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Practice Question

The nurse is examining a client who reports itching on the right arm, The nurse observes a rash made up of multiple flat areas of redness ranging from pinpoint to 0.5 cm in diameter. How should the nurse record this finding?

Answer Choices:

Correct Answer:

Localized red rash comprised of flat areas, pinpoint to 0.5 cm in diameter.

Rationale:

🔷The term macule describes a flat, non-palpable area of discoloration less than 1 cm in diameter, such as redness or hyperpigmentation.

🔷This description fits the finding of flat red areas ranging in size from pinpoint to 0.5 cm, without raised or fluid-filled lesions.

🔷Accurate nursing documentation of skin lesions requires correct terminology (macular, papular, vesicular, pustular) for precise communication with the healthcare team.

🔷Using specific measurements ensures objective assessment and helps track progression or resolution of the rash.

🔷Identifying lesion type guides differential diagnosis, such as differentiating rashes from allergic reactions, infections, or systemic causes.

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This question is from Hesi pre-assessment 1 which contains 59 questions.

More Questions from This Exam
The nurse is administering medications through a nasogastric tube (NGT) which is connected to suction. After ensuring correct tube placement, which action should the nurse take next?

Answer Choices:

A. Flush the tube with water.
B. Crush the tablets and dissolve in sterile water.
C. Clamp the tube for 20 minutes.
D. Administer the medications as prescribed.
At the beginning of the shift, the nurse assesses a client who is admitted from the post-anesthesia care (PACU). When should the nurse document the client's findings?

Answer Choices:

A. Immediately after the assessments are completed.
B. At the beginning, middle, and end of the shift.
C. After client priorities are identified for the development of the nursing care plan.
D. At the end of the shift so full attention can be given to the client's needs.
An older client who requires frequent monitoring fell and fractured a hip. Which nurse is at greatest risk fora malpractice judgment?

Answer Choices:

A. The nurse assigned to care for the client who was at lunch at the time of the fall.
B. The nurse who worked the 7 to 3 shift at the hospital and wrote poor nursing notes.
C. The nurse who transferred the client to the hair when the fall occurred.
D. The charge nurse who completed rounds 30 minutes before the fall occurred.
The nurse is caring a client with a history of hypertension who states an intention to stop taking antihypertensive medications and try spiritual meditation instead. Which is the best response by the nurse?

Answer Choices:

A. Spiritual meditation requires a time commitment of 15 to 20 minutes daily.
B. Complementary therapy and western medicine can be effective for you.
C. It is important that you continue your medication while learning to meditate.
D. Obtain your healthcare provider's permission before starting meditation.
From Exam
Hesi pre-assessment 1

59 Questions

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Question Details
  • Category: RN Nursing Exam(s)
  • Subcategory: HESI Exam(s)
  • Domain: Hesi Nutrition
  • Answer Choices: 4
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