A patient rescued from a house fire has burns on the face, singed nasal hairs and a hoarse voice. Which assessment is the priority?
Airway patency
✓
Burn depth
Pain intensity
Extent of skin surface burned
Correct Answer
Airway patency
Facial burns, singed nasal hair and hoarseness point to inhalation injury, and swelling can close the airway quickly, so airway comes first in the airway, breathing, circulation sequence. Burn depth is assessed after the airway is secured. Pain intensity matters but does not threaten life as fast as an obstructed airway. Extent of skin surface burned guides fluid replacement but is calculated after airway and breathing are addressed.
Category: Burn Assessment
Question 2
A patient's burn is dry, leathery and white, and the patient reports no pain in the center of the burned area. What does the lack of pain indicate?
The burn involves only the outer skin layer
The nerve endings in the area were destroyed
✓
The burn is healing faster than expected
Swelling has numbed the area temporarily
Correct Answer
The nerve endings in the area were destroyed
A full-thickness burn destroys the nerve endings in the dermis, so the burned area itself is typically painless, although nearby partial-thickness areas still hurt. The burn involves only the outer skin layer is wrong because superficial burns are painful. The burn is healing faster than expected is wrong because painlessness here signals deep damage. Swelling has numbed the area temporarily is wrong because the cause is nerve destruction, not swelling.
Category: Burn Assessment
Question 3
Which appearance is typical of a partial-thickness burn?
Pink, dry skin with no blisters
Dry, leathery, white skin that does not blanch
Red, moist, blistered skin that blanches with pressure
✓
Charred tissue with exposed muscle and bone
Correct Answer
Red, moist, blistered skin that blanches with pressure
A partial-thickness burn damages the epidermis and part of the dermis; the superficial form typically produces red, moist, swollen, blistered skin that blanches and is very painful. Pink, dry skin with no blisters describes a superficial burn. Dry, leathery, white skin that does not blanch describes a full-thickness burn. Charred tissue with exposed muscle and bone describes a burn extending below the skin.
Category: Burn Assessment
Question 4
Which burn zone surrounds the central injury, has reduced blood flow, and contains tissue that may still be saved with good care?
Zone of coagulation
Zone of hyperemia
Zone of granulation
Zone of stasis
✓
Correct Answer
Zone of stasis
The zone of stasis has decreased perfusion but potentially viable tissue, so preserving its blood flow affects how deep and large the final wound becomes. Zone of coagulation is the central area of irreversible tissue death. Zone of hyperemia is the outer area of inflammation and increased blood flow that usually recovers on its own. Zone of granulation is not one of the burn zones; granulation describes healing tissue.
Category: Burn Assessment
Question 5
Why does a patient with a large burn need fluid resuscitation early in care?
Fluid shifts out of the vessels and is lost through burned skin
✓
Burn pain makes the kidneys produce extra urine
Extra fluid is needed to cool the burned tissue
Large fluid volumes prevent later scarring
Correct Answer
Fluid shifts out of the vessels and is lost through burned skin
Burns increase capillary permeability, so fluid shifts out of the bloodstream and is lost through the injured skin, causing hypovolemia that can progress to shock. Burn pain makes the kidneys produce extra urine is wrong because the danger is fluid loss, not increased urine. Extra fluid is needed to cool the burned tissue confuses cooling the wound with replacing lost volume. Large fluid volumes prevent later scarring is wrong because fluids restore circulating volume and have no role in scar prevention.
Category: Burn Care
Question 6
During a dressing change on a burn, which finding suggests infection?
Pink, moist granulating tissue
Yellow, foul-smelling drainage
✓
Clear fluid inside an intact blister
Mild itching at the healing edges
Correct Answer
Yellow, foul-smelling drainage
Yellow, foul-smelling discharge, increasing redness and fever are signs of wound infection, which is a common and serious burn complication, so the nurse reports them. Pink, moist granulating tissue is a sign of healing. Clear fluid inside an intact blister is expected with a partial-thickness burn. Mild itching at the healing edges is common as new skin forms.
Category: Burn Care
Question 7
Why does the nurse monitor temperature and use warming measures for a patient with extensive burns?
Warmth makes the blisters form faster
Heat lowers the need for fluid replacement
Burned skin can no longer hold in body heat
✓
Warming the room kills bacteria on the wound
Correct Answer
Burned skin can no longer hold in body heat
Intact skin helps regulate temperature, so losing large areas of it causes heat loss and a risk of hypothermia. Warmth makes the blisters form faster is not a goal of care. Heat lowers the need for fluid replacement is wrong because warmth does not replace lost volume. Warming the room kills bacteria on the wound is wrong because infection is prevented with wound care and aseptic technique.
Category: Burn Care
Question 8
A patient with a burn on the front of the neck asks for a thick pillow under the head for comfort. Why does the nurse avoid using one?
It speeds evaporation from the wound
It makes dressing changes harder to do
It lowers blood flow to the brain
It promotes a flexion contracture as the burn heals
✓
Correct Answer
It promotes a flexion contracture as the burn heals
Healing burn tissue tightens as it scars, and a neck held bent forward on a pillow can heal in that position, so the neck is kept in a neutral or slightly extended position instead. It speeds evaporation from the wound is wrong because head position does not change fluid loss from the burn. It makes dressing changes harder to do is not the reason; the concern is lasting loss of movement. It lowers blood flow to the brain is wrong because a pillow does not reduce cerebral circulation.
Category: Burn Care
Question 9
A patient with atopic dermatitis asks which moisturizer will best protect the skin. What should the nurse recommend?
A fragrance-free, oil-based ointment
✓
A perfumed, water-based lotion
An alcohol-based drying gel
A scented foaming body wash
Correct Answer
A fragrance-free, oil-based ointment
Oil-based ointments hold moisture in the skin better than water-based lotions, and fragrance-free products avoid irritation, so daily use helps repair the damaged skin barrier. A perfumed, water-based lotion holds moisture poorly and the fragrance can irritate. An alcohol-based drying gel further dries the skin. A scented foaming body wash is a cleanser that can strip oils and irritate the skin.
Category: Inflammatory Skin Disorders
Question 10
A patient with atopic dermatitis has scratched areas that now show pus and yellow crusts. What should the nurse suspect?
Normal thickening from scratching
A secondary bacterial infection
✓
A new psoriasis plaque forming
An expected sign of skin healing
Correct Answer
A secondary bacterial infection
Broken, scratched skin lets organisms such as Staphylococcus aureus in, and pus, yellow crusts, increased redness and swelling signal a secondary infection that is reported to the provider. Normal thickening from scratching is lichenification, which is leathery, not crusted with pus. A new psoriasis plaque forming would show a silvery scale, not pus. An expected sign of skin healing is wrong because pus and crusting point to infection.
Category: Inflammatory Skin Disorders
Question 11
Which teaching helps a patient with psoriasis reduce the number of flares?
Stop moisturizing once plaques appear
Pick off the scales to speed healing
Limit alcohol and practice stress reduction
✓
Spend winters in cold, dry air
Correct Answer
Limit alcohol and practice stress reduction
Stress, excessive alcohol, dry skin, cold dry conditions and skin injury can trigger psoriasis flares, so stress management and limiting alcohol are part of teaching. Stop moisturizing once plaques appear is wrong because daily oil-based emollients support healing. Pick off the scales to speed healing injures the skin and can trigger new lesions. Spend winters in cold, dry air exposes the patient to a known trigger.
Category: Inflammatory Skin Disorders
Question 12
A patient has red, scaling, flaking skin covering nearly the entire body. Which nursing priority comes first?
Body image concerns
Teaching about sunscreen use
Restful sleep at night
Fluid and electrolyte balance
✓
Correct Answer
Fluid and electrolyte balance
Generalized exfoliative dermatitis leaves the body with almost no working skin barrier, so fluid and electrolyte loss threatens hemodynamic stability, and IV fluids, electrolyte replacement and vital sign monitoring come first. Body image concerns are real but are addressed after physiological stability. Teaching about sunscreen use is not an urgent need. Restful sleep at night matters but does not outrank circulation.
Category: Inflammatory Skin Disorders
Question 13
A patient developed an itchy rash with small blisters on the wrist after wearing a new metal watch. Which test identifies the allergen?
Patch testing
✓
Skin biopsy
Potassium hydroxide scraping
Viral culture
Correct Answer
Patch testing
In patch testing, suspected allergens are placed on the skin of the back and the sites are checked later for a reaction, making it the standard way to identify the cause of allergic contact dermatitis. Skin biopsy examines tissue but does not show which substance caused the reaction. Potassium hydroxide scraping looks for fungal elements. Viral culture detects viruses such as herpes simplex.
Category: Inflammatory Skin Disorders
Question 14
An infant has yellow-to-brown, greasy crusts on the scalp. Which condition does this suggest?
Psoriasis
Seborrheic dermatitis
✓
Scabies
Contact dermatitis
Correct Answer
Seborrheic dermatitis
Seborrheic dermatitis affects oil-rich areas, and in infants it appears as yellow-to-brown greasy crusts on the scalp, often called cradle cap. Psoriasis causes thick red plaques with a silvery scale. Scabies causes intensely itchy papules and burrows in places such as the finger webs and wrists. Contact dermatitis appears where an irritant or allergen touched the skin.
Category: Inflammatory Skin Disorders
Question 15
How might atopic dermatitis look on a patient with dark skin?
Bright red, sharply outlined patches
Smooth patches with no color change
Darker brown, gray or purple patches
✓
Yellow, waxy patches on the palms
Correct Answer
Darker brown, gray or purple patches
Redness can be hard to see on dark skin, where eczema patches often look darker brown, gray or purple, and postinflammatory hyperpigmentation is more common. Bright red, sharply outlined patches describe how it often looks on lighter skin. Smooth patches with no color change would miss the inflammation that is present. Yellow, waxy patches on the palms do not describe eczema.
Category: Inflammatory Skin Disorders
Question 16
A patient with herpes zoster develops new lesions near the eye and on the tip of the nose. What should the nurse do?
Reassure the patient that facial lesions are expected and harmless
Cover the eye with a warm compress and recheck it later
Apply the prescribed skin ointment directly into the eye
Report it to the provider promptly because vision may be affected
✓
Correct Answer
Report it to the provider promptly because vision may be affected
Shingles involving the eye area can damage vision, and lesions near the eye or ear are reported immediately so treatment and an eye evaluation can begin. Reassure the patient that facial lesions are expected and harmless ignores a threat to sight. Cover the eye with a warm compress and recheck it later delays urgent care. Apply the prescribed skin ointment directly into the eye uses a product not meant for the eye.
Category: Skin Infections
Question 17
Which type of isolation precautions does the nurse follow for a hospitalized patient with scabies?
Contact precautions
✓
Airborne precautions
Droplet precautions
Protective environment
Correct Answer
Contact precautions
Scabies mites spread by direct skin contact and through shared linens, so contact precautions with gloves and a gown are used. Airborne precautions are for organisms that spread through tiny particles that stay in the air, such as tuberculosis. Droplet precautions are for organisms spread by large respiratory droplets. Protective environment shields patients with very weak immune systems from outside organisms.
Category: Skin Infections
Question 18
Which procedure removes a skin cancer in thin layers, examining each layer under a microscope until the margins are clear?
Cryotherapy
Mohs surgery
✓
Electrocautery
Dermabrasion
Correct Answer
Mohs surgery
Mohs surgery removes tissue one layer at a time and checks each under a microscope, sparing healthy skin while ensuring the cancer is fully removed. Cryotherapy destroys tissue by freezing without layer-by-layer examination. Electrocautery uses heat from an electric current to remove tissue. Dermabrasion resurfaces the skin to smooth scars rather than removing cancer.
Category: Skin Tumors and Procedures
Question 19
Why is a skin flap often preferred over a graft to cover a nearby wound?
It needs no wound care afterward
It can cover larger wounds than a graft
It keeps its own blood supply
✓
It carries no risk of infection
Correct Answer
It keeps its own blood supply
A flap is healthy skin that stays partly attached to its original site, so it brings its own blood supply to the wound. It needs no wound care afterward is wrong because flaps still need wound care and infection monitoring. It can cover larger wounds than a graft is wrong because grafts are used for larger wounds. It carries no risk of infection is wrong because any surgical site can become infected.
Category: Skin Tumors and Procedures
Question 20
Which safety measure is used during laser treatment of a pigmented skin lesion?
The room lights are turned off for the procedure
The patient's skin is heated before treatment
Staff stand behind a lead shield
The patient and staff wear protective eyewear
✓
Correct Answer
The patient and staff wear protective eyewear
Laser light can injure the eyes, so the patient and staff wear safety goggles or eye shields. The room lights are turned off for the procedure does not protect the eyes. The patient's skin is heated before treatment is wrong because the skin is cooled, often with ice packs, afterward. Staff stand behind a lead shield is a precaution for ionizing radiation such as x-rays, not lasers.
Category: Skin Tumors and Procedures