CH 56: Management of Patients with Dermatologic Disorders and Wounds

Which procedure done for skin cancer conserves the most amount of normal tissue? A) Mohs micrographic surgery B) Cryosurgery C) Electrosurgery D) Surgical excision

A

Which term describes a fungal infection of the scalp? A) Tinea capitis B) Tinea corporis C) Tinea cruris D) Tinea pedis

A

A 10-year-old child is brought to the office with complaints of severe itching in both hands that's especially annoying at night. On inspection, the nurse notes gray-brown burrows with epidermal curved ridges and follicular papules. The physician performs a lesion scraping to assess this condition. Based on the signs and symptoms, what diagnosis should the nurse expect? A) Scabies B) Impetigo C) Contact dermatitis D) Dermatophytosis

A

A client recently received lip and tongue piercings and subsequently developed a superinfection of candidiasis from the antibacterial mouthwash. What would the nurse recommend for this client? A) Use an antifungal mouthwash or salt water. B)Move the piercing back and forth during washing. C) Use a soft-bristled toothbrush. D) Rinse the mouth after eating food.

A

A client with a history of diabetes mellitus has recently developed furunculosis. What is causing the client's condition? A) infection B) diet C) unknown D) hygiene

A

A night-shift nurse receives a call from the emergency department about a client with herpes zoster who is going to be admitted to the floor. Based on this diagnosis, where should the nurse assign the client? A) Private room B) Semi-private room with a client who had chickenpox and was admitted with a GI bleed C) Isolation room with negative airflow D) Semi-private room with a client diagnosed with pneumonia

A

A nurse is admitting a client with toxic epidermal necrolysis. What is the nursing priority in preventing sepsis? A) Preventing infection B) Limiting protein to limit liver failure C) Hydrating to prevent renal failure D) Assessing for hemorrhage

A

A nurse practitioner prescribes a therapeutic bath for a patient with an exacerbation of psoriasis. She tells the patient to make sure the bath area is well ventilated. Which of the following is the therapeutic bath solution prescribed by the nurse? A) Medicated tars B) Sodium bicarbonate C) Water or saline D) Colloids

A

A patient is diagnosed with malignant melanoma that directly invades the adjacent dermis (vertical growth). The nurse knows that this type of melanoma has a poor prognosis. Which of the following is most likely the type of melanoma described in this scenario? A) Nodular melanoma B) Lentigo-maligna C) Superficial spreading D) Acral-lentiginous

A

Photochemotherapy has been used as a treatment for which of the following skin disorders? A) Psoriasis B) Rosacea C) Shingles D) Allergic dermatitis

A

The nurse is instructing the patient in how to apply a corticosteroid cream to lesions on the arm. What intervention can the nurse instruct the patient to do to increase the absorption of the medication? A) Apply an occlusive dressing over the site after application. B) Apply the medication every 2 hours. C) Apply a thick layer of cream over the lesions so that if some rubs off, there is more to absorb. D) Make sure that the skin is slightly dehydrated so that the medication can absorb through the skin cracks.

A

The nurse notes that the client's lower extremities are covered with very dry skin and that the horny layer of the skin has become thickened. The nurse notes the finding as A) lichenification. B) acantholysis. C) pyodermas. D) dermatitis.

A

The nurse teaches the client who demonstrates herpes zoster (shingles) that A) the infection results from reactivation of the chickenpox virus. B) a person who has had chickenpox can contract it again upon exposure to a person with shingles. C) no known medications affect the course of shingles. D) once the client has had shingles, they will not have it a second time.

A

The school nurse is instructing a parent in the care and elimination of lice from their child's hair. The parent brings all of the products for care in a bag. Which contents are not appropriate for use? A) Shampoo and conditioner B) Plastic fine-toothed comb C) Permethrin (Nix) D) New hair clips

A

Which is not a category of medications used for treatment of the skin? A) inhaled steroids B) antibiotics C) topical corticosteroids D) antihistamines

A

Which primary lesions are associated with acne caused by sebum blockage in hair follicles? A) Comedones B) Striae C) Furuncles D) Carbuncles

A

While in a skilled nursing facility, a client contracts scabies, which is diagnosed the day after discharge. The client is living at her daughter's home with six other people. During her visit to the clinic, the client asks a staff nurse, "What should my family do?" The most accurate response from the nurse is: A) "All family members need to be treated." B) "After you're treated, family members won't be at risk for contracting scabies." C) "If someone develops symptoms, tell him to see a physician right away." D) "Just be careful not to share linens and towels with family members."

A

A young client has head lice. What are appropriate steps in eradication? Select all that apply. A) Comb through each area of the hair to remove lice. B) Apply a pediculicide to the hair (detailed directions also accompany this medication). C) Comb the hair free of tangles while the hair is damp. D) Repeat combings daily until there is no more evidence of lice or nits. E) Use a special lice comb that has narrow stainless steel teeth.

A, B, C, D, and E

A nurse is assessing a client with a new skin disorder. Which questions would the nurse include when asking the client about the change in skin condition? Select all that apply. A) Has the problem spread? B) Have you tried to treat the lesions? C) When did the disorder first begin, and where did it first appear? D) Where are the lesions located? E) Do you exercise daily?

A, B, C, and D

What should the nurse assess for to determine if a patient using corticosteroids for a dermatologic condition is having local side effects? Select all that apply. A) Telangiectasia B) Skin atrophy C) Ecchymosis D) Striae E) Comedones

A, B, and D

A client who has been admitted for weakness and taking fluids poorly is unable to move well in the bed and requires assistance. What are this client's risk factors for developing pressure sores? Select all that apply. A) dehydration B) immobility C) localized edema D) vascular disease E) inactivity

A, B, and E

A patient is diagnosed with psoriasis after developing scales on the scalp, elbows, and behind the knees. The patient asks the nurse where this was "caught." What is the best response by the nurse? A) Psoriasis comes from dermal abrasion. B) Psoriasis is an inflammatory dermatosis that results from an overproduction of keratin. C). Psoriasis is an inflammatory dermatosis that results from a superficial infection with Staphylococcus aureus. D) Psoriasis results from excess deposition of subcutaneous fat.

B

A patient who was recently diagnosed with pruritus on the chest and back is given information about skin care and bathing. The most important advice on cleansing is to avoid: A) Using bath oils mixed with water. B) Washing with soap and hot water. C) Applying a cold compress to the area after washing. D) Bathing with warm water and mild soap.

B

A physician orders an emollient for a client with pruritus of recent onset. The client asks why the emollient should be applied immediately after a bath or shower. How should the nurse respond? A) "To minimize cracking of the dermis." B) "To prevent evaporation of water from the hydrated epidermis." C) "To make the skin feel soft." D) "To prevent skin inflammation."

B

The nurse is caring for a client with a furuncle. What advice should the nurse give a client with a furuncle to prevent the spread of the infection? A) Use tepid bath water. B) Never pick or squeeze a furuncle. C) Keep hair short, clean, and away from the face and forehead. D) Avoid the use of cosmetics.

B

The nurse is caring for a patient with extensive bullous lesions on the trunk and back. Prior to initiating skin care, what is a priority for the nurse to do? A) Wash the lesions vigorously. B) Administer analgesic pain medication. C) Apply cold compresses. D) Rupture the bullous lesions.

B

The nurse is instructing the parents of a child with head lice. Which statement should the nurse include? A) Wash clothes in cold water. B) Use shampoo with piperonyl butoxide. C) Disinfect brushes and combs with bleach. D) Use shampoo with Kwell.

B

The nurse teaches the client who demonstrates herpes zoster (shingles) that A) a person who has had chickenpox can contract it again upon exposure to a person with shingles. B) the infection results from reactivation of the chickenpox virus. C) no known medications affect the course of shingles. D) once a client has had shingles, they will not have it a second time.

B

When performing a skin assessment, the nurse notes a localized skin infection of a single hair follicle. The nurse documents the presence of A) a comedone. B) a furuncle. C) cheilitis. D)a carbuncle.

B

Which of the following information regarding the transmission of lice would the nurse identify as a myth? A) Lice need to be removed from the hair with a fine comb. B) Lice can jump from one individual to another. C) Lice can be spread by sharing of hats, caps, and combs. D) Lice can be seen without magnification.

B

Which sedative medication is effective for treating pruritus? A) Tetracycline B) Hydroxyzine C) Benzoyl peroxide D) Fexofenadine

B

While assessing the skin of a 45-year-old, fair-skinned female client, the nurse notes a lesion on the medial aspect of her lower leg. It has irregular borders, with various shades of black and brown. The client states that the lesion itches occasionally and bled slightly a few weeks ago. She also reveals a history of sunburns. Based on these signs and symptoms, the nurse suspects: A) actinic keratoses. B) melanoma. C) basal cell carcinoma. D) squamous cell carcinoma.

B

While examining a client's leg, a nurse notes an open ulceration with visible granulation tissue in the wound. Until a wound specialist can be contacted, which type of dressing should the nurse apply? A) Sterile petroleum gauze B) Moist sterile saline gauze C) Dry sterile dressing D) Povidone-iodine-soaked gauze

B

The nurse is providing instruction to a client with acne. The nurse promotes avoidance of which food(s)? Select all that apply. A) Onions B) Ice cream C) Chocolate D) Bananas

B and C

A client comes to the physician's office for treatment of severe sunburn. The nurse takes this opportunity to discuss the importance of protecting the skin from the sun's damaging rays. What is the appropriate teaching by the nurse to prevent skin damage? A) "Use a sunscreen with a sun protection factor of 6 or higher." B) "When at the beach, sit in the shade to prevent sunburn." C) "Apply sunscreen even on overcast days." D) "Minimize sun exposure from 1 to 4 p.m., when the sun is strongest."

C

A client has been diagnosed with shingles. Which of the following medication classifications will reduce the severity and prevent development of new lesions? A) Antipyretics B) Corticosteroids C) Antiviral D) Analgesics

C

A client is coming to the office to have a growth removed by the doctor. The client asks "What does cryosurgery do to the growth?" What is the correct response? A) Lasers the growth off B) Freezes the growth, so the physician can remove it at the next appointment C) Through the application of extreme cold, the tissue is destroyed. D) Removes the entire growth

C

A dermatologist recommends an over-the-counter suspension to relieve pruritus. The nurse advises the patient that the lotion should be applied: A) Overnight to enhance absorption. B) Twice a day to prevent crusting on the skin. C) Every 3 to 4 hours for sustained effectiveness. D) Hourly to prevent evaporation.

C

A nurse assesses a client with dry, rough, scaly skin without lesions on the legs. The client reports itching in the affected area. What skin assessment would the nurse document? A) Seborrhea B) Candidiasis C) Pruritus D) Shingles

C

A patient is being evaluated for nodular cystic acne. What systemic pharmacologic agent may be prescribed for the treatment of this disorder? A) Benzoyl peroxide B) Retin-A C) Isotretinoin (Accutane) D) Salicylic acid

C

The home health nurse is caring for a client with scabies. When instructing on the proper procedure to wash preworn contaminated clothing, which nursing instruction is essential? A) Pretreat clothing where scabies contact existed. B) Wash clothes through two laundry cycles. C) Use hot water throughout wash cycle. D) Use commercial grade laundry detergent.

C

The nurse is conducting an admission history and physical examination of a client with a history of contact dermatitis. The nurse assesses whether the client uses which medication classification? A) Antifungals B) Saline irrigations C) Corticosteroids D) Antivirals

C

The nurse should assess all possible causes of pruritus for a patient complaining of generalized pruritus. What does the nurse understand can be another cause for this condition? A) Myasthenia gravis B) Hyperthyroidism C) End-stage kidney disease D) Pneumonia

C

Which drug is an oral retinoid used to treat acne? A) Estrogen B) Benzoyl peroxide C) Isotretinoin D) Tetracycline

C

Which of the following nonsedating antihistamines is appropriate for daytime pruritus? A) Diphenhydramine (Benadryl) B) Lorazepam (Ativan) C) Fexofenadine (Allegra) D) Hydroxyzine (Atarax)

C

Which of the following nonsedating antihistamines is appropriate for daytime pruritus? A) Hydroxyzine (Atarax) B) Lorazepam (Ativan) C) Fexofenadine (Allegra) D) Diphenhydramine (Benadryl)

C

Which term refers to a graft derived from one part of a client's body and used on another part of that same client's body? A) Allograft B) Homograft C) Autograft D) Heterograft

C

A nurse assesses a client with dry, rough, scaly skin without lesions on the legs. The client reports itching in the affected area. What skin assessment would the nurse document? A) Candidiasis B) Shingles C) Seborrhea D) Pruritus

D

A patient has a moisture-retentive dressing for the treatment of a sacral decubitus ulcer. How long should the nurse leave the dressing in place before replacing it? A) 24 to 36 hours B) 4 to 6 hours C) 8 hours D) 12 to 24 hours

D

A physician has ordered a wet-to-damp dressing for an infected pressure ulcer. The nurse knows that the primary reason for this treatment is to: A) debride the wound. B) reduce pain. C) prevent the spread of the infection. D) keep the wound moist.

D

A young adult visits a health clinic for treatment of a severe case of eczema on his left leg. Which of the following is the preferred method for delivering medication in this scenario? A) Cream B) Topical anesthetic C) Therapeutic bath D) Ointment

D

The classic lesions of impetigo manifest as A) patches of grouped vesicles on red and swollen skin. B) comedones in the facial area. C) abscess of skin and subcutaneous tissue. D) honey-yellow crusted lesions on an erythematous base.

D

The nurse assesses the client and observes reddish-purple to dark blue macules, plaques, and nodules. The nurse recognizes that these manifestations are associated with which condition? A) Syphilis B) Platelet disorders C) Allergic reactions D) Kaposi sarcoma

D

The nurse is caring for a client who may have a lice infestation. The nurse is using a bright light focused on an area of the head to confirm the presence of lice. In which manner is it easiest to differentiate nits from dandruff? A) Nits are difficult to move from hair shafts. B) Dandruff is throughout the hair. C) Dandruff looks white and flaky. D) Nits are located near the scalp.

D

The nurse is conducting a community education program on basal cell carcinoma (BCC). Which statement should the nurse make? A) It metastasizes through blood or the lymphatic system. B) It is more invasive than squamous cell carcinoma (SCC). C) It is a malignant proliferation arising from the epidermis. D) It begins as a small, waxy nodule with rolled translucent, pearly borders.

D

The nurse is providing teaching to a client with acne who is using isotretinoin therapy. Which statement should the nurse make? A) Take vitamin A supplements. B) The side effects are irreversible. C) Contraceptives are not needed during treatment. D) It is teratogenic in humans.

D

The nurse is working with community groups. At which of the following locations would the nurse anticipate a possible scabies outbreak? A) Gymnasium B) Shopping mall C) Swimming pool D) College dormitory

D

The nurse prepares a patient with a benign skin lesion for surgical excision, intralesional corticosteroid therapy, and radiation. Which of the following is most likely the lesion described? A) Seborrheic keratoses B) Angioma C) Wart D) Keloid

D

When caring for a client with severe impetigo, the nurse should include which intervention in the care plan? A) Placing mitts on the client's hands B) Continuing to administer antibiotics for 21 days as ordered C) Applying topical antibiotics as ordered D) Administering systemic antibiotics as ordered

D

Which of the following is also known as "jock itch"? A) Tinea pedis B) Tinea unguium C) Tinea corporis D) Tinea cruris

D