Caring for Clients with Skin, Hair, and Nail Disorders

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 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

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

Cosmetics

A nurse is assessing a teenage client with acne vulgaris. The client's mother states, "I keep telling him that this is what happens when you eat as many french fries as he does." What aspect of the pathophysiology of acne should inform the nurse's response?

Diet is thought to play a minimal role in the development of acne.

A public health nurse is participating in a health promotion campaign that has the goal of improving outcomes related to skin cancer in the community. What action has the greatest potential to achieve this goal?

Educating participants about the early signs and symptoms of skin cancer

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 patient is being evaluated for nodular cystic acne. What systemic pharmacologic agent may be prescribed for the treatment of this disorder?

Isotretinoin (Accutane)

A client who presented with a reddened rash on the face was diagnosed with rosacea. Which statement about rosacea is not true?

It is a form of acne

What percent of those undergoing piercings suffer complications?

31

The nurse is instructing the patient in how to apply a corticosteroid cream to lesions on the arm. What intervention can the nurse instruct the patient to do to increase the absorption of the medication?

Apply an occlusive dressing over the site after application.

A nurse is providing care for a client who has psoriasis. Following the appearance of skin lesions, the nurse should prioritize what assessment?

Assessment of the client's joints for pain and decreased range of motion

The nurse caring for a client with repeated episodes of contact dermatitis is providing instruction to prevent future episodes. Which information should the nurse include?

Avoid cosmetics with fragrance.

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.

A nurse practitioner is seeing a 16-year-old client who has come to the dermatology clinic for treatment of acne. The nurse practitioner would know that the treatment may consist of which of the following medications?

Benzoyl peroxide and erythromycin

Which statement is accurate regarding isotretinoin?

It is teratogenic in humans.

A school nurse has sent home four children who show evidence of pediculosis capitis. What is an important instruction the nurse should include in the note being sent home to parents?

Nits may have to be manually removed from the child's hair shafts.

Onychomycosis is a fungal dermatophyte infection of the fingernails or toenails. Which is not a factor for promotion of this infection?

alternating pairs of shoes daily

The nurse is caring for a client who developed a pressure injury as a result of decreased mobility. The nurse on the previous shift has provided client teaching about pressure injuries and healing promotion. The nurse determines that the client has understood the teaching by observing the client:

avoid placing body weight on the healing site.

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

Which factor aggravates the condition caused by acne vulgaris?

friction

A client with a history of diabetes mellitus has recently developed furunculosis. What is causing the client's condition?

infection

A client has just been told that he has deep malignant melanoma. The nurse caring for this client should anticipate that the client will undergo what treatment?

wide excision

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 nurse is caring for a client whose skin cancer will soon be removed by excision. Which of the following actions should the nurse perform?

Teach the client about self-care after treatment

A nurse is leading a health promotion workshop that is focusing on cancer prevention. What action is most likely to reduce participants' risks of basal cell carcinoma (BCC)?

Teaching participants to limit their sun exposure

Which term describes a fungal infection of the scalp?

Tinea capitis

A nurse receives a report on a client who has circular lesions on his neck. Which condition is the client most likely to have?

Tinea corporis

A nurse assesses a client with dry, rough, scaly skin without lesions on the legs. The client reports itching in the affected area. What skin assessment would the nurse document?

Pruritus

A 30-year-old client has just returned from the operating room after having a "flap" done following a motorcycle accident. The client's spouse asks the nurse about the major complications following this type of surgery. What would be the nurse's best response?

"The major complication is when the blood supply fails and the tissue in the flap dies."

A client has received a diagnosis of irritant contact dermatitis. What action should the nurse prioritize in the client's subsequent care?

Helping the client identify and avoid the offending agent

Development of malignant melanoma is associated with which risk factor?

History of severe sunburn

A 35-year-old kidney transplant client comes to the clinic exhibiting new skin lesions. The diagnosis is Kaposi sarcoma. The nurse caring for this client recognizes that this is what type of Kaposi sarcoma?

Iatrogenic

When writing a plan of care for a client with psoriasis, the nurse would know that an appropriate nursing diagnosis for this client would be what?

Impaired Skin Integrity Related to Scaly Lesions

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

While performing an initial assessment of a client admitted with appendicitis, the nurse observes an elevated blue-black lesion on the client's ear. The nurse knows that this lesion is consistent with what type of skin cancer?

Malignant melanoma

A nurse practitioner prescribes a therapeutic bath for a patient with an exacerbation of psoriasis. She tells the patient to make sure the bath area is well ventilated. Which of the following is the therapeutic bath solution prescribed by the nurse?

Medicated tars

A client's blistering disorder has resulted in the formation of multiple lesions in the client's mouth. What intervention should be included in the client's plan of care?

Provide chlorhexidine solution for rinsing the client's mouth.

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?

Red, raised patches of skin covered with silvery scales

A nurse is caring for a client admitted to the medical unit with a diagnosis of pemphigus vulgaris. When writing the care plan for this client, what nursing diagnoses should be included? Select all that apply.

Risk for Infection Related to Lesions Impaired Skin Integrity Related to Epidermal Blisters Disturbed Body Image Related to Presence of Skin Lesions Acute Pain Related to Disruption in Skin Integrity

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])

Which drug is a topical corticosteroid used to treat psoriasis?

Triamcinolone

A client is being treated for acne vulgaris. What warning must be given to this client regarding the application of benzoyl peroxide

Use gloves with application.

A client has had a surgical procedure to correct an ingrown toenail. Which care recommendation would not help to prevent recurrences?

Use scissors to trim toenails

The nurse is instructing the parents of a child with head lice. Which statement should the nurse include?

Use shampoo with piperonyl butoxide.

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 55-year-old woman is scheduled to have a chemical face peel. The nurse is aware that the client is likely seeking treatment for which of the following?

Wrinkles near the lips and eyes

When performing a skin assessment, the nurse notes a localized skin infection of a single hair follicle. The nurse documents the presence of

a furuncle.

A client has been diagnosed with shingles. Shingles, also known as herpes zoster, is a skin disorder that develops years after an infection with varicella (chickenpox). Which is not an assessment finding with shingles?

nausea and vomiting

A client is being treated for acne vulgaris. What contributes to follicular irritation?

overproduction of sebum

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 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

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