NURSING EXAM QUESTIONS
FUNDAMENTALS OF NURSING
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Question
[CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
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Correct the initial assessment form
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Redo the initial assessment and document current findings
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Conduct and document an emergency assessment
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Perform and document a focused assessment on skin integrity
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Detailed explanation-1: -When you receive the shift report, you learn that your patient has no special skin care needs. You are surprised during the bath to observe reddened areas over bony prominences. What action is appropriate? Perform and document a focused assessment of skin integrity.
Detailed explanation-2: -Shift assessment includes airway, breathing and circulation. Airway assessment usually assesses on patient secretion, artificial airway, noise and cough. Air entry and movement, oxygen requirement, work of breathing, ventilator dependent and breath sound usually assess in breathing assessment.
Detailed explanation-3: -Which data would a nurse consider least important during an assessment of skin integrity? Family history is not an important factor in the development of pressure ulcers and general skin integrity.