Question

A nurse is assessing a client who is receiving treatment for psoriasis. Which of the following images depicts what the nurse should expect to observe?

Answer 1

Correct Answers

Correct Images:

Rationale :

🩺 Psoriasis classically presents as erythematous plaques covered with thick, silvery scales, most commonly on extensor surfaces (elbows, knees), scalp, and lower back.

🩺 The lesions are sharply demarcated, often symmetric, and may appear raised with dry, flaky scale that sheds easily.

🩺 This appearance reflects rapid epidermal cell turnover and chronic inflammation.

🩺 When scale is gently removed, pinpoint bleeding (Auspitz sign) may occur.

🩺 Among the options shown, the second image best matches these hallmark features.

❌ Images with diffuse redness without scale

❌ These lack the characteristic silvery scale.

❌ They are more consistent with dermatitis or irritation.

❌ Images with vesicles or oozing

❌ Psoriasis plaques are dry, not vesicular.

❌ Oozing suggests eczema or infection.

❌ Images with scattered papules without plaques

❌ Psoriasis typically forms plaques, not isolated papules.

❌ The borders are less defined in those images.

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Answer 2

Correct Answers

Correct Images:

Rationale :

🩺 Psoriasis classically presents as erythematous plaques covered with thick, silvery scales, most commonly on extensor surfaces (elbows, knees), scalp, and lower back.

🩺 The lesions are sharply demarcated, often symmetric, and may appear raised with dry, flaky scale that sheds easily.

🩺 This appearance reflects rapid epidermal cell turnover and chronic inflammation.

🩺 When scale is gently removed, pinpoint bleeding (Auspitz sign) may occur.

🩺 Among the options shown, the second image best matches these hallmark features.

❌ Images with diffuse redness without scale

❌ These lack the characteristic silvery scale.

❌ They are more consistent with dermatitis or irritation.

❌ Images with vesicles or oozing

❌ Psoriasis plaques are dry, not vesicular.

❌ Oozing suggests eczema or infection.

❌ Images with scattered papules without plaques

❌ Psoriasis typically forms plaques, not isolated papules.

❌ The borders are less defined in those images.

Distractor Analysis :

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Answer 3

Correct Answers

Correct Images:

Rationale :

🩺 Psoriasis classically presents as erythematous plaques covered with thick, silvery scales, most commonly on extensor surfaces (elbows, knees), scalp, and lower back.

🩺 The lesions are sharply demarcated, often symmetric, and may appear raised with dry, flaky scale that sheds easily.

🩺 This appearance reflects rapid epidermal cell turnover and chronic inflammation.

🩺 When scale is gently removed, pinpoint bleeding (Auspitz sign) may occur.

🩺 Among the options shown, the second image best matches these hallmark features.

❌ Images with diffuse redness without scale

❌ These lack the characteristic silvery scale.

❌ They are more consistent with dermatitis or irritation.

❌ Images with vesicles or oozing

❌ Psoriasis plaques are dry, not vesicular.

❌ Oozing suggests eczema or infection.

❌ Images with scattered papules without plaques

❌ Psoriasis typically forms plaques, not isolated papules.

❌ The borders are less defined in those images.

Distractor Analysis :

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Answer 4

Correct Answers

Correct Images:

Rationale :

🩺 Psoriasis classically presents as erythematous plaques covered with thick, silvery scales, most commonly on extensor surfaces (elbows, knees), scalp, and lower back.

🩺 The lesions are sharply demarcated, often symmetric, and may appear raised with dry, flaky scale that sheds easily.

🩺 This appearance reflects rapid epidermal cell turnover and chronic inflammation.

🩺 When scale is gently removed, pinpoint bleeding (Auspitz sign) may occur.

🩺 Among the options shown, the second image best matches these hallmark features.

❌ Images with diffuse redness without scale

❌ These lack the characteristic silvery scale.

❌ They are more consistent with dermatitis or irritation.

❌ Images with vesicles or oozing

❌ Psoriasis plaques are dry, not vesicular.

❌ Oozing suggests eczema or infection.

❌ Images with scattered papules without plaques

❌ Psoriasis typically forms plaques, not isolated papules.

❌ The borders are less defined in those images.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 5

Correct Answers:

“Place a piece of gauze over the stoma while changing the pouch."
"Cut the opening of the pouch 1/' of an inch larger than the stoma.”
“Empty the ostomy pouch when it becomes one-third full of contents."

Rationale :

🔹 “Place a piece of gauze over the stoma while changing the pouch.”

🔹 A new stoma is highly vascular, so small amounts of bleeding or mucus are expected during pouch changes.

🔹 Gauze helps absorb drainage and keeps the area clean while the pouch is off.

🔹 This also protects clothing and bedding during care.

🔹 Light bleeding that stops quickly is normal.

🔹 “Cut the opening of the pouch 1/8 inch larger than the stoma.”

🔹 The pouch opening should be slightly larger than the stoma to prevent constriction and ischemia.

🔹 Allowing a 1/8-inch margin prevents pressure injury while still protecting surrounding skin.

🔹 An opening that is too small can damage the stoma.

🔹 Proper sizing helps maintain peristomal skin integrity.

🔹 “Empty the ostomy pouch when it becomes one-third full of contents.”

🔹 Emptying at one-third full prevents excess weight from pulling on the skin barrier.

🔹 Overfilled pouches are more likely to leak or detach.

🔹 Regular emptying reduces odor and discomfort.

🔹 This practice helps prevent skin breakdown and pouch failure.

❌ Incorrect / Unsafe Instructions

❌ “Use povidone-iodine to clean around the stoma.”

❌ Povidone-iodine is too harsh and can irritate peristomal skin.

❌ Stoma care should be done with warm water or mild soap only.

❌ “Expect the stoma to turn a purple-blue color as it heals.”

❌ A healthy stoma should be pink to red and moist, similar to oral mucosa.

❌ Purple, blue, brown, or black discoloration indicates ischemia and poor perfusion and requires immediate evaluation.

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Answer 6

Correct Answers:

Ensure bubbling is present in the water-seal chamber.

Rationale :

🔹 The water-seal chamber acts as a one-way valve, allowing air to escape from the pleural space while preventing air from re-entering.

🔹 Intermittent bubbling in the water-seal chamber is expected, especially when the client coughs or exhales, and indicates that air is being evacuated.

🔹 This finding confirms that the chest tube system is patent and functioning properly.

🔹 Continuous bubbling would be abnormal and suggest an air leak, but some bubbling is necessary early on.

🔹 Monitoring the water-seal chamber is a key nursing responsibility in chest tube management.

❌ Empty the drainage collection chamber when full.

❌ The collection chamber should be emptied based on facility policy and provider orders, not simply when full.

❌ Sudden emptying without measurement can disrupt accurate output tracking.

❌ Milk the chest tube at least three times per day.

❌ Routine milking is contraindicated because it can create excessive negative pressure.

❌ This may damage lung tissue.

❌ Clamp the chest tube when transferring the client.

❌ Clamping can cause tension pneumothorax.

❌ Chest tubes should remain unclamped unless ordered for a specific reason.

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Answer 7

Correct Answers:

Use foot splints.

Rationale :

🔹 Plantar flexion contractures occur when the foot is held in a downward position for prolonged periods.

🔹 Foot splints (foot boots) maintain the foot in dorsiflexion, preserving normal ankle alignment.

🔹 This intervention prevents shortening of the Achilles tendon and calf muscles.

🔹 Foot splints are especially important in immobile or bedridden clients.

🔹 They are a direct and effective method to prevent foot drop.

❌ Prop the feet up.

❌ Elevating the feet does not maintain proper ankle alignment.

❌ It does not prevent plantar flexion.

❌ Use a trochanter roll.

❌ Trochanter rolls prevent external hip rotation, not foot contractures.

❌ They do not affect ankle positioning.

❌ Apply an abduction pillow.

❌ Abduction pillows maintain hip alignment.

❌ They do not prevent foot drop.

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Answer 8

Correct Answers:

Have the client tuck his chin to his chest during suctioning.

Rationale :

🔹 Tucking the chin to the chest helps close the airway slightly, reducing the risk of trauma to the nasopharyngeal tissues during catheter insertion.

🔹 This position also helps guide the catheter smoothly along the natural anatomy of the nasopharynx.

🔹 Proper positioning minimizes gagging, discomfort, and mucosal injury.

🔹 It supports safer passage of the catheter toward the posterior pharynx.

🔹 Positioning is a key safety-focused nursing intervention during nasopharyngeal suctioning.

❌ Incorrect Actions

❌ Apply a petroleum-based lubricant to the catheter.

❌ Petroleum-based lubricants can be aspirated and cause lung injury.

❌ A water-soluble lubricant should be used instead.

❌ Set the suction device to 120 mm Hg.

❌ Adult nasopharyngeal suctioning should be set at 100–120 mm Hg, but the nurse should use the lowest effective pressure.

❌ Stating a fixed high value without adjustment increases mucosal damage risk.

❌ Apply suction to the catheter during insertion.

❌ Suction should be applied only during withdrawal, not insertion.

❌ Applying suction during insertion can cause hypoxia and tissue trauma.

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Answer 9

Correct Order:

Order : 1 : No answer text available
Order : 2 : No answer text available
Order : 3 : No answer text available
Order : 4 : No answer text available
Order : 5 : No answer text available

Rationale :

1) 🧤 Don clean gloves

🔹 Gloves protect the nurse from exposure to urine/body fluids and reduce cross-contamination.

🔹 Catheter removal is a clean procedure, so clean (nonsterile) gloves are appropriate.

🔹 Gloves should be on before touching the catheter, tubing, or perineal area.

2) 💉 Attach the syringe to the balloon injection port

🔹 The syringe must be connected to the balloon port (not the drainage port) to safely deflate the retention balloon.

🔹 Using the correct port prevents accidental disconnection of the drainage system.

🔹 This ensures the balloon can be fully deflated without trauma.

3) 🫧 Withdraw the solution from the balloon

🔹 The balloon must be completely deflated to prevent urethral tearing and severe pain.

🔹 Withdraw the full amount of sterile water that was used to inflate the balloon (often 10 mL, based on catheter type).

🔹 If resistance occurs or fluid does not return, the nurse should stop and reassess—removal with an inflated balloon is unsafe.

4) ➡️ Slowly pull the catheter out of the urethral canal

🔹 Gentle, slow removal minimizes discomfort and reduces urethral irritation.

🔹 The nurse should ask the client to exhale during removal to relax sphincter muscles.

🔹 Observe for pain, resistance, or bleeding, which may indicate incomplete balloon deflation or urethral trauma.

5) 🧻 Dry the perineal area

🔹 After removal, cleansing and drying help protect the skin from moisture-associated breakdown.

🔹 It improves comfort and reduces risk of irritation from urine residue.

🔹 This is part of post-removal hygiene and reassessment.

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Answer 10

Correct Answers:

Tie the linens' bag securely at the top.

Rationale :

🔹 Soiled linens from clients on contact precautions must be contained to prevent the spread of microorganisms.

🔹 Securing the linen bag at the top prevents leakage, aerosolization, and contamination of the environment.

🔹 Linens should be handled as little as possible and removed according to facility infection-control policy.

🔹 Proper containment protects both healthcare workers and other clients.

🔹 This action directly supports standard and transmission-based precautions.

❌ Rinse the linens prior to removing them from the room

❌ Rinsing can aerosolize microorganisms and spread contamination.

❌ Linens should never be rinsed in the client-care area.

❌ Wear sterile gloves when handling the linens

❌ Sterile gloves are unnecessary; clean gloves are sufficient.

❌ Sterility does not add protection in this situation.

❌ Double-bag the linens

❌ Double-bagging is not routinely required unless the bag is visibly leaking.

❌ Unnecessary double-bagging increases waste without added benefit.

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QLexNursing

1 :
A nurse is assessing a client who is receiving treatment for psoriasis. Which of the following images depicts what the nurse should expect to observe?

Correct Answers

Correct Images:

2 :
A nurse is assessing a client who is receiving treatment for psoriasis. Which of the following images depicts what the nurse should expect to observe?

Correct Answers

Correct Images:

3 :
A nurse is assessing a client who is receiving treatment for psoriasis. Which of the following images depicts what the nurse should expect to observe?

Correct Answers

Correct Images:

4 :
A nurse is assessing a client who is receiving treatment for psoriasis. Which of the following images depicts what the nurse should expect to observe?

Correct Answers

Correct Images:

5 :
A nurse is completing discharge teaching about ostomy care with a client who has a new stoma. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

❌ Incorrect / Unsafe Instructions

6 :
A nurse is caring for a client who has a chest tube with a closed drainage system. Which of the following actions should the nurse take?

7 :
A nurse is caring for a client who is immobile. Which of the following interventions should the nurse plan to take to prevent plantar flexion contractures?

8 :
A nurse is caring for an adult client who requires nasopharyngeal suctioning. Which of the following actions should the nurse take?

❌ Incorrect Actions

9 :
A nurse is preparing to remove an indwelling urinary catheter from a client. In what order should the nurse perform the following steps? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

10 :
A nurse is planning care for a client who has contact precautions in place. Which of the following actions should the nurse plan to take when removing soiled linens from the client's room?

QLexNursing

1 : A nurse is assessing a client who is receiving treatment for psoriasis. Which of the following images depicts what the nurse should expect to observe?

Correct Answers

Correct Images:

2 : A nurse is assessing a client who is receiving treatment for psoriasis. Which of the following images depicts what the nurse should expect to observe?

Correct Answers

Correct Images:

3 : A nurse is assessing a client who is receiving treatment for psoriasis. Which of the following images depicts what the nurse should expect to observe?

Correct Answers

Correct Images:

4 : A nurse is assessing a client who is receiving treatment for psoriasis. Which of the following images depicts what the nurse should expect to observe?

Correct Answers

Correct Images:

5 : A nurse is completing discharge teaching about ostomy care with a client who has a new stoma. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

❌ Incorrect / Unsafe Instructions

6 : A nurse is caring for a client who has a chest tube with a closed drainage system. Which of the following actions should the nurse take?

7 : A nurse is caring for a client who is immobile. Which of the following interventions should the nurse plan to take to prevent plantar flexion contractures?

8 : A nurse is caring for an adult client who requires nasopharyngeal suctioning. Which of the following actions should the nurse take?

❌ Incorrect Actions

9 : A nurse is preparing to remove an indwelling urinary catheter from a client. In what order should the nurse perform the following steps? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

10 : A nurse is planning care for a client who has contact precautions in place. Which of the following actions should the nurse plan to take when removing soiled linens from the client's room?

1 :
A nurse is assessing a client who is receiving treatment for psoriasis. Which of the following images depicts what the nurse should expect to observe?

2 :
A nurse is assessing a client who is receiving treatment for psoriasis. Which of the following images depicts what the nurse should expect to observe?

3 :
A nurse is assessing a client who is receiving treatment for psoriasis. Which of the following images depicts what the nurse should expect to observe?

4 :
A nurse is assessing a client who is receiving treatment for psoriasis. Which of the following images depicts what the nurse should expect to observe?

5 :
A nurse is completing discharge teaching about ostomy care with a client who has a new stoma. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

6 :
A nurse is caring for a client who has a chest tube with a closed drainage system. Which of the following actions should the nurse take?

7 :
A nurse is caring for a client who is immobile. Which of the following interventions should the nurse plan to take to prevent plantar flexion contractures?

8 :
A nurse is caring for an adult client who requires nasopharyngeal suctioning. Which of the following actions should the nurse take?

9 :
A nurse is preparing to remove an indwelling urinary catheter from a client. In what order should the nurse perform the following steps? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

10 :
A nurse is planning care for a client who has contact precautions in place. Which of the following actions should the nurse plan to take when removing soiled linens from the client's room?