H+C Chapters 10, 60, 61 Practice Quizzes
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:
"All family members need to be treated."
A patient comes to the clinic and asks the nurse why the skin of the forehead, palms, and soles has a yellow-orange tint. There is no yellowing of the sclera or mucous membranes. What should the nurse question the patient regarding?
"Have you been eating a large amount of carotene-rich foods?"
A patient undergoing rehabilitation reports problems with constipation. Which suggestion would be least appropriate?
"Keep your fluid intake to fewer than 2 liters per day."
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?
"To prevent evaporation of water from the hydrated epidermis."
The nurse is providing instruction to a client with acne. The nurse promotes avoidance of which food(s)? Select all that apply.
-Chocolate -Ice cream
A young client has head lice. What are appropriate steps in eradication? Select all that apply.
-Repeat combings daily until there is no more evidence of lice or nits. -Apply a pediculicide to the hair (detailed directions also accompany this medication). -Comb the hair free of tangles while the hair is damp. -Use a special lice comb that has narrow stainless steel teeth. -Comb through each area of the hair to remove lice.
Biopsies are performed on which of the following? Select all that apply.
-Skin nodules -Plaques -Ulcers -Blisters
A nurse is performing a baseline assessment of a client's skin integrity. What are the priority assessments? Select all that apply.
-presence of pressure ulcers on the client -overall risk of developing pressure ulcers -potential areas of pressure ulcer development
When a patient has been diagnosed with scabies, if the infection has spread, family members may complain of pruritus within which time frame?
1 month
The nurse is caring for an adult patient with a normal body temperature. What should the nurse know would be the approximate insensible water loss per day in this patient?
600 mL/day
A client has a rash on the arm that has been treated with an antibiotic without eradicating the rash. What type of examination can be used to determine if the rash is a fungal rash using ultraviolet light?
A Wood's light examination
Which of the following describes a total absence of pigment melanin?
Albinism
Which of the following terms refers to a graft derived from one part of a patient's body and used on another part of that same patient's body?
Autograft
A patient is diagnosed with seborrheic dermatitis on the face and is prescribed a corticosteroid preparation for use. What should the nurse educate the patient about regarding use of the steroid on the face?
Avoid using the medication around the eyelids because it may cause cataracts and glaucoma.
During a routine examination of a client's fingernails, the nurse notes a horizontal depression in each nail plate. When documenting this finding, the nurse should use which term?
Beau's line
The nurse is caring for a client who has had emphysema for 10 years. When performing a fingernail assessment, what does the nurse anticipate the client's nails will be documented as?
Clubbing
The nurse is working with community groups. At which of the following locations would the nurse anticipate a possible scabies outbreak?
College dormitory
Which of the following is the primary lesion associated with acne, caused by sebum blockage in hair follicles?
Comedone
The nurse is applying a cold towel to a patient's neck to reduce body heat. How does the nurse understand that the heat is reduced?
Conduction
A nurse is assessing a client who will be discharged home after rehabilitation for a stroke. The nurse is questioning the client about his instrumental activities of daily living (IADLs). Which of the following would the nurse address?
Cooking
After teaching a group of students about the structure of the skin, the nursing instructor determines that the teaching was successful when the group identifies which of the following as the true skin?
Dermis
A nurse is caring for an elderly bedridden adult. To prevent pressure ulcers, which intervention should the nurse include in the care plan?
Develop a written, individual turning schedule.
The nurse is differentiating between a macule and a papule when evaluating a client's skin lesion. The nurse determines that the lesion is a papule when which characteristic is noted?
Elevated and palpable
During a routine checkup, a nurse observes the client's skin to be tight and shiny. Which of the following is the correct indication of this sign?
Fluid retention
Which term refers most precisely to a localized skin infection of a single hair follicle?
Furuncle
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?
Kaposi sarcoma
What advice should the nurse give a client with a furuncle to prevent the spread of the infection?
Never pick or squeeze a furuncle.
The nurse is caring for a client with questionable 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?
Nits are difficult to move from hair shafts.
A nurse is performing passive range of motion to a client's upper extremities. The nurse touches the client's thumb to each fingertip on the same hand. The nurse is performing which of the following?
Opposition
Which therapeutic exercise is done by the nurse without assistance from the client?
Passive
A patient is visiting the physician to determine what type of allergy is causing a rash. What type of testing does the nurse anticipate the physician will schedule?
Patch test
The nurse notes several very small, round, red and purple macules on a patient's skin. The patient has a history of anticoagulant use. The nurse records this finding as which of the following?
Petechiae
A nurse is admitting a client with toxic epidermal necrolysis. What is the nursing priority in preventing sepsis?
Preventing infection
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?
Private room
The nurse working on a rehabilitation unit rotates a client's forearm so that the palm of the hand is facing down. The nurse documents this as which type of movement?
Pronation
A nurse is preparing an in-service presentation that focuses on promoting pressure ulcer healing. The nurse is planning to include information about appropriate nutrition. Which of the following would the nurse include as important for overall tissue repair?
Protein
The nurse is evaluating the serum albumin of a client newly admitted on the rehabilitation unit. The nurse determines that the client's serum albumin concentration is low, indicating that the client has which deficiency?
Protein
A nurse is caring for a client who requires a wheelchair. Which piece of equipment impedes circulation to the area it's meant to protect?
Ring or donut
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?
Scabies
A patient is complaining of severe itching that intensifies at night. The nurse decides to assess the skin using a magnifying glass and penlight to look for the "itch mite." What skin condition does the nurse anticipate finding?
Scabies
A client with psoriasis visits the dermatology clinic. When inspecting the affected areas, the nurse expects to see which type of secondary lesion?
Scale
With repeated reactions of contact dermatitis, which of the following can occur?
Secondary bacterial infection
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?
Shampoo and conditioner
During which stage of pressure ulcer development does the ulcer extend into the underlying structures, including the muscle and possibly the bone?
Stage IV
During assessment, a patient reports that she sometimes "wets herself" when sneezing. The nurse documents this as which of the following?
Stress incontinence
The nurse is having difficulty seeing a client's rash. Which action(s) should the nurse perform to facilitate the assessment? Select all that apply.
Stretch the skin gently. Point a penlight laterally across the affected part.
A patient learning to ambulate with crutches advances both crutches and then lifts both feet, moving them forward and landing them in front of the crutches. The patient then repeats this motion. The nurse identifies this as which type of crutch gait?
Swing-through
To prevent foot drop, what is the best way for the nurse to position the client?
To keep the feet at right angles to the leg
To treat a client with acne vulgaris, the physician is most likely to order which topical agent for nightly application?
Tretinoin (retinoic acid [Retin-A])
When developing a plan of care for a patient with impaired physical mobility who must remain on complete bedrest, which of the following would the nurse most likely include to prevent external rotation of the hip?
Trochanter roll
The nurse is reading the physician's report of an elderly client's physical examination. The client demonstrates xanthelasma, which refers to which symptom?
Yellowish waxy deposits on the eyelids
The nurse notes that the client demonstrates generalized pallor and recognizes that this finding may be indicative of
anemia.
The purpose of melanin is to:
determine skin color.
The nurse is assessing the skin of a client with tinea pedis and notes a linear crack. The nurse documents this as
fissure.
The classic lesions of impetigo manifest as
honey-yellow crusted lesions on an erythematous base.
A client is being treated for acne vulgaris. What contributes to follicular irritation?
overproduction of sebum
A client with spinal cord injury has no awareness of the need to void. This type of incontinence is termed
reflex (neurogenic) incontinence.
A client is preparing for discharge from the emergency department after sustaining an ankle sprain. The client is instructed to avoid weight bearing on the affected leg and is given crutches. After instruction, the client demonstrates proper crutch use in the hallway. What additional information is most important to know before discharging the client?
Whether the client needs to navigate stairs routinely at home
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?
"Apply sunscreen even on overcast days."
Which of the following actions helps the nurse to determine the quality of the skin turgor?
Grasping the skin
The nurse observes an African-American patient with a large hypertrophied area of scar tissue on the left ear lobe. What does the nurse document this finding as?
Keloid
The nurse is preparing to perform a Wood's light examination. Which of the following would be most important for the nurse to do?
Make sure that the room is darkened.
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?
Moist sterile saline gauze
A nurse assesses a client with dry, rough, scaly skin without lesions and the presence of itching on the legs. What skin assessment would the nurse document?
Pruritus
Which of the following diagnostics is used to examine cells from herpes zoster?
Tzanck smear
The nurse is instructing the parents of a child with head lice. Which statement should the nurse include?
Use shampoo with piperonyl butoxide.
While assessing a patient at the clinic the nurse notes patchy, milky white spots. The nurse knows that this finding is a symptom of what?
Vitiligo
What advice should the nurse give a client with dermatitis until the etiology of the dermatitis is identified?
Wear rubber gloves when in contact with soaps.
A nurse is completing an assessment of a client who has just been transferred to the rehabilitation facility. During the health history, the nurse asks about the client's activities of daily living (ADLs). About which areas would the nurse gather information? Select all that apply.
-Toileting -Eating -Bathing
Which cells play a role in cutaneous immune system reactions?
Langerhans' cells
Which of the following information regarding the transmission of lice would the nurse identify as a myth?
Lice can jump from one individual to another.
A patient's skin is examined and the nurse notes the presence of herpes simplex/zoster skin lesions. The nurse describes the lesions as:
Pus-filled vesicles; circumscribed and elevated masses >0.5 cm.
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?
Through the application of extreme cold, the tissue is destroyed.
A dermatologist recommends an over-the-counter suspension to relieve pruritus. The nurse advises the patient that the lotion should be applied:
Every 3 to 4 hours for sustained effectiveness.
The nurse is developing a plan of care for a client with toxic epidermal necrolysis (TEN) or Stevens-Johnson syndrome. Which action should the nurse include?
Frequently inspect the oral cavity.
Which nursing intervention can help a client maintain healthy skin?
Keeping the client well hydrated
Photochemotherapy has been used as a treatment for which of the following skin disorders?
Psoriasis
A patient is scheduled for Mohs microscopic surgery for removal of a skin cancer lesion on his forehead. The nurse knows to prepare the patient by explaining that this type of surgery requires:
Removal of the tumor, layer by layer.
A client is undergoing photochemotherapy involving a combination of a photosensitizing chemical and ultraviolet light. What health problem does this client most likely have?
psoriasis
Nursing students are reviewing information about various types of skin lesions. The students demonstrate understanding of the information when they identify which of the following as a vascular lesion?
Spider angioma
The nurse assessing a client on a rehabilitation units notices that the patient experiences pain when his right arm is moved away from the midline of his body. The nurse documents pain upon which type of movement?
Abduction
A nurse is teaching a client about vitamins. What vitamin would the nurse recommend the client attain by exposing the skin to ultraviolet light on a daily basis?
Cholecalciferol
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?
End-stage kidney disease
A client spends most of his time in a wheelchair. The nurse would be especially alert for the development of pressure ulcers in which area?
Ischial tuberosity
A patient has a serum bilirubin concentration of 3 mg/100 mL. What does the nurse observe when performing a skin assessment on this patient?
Jaundice
The nurse is performing a physical examination of a patient and observes a well-healed old scar on the right shoulder. The scar is hypertrophied, elevated, and irregular without any redness or irritation. The patient states, "I had shoulder surgery about 5 years ago." The nurse documents this finding as which of the following?
Keloid
The nurse is assessing the periwound skin of an African American client for inflammation. The nurse determines that inflammation is present when which characteristic is noted?
Purple-gray cast
A client has a boil that is located in the left axillary area and is elevated with a raised border, and filled with pus. How would the nurse document this type of lesion?
Pustule
A nurse is developing a plan of care for an 85-year-old woman who is bedridden following a stroke. Which of the following would the nurse be least likely to include in the plan of care for this patient to reduce her risk for pressure ulcers?
Repositioning the patient about once a shift
A type of therapeutic exercise, performed by a client, in which the muscle alternately contracts and relaxes is
isometric.
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.
-Skin atrophy -Striae -Telangiectasia
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.
-When did the disorder first begin, and where did it first appear? -Where are the lesions located? -Has the problem spread? -Have you tried to treat the lesions?
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?
Psoriasis is an inflammatory dermatosis that results from an overproduction of keratin.
A young college student recently had her tongue and lip pierced. She has developed a superinfection of candidiasis from the antibacterial mouthwash. Which of the following would be the correct recommendation for her?
Use an antifungal mouthwash or salt water.
A nurse is teaching a client with a long leg cast how to use crutches properly while descending a staircase. The nurse should tell the client to transfer body weight to the unaffected leg, and then:
advance both crutches.
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?
Use hot water throughout wash cycle.
A 15 year-old pubescent boy is having a sports physical for school. Findings on the face and body indicate that the client is overproducing sebum, which is consistent with the client's age. What is the primary function of sebum?
prevents drying and cracking of the skin and hair