: Select all that apply.
1. Perform a Rinne test.
2. Eliminate extraneous noise.
3. Review prescribed medications.
4. Report the change to the physician.
5. Speak in a tone that includes shouting.
Question 3The nurse is assisting a graduate nurse to develop a plan of care for a newly admitted client. The client has been diagnosed with pneumonia and has a Stage II pressure ulcer.
Which of the following nursing diagnoses will be of the greatest initial importance when planning care?
A) Potential for infection related to impaired skin integrity
B) Pain related to destruction of tissue
C) Knowledge deficit related to care of skin disorder
D) Risk for infection related to impaired skin integrity
Question 4An otoscopic examination of an older patient reveals a red, bulging membrane with absent distorted light reflex. Which condition would the nurse suspect?
1. Scar tissue
2. Otitis media
3. External otitis
4. Ruptured tympanic membrane
Question 5An older patient has sensorineural hearing loss. Which health problems should the nurse recognize as causing this type of hearing loss? Standard Text: Select all that apply.
1. Presbycusis
2. Meniere's disease
3. Impacted cerumen
4. Otitis media infection
5. Tympanic membrane perforation
Question 6The nurse is reviewing an older patient's currently prescribed medications. Which medications have side effects that increase visual disturbances? Standard Text: Select all that apply.
1. Propranolol (Inderal)
2. Warfarin (Coumadin)
3. Tamoxifen (Nolvadex)
4. Amiodarone (Cordarone)
5. Calcium carbonate (Tums)
Question 7A client has been treated for a skin tear. Which of the following dietary selections contains ingredients that will be most favorable to wound healing?
A) Bacon, toast, and coffee
B) Cereal, milk, and toast
C) Eggs, toast, and orange juice
D) Ham slices, milk, and applesauce