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chapter24

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A nurse is assessing a patient with a bee sting. To relieve pain, what will most likely be included in the patient's treatment plan? Select all that apply. 1 Cold compresses 2 Chlorocyclohexane 3 Antipruritic lotion 4 Gamma-Benzene hexachloride 5 Antihistamines

1 3 5 The symptoms of a bee sting are burning pain, swelling, and itching in the affected area. Cool compresses are used to reduce the burning sensation. Antipruritic lotion is used to reduce itching. Antihistamines are used for allergies. Chlorocyclohexane is used to control bedbugs. Gamma-benzene hexachloride is used to treat pediculosis. Text Reference - p. 437

A mother and her child have been diagnosed with scabies after attending a camp together. An appropriate measure in treating this condition is 1 Topical application of griseofulvin 2 Applying 5% peremethrin to the body 3 Moist compresses applied frequently 4 Administration of systemic antibiotics

A patient is recovering from incision and drainage for a furuncle. What action should the nurse take when caring for this patient? 1 Clean the oozing wound with soap and plain water. 2 Leave the crust that forms over the damaged area undisturbed. 3 Keep the wound dry and covered with a dressing for rapid healing. 4 Use antibiotic ointment with a dressing that is both absorbent and adherent

Which surgical therapy can only be used to remove small, soft skin tumors and superficial lesions? 1 Excision 2 Curettage 3 Skin scraping 4 Punch biopsy

Which therapy uses subfreezing temperatures to destroy epidermal lesions? 1 Excision 2 Cryosurgery 3 Punch biopsy 4 Electrodesiccation

Which white blood cell count is the best indicator that a 54-year-old patient with cellulitis has recovered from the infection? 1 2000/mm3 2 5000/mm3 3 13,000/mm3 4 16,500/mm3

A nurse is assessing a woman who has nodulocystic acne. While administering isotretinoin, which interventions are necessary to ensure patient safety? Select all that apply. 1 Perform a hemoglobin level test. 2 Conduct a pregnancy test. 3 Conduct a cholesterol level test. 4 Conduct a liver function test. 5 Determine if the patient has a history of depression

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Which nursing intervention would be most effective in improving the comfort of a patient with herpes zoster? 1 Direct sunlight 2 Dry heating pad 3 Cool, wet dressing 4 Warm, moist compress

A patient who is undergoing therapy for a dermatologic condition is experiencing persistent itching and burns on the skin from sun exposure. Which therapy should the nurse suspect the patient has been undergoing? 1 Phototherapy 2 Radiation therapy 3 Laser technology therapy 4 Immunomodulator therapy

The patient has been diagnosed with tinea unguium (onchomycosis) under the nails and does not like the oral antifungal medication. What is the best alternate treatment the nurse should describe for the patient? 1 Nail avulsion 2 Antifungal cream 3 Thinning of fingernails 4 Soaking nails in salt water

About which treatments should the nurse educate the patient with scaly, ringlike lesions with well-defined margins on both arms? Select all that apply. 1 Cryosurgery 2 Oral penicillin 3 Cool compress 4 Mupirocin cream 5 Miconazole cream

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When studying the incidence of skin cancers in a population, a nurse finds that a greater number of skin cancer cases have been reported in white patients than in African American patients. What could be the most likely cause of such an occurrence? 1 Whites have less melanin content in their skin than African Americans. 2 Whites have greater melanin content in their skin than African Americans. 3 Whites usually have more exposure to the sun than African Americans. 4 Whites usually have less exposure to the sun than African Americans.

1 Melanin provides natural protection to the skin against the harmful radiation of the sun. Therefore, melanin plays a major role in preventing skin cancer. African American people are darker skinned and have greater melanin content in their skin. Therefore, they are less susceptible to skin cancer than white people. White people are lighter skinned and have less melanin. Differences in sun exposure between the two populations cannot be predicted. Text Reference - p. 428

Which intervention would be most helpful in managing cellulitis in an 83-year-old patient with heart failure? 1 Apply warm, moist heat 2 Maintain strict bed rest 3 Perform passive range of motion exercises 4 Soak the extremity in cool, sterile saline

1 The application of warm, moist heat speeds the resolution of inflammation and infection when accompanied by appropriate antibiotic therapy. It does this by increasing local circulation to the affected area to bring macrophages to the area and carry off cellular debris. Strict bed rest is not advised, because this will place the patient at an increased risk for blood clot formation. Passive range of motion may be performed; however, this will not alter the course of the cellulitis. The extremity should not be soaked in cool saline because of vasoconstriction and possible delayed wound healing. Text Reference - p. 435

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. The nursing diagnosis that best describes this patient response is 1 Social isolation related to fear of rejection 2 Ineffective coping related to lack of social support 3 Impaired skin integrity related to presence of lesions 4 Ineffective health maintenance because of presence of lesions

1 The chronicity of psoriasis can be severe and disabling as people withdraw from social contacts because of visible lesions. Quality of life is also affected negatively. The information presented does not indicate the patient does not have support. Impaired skin integrity is not a priority diagnosis. There is no information to indicate the patient has ineffective health maintenance. Text Reference - p. 444

A patient presents with intense pain and pruritus from a recent bee sting. What is the most appropriate nursing action? 1 Apply warm compresses. 2 Apply a local antipruritic lotion. 3 Administer antibiotics as prescribed. 4 Apply moisturizers

2 Bee stings may cause intense pain and pruritus. These symptoms are usually relieved by a local application of antipruritic lotions. Cold compresses can be given to soothe the burning sensation. Antihistamines can be administered. Antibiotics are not indicated because there is no evidence of infection. Moisturizers are not helpful in relieving the symptoms Text Reference - p. 437

A patient diagnosed with malignant melanoma has been prescribed vemurafenib. The nurse recalls that the medication was prescribed on the basis of what test? 1 Microdermabrasion 2 Genetic testing 3 Clark level testing 4 Breslow measurement

A 54-year-old patient with diabetes mellitus has cellulitis of the right lower extremity. Which assessment finding would the nurse expect on physical examination? 1 Delayed capillary refill time 2 Pallor of the right toes 3 Warmth of the area 4 Paresthesias of the right lower extremity

What condition does the nurse suspect in an asthmatic patient who reports erythema, oozing vesicles, and severe itching of the skin? 1 Urticaria 2 Drug reaction 3 Atopic dermatitis 4 Allergic contact dermatitis

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? 1 The UVA rays of the sun cause tanning. 2 The UVB rays of the sun cause sunburn. 3 The UVC rays of the sun cause collagen damage. 4 The UVC rays of the sun cause increased melanin production.

A patient exhibits small, red pruritic lesions between the fingers and toes. On examination the nurse discovers that the lesions appear in a pattern of small lines. Which condition do these symptoms most likely represent? 1 Scabies 2 Varicella 3 Contusions 4 Herpes zoster

A patient has sensitive skin and breaks out with rashes when using ordinary soap. What advice should the nurse give the patient regarding hygienic skin measures? 1 Use mild, moisturizing soaps. 2 Use hot water to take a bath. 3 Rub the skin vigorously. 4 Avoid antibacterial soaps.

A patient with a skin infection is prescribed a topical ointment. What action should the nurse take when applying this treatment? 1 Applying a thin layer of the ointment on the affected area 2 Spreading the ointment on the affected area in a circular motion 3 Applying the ointment on the affected area and then applying a dressing 4 Applying a thick layer of ointment with a gloved hand for better results

The nurse should teach a patient who is taking which drug to avoid prolonged sun exposure? 1 Tetracycline 2 Ipratropium 3 Morphine sulfate 4 Oral contraceptives

The nurse would assess a patient admitted with cellulitis for what localized manifestation? 1 Pain 2 Fever 3 Chills 4 Malaise

he nurse is caring for patients who have undergone various cosmetic topical procedures and are experiencing side effects. Which patient had the epidermis and top dermal layer removed by application of aluminum oxide? 1 A patient with a light pink tone skin for about 24 hours 2 A patient with moderate swelling and crusting for a week 3 A patient with photosensitivity with slight irritation of the skin 4 A patient with erythema, swelling, flaking, and changes in pigmentation

A patient is prescribed tetracycline for severe acne. What should the nurse teach the patient about this medication? Select all that apply. 1 Do not take the medication with milk. 2 Drink milk two hours after taking tetracycline. 3 Take tetracycline one hour before consuming milk. 4 Take tetracycline 15 minutes after consuming milk. 5 Take tetracycline on a full stomach as long as dairy product is not consumed.

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The nurse is caring for a patient with purulent drainage from an inflamed site. Which are the most appropriate actions for the nurse to take? Select all that apply. 1 Soak the affected area in salt water. 2 Use cool, sterile water for wet dressing. 3 Leave the wet dressing in place for 10 to 30 minutes. 4 Use tap water at room temperature for wet dressing. 5 Replace the wet dressing if the patient's skin appears macerated

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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. 1 Cryosurgery 2 White petroleum 3 Silver sulfadiazine 4 Topical immunotherapy 5 Blunt dissection with scissors

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Which cosmetic procedure improves the appearance of both acne scarring and actinic and seborrheic keratoses? 1 Use of chemical peels 2 Use of α-hydroxy acids 3 Application of tretinoin 4 Use of microdermabrasion

1 The use of chemical peels improves the appearance of skin that has been damaged because of acne scarring and actinic and seborrheic keratosis. α-hydroxy acids can smoothen photodamaged, wrinkled, or acne-scarred skin. The application of tretinoin can improve the appearance of photodamaged skin and treat fine wrinkling; tretinoin also reduces actinic keratoses. With the use of microdermabrasion, photodamaged, wrinkled, and acne-scarred skin can be smoothened. Text Reference - p. 445

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. 1 The nevi are larger than 5 mm in size. 2 The nevi are well circumscribed. 3 The nevi are dark in color. 4 The skin over the nevi is eroded. 5 There is discharge from the nevi

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A nurse advises a patient with skin that is extremely sensitive to the sun to select a sunscreen which blocks both UVA and UVB rays. Which statements by the patient indicate that the teaching is effective? Select all that apply. 1 "The sunscreen should have an SPF of at least 15." 2 "The sunscreen should be water resistant." 3 "The sunscreen should be labeled as broad spectrum." 4 "The sunscreen should have benzophenone as the major constituent." 5 "The sunscreen should have para-aminobenzoic acid (PABA) as the major constituent.

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A nurse is caring for a patient with quadriplegia who is confined to bed. The patient shows signs of skin irritation. Which measures are appropriate for preventing further skin damage when bathing the patient? Select all that apply. 1 Use hot water for baths. 2 Scrub the skin very lightly. 3 Use lipid-free cleansers. 4 Use soaps having a high acid content. 5 Apply a moisturizer after wiping the skin dry with a towel.

2 3 The patient shows signs of skin irritation, so the skin should be scrubbed lightly. Vigorous scrubbing may increase skin irritation. Use of mild, lipid-free cleansers can also reduce skin irritation. Hot water can increase the dryness of the skin, making it more prone to irritation. Soaps having high acid content can also cause skin irritation and are therefore not recommended for this patient. Moisturizers should always be applied on damp skin so that the moisture is sealed. Text Reference - p. 430

A patient complains of excessive itching along the abdomen near the umbilicus. What instructions should the nurse give to the patient to relieve pruritus? Select all that apply. 1 Rub the affected area gently. 2 Place moist cotton sheets on the affected area. 3 Warm the affected area with warm compresses. 4 Apply menthol or camphor locally to the affected area. 5 Use good-quality moisturizers on the affected area after drying it.

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A patient is diagnosed with vaginal candidiasis. What nursing interventions are appropriate for this patient? Select all that apply. 1 Administer antibiotics as advised. 2 Instruct the patient to keep the area clean and dry. 3 Instruct the patient to avoid any vaginal suppositories. 4 Inform the patient to abstain from sex or use condoms. 5 Instruct the patient to use antifungal powder on the affected skin

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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? 1 The patient has nevi. 2 The patient has lentigo. 3 The patient has acrochordons. 4 The patient has seborrheic keratoses

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? 1 Impetigo 2 Carbuncle 3 Erysipelas 4 Folliculitis

During an admission assessment, the nurse decides to implement contact precautions if which of these disorders is present in a patient? 1 Psoriasis 2 Tinea unguium 3 Impetigo on the lower legs 4 Candidiasis in the groin area

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? 1 Plantar warts 2 Herpes zoster 3 Verruca vulgaris 4 Herpes simplex virus type 1

The nurse is caring for a patient with a skin suture. How should the nurse care for this wound? 1 Cover with a wet sterile dressing. 2 Clean daily with saline solution. 3 Apply an antibiotic and leave open to air. 4 Administer diphenhydramine to treat inflammation

Which does the nurse suspect in a patient who reports severe nighttime body itching and has red, crusted papules? 1 Lice 2 Ticks 3 Scabies 4 Bedbugs

he nurse is providing preoperative teaching for the patient having a face-lift (rhytidectomy) surgery. Which patient response indicates the patient understands the teaching? 1 "I am afraid of the pain afterwards, while it is healing." 2 "I can't wait to have my forehead and lip wrinkles eliminated." 3 "I have some time off work so I will not look so bad when I go back." 4 "Now I can be excited to go to my 50th high school reunion this week

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. 1 Oral penicillin 2 Incision and drainage 3 Antistaphylococcal soap 4 Warm compress of aluminum acetate 5 Immobilization and elevation of the affected area

3 4 Folliculitis is characterized by small pustules at the hair follicle openings and minimal erythema. Antistaphylococcal soap-and-water cleansing is used to treat folliculitis. Warm compresses of water or aluminum acetate solution are also used as treatment. Systemic antibiotics, such as oral penicillin, are used in the treatment of impetigo, furunculosis, and cellulitis. Incision and drainage is used to treat furuncle and furunculosis. Immobilization and elevation of the affected area is appropriate for patients with cellulitis. Text Reference - p. 434

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? 1 Cellulitis 2 Furuncle 3 Impetigo 4 Folliculitis

3 Impetigo is marked by vesiculopustular lesions that develop a thick, honey-colored crust surrounded by erythema. They are most common on the face as a primary infection. Cellulitis manifests clinically as a hot, tender, erythematous, edematous area with a diffuse border. Furuncle is marked by a tender erythematous area around a hair follicle. Small pustules at the hair follicle opening with minimal erythema and development of crusting are indicative of folliculitis. Text Reference - p. 434

A 56-year-old white patient presents with a flat, dry, scaly area on the eyebrows that is treated with a chemical peel. What should the nurse include in the discharge teaching? 1 Metastasis of this type of cancer is rare. 2 The patient has an increased risk for melanoma. 3 Recurrence of the premalignant lesion is possible. 4 Untreated lesions may metastasize to regional lymph nodes

3 The flat or elevated dry scaly area is actinic keratosis from sun damage and is a premalignant skin lesion common in older whites, with possible recurrence even with adequate treatment. Metastasis of basal cell carcinoma is rare; it is a small, slowly enlarging papule. There is an increased risk for melanoma with atypical or dysplastic nevi. With squamous cell carcinoma, untreated lesions may metastasize to regional lymph nodes and distant organs, but it has a high cure rate with early detection and treatment. Text Reference - p. 445

A patient describes having small, firm reddened raised lesions with flat, rough patches causing intense pruritis to the nurse. What would be the nurse's next assessment? 1 History of seasonal allergies 2 Initiation of new medication 3 Previous pruritic skin lesions 4 Activities in past two to seven days

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. About which infection should the nurse educate the patient? 1 Impetigo 2 Candidiasis 3 Herpes zoster 4 Herpes simplex virus

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? 1 Cellulitis 2 Impetigo 3 Carbuncle 4 Furunculosis

A patient has itchy red papules that are circumscribed with vesicles. Which drug treatments should the nurse expect to be prescribed for this patient? Select all that apply. 1 Cetirizine 2 Mupirocin 3 Fluorouracil 4 Hydroxyzine 5 Corticosteroids

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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? 1 Furuncle 2 Carbuncle 3 Folliculitis 4 Furunculosis

4 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? 1 Furuncle 2 Carbuncle 3 Folliculitis Correct 4 Furunculosis

The nurse is caring for a patient who has lost excessive hair from the scalp and some other parts of the body. The patient is also unable to sweat. Which therapy does the nurse suspect that the patient has been undergoing? 1 Drug therapy 2 Phototherapy 3 Laser technology 4 Radiation therapy

4 Radiation therapy can cause alopecia (permanent hair loss) of the irradiated areas and temporary impairment of the sweat glands. Drug therapy includes the use of various drugs such as antibiotics, corticosteroids, antihistamines, topical fluorouracil, and immunomodulators; drug therapy is not generally associated with hair loss and sweat gland impairment. A patient undergoing phototherapy will experience erythema, sunburn, and persistent pruritus. Laser light does not accumulate in the body cells and cannot produce cellular changes or damage. Text Reference - p. 440

The nurse should recognize which patient as likely to have the poorest prognosis? 1 A 60-year-old diagnosed with nodular ulcerative basal cell carcinoma 2 A 59-year-old man who is being treated for stage IV malignant melanoma 3 A 70-year-old woman who has been diagnosed with late squamous cell carcinoma (SCC) 4 A 51-year-old woman whose biopsy has revealed superficial squamous cell carcinoma

When a patient has psoriasis, which sign would a nurse expect to find? 1 Pustules in skinfolds 2 Itchy, scaly patches on scalp 3 Macular rash on the trunk area 4 Vesicular rash on the extremities

Which patient does the nurse determine will benefit the most from treatment with methotrexate? 1 The patient with a benign adipose tumor 2 The patient with autoimmune chronic dermatitis 3 The patient with inflammatory disorder of sebaceous glands 4 The patient with an increase in normal melanocytes in the basal layer of epidermis

A patient is experiencing atrophy of the skin of the forearm that started after three weeks of treatment. Which therapy should the nurse suspect the patient is undergoing? 1 Mupirocin therapy 2 Hydroxyzine therapy 3 Corticosteroid therapy 4 Topical fluorouracil therapy

The nurse is providing preoperative teaching for the patient having a face-lift (rhytidectomy) surgery. Which patient response indicates the patient understands the teaching? 1 "I am afraid of the pain afterwards, while it is healing." 2 "I can't wait to have my forehead and lip wrinkles eliminated." 3 "I have some time off work so I will not look so bad when I go back." 4 "Now I can be excited to go to my 50th high school reunion this week.

The nurse, preparing educational information about types of skin cancer, recalls the type that has a higher risk for metastasis and poor prognosis unless it is treated early is: 1 Basal cell 2 Myeloma 3 Melanoma 4 Squamous cell

In teaching a patient who is using topical fluorouracil (5-FU) to treat actinic keratosis, the nurse should tell the patient which of the following? Select all that apply. 1 Systemic side effects are very rare. 2 The patient will look worse before looking better. 3 The patient needs to avoid sunlight during treatment. 4 Treatment with this medication is limited to one week. 5 Abruptly discontinuing the use of the medication may cause a reappearance of the actinic keratosis

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A patient with skin lesions is advised to have a patch test. The nurse applies the patch on the patient's skin and instructs the patient to come back after two days for further treatment. What is the likely reason the patch test was performed? 1 To determine the causative agents of allergies in the patient. 2 To determine the prognosis of skin cancer in the patient. 3 To determine the presence of skin infections in the patient.

1 The patch test is done to identify the cause of allergies in patients. It is performed by applying the allergen on the skin of the patient and evaluating the skin after 48 hours. The presence of erythema, papules, and vesicles indicate an allergic reaction. A patch test is not useful to determine the presence or prognosis of skin cancer. The prognosis of skin cancer can be determined through Breslow and Clark measurements. The presence of skin infections can be determined through microscopic studies. The presence of melanoma can be determined through biopsies. Text Reference - p. 437

2 4 5 Pruritus, or severe itching, needs to be controlled because an excoriated lesion may be difficult to assess. A variety of measures can be used to control pruritus. The pruritic area should always be moist because dry skin increases the itch sensation. When applied topically, menthol and camphor numb the itch receptors and thus decrease itch sensation. Applying moisturizers and moist linen can be helpful in controlling itch. Heat and rubbing the affected area causes vasodilation, which worsens itching. Text Reference - p. 443

When a patient has psoriasis, which sign would a nurse expect to find? 1 Pustules in skinfolds 2 Itchy, scaly patches on scalp 3 Macular rash on the trunk area 4 Vesicular rash on the extremities

2 Psoriasis is a noncontagious autoimmune disease. It usually presents as itchy scales on the scalp, knees, or elbows, the result of an overproduction of skin cells. Other commonly affected areas are the joints, fingernails, and toenails. Psoriasis does not present as pustules, as a macular rash, or as a vesicular rash. Text Reference - p. 439

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. 1 Petechiae 2 Skin desquamation 3 Presence of skin tags 4 Seborrhea-like lesions 5 Rashes under the breast and axillae

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A nurse is caring for a patient with liver disease that is scheduled for psoralen plus UVA therapy (PUVA). The nurse understands that the reason that extreme caution should be exercised while administering the therapy to the patient is what? 1 Psoralen will cause erythema in the patient. 2 Psoralen will excrete slowly in the patient. 3 Psoralen will prolong photosensitivity in the patient. 4 Psoralen will cause nausea and vomiting in the patient.

3 In psoralen plus UVA light (PUVA) therapy, a photosensitizing drug called psoralen is given to patients for a prescribed amount of time before exposure to UVA light. The drug should be administered with extreme caution in patients having liver disease. Liver disease tends to slow down metabolism, and this may lead to prolonged photosensitivity. Erythema is a side effect of phototherapy and is not accentuated by psoralen. Psoralen excretion may be slower in patients with impaired renal function. It is not the reason for taking special precautions in the patient. Nausea and vomiting are common side effects of psoralen, not specifically related to liver impairment, and they do not call for special precautions. Text Reference - p. 440

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? 1 Obese people drink less water. 2 Obese people have lowered immunity. 3 Obese people are prone to overheating and sweating. 4 Obese people have improved arterial and venous flow.

3 Obesity increases the risk of skin inflammation and dryness. Increased subcutaneous fat can lead to overheating and increased sweating. Increased sweating may lead to skin inflammation and dryness. Obese people are not known to drink less water. Lowered immunity does not lead to skin inflammation and dryness. Obese people tend to have an impaired arterial and venous flow; however, this does not inflame or dry the skin. Text Reference - p. 430

A patient presents with tiny skin lesions on the chest and back that have a diameter less than 0.5 cm. Which procedure should be used to obtain a sample of these lesions? 1 Curettage 2 Skin scraping 3 Punch biopsy 4 Electrodessication

3 Punch biopsy is a common dermatologic procedure used to obtain a tissue sample for histologic study. It is generally reserved for lesions smaller than 0.5 cm. Curettage is useful for removing soft skin tumors and superficial lesions, such as warts and actinic keratoses. Skin scraping is done to obtain a sample of surface cells for microscopic inspection and diagnosis. Electrodessication is useful in coagulation of bleeding vessels to obtain hemostasis and destruction of small telangiectasias. Text Reference - p. 442

Which fungal infection manifests on the surface of a patient's skin with an erythematous and typical annular scaly appearance and well-defined margins? 1 Tinea Pedis 2 Tinea Cruris 3 Tinea Corporis 4 Tinea Unguium

3 Tinea corporis is commonly referred to as ringworm. Tinea corporis infection has an erythematous, annular (ringlike) scaly appearance with well-defined margins. A tinea pedis fungal infection is characterized by scaly plantar surfaces that are pruritic and blistering in nature. Tinea cruris infection does not affect mucous membranes, and it is associated with well-defined scaly plaque on the patient's groin area. A patient with tinea unguium infection has brittle, thickened, and broken nails with yellowish discoloration. Text Reference - p. 436

The nurse assesses a scaly, ring like rash with a clear center on a patient's leg. Regarding which skin infection should the nurse educate the patient? 1 Cellulitis 2 Tinea cruris 3 Plantar warts 4 Tinea corporis

The nurse is caring for a patient with a sacral pressure ulcer that is being treated with wet-to-dry dressings. Which statement regarding the rationale for this type of dressing is most accurate? 1 An occlusive dressing should cover the wet dressing. 2 The wet-to-dry dressing should be tightly packed into the wound. 3 The dressing should be allowed to dry completely before removal. 4 A wet-to-dry dressing will provide mechanical debridement of this wound.

What action should the nurse take to help a patient with pruritis? 1 Keep the area as dry as possible. 2 Administer fexofenadine to control itching. 3 Allow the patient to gently rub the itching area for quick relief. 4 Wet cotton sheets with warm water and place them over the itching area

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? 1 Urticaria 2 Tinea corporis 3 Atopic dermatitis 4 Allergic contact dermatitis

4 Allergic contact dermatitis is a manifestation of delayed hypersensitivity characterized by red papules and plaques, and also is circumscribed sharply with occasional vesicles. It is usually pruritic. The area of dermatitis frequently takes the shape of the causative agent. Urticaria is spontaneously occurring, with raised or irregularly shaped wheals, varying size, and usually multiple in number. Tinea corporis is a fungal infection of the skin also known as ringworm. Text Reference - p. 438

The nurse is preparing to administer a topical corticosteroid preparation to a patient who has a severe skin inflammation. Which of these forms of topical corticosteroids is the most potent delivery system for this agent? 1 Gel 2 Spray 3 Cream 4 Ointment

4 The most potent delivery system for a topical corticosteroid is an ointment form. Gels, sprays, and creams are not as potent. Text Reference - p. 19

A nurse is teaching a patient about self-examination of skin lesions. The skin should be examined for which of the following characteristics? Select all that apply. 1 Asymmetry of the lesion 2 Irregularity of the borders of the lesion 3 Depth of the lesion 4 A change or evolution in appearance of the lesion 5 Temperature of the lesion

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Which treatments would be beneficial for a patient with popular, wheal-like lesions and severe pruritus? Select all that apply. 1 Spinosad 2 Doxycycline 3 Chlorocyclohexane 4 γ-Benzene hexachloride 5 Permethrin topical solution

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A nurse is caring for a patient diagnosed with shingles. The primary health care provider prescribes acyclovir to be administered as soon as possible. The most likely reason for the medication is to prevent what? 1 To prevent pain 2 To prevent postherpetic neuralgia 3 To prevent worsening of symptoms 4 To prevent the patient from getting restless

The patient has had rashes and alopecia. What vitamin in which foods should be encouraged as a nutritional aid to these problems? 1 Vitamin A in sweet potatoes, carrots, and dark leafy greens 2 Vitamin B7 (biotin) in liver, cauliflower, salmon, and carrots 3 Vitamin C in peppers, dark leafy greens, broccoli, and kiwi 4 Vitamin D in canned salmon, sardines, fortified dairy, and eggs

2 A deficiency of Vitamin B7 (biotin) may result in rashes and alopecia. Eating foods with biotin will help decrease these problems. Vitamins A and C are needed for wound healing. Vitamin D is needed for bone and body health. Text Reference - p. 430

A patient tells a nurse, "I think I might have head lice." Which assessment findings would the nurse observe with this infestation? 1 Diffuse pruritic wheals 2 Oval white dots stuck to hair shafts 3 Itchy redness and edema over the area of infestation 4 Pruritic papules with linear burrows at the hairline

2 The eggs of lice, known as nits, appear as oval white dots attached to hair shafts. The lice are not usually visible. Diffuse pruritic wheals may be seen with localized inflammation such as that in response to an insect bite. Itchy redness and edema over the area of infestation are not characteristic of head lice. Pruritic papules with linear burrows at the hairline are characteristic of scabies. Text Reference - p. 437

The nurse is caring for patients who are experiencing side effects of different cosmetic topical procedures. Which patient may have been treated for fine wrinkling? A patient with severe redness, flaking, and oozing at the treated area 2 A patient who has photosensitivity and a pink tone that lasts for 24 hours 3 A patient with redness and inflammation and increase in the pigmentation 4 A patient who is experiencing photosensitivity and has redness lasting for seven weeks

3 Tretinoin is used in the treatment of fine wrinkling; its side effects include erythema, swelling, and pigmentation changes. A patient with severe erythema, oozing, and flaking of the skin may have been treated with α-hydroxy acids at high concentrations. A patient with photosensitivity and a pink tone that resolves within 24 hours may have been treated with microdermabrasion. A patient experiencing photosensitivity and erythema that lasts from six to eight weeks may have been treated with chemical peels. Text Reference - p. 445

1 Scabies are contagious microscopic mites that manifest as linear burrows, frequently seen between the fingers and toes. A scabies infestation causes intense itching, especially at night. Varicella (chickenpox) is a highly contagious airborne disease that appears as an itchy vesicular rash. A contusion is a bruise that results from the leakage of blood from capillary vessels into surrounding tissue. Herpes zoster (shingles) is a viral disease seen in older adults that manifests as a painful rash with blisters. Herpes zoster may occur as a reactivation of the varicella virus, which lies dormant in the ganglion after a primary case of chickenpox. Text Reference - p. 437

A nurse is assessing a patient diagnosed with malignant melanoma. The nurse understands that the prognosis of the cancer can be assessed by using the Breslow measurement. How is the prognosis related to Breslow measurement? 1 The larger the tumor, the worse the prognosis 2 The deeper the tumor, the worse the prognosis 3 The darker the tumor, the worse the prognosis 4 The greater number of tumors, the worse the prognosis

2 Tumor thickness is an important prognostic factor for melanoma. The Breslow measurement is used to assess the depth of the tumor in millimeters. The deeper the tumor, the worse will be the prognosis of melanoma. Size of the tumor, color of the tumor, and an increase in the number of tumors are not determined using the Breslow measurement. Text Reference - p. 433

What is the best action for a nurse to take to relieve a patient's pruritus? 1 Applying topical antiviral agents 2 Rubbing the pruritic area 3 Applying a heating pad twice daily 4 Applying cold, wet dressings to pruritic area

The nurse is teaching the residents of an independent living facility about preventing skin infections and infestations. What should be included in the teaching? 1 Use cool compresses if an infection occurs. 2 Oral antibiotics will be needed for any skin changes. 3 Antiviral agents will be needed to prevent outbreaks. 4 Inspect skin for changes when bathing with mild soap

4 Individuals living in independent living facilities are usually older, which means their skin does not need cleaning with hot water and vigorous scrubbing or as often as a younger person. Mild soap (e.g., Ivory) should be used to avoid loss of protection from neutralization of the skin's surface. The skin should be inspected for changes while bathing. Cool compresses are used with ringworm or stings for the antiinflammatory effect. Oral antibiotics are used for Lyme disease from ticks. Antiviral agents are used for viral infections but not to prevent outbreaks. Text Reference - p. 430

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? 1 Chemical peels 2 Surgical excision 3 Electrodesiccation 4 Topical nitrogen mustard

4 Mycosis fungoides is a form of cutaneous T-cell lymphoma in which lymphocytes become malignant, affecting the skin. It is characterized by indurated erythematous plaques on the trunk that are similar in appearance to psoriasis lesions. Therefore, topical nitrogen mustard, a chemotherapy agent, will be beneficial. Chemical peeling is useful against actinic keratosis. Surgical excision is a treatment option for both basal cell carcinoma and squamous cell carcinoma. Squamous cell carcinoma, a malignant tumor of squamous cells of the epidermis, requires treatment with electrodesiccation, in which the skin growths are scraped or burned away. Text Reference - p. 432

The nurse reviews lab values for a male patient with herpes zoster. With which result should the nurse be most concerned? 1 Calcium: 9.0 mg/dL 2 Hemoglobin: 14 g/dL 3 Platelets: 150,000/mm3 4 White blood cell count: 1000/mm3

4 Herpes zoster may occur as reactivation of the varicella virus, which is dormant in the ganglion after a primary case of chickenpox. Reactivation is seen in immunocompromised patients. The nurse would be concerned about the patient's immune status, and therefore a check of the white blood cell count would be warranted. A normal white blood cell count is 4000 to 10,000 mm3. The other answer options all contain lab values within normal limits: platelets 150,000 to 350,000/mm3, hemoglobin 13 to 18 g/dL in males and 12 to 16 g/dL in females, and calcium 8.5 to 10.5 mg/dL. Text Reference - p. 436

The nurse is caring for a patient in whom chickenpox is suspected. The patient has pustules and redness only on the left side of the face. Which skin condition may the patient have? 1 Furuncle 2 Candidiasis 3 Verruca vulgaris 4 Herpes zoster (shingles)

4 The patient may have herpes zoster (shingles), marked clinically by a linear distribution of vesicles or pustules along a dermatome on an erythematous base. The lesions resemble those of chickenpox. Herpes zoster appears unilaterally on the trunk, face, and lumbosacral areas. Furuncle is a bacterial infection characterized by a tender erythematous area around a hair follicle; it is most common on the face, back of the neck, axillae, breasts, and buttocks. Candidiasis is characterized by a diffuse papular erythematous rash with pinpoint satellite lesions around the edges of affected area. Patients with verruca vulgaris have circumscribed, hypertrophic, flesh-colored papules that are painful when compressed laterally. Text Reference - p. 436

When teaching sun safety guidelines, what instructions should the nurse include when teaching about sunscreen lotion and creams? Select all that apply 1 Sunscreens should have a minimum sun protection factor (SPF) of 15. 2 Sunscreens should be applied 20 to 30 minutes before going outdoors. 3 Sunscreens are not required in cloudy weather. 4 Sunscreens should be reapplied after six hours. 5 Sunscreens should be reapplied immediately after swimming.

1 2 5

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? 1 Impetigo 2 Cellulitis 3 Carbuncle 4 Furunculosis

patient with severe dermatitis is prescribed a therapeutic bath. What actions should the nurse take when providing the bath to this patient? Select all that apply. 1 Have the patient soak in a bath for 20 minutes once a day. 2 Add sodium bicarbonate, but not oils, directly to the bath water. 3 Fill the bathtub until the affected area is covered with cool water. 4 Apply cream to the affected area after getting out of the bathtub. 5 Dry the affected area by rubbing with a towel after getting out of the bathtub.

2 4 Sodium bicarbonate can be directly added to the bath water of a patient with severe dermatitis to facilitate healing. To sustain the hydrating effect, creams and ointment emollients should be applied to the affected area. Oils are not preferred because the addition of oils makes the tub extremely slippery and the patient might be injured. The patient must soak in the bathtub for 15 to 20 minutes three or four times a day. The bathtub should be filled with tepid water until it covers the affected area. The affected area should not be dried by rubbing with a towel but must be gently patted to avoid increased irritation and inflammation. Text Reference - p. 443

The nurse assesses an eroded, ulcerative growths 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? 1 Basal cell carcinoma 2 Malignant melanoma 3 Squamous cell carcinoma 4 Cutaneous T-cell lymphoma

2 Malignant melanoma is characterized by variegated color, including red, white, blue, black, gray, and brown. The growth may be flat or elevated; it is eroded or ulcerated and usually less than 1 cm. Basal cell carcinoma is characterized by a small, slowly enlarging papule with semitranslucent borders and overlying telangiectasia. Squamous cell carcinoma is marked by a thin, scaly, erythematous plaque that does not invade the dermis. Cutaneous T-cell lymphoma involves three stages; a patch is the characteristic feature of the early stage, and tumors are observed in the advanced stage. Text Reference - p. 432

Which laboratory result is the best indicator that a patient with cellulitis is recovering from this infection? 1 White blood cells (WBC) of 2900/μL 2 WBC of 8200/μL 3 WBC of 12,700/μL 4 WBC of 16,300/μL

2 The normal WBC count is generally 4000 to 11,000/μL. For this reason, the patient's level would be returning to normal if it were 8200/μL, indicating recovery from cellulitis. The 2900/µL is too low and indicates that another problem is occurring. WBCs of 12,700/µL and 16,300/µL are evidence of continuing infection. Text Reference - p. 434

The nurse is teaching safety to a patient who has been prescribed phototherapy. Which statements by the patient indicate that teaching has been effective? 1 "I can be exposed to the sun any time except during sunrise." 2 "I can be exposed to ultraviolet bulbs at home but cannot go outside." 3 "I can remove my protective eyewear if the glass windows are closed." 4 "I must wear protective eyewear that blocks 100 percent of the ultraviolet light when going out.

4 The patient is undergoing phototherapy, which means that the patient is taking psoralen, a photosensitizing drug. Therefore, the patient should wear any protective eyewear that blocks 100 percentof ultraviolet light when going outside, to prevent the sun's ultraviolet rays from affecting the eyes. Any exposure to the sun during the day may affect the patient's skin. The patient should not be exposed to ultraviolet radiation at home. The patient must wear protective eyewear even if the glass windows are closed because ultraviolet light can penetrate glass. Text Reference - p. 440

The nurse assesses an elevated, dry, hyperkeratotic, scaly papule in an older adult patient. With what condition does the assessment data correlate? 1 Dysplastic nevus 2 Actinic keratosis 3 Basal cell carcinoma 4 Squamous cell carcinoma

2 Actinic keratosis manifests clinically as dry, scaly, hyperkeratotic papules, either flat or elevated. A dysplastic or atypical nevus is often larger than 5 mm. It features irregular borders, which may be notched; variegated color (e.g., tan, brown, black, red, or pink) within a single mole; and at least one flat portion, often at the edge of the mole. Basal cell carcinoma is characterized by a small, slowly enlarging papule with semitranslucent or pearly borders. Squamous cell carcinoma appears as a thin, scaly, erythematous plaque that does not invade the dermis. Text Reference - p. 432

A patient has sharply demarcated red plaques on the face that are hot, hard, and painful, along with a body temperature of 101o F as a result of a β-hemolytic Streptococcus infection. About what treatment should the nurse educate the patient? 1 Systemic penicillin 2 Warm, moist compresses on the plaques 3 Application of retapamulin to the affected area 4 Cleansing with antistaphylococcal soap and water

The nurse is caring for patients who have undergone various cosmetic topical procedures and are experiencing side effects. Which patient had the epidermis and top dermal layer removed by application of aluminum oxide? 1 A patient with a light pink tone skin for about 24 hours 2 A patient with moderate swelling and crusting for a week 3 A patient with photosensitivity with slight irritation of the skin 4 A patient with erythema, swelling, flaking, and changes in pigmentation

Which cosmetic procedure is teratogenic? 1 Use of tretinoin 2 Use of chemical peels 3 Use of α-hydroxy acids 4 Use of microdermabrasion

The patient is in the hospital for a surgical procedure and has dry skin and pruritis on the legs that cause the patient to scratch at the skin uncontrollably. What measures can the nurse use to help stop the itch/scratch cycle? Select all that apply. 1 Moisturize the skin on the legs 2 Provide a warm blanket and room 3 Administer antihistamines at bedtime 4 Use careful hand washing after rubbing her legs 5 Cleanse the legs with a saline solution twice daily

1 3 Moisturizing the skin to decrease the dryness and the itch sensation and bedtime antihistamines to decrease a potential allergic reaction and provide some sedation will help the patient sleep, because pruritis is often worse at night and the patient needs sleep for healing. Using nonallergic sheets also may help. Anything causing vasodilation, such as warmth or rubbing, should be avoided. Saline solution would only further dry the skin and so would not be used on the patient's legs. Text Reference - p. 443

Which assessment finding of a 70-year-old male patient's skin should the nurse prioritize? 1 The patient's complaint of dry skin that is frequently itchy. 2 The presence of an irregularly shaped mole that the patient states is new. 3 The presence of veins on the back of the patient's leg that are blue and tortuous. 4 The presence of a rash on the patient's hand and forearm to which the patient applies a corticosteroid ointment.

2 Although dry skin that is frequently itchy, veins on the back of the patient's leg, and a rash on the patient's hand and forearm are significant, the presence of an irregular mole that is new is suggestive of a neoplasm and warrants immediate follow-up. Text Reference - p. 430

What practice should the nurse teach a patient to follow when the patient is applying topical medication? 1 Avoid applying medications directly on to dressings 2 Use a tongue blade whenever the patient's skin integrity allows 3 Avoid covering skin regions that have topical medication in place 4 Apply a layer of medication that is just thick enough to ensure coverage

4 Patients should be directed to avoid applying topical medications too thickly. Medications may be applied directly on to dressings, and regions with medications may be covered. A tongue blade is not normally used for the application of a thin coat. Text Reference - p. 443

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 ring like 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? 1 "Have you removed a tick?" 2 "Were you stung by a wasp?" 3 "Have you noticed any bugs under your mattress?" 4 "Have you been itching all over?

Which patient would be more likely to have the highest risk of developing malignant melanoma? 1 A fair-skinned woman who uses a tanning booth regularly 2 An African American patient with a family history of cancer 3 An adult who required phototherapy as an infant for the treatment of hyperbilirubinemia 4 A Hispanic male with a history of psoriasis and eczema who responded poorly to treatment

A patient has been prescribed isotretinoin for severe acne. What assessment should the nurse perform before administering the drug? Select all that apply. 1 Assess liver function test. 2 Perform pulmonary function tests. 3 Ask the patient whether she is pregnant. 4 Ask the patient whether she is planning to conceive. 5 Assess the patient's fluid intake

1 3 4

A patient diagnosed with actinic keratosis is prescribed fluorouracil. To prevent side effects of the medication, what action should the nurse take? 1 Instruct the patient to avoid sunlight. 2 Advise the patient to use antipruritic lotion. 3 Administer gamma-benzene hexachloride. 4 Administer an antihistamine.

1 Fluorouracil is a topical cytotoxic agent. It is used for the treatment of actinic keratosis and is a photosensitizing drug. Patients should be instructed to avoid sunlight during treatment. Antipruritic lotion is used to relieve itching in cases of insect bites. Gamma-benzene hexachloride is used to treat pediculosis. Antihistamines are used to prevent allergic reactions. Text Reference - p. 441

Which patient with a skin condition should be treated with 5% permethrin topical solution? 1 The patient with scabies 2 The patient with pediculosis 3 The patient with Lyme disease 4 The patient with tinea corporis

1 Scabies is caused by a mite, Sarcoptes scabiei. Scabies is marked by severe body itching, usually at night and is treated with 5% permethrin solution, an insect repellent. A patient with pediculosis may be bitten by lice. γ-Benzene hexachloride is used to treat lice. Lyme disease is caused by Borrelia burgdorferi, which is transmitted through tick bites. The patient experiences a rash and flu-like symptoms. Oral antibiotics such as doxycycline and tetracycline are effective against Lyme disease. Tinea corporis is caused by various dermatophytes. It is treated with cool compresses and creams of ketoconazole, miconazole, and clotrimazole. Text Reference - p. 437

Which nursing intervention would be most helpful in managing a patient newly admitted with cellulitis of the right foot? 1 Applying warm, moist heat 2 Wrapping the foot snugly in blankets 3 Encouraging frequent ambulation 4 Not elevating the affected extremity

1 The application of warm, moist heat speeds the resolution of inflammation and infection when accompanied by appropriate antibiotic therapy. It does this by increasing local circulation to the affected area to bring macrophages to the area and carry off cellular debris. Immobilization and elevation are also used. Snug blankets would not be helpful and could decrease circulation to this sensitive tissue. Elevation and immobilization, not frequent ambulation and nonelevation of the extremity, would be beneficial for healing.

A patient is being treated for scaly skin lesions. The results of a potassium hydroxide (KOH) test that was performed using the scrapings of the lesions are positive. How should the nurse interpret the result? 1 The patient has basal cell carcinoma. 2 The patient has a fungal infection. 3 The patient has contact dermatitis. 4 The patient has scabies

Which localized finding would the nurse expect in the patient with diabetes recently diagnosed with cellulitis? 1 Chills 2 Swelling 3 Fatigue 4 Fever

Which base used for topical agents produces a drying effect of the skin? 1 Gel 2 Paste 3 Cream 4 Ointment

2 A paste is a mixture of ointment and powder. The moisture from the paste is absorbed into the skin, which dries the affected area. A gel is a nongreasy combination of propylene glycol and water; some gels may also contain alcohol. A cream is an emulsion of oil and water used for lubrication and protection. An ointment is a combination of oil and water, useful for lubrication and for prevention of dehydration. Text Reference - p. 440

In teaching a patient with basal cell carcinoma (BCC) about this disorder, the nurse considers that which statement about this skin cancer is true? 1 BCC is the most deadly type of skin cancer. 2 BCC is the most common type of skin cancer. 3 Prognosis depends upon the thickness of the lesion. 4 The cancerous cells of BCC usually spread beyond the skin

2 BCC is a locally invasive malignancy arising from epidermal basal cells. It is the most common type of skin cancer and also the least deadly. The cancerous cells of BCC almost never spread beyond the skin. BCC is the least deadly type of skin cancer. Prognosis depends on other factors too, not just the thickness of the lesion. BCC does not generally spread beyond the skin. Text Reference - p. 431

Which patient does the nurse suspect is most at risk for contracting Lyme disease? 1 The patient bitten by lice 2 The patient bitten by ticks 3 The patient bitten by mites 4 The patient stung by wasps

2 Borrelia burgdorferi is a spirochete transmitted by ticks in certain geographic areas; the person bitten by a tick is at risk for Lyme disease. A person who is bitten by lice such as Pediculus humanus var. capitis, Pediculus humanus var. corporis, or Phthirus pubis is at risk for pediculosis. A person who is bitten by a mite such as Sarcoptes scabiei may have scabies. A person who is stung by a wasp of the Hymenoptera species may experience a severe hypersensitivity reaction. Text Reference - p. 437

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? 1 Administer mild sedatives at night. 2 Administer acyclovir as prescribed within 72 hours. 3 Apply silver sulphadiazine on the ruptured vesicles. 4 Apply wet compresses to the affected area

2 Classic clinical manifestation of herpes zoster (shingles) is a linear distribution of grouped vesicles along a dermatome. Often there is a burning pain preceding an outbreak. Postherpetic neuralgia is a preventable condition if the antiviral agents are administered within 72 hours. Using a mild sedative at night, applying silver sulphadiazine on the vesicles, and applying wet compresses may decrease symptoms, but they have no effect on the prevention of postherpetic neuralgia. Text Reference - p. 436

The nurse is educating a patient regarding complications due to diabetes. Which skin infection's incidence is increased in patients with diabetes mellitus? 1 Cellulitis 2 Impetigo 3 Folliculitis 4 Furunculosis

The patient with diabetes mellitus has peripheral vascular disease. Which dermatologic manifestations should the nurse expect to assess? 1 Redness of exposed areas of the skin on the hand, foot, face, or neck and infected dermatitis 2 Leathery, brownish skin on lower leg, pruritis, concave lesions with edema, and scar tissue with healing 3 Loss of hair in periphery, delayed capillary filling, dependent rubor, neuropathy, and delayed wound healing 4 Atrophy, epidermal thinning, increased vascular fragility, impaired wound healing, thin loose dermis, and excess fat at the back of the neck

3 The patient with diabetes mellitus and peripheral vascular disease is likely to have loss of peripheral hair, delayed capillary filling, dependent rubor, neuropathy, and delayed wound healing. The patient with a nicotinic acid (niocin) deficiency manifests redness of exposed areas of the skin on the hand or foot, face, or neck and infected dermatitis. The patient with venous ulcers will have leathery, brownish skin on the lower leg, pruritus, concave lesions with edema, and scar tissue with healing. The patient with glucocorticoid excess (Cushing's syndrome) may have atrophy, epidermal thinning, increased vascular fragility, impaired wound healing, thin loose dermis, and excess fat at the back of the neck, clavicles, abdomen, and face. Text Reference - p. 430

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? 1 Patient bitten by lice 2 Patient stung by a bee 3 Patient bitten by mites 4 Patient bitten by bedbugs

4 Bedbug bites are treated with the use of antihistamines and topical corticosteroids. Lice bites cause minute, red noninflamed points that are flush with the skin. Pyrethrins and spinosad are used in the treatment of pediculosis (lice infestation). People who are stung by bees or wasps may experience intense burning and local pain at the site of the bite, along with swelling and itching. The sting may be treated with cool compresses and antihistamines as necessary. The patient bitten by mites may have scabies, often marked by severe itching and crusting between the fingers. Scabies is treated with a 5% topical lotion of permethrin. Text Reference - p. 437

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 1 Lentigo 2 Psoriasis 3 Acne vulgaris 4 Seborrheic keratosis

4 Clinical manifestations of seborrheic keratosis include irregularly round or oval, often verrucous papules or plaques with well-defined shape and the appearance of being stuck on. The lesions increase in pigmentation with time and are usually multiple and possibly itchy Clinical manifestations of lentigo include hyperpigmented, brown to black macule or patch (flat lesion) over sun-exposed areas. Clinical manifestations of psoriasis include sharply demarcated silvery scaling plaques on reddish colored skin commonly on the scalp, elbows, knees, palms, soles, and fingernails. Acne vulgaris is manifested by noninflammatory lesions, including open comedones (blackheads) and closed comedones (whiteheads), and inflammatory lesions, including papules and pustules. Text Reference - p. 439

Which surgical approach is used for coagulation of bleeding deep vessels to obtain hemostasis? 1 Curettage 2 Cryosurgery 3 Electrodesiccation 4 Electrocoagulation

4 Electrocoagulation involves the use of a dipolar electrode for coagulation and can affect deep blood vessels. Curettage is the removal and scooping away of the tissue using an instrument with a circular cutting edge attached to a handle. Cryosurgery is the use of subfreezing temperatures to destroy epidermal lesions. Electrodesiccation is useful for superficial vessels. Text Reference - p. 442

The nurse is assessing a patient who had a face-lift procedure earlier in the day. The nurse notes that the skin in the surgical area is warm and pink and blanches with gentle pressure. What is the appropriate action by the nurse, based on this assessment finding? 1 Apply moist heat to the area. 2 Take the patient's temperature. 3 Notify the health care provider immediately. 4 Document the assessment finding as normal.

4 Postoperative assessment for the patient who has had a face-lift includes careful monitoring for adequate circulation. Warm, pink skin that blanches on pressure indicates that adequate circulation is present in the surgical area. Supportive, compressive dressings and ice packs (not moist heat) may be necessary early in the postoperative period. Moist heat should not be applied to the area. It is not necessary to take the patient's temperature. The health care provider does not need to be notified because this finding is normal. Text Reference - p. 446

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? 1 Vitamin A 2 Vitamin B 3 Vitamin C 4 Vitamin K

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