A patient has had a "terrible itch" for several months that he has been continuously scratching. On examination, the nurse might expect to find:
a. A keloid.
b. A fissure.
c. Keratosis.
d. Lichenification.
ANS: D
Lichenification results from prolonged, intense scratching that eventually thickens the skin and produces tightly packed sets of papules. A keloid is a hypertrophic scar. A fissure is a linear crack with abrupt edges, which extends into the dermis; it can be dry or moist. Keratoses are lesions that are raised, thickened areas of pigmentation that appear crusted, scaly, and warty.
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The nurse is caring for a patient diagnosed with cardiogenic shock due to cardiomyopathy. Which of the following manifestations is the nurse most likely to assess in this patient?
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Which finding indicates that rehydration is complete and hypovolemic shock has been successfully treated in a patient?
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The nurse wants to teach a child newly enrolled in English as a second language class about the importance of handwashing before meals and of not eating food dropped on the examination room floor
What is the best way to assimilate the nurse's cultural values about hygienic nutrition? 1. Schedule a medical interpreter to accompany the client to his or her next visit. 2. Have the child repeat her or his interpretation of the information that was taught. 3. Provide written materials in English about hygiene and diet for the client to take home. 4. Have the nurse model proper handwashing before examining the child and throw out the dropped cookie.