1.MADOULE1 Integumentary, Musculoskeletal, and Cancer

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Sample questions from 1.MADOULE1 Integumentary, Musculoskeletal, and Cancer

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 78-year-old resident in a long-term care facility has limited mobility, urinary incontinence, and a stage 1 pressure injury over the sacrum. The resident is afebrile, and the skin is intact but persistently red and nonblanchable. Which intervention should the nurse implement first?

   • A.Massage the reddened area for 5 minutes every shift
   • B.Reposition the resident at least every 2 hours and offload the sacrum
   • C.Apply a heating pad to increase circulation to the area
   • D.Place a donut-shaped cushion under the sacrum

   Rationale: Repositioning and offloading relieve pressure, the primary cause of pressure injury, and prevent further tissue damage. Massaging can injure fragile tissue, heat can cause burns, and donut cushions concentrate pressure around their edges. The exam takeaway is to remove pressure rather than stimulate or heat an injured area.

2. 2.A 67-year-old client in an outpatient dermatology clinic has a changing pigmented lesion on the upper back. The lesion is asymmetric, has irregular borders, varies in color, and has increased from 5 mm to 9 mm in 3 months. Which action should the nurse anticipate?

   • A.Reassure the client that lesions under 1 cm are benign
   • B.Schedule prompt evaluation and biopsy by the provider
   • C.Apply a topical corticosteroid and reassess in 6 months
   • D.Recommend that the client scrub the lesion daily

   Rationale: Asymmetry, border irregularity, color variation, and evolving size are concerning for melanoma and warrant prompt diagnostic evaluation. A size under 1 cm does not exclude melanoma, and delaying evaluation for a steroid trial could postpone diagnosis. Scrubbing a suspicious lesion is not treatment and may cause injury.

3. 3.A 24-year-old client arrives at the emergency department 20 minutes after a house fire with facial burns, singed nasal hairs, hoarseness, and soot in the mouth. Respirations are 28/min, oxygen saturation is 94% on room air, and blood pressure is 132/78 mm Hg. What is the priority action?

   • A.Apply topical antimicrobial cream to the facial burns
   • B.Prepare for early endotracheal intubation
   • C.Obtain a detailed history of the fire exposure
   • D.Encourage the client to drink water

   Rationale: Hoarseness, facial burns, and soot indicate possible inhalation injury with rapidly progressive airway edema, so securing the airway early is the priority. Topical therapy and a detailed history can wait until airway safety is addressed. Oral fluids are unsafe when airway compromise and an urgent procedure are possible.

4. 4.A 72-year-old client with diabetes is admitted to a medical unit with a draining venous leg ulcer. The wound is covered with a clean dressing, and the client is afebrile with a white blood cell count of 8,000/mm3. Which task is appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?

   • A.Assess the ulcer for infection and measure its depth
   • B.Change the dressing using the prescribed sterile technique
   • C.Obtain and record the client's temperature and report a fever
   • D.Teach the client how to perform wound care at home

   Answer and rationale are in the full material.

5. 5.A 56-year-old client with a 30% total body surface area burn is in the first 6 hours of fluid resuscitation. The client has a urinary catheter, and urine output has fallen to 15 mL/hr; blood pressure is 92/58 mm Hg and heart rate is 122/min. What should the nurse do first?

   • A.Notify the provider and anticipate adjustment of IV fluid resuscitation
   • B.Restrict fluids to prevent pulmonary edema
   • C.Administer the prescribed oral analgesic
   • D.Remove the urinary catheter to reduce infection risk

   Answer and rationale are in the full material.