skin disorders
A nurse collecting tissue for a Tzanck smear should (Select the appropriate interventions and place the steps in sequence
Wash the lesion. Open the lesion with a hypodermic needle. Saturate the sterile swab with exudates. . Place the specimen in a culture tube and take it to the laboratory
a pt has just been prescribed isotretinoin accutane for resistant acne. which are teaching points for this patient
a serious adverse effect of isotretionoin
a nurse is teaching a class about the functions of skin. what would be the correct teaching about how the skin protects the body
shields underlying tissues from trauma and pathogens and prevents excess loss of fluids from those tissues
covering a wound with skin
skin grafting
characterized by scaly ulcers or raised lesions
squamous cell carcinoma
types of carcinomas, unlike basal cell carcinomas, that grow rapidly and metestasize
squamous cell carcinoma
usually caused by overuse of alcohol and tobacco.
squamous cell carcinoma
which factor may aggrevate psoriasis in this patient
stress
burn affecting only the epidermis
superficial burn
pink to red and painful, like a sunburn
superficial burn
a severe sunburn
superficial partial thickness burn
blistered, weepy, and pale to red or pink
superficial partial thickness burn
the type of biopsy indicated for deep specimens in which sutures are required to close the site
surgical excision
when completing an assessment of an older patients skin what are some of the age related changes the nurse may expect to see
thinning of skin layers resulting in wrinkling dryness and itching increase development of skin lesions including lentigines, acrochordons, and angiomas size and number of sweat glands decreased.
effectove against fungi, used to treat fungal infections
topical antifungal agents ( nystatin)
reduce inflammation in various skin disorders
topical antiinflammatories ( hydrocortisone)
A test that used to diagnose vial infections
tzsanck smear
herpes simplex, herpes zoster
vesicle
which are true statements about impetigo
vesicle or pustule tat ruptures leaving a thick crust treated with antibiotic therapy, erythromycin or dicloxacillin.
allergic response, insect bites, hives
wheak
an examination in which the pt's skin inspected under a black light in a darkened room
woodslight
which are statements that should be included in this patient's teaching plan
your condition is chronic but not contagious and usually responds to treatment report signs of secondary infection to your provider, such as fever , purulent discharge and increased redness psoriasis typically has periods of exacerbation and remission.
A patient reveals the use of angelica as an alternative therapy. Which instruction should the nurse provide for this patient
The agent can cause a skin rash if a patient is exposed to sunlight
An older adult patient is complaining about her wrinkled skin. How could the nurse explain this occurrence to her?
This is caused by thinning of the skin and degeneration of elastin fibers."
A patient has received an order for ketoconazole (Nizoral). The nurse knows that this medication is used for which purpose
To treat a fungal infection
Which is an appropriate implementation for a patient with severe psoriasis who has a nursing diagnosis of "Disturbed body image, related to skin lesions"?
Touching the patient often
24. During the first 24 hours after a burn, fluid replacement is the treatment priority. Which assessment should alert the nurse that the fluid protocol is ineffective?
Urine output of 20 mL/hr
A woman of childbearing age is to begin taking Soriatane. Which instructions should the patient receive concerning this medication?
Use reliable contraception during therapy and for 3 years after therapy with Soriatane.
who is at greatist risk for skin cancer
caucasians
the nurse advises the pt with shingles that the condition is communicable to people who have never been exposed to
chickenpox
a type of therapy used in the treatmetn of psoriasis, vitiligo, and chronic eczema is
phototherapy
psoriasis
plaque
a prominent symptoms of psoriasis, dermatitis, eczema, and insect bites is
pruritus
you are giving a lecture to a group of clients who have psoriasis. your discussion should include which of the following
psoriasis can be aggravted by stress treatment may include methotrexate and ultaviolet light uva.
the type of biopsy in which circular tool cuts around the lesion, which is then lifted and severed
punch biopsy
acne, impetigo
pustule
disfiguring scars
reconstrictive scars
development defects
reconstrictive surgery
birthmarks
reconstructive surgery
thin, red lines on skin itching
scabies
A patient had a deep skin biopsy. How should the nurse respond to the patient's concern about postprocedure care?
"An appointment will be made for you to return for suture removal."
A family member of an older patient with severe dermatitis says, "I was always so careful to bathe him every day. I guess I just wasn't careful enough." What is the best response by the nurse?
"Dermatitis is not caused by poor hygiene
used to detect mites
scabies scraping
1. A patient with severe psoriasis who is to be treated with the systemic drug methotrexate sodium anxiously asks, "Is this cancer drug safe? Are there some side effects I need to know about?" What is the best response by the nurse
"We use this drug to treat many kinds of patients, including patients with cancer. You will have periodic blood tests."
What information should a nurse provide to a patient with vitiligo receiving phototherapy?
"Wear protective clothing
Displaying her hands, a patient asks, "Do you think my liver is OK? Look at all these liver spots!" What is the most appropriate nursing response?
. "The spots are normal aging changes and have nothing to do with your liver."
. A daughter of an older adult patient who has just returned from surgery is distressed about her father's pale, cold hands and feet. What is the best response by the nurse after covering the patient with an extra blanket?
. "When patients have blood loss during surgery, superficial vessels close off temporarily, resulting in cold extremities."
A nurse is caring for a patient with pruritus. Which implementation can the nurse perform without a physician's order?
. Apply lubricant to unbroken skin
Which action should a nurse implement to make a patient with atopic dermatitis more comfortable
. Instruct the patient to wear loose clothing.
A confused patient has been restrained because of combativeness and hyperactivity. What skin assessment may occur as a result of the restraints?
. Senile purpura
Which sign or symptom suggests that a patient with impaired skin integrity is developing a systemic infection
. Temperature that has risen to 101
8. A physician asks a nurse to take a smear from herpetic lesions in an older patient's hip to diagnose the disorder. What is the most probable test that will be performed
. Tzanck smear to test for viral culture
the assessment of patients with seborrheic dermatitis includes inspecting affected areas for
scales and crusts
if one arm and one leg are burned what is the estimated burn size, according to the rule of nines.
27 %
When assessing the capillary refill, a nurse should document as normal a refill time of __________ seconds
3
when asssessing capilliary refill, after applying pressure to cause blanching and then releasing the pressure, the nurse should observe that the color returns to normal within
3-5 seconds
A nurse is caring for an adult patient with extensive burns on the front of the trunk, including the genitalia, and the fronts of both legs. How should the nurse document the burn size using the rule of nines?
37 percent
can be reduced by use of custom fitted garments that apply continous pressure hours a day
scarring
A nurse is screening patients that the plastic surgeon is considering for phototherapy. Which patient should the nurse exclude?
A 34-year-old woman with lupus erythematosus
A nurse is caring for an obese patient who has been bedridden for a long time and who has a nursing diagnosis of "Risk for infection, related to obesity." Where is the best location for the nurse to assess for the moist red lesions of Candida albicans
Abdominal skin folds
A patient presents with a Stage 3 pressure ulcer to the sacrum. The wound has a large amount of exudate. What type of dressing would be utilized for this type of wound?
Absorptive
An obese patient is admitted with intertrigo between the abdominal skinfolds. The physician treats the patient for the presence of C. albicans. Which interventions are used for this condition?
Apply antifungals and corticosteroids as ordered
A patient with a minor skin infection has orders to apply which of these topical medications?
Bacitracin and polymyxin B (Polysporin
can be reduced by use of pressure dressings in early stages of care
scarring
the most common problem for patients with pruritis is potential for skin breakdown related to
scratching
a specimen no deeper than the dermis is obtained with a scalpel
shave biopsy
Patients who are pregnant, malnourished, immunosuppressed, or taking antibiotics are among those who are at risk for which condition?
Candidiasis
What should a nurse be sure to frequently assess when caring for a burn patient with eschar formation around an entire arm?
Capillary refill
17. An 80-year-old patient comes to the emergency department with extreme pain and itching in the hip and leg and has herpetic vesicular lesions on the left hip. What should the nurse inquire about patient exposure to
Chickenpox
. What information is most essential for a nurse to gather when interviewing a young woman who is taking the drug isotretinoin (Accutane) for acne?
Current method of birth control
. What should a nurse ask about when taking the functional assessment of a patient with a skin disorder?
Exposure to chemicals or irritants
The nurse is caring for a patient who sustained a burn injury 1 week ago and has been transferred to the nursing unit. The patient has a bounding pulse and hypertension. This would signify which condition?
Fluid volume excess
A nurse organizes a nursing care plan on the nursing diagnosis of "Acute pain, related to postherpetic neuralgia." Which is the least appropriate implementation
Give antiviral medication as prescribed
. A patient who has undergone treatment for herpes simplex virus type 2 (HSV type 2) expresses relief that she is cured. What should the nurse include in her teaching?
HSV lies dormant and can be triggered without any sexual contact.
How does cutaneous T-cell lymphoma differ from squamous cell and basal cell carcinoma
Has a cause unrelated to sun exposure
used to diagnose fungal infections by studing a skin specimen
KOH examination
"Pigmented spots on sun-exposed areas, commonly called liver spots, although they have nothing to do with the liver" is a description of which of the following?
Lentigines
Which of these is a general term used to document a wound, sore, tumor, or other tissue damage?
Lesion
The LVN/LPN is preparing to change a dressing on a patient with negative pressure wound therapy. Which of these is the most important nursing intervention?
Medicate the patient about 1 hour before the procedure.
The LVN/LPN is conducting an assessment on a patient with anxiety and notes that the patient has white lips, mucous membranes, and nail beds. How is this documented?
Pallor
Which of these are accurate descriptions of basal cell carcinomas?
Pearly appearance Treated with surgical excision Related to sun exposure
Which conditions can be improved with negative pressure therapy
Pressure ulcers Skin grafts Dehisced surgical wound
A patient is being treated with intravenous amphotericin B for a severe fungal infection. This drug treatment is highly toxic to which body system?
Renal
Which of the following is not a function of the skin?
Secretion of hormones
An older adult patient is admitted to the hospital with multiple large, purplish bruises on the arms. When questioned further, the patient states "these happen when I barely bump into something". How are these lesions documented?
Senile purpura
The nurse is determining the presence of jaundice in a dark-skinned patient. Observation of which areas would assist in the visual evaluation?
Soles of feet Oral mucous membrane Palms of hands Conjunctivaes
Which assessment by an emergency department nurse most indicates that a burn patient might be at risk for respiratory impairment?
Sooty sputum
A patient presents for a shave biopsy of a skin lesion on the shoulder. What type of excision is done with this procedure?
Specimen obtained from the dermis with a scalpel
5. An excited mother of a teenage boy with severe acne furiously reports to the nurse, "I've told him a thousand times he should bathe more often! I've kept after him about all that junk food he eats. I jump on him when I see him squeezing his zits. I tried to get him to scrub his face three times a day!" Which statement indicates the most likely cause of the boy's acne?
Squeezing lesions
25. Which age-related skin changes should a nurse anticipate when performing a physical assessment on an 80-year-old man
a. Increased nasal hair b. Flattened nails Increased hair on the helix of the ea . Presence of seborrheic keratosis
which of the following is a drug used to treat HSV-1?
acyclovir ( zovirax)
excess tissue around the eyes
aesthetic surgery
facial wrinkles
aesthetics surgery
receding chin
aesthetics surgery
you are caring for a client who asks you about the causes of contact dermatitis. you understand that contact dermatitis. you understand that contact dermatitis is caused by which of the following
an allergic response
benign tumors filled with blood vessels
angiomas
which drug used to remove heavy scales in patients with psoriasis can stain normal skin and hair
anthralin anthra- derm
a common risk factor for developing candidiasis is
antibiotic therapy
used to treat psoriasis
antipsoriatics ( anthralin)
interfere with viral replication
antiviral agents ( acyclovir)
the nurse is taking care of a patient who has a skin biopsy scheduled. when a skin biopsy is scheduled, the provider may advise the patient to avoid which drugs before the procedure to reduce bleeding
aspirin
food allergies can cause
atopic dermatitis
what is the cause of psoriasis?
autoimmune disorder
what should be included in the teaching plan for a patient with atropic dermatitis?
avoid constrictive clothing use sunscreens and moisturizers topical corticosteroids provide the best control of inflammation.
what is the best way to prevent skin cancer?
avoid excessive sun exposure
which is a topical herbal preparation used as an emollient
balm of gillead
a condition with painless, nodular lesions, that have a pearly appearance
basal cell carcinoma
carcinomas that grow slowly and rarely metastasize, but they should be removed because they can cause local tissue destruction
basal cell carcinoma
the removal of skin for microscopic examination
biopsy
a nursing problem for the patient with atopic dermatitis may include potential for infection related to
breaks in skin
which are true statement about candidiasis?
candidiasis infections, which are manifested as red lesions, with white plaques,. three common sites for candidiasis include the mouth, skin,and vagina. oral candidiasis is treated with nyastatin. one area that is susceptible to candidiasis owing to the contant moisture found there , is an ostomy site.
which are assessments of the fingernails and toenails that nurses monitor
capillary refill color of nail bed
after a burn injury, shifts in fluids and electrolytes cause local edema and a decrease in
cardiac output
which are true statements about acne skin disorders
comedones ( whiteheads and blackheads) pustules, and cysts are characteristics of acne. two oral antibiotics that are frequently given for acne are tetracycline and erythromycin. a drug prescribed for patients if acne is severe and unresponsive to antibiotics isotretinoin ( accutane). acne is a condition in which androgenic hormones cause increased sebum production and bacteria proliferation, causing hair follicles to block and become inflammed.
which should not be used in patients with intertigo because it supports the growth of c albicans.
cornstarch
which are skin changes related to malnutrition?
crackled skin dermatitis dry skin
may be accomplished by mechanical means, surgical excision or enzymes
debridement
removal of debris and necrotic dead tissue from a wound
debridement
the nurse is taking care of patient with psoriasis in the hospital. the nurse recognizes that which are problems for the patient with psoriasis
decreased socialization related to embarrassment about flaky skin lesions
burned tissue is painful and sensitive to cold air
deep partial thickness burn
large thick walled blisters or edema
deep partial thickness burn
weeping , cherry red , exposed dermis
deep partial thickness burn
you are caring for several clients with skin disorder. you understand that the skin regulates body temperature by which of the following
dilating and constrictive surface blood vessels
burn involving the epidermis, dermis and underlying tissue including fat, muscle and bone
full thickness burn
burned tissue lacking sensation
full thickness burn
dry, leathery, and sometimes red, white, brown or black.
full thickness burn
the potassium hydroxide ( koh) examination is used in combination with a culture to diagnose infections of the skin, hair, or nails that are
fungal
vitamin A is essential for
healthy skin
the nurse is working in the postoperative area and just received a patient recovering from a bleproplasty. for which complication should the nurse monitor
hematoma corneal injury
a pt with a burn experiences a shift of plasma proteins from the capillaries. This is likely to result in
hypoproteinemia
which is a complication of untreated fluid shifts in burn patients.
hypovolemic shock
you are caring for a female patient who is being treated with isotretinon ( accutane) at the clinic for severe acne after other treatments have failed. all of the following statements should be included in the teaching plan. which of the following statements should be included in the teaching plan. which of the following statements is most important.
if sexually active, you must used reliable contraception.
the nurse is teaching a pt with burns and his family about the different stages of burns. which problems are more likely to occur in the emergent stage of patient with burns
impaired tissue perfusion fluid imbalance related to fluid volume excess
what is the primary problem for this patient
inadequate self care related to lack of understanding of psoriasis and its treatment
which are changes that occur in older adults
increased facial hair thinning of scalp hair
acne lesions develops when there is
increased sebum production
the burn patient is at greatist risk for
infection
inflammation of the skin where two skin surfaces touch
intertigo
which skin disorder characterized by irritation and redness in body folds is common among patients in long term care facilities
intertrigo
characteristics of typical melanomas include which of the following
irregular lesion with uneven coloration
nevi moles are carefully inspected for pigmentation, ulcerations, changes in surrounding skin, and
irregularities in shape
while assessing an obese older patient in a long term care facility, you notice that the patient has intertrigo in body folds axilla, beneath the breast. which measuress is most important to reduce the risk of a reccurrence?
keep the body fold clean and dry
dissolve keratin and slow bacterial growth, used to treat acne and psoriasis
keratolytics
topical drug capable of dissolving keratin
keratolytics
decrease proliferation of epidermal cells in psoriasis
keratolytics ( cool tar)
when inspecting the skin of an older adult you observe flat, pigmented spots on the backs of both hands. you should recognize these as
lentigines
itching of hairy areas of body head, pubis, nits eggs seen as tiny white particles attached to hair shafts
lice
which foods contain nutrients that are vital for healthy skin
liver sweet potatoes cantaloupe spinach carrots
which are true statements about cellulitis?
local tenderness and reddened and redness at first, then malaise, chills, and fever site becomes more erythematous, nodules , and vesicles may form, vesicles, may rupture releasing purulent material
freckle, petechia, hypopigmentation
macule
you are caring for a client who is experiencing severe itching secondary to atopic dermatitis. which of the following meausres should be recommended to help prevent scratching and skin injury
maintain the room temperature around 70 degree F wash new clothing before wearing it wear loose clothing
disorder that arises from the pigment producing cells in the skin
melanoma
the most serious form of skin cancer is
melanoma
treatment used is mohs surgery to determine margins of malignancy
melanoma
mole
nevi
fibroma
nodule
which are true statements about herpes zoster virus
older adults are especially susceptible to complications, including opthalmic involvement, from herpes zoster virus. patient with herpes zoster virus exhibit early symptoms of heightened sensitivity along a nerve pathway, pain and itching. wet dressings soaked in Burow's solution may be used to treat lesions associated with herpes zoster virus herpes zoster infection is commonly called shingles
the nurse is taking care of a pt with shingles at an outpatient clinic. the nurse will monitor the pt for which problem
pain related to lesions and postherpetic neuralgia
the nurse is assisting with teaching a community health program about patients with burns which problems are related to patients with burns
pain related to the tissue trauma potential infection related to loss of protective skin barrier hypothermia related to impaired heat regularities ability of injured skin impaired mobility related to contractures pain
mole, wart
papule
vitiligo
patch
a test used to identify allergens in which common irritants are applied to the skin
patch testing
kill parasites and their eggs used to treat pediculosis lice and scabies mite infestations
pediculicides and scabicides ( crotamiton ) eurax
a chronic autoimmune condition in which bullae ( blisters) develop on the face , back, chest, groin, and umbilicus
pemiphigus
following a burn injury, plasma leaks into the tissue due to increased capillary
permeability