Term 2 comprehensive test questions

A nurse is caring for a client who has a diagnosis of bullous pemphigoid and who is being treated on the medical unit. The nurse knows that systemic treatment will most likely include which element?

Corticosteroid therapy

The nurse is caring for a client experiencing rosacea. Which is the earliest symptom of the disease process?

Flushed Face Appearance

Which factor aggravates the condition caused by acne vulgaris?

Friction

A client with scabies has been prescribed a scabicide. What should the nurse tell the client to do before beginning treatment?

Have a thorough bath.

The nurse knows that inflammatory response following a burn is proportional to the extent of injury. Which factor presents the greatest impact on the ability to modify the magnitude and duration of the inflammatory response in a client with a burn?

Preexisting conditions

An emergency department nurse has just admitted a client with a burn. What characteristic of the burn will primarily determine whether the client experiences a systemic response to this injury

The total body surface area (TBSA) affected by the burn

Which type of burn injury requires skin grafting?

full thickness

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:

melanoma.

In a client who has been burned, which medication should the nurse expect to use to prevent infection?

Mafenide (Sulfamylon)

The nurse is providing education to the client with multiple burns and lists the options for skin grafting and application techniques. Which is the primary benefit for using an autograft slit graft versus other types of grafts?

Rejection is unlikely.

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 expec

Scabies

A nurse is assessing a client admitted with deep partial-thickness and full-thickness burns on the face, arms, and chest. Which finding indicates a potential problem?

Urine output of 20 ml/hour

During the acute phase of a burn, a nurse should assess:

circulatory status.

A client who was severely burned begins to exhibit symptoms of renal failure during treatment. What physiologic process can cause acute renal failure?

hemoconcentration

Which of the following conditions is the cause of thickening of the nail?

Fungal Infection

When assessing a client with partial-thickness burns over 60% of the body, which finding should the nurse report immediately?

Hoarseness of the voice

The nurse has assessed a client's superficial fungal infection that began in the skin between the toes and has spread to the soles of the feet. How would the nurse document this finding?

Tinea Pedis

Which of the following is also known as "jock itch

Tinea cruris

A patient has a burn injury that has destroyed all of the dermis and extends into the subcutaneous tissue, involving the muscle. This type of burn injury would be documented as which of the following?

full thickness

A client presents with silvery scales on the elbows and knees. The physician has made a diagnosis of plaque psoriasis. What is the probable cause of psoriasis? Select all that apply

-genetic predisposition -a triggering mechanism, such as systemic infection, injury to the skin, vaccination, or injection

Which factor causes wrinkles among older adults?

Loss of subcutaneous tissue

A patient visits a clinic for assessment of an inflammatory skin disorder. The nurse diagnoses the condition as psoriasis based on the appearance of the skin. Which of the following describes the dermatoses?r

Red, raised patches of skin covered with silvery scales

A patient has a burn injury that has damaged the epidermis. There are no blisters, and the skin is pink in color. This type of burn injury would be documented as which of the following?

Superficial

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])

A client has a skin graft and is also using a pressure garment as part of the recovery following a burn injury. Which of the following measures would the nurse advise the client to follow?

Use a sunscreen with a high SPF while outdoors to protect against pigment changes

A client with a burn wound is prescribed mafenide acetate 5% twice daily. Nursing implications associated with this medication include`

premedicating the client with an analgesic prior to application.

The nurse is caring for a client with a blistering disease. Which action will the nurse take to relieve this client's discomfort? Select all that apply.

-Dry the skin carefully after bathing. -Apply warmed blankets as necessary. -Premedicate with analgesics before skincare.

Which instructions should a nurse provide a client with burns who has undergone a skin grafting? Select all that apply.

-Restrict movement for a period of time. -Wear a pressure garment for up to two years

The nurse cares for a 30-year-old client who suffered severe head and facial burn injuries. Which action, if completed by the client, indicates the client is adapting to altered body image? Select all that apply.

-Wears hats and wigs -Participates actively in daily activities

A 1-year-old client has a localized rash and is miserably itchy. The client's mother indicates having just started to use a new skin cream and that the rash developed within 12 hours of the first dose. What treatments would pediatrician prescribe? Select all that apply.

-remove allergen -cool baths without soap twice daily

An older adult resident of a long-term care facility has been experiencing generalized pruritus that has become more severe in recent weeks. What intervention should the nurse add to this resident's plan of care?

Avoid using hot water during the client's baths

The nurse receives a client following a serious thermal burn. Which complication will the nurse take action to prevent first?

Hypovolemia

An older adult client, who is bedridden, is admitted to the unit because of a pressure injury that can no longer be treated in a community setting. During assessment, the nurse finds that the ulcer extends into the muscle and bone. At what stage should the nurse document this injury?

IV

An 82-year-old client is being treated in the hospital for a sacral pressure ulcer. What age-related change is most likely to affect the client's course of treatment?

Increased time required for wound healing

When planning care for a client with burns on the upper torso, which nursing diagnosis should take the highest priority?

Ineffective airway clearance related to edema of the respiratory passages

A client who has sustained burns to the anterior chest and upper extremities is brought to the burn center. During the initial stage of assessment, which nursing diagnosis is primary

Risk for Impaired Gas Exchange

The nurse participates in a health fair about fire safety. When clothes catch fire, which intervention helps to minimize the risk of further injury to an affected person at a scene of a fire?

Roll the client in a blanket.

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

The nurse is caring for a client with herpes zoster. What symptom(s) can the nurse anticipate?

-Client states pain and itchiness. -Rash appears first as vesicles then crusts. -A secondary skin infection can begin.

During the recovery of an extensive burn, the client is uncomfortable wearing the tight-fitting custom garment. Which is the best response by the nurse?

"A snug fit is needed to minimize scarring and to smooth the skin."

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 manufacturing plant has exploded, and the nurse is assigned to triage burn victims as they arrive to the hospital. Which is the most important question for the nurse to ask prior to the arrival of victims?

"Are the burns associated with chemicals used in the plant

The nurse is caring for a client diagnosed with herpes zoster. Which statement by the client needs further clarification by the nurse?

"Once I get the infection, I cannot get it again."

Tattoo ink is approved by the Federal Food, Drug, and Cosmetic Act; however, none are approved for injection into the skin. Some, but not all, tattoo artists are members of the Alliance for Professional Tattooists. Infection is a concern with both tattoos and piercings. Tattoo ink is injected into the dermal layer of the skin. Hepatitis B and C can be transmitted as a blood-borne infectious disease.

-Cosmetic pigment is approved by the Federal Food, Drug, and Cosmetic Act. -Infection is a potential complication of tattoos and piercings. -Tattoo is injected into the dermal layer of the skin.

Which of the following are possible indicators of pulmonary damage from an inhalation injury? Select all that apply.

-Singed nasal hair -Hoarseness -Facial burns

A client received burns to his entire back and left arm. Using the Rule of Nines, the nurse can calculate that he has sustained burns on what percentage of his body?

27%

A client has experienced burns covering the back and front of both legs. Using the Rule of Nines, what percentage would the nurse assign to the client's injury when documenting? Fill in the blank with a number.

36

A client is brought to the emergency department with partial-thickness and full-thickness burns on the left arm, left anterior leg, and anterior trunk. Using the Rule of Nines, what is the total body surface area that has been burned?

36%

A client is brought to the ED by paramedics, who report that the client has partial-thickness burns on the chest and legs. The client has also suffered smoke inhalation. What is the priority in the care of a client who has been burned and suffered smoke inhalation?

Airway management

A client has just been diagnosed with rosacea. The nurse knows that initial treatment of rosacea includes what action?

Antibiotics

A nurse is doing a shift assessment on a group of clients after first taking report. An older adult client is having the second dose of IV antibiotics for a diagnosis of pneumonia. The nurse notices a new rash on the client's chest. The nurse should ask what priority question regarding the presence of a reddened rash?

Are you allergic to any foods or medications

Which diagnostic test would be used if a malignancy is suspected?

Biopsy

During the course of a health interview, Mrs. Young tells the nurse that she has been using a new perfume because she wants to smell good. She explains that she has had a rash on her arms and neck since she purchased and used the product. What would be an initial diagnosis for Mrs. Young?

Contact dermatitis

A client has recently been diagnosed with advanced malignant melanoma and is scheduled for a wide excision of the tumor on her chest. In writing the plan of care for this client, what major nursing diagnosis should the nurse include?

Deficient Knowledge about Early Signs of Melanoma

A client has undergone dermabrasion to decrease scarring from severe acne endured as a teen. After completion of the procedure, the nurse reviews the client's home care instructions. Which instruction is appropriate for this client?

Don't touch the area treated.

The nurse is caring for a client who is experiencing discomfort following a tongue piercing. Which instruction is most helpful?

Eat soft foods.

Which is the primary preventable cause of skin cancer?

Exposure to UV radiation

Which is the principal hardening ingredient of the hair and nails?

Keratin

While reviewing an older adult's medical record, the nurse notes that the patient has solar lentigo. he nurse interprets this as which of the following

Liver spots

When providing initial assessment to a client who has suffered an electrical burn, which assessment finding will provide the most important data?

Location of entry and exit wounds

Which of the following is the analgesic of choice for burn pain?

Morphine sulfate

A client receives treatment for a dermatophyte infection of the toenail. How would the nurse document this condition in the chart?

Onychomycosis

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 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

A patient visits a health clinic with a skin lesion on her right forearm. The lesion is inflamed, swollen, and draining. The nurse practitioner knows the best choice of a treatment would be the application of which of the following?

Soothing lotion

Pressure sores are categorized into one of four stages depending on the extent of injury. Which phase is described as "the pressure sore is red and accompanied by blistering or a shallow break in the skin, sometimes described as a skin tear. Impairment of the skin leads to microbial colonization and infection of the wound"?

Stage II

Several temporary and permanent sources are available for covering a burn wound. These may be manufactured synthetically, obtained from a biologic source, or a combination of the two. Which graft is described as a biologic source of skin similar to that of the client?

allograft

A client has a third-degree burn on the leg. The wound is being treated by the open method. After about 4 days, a hard crust has formed around the leg and is impairing the circulation to the leg. What procedure would be done to relieve pressure on the affected area?

escharotomy

A nurse discovers scabies when assessing a client who has just been transferred to the medical-surgical unit from the day surgery unit. To prevent scabies infection in other clients, the nurse should:

isolate the client's bed linens until the client is no longer infectious.

A client with a superficial partial-thickness solar burn (sunburn) of the chest, back, face, and arms is seen in urgent care. The nurse's primary concern should be:

pain management.

A client is undergoing diagnostics for an injury to the right arm. The physician has ordered an MRI on the arm, which has a colorful tattooed "sleeve." What effect could the MRI have on the client's skin?

edema

Within the burn unit, clients may develop complications based on the type of burn they endured. Which burns have a common complication of cardiac dysrhythmias?

electrical

A day care worker comes to the clinic for mild itching and rash of both hands. The nurse suspects contact dermatitis. The diagnosis is confirmed if the rash appears

erythematous with raised papules.

Specific potential complications are common to specific types of burns. Which burns can impair ventilation?

face, neck, chest

The nurse is assessing a client in the clinic and observes a fine skin rash over the arms and trunk. What question is a priority that the nurse asks related to the rash?

"What medication are you taking?"

Which assessment finding indicates an increased risk of skin cancer

A deep sunburn

Which of the following aggravates the condition caused by acne vulgaris?

Cosmetics

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 structure or process does not keep the body warm?

respiration

Which antimicrobials is not commonly used to treat burns?

tetracycline

Which is the primary reason for placing a client in a horizontal position while smothering flames are present?

To keep fire and smoke from airway

Which of the following pigments influences hair color

Melanin

Which of the following medications is used to reduce turnover time of the psoriatic epidermis?

Methotrexate

The nurse is caring for a geriatric client who has developed chapped and itchy skin. Which nursing intervention included in this client's plan of care should the nurse alter?

Daily bathing with warm-hot water

Which type of burn injury involves destruction of the epidermis and upper layers of the dermis as well as injury to the deeper portions of the dermis?

Deep Partial Thickness

When caring for a client in a prenatal clinic who has history of acne vulgaris, which client medication would the nurse advise against?

Isotretinoin

Which term describes a fungal infection of the scalp?

Tinea capitis

Which drug is a topical corticosteroid used to treat psoriasis

Triamcinolone

A nurse is developing a care plan for a client recovering from a serious thermal burn. After maintaining respirations, the nurse knows that the most important immediate goal of therapy is:

maintaining the client's fluid, electrolyte, and acid-base balance.