Chapter 23, Nursing Management: Integumentary Problems: Integ. Problems

A patient has developed a skin infection with an associated fever of 101.6° F, white blood cell count of 28,000, headache, and malaise. With what skin infection does the nurse determine these clinical manifestations correlate? Impetigo Carbuncle Folliculitis Erysipelas

Erysipelas

In a patient admitted with cellulitis of the left foot, which clinical manifestation would the nurse expect to find on assessment of the left foot? Erythema and swelling Pallor and poor turgor Cyanosis and coolness Edema and brown skin discoloration

Erythema and swelling

The nurse is educating a patient regarding complications due to diabetes. Which skin infection's incidence is increased in patients with diabetes mellitus? Cellulitis Impetigo Folliculitis Furunculosis

Folliculitis

A patient who has redness around a hair follicle and necrotic debris in the ruptured material undergoes incision and drainage of painful nodules. The patient's temperature is 100° F. Which skin infection does the patient have? Furuncle Carbuncle Folliculitis Furunculosis

Furunculosis

A patient who is obese and has a diagnosis of diabetes is at risk for a bacterial skin infection. For what infection should the nurse educate the patient to monitor? Cellulitis Impetigo Carbuncle Furunculosis

Furunculosis

A patient informs the nurse that he or she has tingling and burning on the lower lip. The nurse assesses redness and a group of vesicles on the lower lip. Which infection should the nurse educate the patient? Impetigo Candidiasis Herpes zoster Herpes simplex virus

Herpes simplex virus

The nurse assesses a vesiculopustular lesion with a thick, honey-colored crust surrounded by erythema on the left side of a patient's arm. The patient states that he or she had a few bumps in the area that the patient had been scratching. What complication has the patient developed from this condition? Cellulitis Furuncle Impetigo Folliculitis

Impetigo

During an admission assessment, the nurse decides to implement contact precautions if which of these disorders is present in a patient? Psoriasis Tinea unguium Impetigo on the lower legs Candidiasis in the groin area

Impetigo on the lower legs

The nurse assesses an eroded, ulcerative growth less than 1 cm wide on a patient's chest. The lesion is flat and variegated in color. What condition should be suspected related to this assessment finding? Basal cell carcinoma Malignant melanoma Squamous cell carcinoma Cutaneous T-cell lymphoma

Malignant melanoma

The nurse, preparing educational information about types of skin cancer, recalls that which type has a higher risk for metastasis and poor prognosis unless it is treated early? Myeloma Basal cell Melanoma Squamous cell

Melanoma

A nurse is performing a skin assessment for an obese patient. The nurse suspects the patient has diabetes mellitus. Which skin conditions indicate diabetes mellitus? Select all that apply. Petechiae Skin desquamation Presence of skin tags Seborrhea-like lesions Rashes under the breast and axillae

Presence of skin tags Rashes under the breast and axillae

The nurse would assess a patient admitted with cellulitis for what localized manifestation? Pain Fever Chills Malaise

Pain

The nurse is caring for patients at a camp with bites and stings inflicted by insects or arachnids. Which patient may require the application of topical corticosteroids? Patient bitten by lice Patient stung by a bee Patient bitten by mites Patient bitten by bedbugs

Patient bitten by bedbugs

A nurse observes that a group of patients has a darker skin tone after being outside for a period of time. The nurse recalls that the reason for this finding is what? The UVA rays of the sun cause tanning. The UVB rays of the sun cause sunburn. The UVC rays of the sun cause collagen damage. The UVC rays of the sun cause increased melanin production.

The UVA rays of the sun cause tanning.

A nurse is assessing a patient who has numerous nevi on the face. The nurse determines that the nevi are not cancerous. Which observations led the nurse to conclude that the nevi are normal? Select all that apply. The nevi are dark in color. The nevi are well circumscribed. The skin over the nevi is eroded. There is discharge from the nevi. The nevi are larger than 5 mm in size.

The nevi are dark in color. The nevi are well circumscribed.

A middle-aged obese patient presents with small, skin-colored, soft, pedunculated papules on the neck, axillae, and upper trunk. How should the nurse interpret these findings? The patient has nevi. The patient has lentigo. The patient has acrochordons. The patient has seborrheic keratoses.

The patient has acrochordons.

Which patient does the nurse determine will benefit the most from treatment with methotrexate? The patient with a benign adipose tumor The patient with autoimmune chronic dermatitis The patient with inflammatory disorder of sebaceous glands The patient with an increase in normal melanocytes in the basal layer of epidermis

The patient with autoimmune chronic dermatitis

Which patient with a skin condition should be treated with 5% permethrin topical solution? The patient with scabies The patient with pediculosis The patient with tinea corporis The patient with Lyme disease

The patient with scabies

The nurse assesses a scaly, ringlike rash with a clear center on a patient's leg. Regarding which skin infection should the nurse educate the patient? Cellulitis Tinea cruris Plantar warts Tinea corporis

Tinea corporis

Which fungal infection manifests on the surface of a patient's skin with an erythematous and typical annular scaly appearance and well-defined margins? Tinea pedis Tinea cruris Tinea corporis Tinea unguium

Tinea corporis

A patient with a history of persistent macular eruption notices the gradual appearance of hard, reddened plaques on his or her trunk that are similar in appearance to psoriasis lesions. Which treatment does the nurse suspect will be beneficial in this patient? Chemical peels Surgical excision Electrodesiccation Topical nitrogen mustard

Topical nitrogen mustard

A patient comes to the clinic and informs the nurse that the patient thinks that he or she may have been bitten or stung about three or four weeks ago. A ringlike rash is now present on the area and the patient states he or she has been feeling "flu-like". What question pertaining to this condition should the nurse ask the patient? "Have you removed a tick?" "Were you stung by a wasp?" "Have you been itching all over? "Have you noticed any bugs under your mattress?"

"Have you removed a tick?"

Which white blood cell count is the best indicator that a 54-year-old patient with cellulitis has recovered from the infection? 2000/mm 3 5000/mm 3 13,000/mm 3 16,500/mm 3

5000/mm 3 The normal white blood cell count is 4000 to 11,000 cells/mm 3

The nurse should recognize which patient is likely to have the poorest prognosis? A 60-year-old diagnosed with nodular ulcerative basal cell carcinoma A 59-year-old man who is being treated for stage IV malignant melanoma A 70-year-old woman who has been diagnosed with late squamous cell carcinoma (SCC) A 51-year-old woman whose biopsy has revealed superficial squamous cell carcinoma

A 59-year-old man who is being treated for stage IV malignant melanoma

Which patient would be more likely to have the highest risk of developing malignant melanoma? A fair-skinned woman who uses a tanning booth regularly An African American patient with a family history of cancer An adult who required phototherapy as an infant for the treatment of hyperbilirubinemia A Hispanic male with a history of psoriasis and eczema who responded poorly to treatment

A fair-skinned woman who uses a tanning booth regularly

A nurse works in a dermatology clinic and counsels many patients in a day. Which patients should the nurse consider at high risk of developing skin malignancies? Select all that apply. A farmer A school teacher A baseball player A software engineer A construction worker

A farmer A baseball player A construction worker

The nurse assesses an elevated, dry, hyperkeratotic, scaly papule in an older adult patient. What condition does the assessment data correlate? Actinic keratosis Dysplastic nevus Basal cell carcinoma Squamous cell carcinoma

Actinic keratosis

A patient describes having small, firm reddened raised lesions with flat, rough patches causing intense pruritus to the nurse. The nurse suspects contact dermatitis. What would be the nurse's next assessment? History of seasonal allergies Initiation of new medication Previous pruritic skin lesions Activities in past two to seven days

Activities in past two to seven days

A patient is diagnosed with herpes zoster and is at risk for developing postherpetic neuralgia. What action should the nurse take to prevent postherpetic neuralgia in the patient? Administer mild sedatives at night. Apply wet compresses to the affected area. Administer acyclovir as prescribed within 72 hours. Apply silver sulfadiazine on the ruptured vesicles.

Administer acyclovir as prescribed within 72 hours.

A patient shows the nurse how the skin around an abdominal dressing is red and states that it itches. The nurse identifies an area of red papules with occasional papules that matches the area that had been taped around the dressing. The nurse suspects that the patient has which skin condition? Urticaria Tinea corporis Atopic dermatitis Allergic contact dermatitis

Allergic contact dermatitis

A patient is diagnosed with folliculitis after frequent use of a hot tub. About what treatment options should the nurse educate the patient? Select all that apply. Oral penicillin Incision and drainage Antistaphylococcal soap Warm compress of aluminum acetate Immobilization and elevation of the affected area

Antistaphylococcal soap Warm compress of aluminum acetate

What condition does the nurse suspect in an asthmatic patient who reports erythema, oozing vesicles, and severe itching of the skin? Urticaria Drug reaction Atopic dermatitis Allergic contact dermatitis

Atopic dermatitis

In teaching a patient with basal cell carcinoma (BCC) about this disorder, the nurse considers that which statement about this skin cancer is true? BCC is the deadliest type of skin cancer. BCC is the most common type of skin cancer. Prognosis depends upon the thickness of the lesion. The cancerous cells of BCC usually spread beyond the skin.

BCC is the most common type of skin cancer.

A patient has chills, malaise, and a body temperature of 100° F. Further assessment reveals a hot, tender, reddened, edematous area with a diffuse border on one leg. Which skin infection does the nurse suspect the patient initially had? Impetigo Cellulitis Carbuncle Furunculosis

Cellulitis

About which treatments should the nurse educate the patient with scaly, ringlike lesions with well-defined margins on both arms? Select all that apply. Cryosurgery Oral penicillin Cool compress Mupirocin cream Miconazole cream

Cool compress Miconazole cream

A patient has a growth on the bottom of one foot, which is growing inward, is painful when pressure is applied, and has interrupted skin markings. Which treatments may the patient receive? Select all that apply. Cryosurgery White petroleum Silver sulfadiazine Topical immunotherapy Blunt dissection with scissors

Cryosurgery Topical immunotherapy

When a patient has psoriasis, which sign would a nurse expect to find? Pustules in skinfolds Itchy, scaly patches on scalp Macular rash on the trunk area Vesicular rash on the extremities

Itchy, scaly patches on scalp

A nurse is assessing an obese patient with skin that is dry and irritated. The nurse understands that the most likely reason the patient is experiencing the skin condition is what? Obese people drink less water. Obese people have lowered immunity. Obese people are prone to overheating and sweating. Obese people have improved arterial and venous flow.

Obese people are prone to overheating and sweating.

A patient tells a nurse, "I think I might have head lice." Which assessment findings would the nurse observe with this infestation? Diffuse pruritic wheals Oval white dots stuck to hair shafts Pruritic papules with linear burrows at the hairline Itchy redness and edema over the area of infestation

Oval white dots stuck to hair shafts

The nurse is caring for four patients with skin infections. In which patient does the nurse suspect infection with group A β-hemolytic streptococci? Pt 1: hot red, hard, painfukl plaques with distinct borders. Pt 2: Hot, red, and swollen area that has no clear border and is sore to the touch. Pt 3: Linear distribution of vesciles on the right side of the back only. Pt 4: reddish lesion, sore to the touch, around a hair follice.

Pt 1

The nurse is caring for four patients in a dermatology unit. Which patient may be treated with liquid nitrogen therapy? Pt A- cheesy white plaque, resembling milks curds, in the mouth: candida albicans Pt B- circumscribed flesh clored papule thats growing and painful when its sides are pressed: Human papilloma virus Pt C- Interdigital scaling and maceration, along with erythema, on scaly plantar surfaces: Dermatophyte Pt D- Distrubution of pustules along a specific line on the left side of the stomach with redness of the area, a burning sensation, and pain: Varicella zoster

Pt B- circumscribed flesh clored papule thats growing and painful when its sides are pressed: Human papilloma virus

Which does the nurse suspect in a patient who reports severe nighttime body itching and has red, crusted papules? Lice Ticks Scabies Bedbugs

Scabies

During the assessment of a patient, the nurse notes an area of irregularly round verrucous papules with well-defined shapes. The patient states that they have become darker over the past few months and are often itchy and irritating. The nurse recognizes this finding as what? Lentigo Psoriasis Acne vulgaris Seborrheic keratosis

Seborrheic keratosis

A patient with psoriasis tells the nurse that the patient has quit his or her job as a restaurant hostess because the patient believes the lesions on his or her hands and arms are unattractive to customers. Which nursing diagnosis best describes this patient response? Social isolation related to fear of rejection Ineffective coping related to lack of social support Impaired skin integrity related to presence of lesions Ineffective health maintenance because of presence of lesions

Social isolation related to fear of rejection

Which treatments would be beneficial for a patient with papular, wheal-like lesions and severe pruritus? Select all that apply. Spinosad Doxycycline Chlorocyclohexane γ-Benzene hexachloride Permethrin topical solution

Spinosad γ-Benzene hexachloride

A patient has sharply demarcated red plaques on the face that are hot, hard, and painful, along with a body temperature of 101 o F as a result of a β-hemolytic Streptococcus infection. About what treatment should the nurse educate the patient? Systemic penicillin Warm, moist compresses on the plaques Application of retapamulin to the affected area Cleansing with antistaphylococcal soap and water

Systemic penicillin

The nurse assesses circumscribed, hypertrophic, flesh-colored papules on a patient's knee. The patient states they are recurring even after removal. How should the nurse document these findings? Plantar warts Herpes zoster Verruca vulgaris Herpes simplex virus type 1

Verruca vulgaris

A patient complains of frequently having bleeding gums as well as widespread bruising and small red and purple dots all over the body. The patient is most likely deficient in which vitamin? Vitamin A Vitamin B Vitamin C Vitamin K

Vitamin C (Scurvy)

A nurse is assessing a patient who reports extreme fatigue and muscle pain. The patient reports spending very little time outdoors. The skeletal muscles of the patient are very weak. Which deficiency is most likely to cause such symptoms? Vitamin A deficiency Vitamin B deficiency Vitamin C deficiency Vitamin D deficiency

Vitamin D deficiency

The nurse reviews lab values for a male patient with herpes zoster. With which result should the nurse be most concerned? Calcium: 9.0 mg/dL Hemoglobin: 14 g/dL Platelets: 150,000/mm 3 White blood cell count: 1000/mm 3

White blood cell count: 1000/mm 3

Which laboratory result is the best indicator that a patient with cellulitis is recovering from this infection? White blood cells (WBC) of 2900/µL White blood cells (WBC) of 8200/µL White blood cells (WBC) of 12,700/µL White blood cells (WBC) of 16,300/µL

White blood cells (WBC) of 8200/µL