Chapter 25: Skin Infections and Inflammation, Chapter 25: Skin Disorders, Chapter 25: Skin irritation and trauma Study Set

The home health nurse is caring for an older patient confined to bed. What interventions does the nurse take to prevent pressure injuries in the patient? Select all that apply.

Keep the patient's skin directly off plastic surfaces. Place a bed pillow under the ankles.

A patient has folliculitis caused by methicillin-resistant Staphylococcus aureus (MRSA). What does the nurse instruct the patient and family about preventing the spread of MRSA?

Change the bandage whenever drainage seeps through.

A patient has an odorous purulent wound. How does the nurse best support this patient?

Changes the dressing frequently

Which organism is associated with "hitch-hiking" infestation?

Cimex lectularius

During morning rounds, the nurse discovers that an older adult patient has been incontinent during the night. To protect the skin, what does the nurse do first?

Clean the patient.

Which is a risk factor for candidial infection?

Diabetes mellitus

The nurse admits a patient to the clinic who is reporting severe itching of the arms and legs caused by exposure to poison ivy. The nurse anticipates that the health care provider will prescribe which medication?

Diphenhydramine

A patient with psoriasis who is on biologic therapy has developed an infection. What would be the priority nursing interventions to treat this patient? Select all that apply.

Discontinuing the medication Notifying the primary health care provider

Which questions should the nurse ask a patient suspected of having psoriasis? Select all that apply.

Do you have a history of skin trauma? Do you have a history of hypertension? Do you have a family history of psoriasis?

A patient with a skin infection with a raised vesicle that becomes hemorrhagic reports itching and swelling. The patient has a history of contact with an infected animal. What drugs would be most beneficial for the patient? Select all that apply.

Doxycycline Ciprofloxacin

A patient has had a melanoma lesion removed. For secondary prevention, what is important for the nurse to teach the patient?

Perform a total skin self-examination monthly with a partner.

A patient with a skin infection reports intense itching that is unbearable at night. Which drug may be beneficial for this patient?

Permethrin

Which drug is used to treat both scabies and pediculosis?

Permethrin

Which condition may worsen itching in patients with pre-existing pruritus?

Perspiration

Which drug-induced skin reaction is characterized by vesicles, erosions, and crusts?

Stevens-Johnson syndrome

Which medication has the potential to cause teratogenic effects in a patient with psoriasis?

Tazarotene

The nurse is developing a teaching plan for a patient diagnosed with methicillin-resistant Staphylococcus aureus infection. The nurse plans to include which instruction in the patient's teaching plan?

The infected area should be covered with a clean, dry bandage.

A patient with a skin infection in the chin area reports small, red patches filled with fluid and hair in the center of the lesion. What should the nurse infer from these findings?

The patient has folliculitis.

Which surgical technique helps to remove full-thickness skin in the area of a lesion?

Wide excision

A full-thickness pressure injury is covered by a layer of black nonviable, denatured collagen. What term is used to describe this condition?

Wound eschar

What is the duration of the first phase of wound healing?

3 to 5 days

Which disease may cause urticaria?

Cancer

Which part of the body is least likely to be affected by psoriasis?

Facial skin

Which is a synonym of "jock itch"?

Tinea cruris

Which statement by a patient with psoriasis indicates to the nurse that additional teaching about the patient's condition is required?

"A tanning bed will supply the ultraviolet light I need."

In teaching a patient about skin cancer prevention, which instruction does the nurse include?

"Avoid sun exposure between 11 AM and 3 PM."

A patient with psoriasis is prescribed topical corticosteroids. Which nursing instruction regarding medication usage would be beneficial to this patient?

"Check for local tissue reaction."

The nurse is assessing a patient who is suspected to have tinea pedis. Which question asked by the nurse would be most appropriate to confirm the diagnosis?

"Did you share your athletic equipment with other people?"

The nurse is assessing a patient who is suspected to have shingles. Which question asked by the nurse would be most appropriate to confirm the diagnosis?

"Do you have a history of chickenpox?"

The nurse is teaching a patient who has a methicillin-resistant Staphylococcus aureus (MRSA) infection. Which patient statement indicates a need for further teaching?

"I should replace my bandage every eight hours."

The nurse is teaching a patient ways to reduce skin inflammation. Which statement made by the patient shows effective learning?

"I will add cornstarch to the water before bathing."

The nurse is teaching a patient with a furuncle about measures to prevent the spread of infection. Which statements made by the patient show ineffective learning? Select all that apply.

"I will squeeze the lesion." "I will keep the lesion moist."

The registered nurse is teaching a student nurse about providing the emotional support to a patient with psoriasis. Which statement made by the student nurse indicates the need for further teaching?

"I will wear gloves while touching the patient during social interactions."

A registered nurse is precepting a student nurse who is educating the parents of a child with methicillin-resistant Staphylococcus aureus (MRSA) infection. Which of the nursing student's statements requires correction?

"Stop giving your child the antibiotics once the wound has healed."

A patient with chronic wounds is worried about treatment costs. What nursing tips for home care may be of help to the patient? Select all that apply.

"You can use clean tap water and nonsterile supplies." "Thoroughly wash your hands before touching any supplies.

Arrange the events of the proliferative phase of wound healing in the correct sequence.

1. Fibrin strands form a scaffold or framework. 2. Mitotic fibroblast cells migrate into the wound and stimulate the secretion of collagen. 3. Collagen, together with ground substance, builds tough and inflexible scar tissue. 4. Capillaries in areas surrounding the wound form "buds" that grow into new blood vessels. 5. Capillary buds and collagen deposits form "granulation" tissue in the wound, and the wound contracts. 6. Epithelial cells grow over the granulation tissue bed.

Arrange the events of pathophysiology of psoriasis chronologically.

1. Overstimulation of Langerhan's cells 2. Activation of T-lymphocytes 3. Targeting the keratinocytes 4. Increase in cell division 5. Formation of plaque

What method does the nurse use to measure the length of a patient's wound?

12 o'clock position to the 6 o'clock position

A pregnant patient reports white plaques on her abdomen. Which biologic agent is contraindicated for her?

Adalimumab

Which medication acts as a strong irritant and causes chemical burns in patients with psoriasis?

Anthralin

A patient who is receiving drug therapy for urticaria reports an increasing sedative effect. The patient admits to consuming alcohol on a daily basis. Which category of medication could be the reason for this condition?

Antihistamines

Which skin inflammation is characterized by extreme itching?

Atopic dermatitis

The nurse is teaching a patient about decreasing the risk for melanomas and other skin cancers. Which primary prevention technique is most important for the nurse to include?

Avoiding or reducing skin exposure to sunlight

Which category of medications can aggravate psoriasis?

Beta-blocking agents

Which systemic drug is most commonly used to treat psoriasis?

Bexarotene

A patient with a history of a leg ulcer reports pain and redness in the same area. Upon assessment, the nurse finds the area to be edematous, warm, and tender on palpation with noticeable lymphadenopathy. What should the nurse suspect the patient to be experiencing with these symptoms?

Cellulitis

Which skin infection is associated with a typical "satellite lesion"?

Candidiasis

A patient with skin inflammation reports redness at the affected area. The primary health care provider diagnosed the condition and prescribed the patient to use gel for hair. What diagnosis would the nurse expect to find in the patient's medical record?

Contact dermatitis

Pressure mapping is used to measure pressure distribution. What does the blue color indicate in a pressure map?

Cooler area under lower pressure

Which surgical therapy involves the isolated lesion's cell destruction by local application of liquid nitrogen?

Cryosurgery

A patient with a skin infection on the neck reports itching, swelling, and a history of contact with an infected animal. Upon assessment, the nurse finds the infected area to be edematous and tender. The patient also has fever, chills, and enlarged lymph nodes. What could be the possible diagnosis?

Cutaneous anthrax

Which skin infection is characterized by a painless lesion and formation of eschar regardless of treatment?

Cutaneous anthrax

What category of medication may affect the wound contraction of wound healing?

Cytotoxic drugs

While assessing a patient, the nurse identifies that there is no change in the size of the wound. Which category of medications could be the reason for this condition?

Cytotoxic drugs

Which body area is most commonly affected by psoriasis?

Elbow

A patient with a foot ulcer says, "I feel helpless." What is the nurse's best response?

Encourage participation in care of the wound.

Which clinical manifestation is observed during the inflammatory phase of wound healing?

Erythema

Which type of lesion occurs as a result of necrosis?

Eschar

Which nursing interventions can the nurse working in a long-term care facility delegate to a nursing assistant?

Every 2 hours, reposition a patient who has had a stroke and is incontinent.

Which inflammatory condition leads to dehydration and hypothermia?

Exfoliative psoriasis

Which condition may trigger recurrence of herpes simplex virus (HSV) infection in an otherwise healthy male?

Fatigue

What is the triggering factor for the recurrence of herpes simplex skin infection?

Fever

A patient with a skin infection in the axilla reports a small, red lesion filled with pus. Upon assessment, the nurse notices the area to be erythematous and tender on palpation with noticeable lymphadenopathy. What could be the possible diagnosis?

Furuncle

The nurse is caring for a patient with a loss of tissue integrity. The diagnostic reports reveal damage to the dermis and subcutaneous tissue. What is the name of the process that will replace the damaged tissue?

Granulation

Which process involves the replacement of damaged tissue with scar tissue that aids in wound healing?

Granulation

Which skin infection would cause a patient to report facial drooping?

Herpes zoster

Which skin infection may spread to patients from health care personnel?

Herpetic whitlow

The nurse anticipates that a patient with a deep necrotizing wound caused by a brown recluse spider bite may require which type of healing therapy?

Hyperbaric oxygen

An older adult patient with a skin infection reports itching at the infection site, along with fever and malaise. Upon assessment, the nurse finds the patient to be immunosuppressed. Which drug does the nurse expect the primary health care provider to prescribe?

Intravenous acyclovir

Which description is characteristic of a wound that is healing by third intention?

It is a potentially infected surgical wound.

The nurse instructs a patient at high risk for pressure injuries to avoid having any reddened areas massaged. Why does the nurse recommend this?

It may damage capillary beds.

A patient has pruritus. Which measure is used to reduce skin damage from scratching and prevent secondary infection?

Keep the fingernails trimmed short.

Which factor may cause a systemic altered inflammatory response?

Leukemia

The nurse is teaching a patient with loss of sensation and movement in the lower extremities secondary to spinal cord injury about protecting skin integrity. Which daily prevention strategy does the nurse include in the patient's teaching plan?

Lift hips off the chair at least every hour.

What systemic disease causes itching without skin lesions?

Liver disease

What is the dosage frequency of adalimumab?

Loading dose followed by maintenance dose every other week

The nurse assesses a patient's leg ulcer and notices redness, pain, and swelling around the wound along with fever and lymphadenopathy. The patient's medical record reveals an allergy to penicillin. What would be effective medications to treat this infection? Select all that apply.

Macrolide Tetracycline Aminoglycoside

A patient with a pediculosis skin infection reports itching and skin abrasions from scratching. What would be the drug of choice?

Malathion

The nursing instructor reviews instructions with the nursing student on caring for an older adult patient with a pressure injury. What action by the nursing student indicates a need for further instruction about proper skin care for this patient?

Massages bony prominences

Which skin cancer mostly occurs at the site of moles and birthmarks?

Melanoma

A patient with skin inflammation reports weeping lesions and itching at the affected area. Upon assessment, the nurse observes weeping papules, fissuring, and lichenification on the foot. What could be the possible diagnosis?

Non-specific eczematous dermatitis

Which risk categories are measured by the Braden Scale assessment tool? Select all that apply.

Mobility Incontinence Mental status Nutritional status

A patient with contact dermatitis reports redness in the earlobes. What could be the reason for this?

Nickel allergy

Which type of allergy is associated with linear streaks of vesicles?

Plants

Which of the following laboratory studies is used to monitor nutritional status in a patient with a healing pressure injury?

Prealbumin

The nurse is assessing a lesion in a patient with psoriasis. Which information should the nurse obtain from this patient? Select all that apply.

Presence of itching Time of disease onset Description of disease progression

A patient has been ordered anthralin treatment for psoriasis. What does the nurse teach the patient about self-management of this drug?

Prevent drug contact with uninvolved skin.

What is the best way for the nurse to prevent a patient's stage I pressure injury from advancing to stage II?

Promote mobility and/or frequent repositioning.

Which condition will occur from stimulation of the itch-specific nerve fibers?

Pruritus

Which skin inflammation is often relieved by increasing exposure to sunlight?

Psoriasis

Which of the following is the most common type of psoriasis?

Psoriasis vulgaris

Which is a common causative drug of toxic epidermal necrolysis (TEN)?

Pyrazolones

The nurse is caring for a patient with a surgical incision. Which process of wound healing is affected if there is damage to the hair follicles and sweat glands?

Re-epithelialization

Which process promotes the healing of partial-thickness wounds?

Re-epithelialization

Which process occurs in the third intention of wound healing?

Removal of debris

What is the nurse's primary focus in the management of urticaria?

Removal of triggering substance

What does the nurse tell an older patient and family about preventing skin cancer?

Report any change in a lesion.

What process of wound healing involves the production of keratin?

Resurfacing

Deep tissue wounds, such as chronic pressure injuries, take longer to heal because they heal by which intention?

Second

Which are common complications of pressure injuries? Select all that apply.

Sepsis and Kidney failure

The nurse is evaluating the effectiveness of interventions for pressure injury management. Which diagnostic test result with an increased level indicates patient progress and effective health care team collaboration?

Serum albumin

Which form of dermatophytosis should the nurse document when the patient experiences the lesions in the groin?

Tinea cruris

A patient with a skin infection on the hand reports itching near the site of infection. Upon assessment, the nurse notices serpiginous patches with elevated borders. What could be the possible diagnosis?

Tinea manus

A patient with a skin infection reports itching near the site of infection. Upon observation, the nurse notices annular patches with scaling on the foot. What could be the possible diagnosis?

Tinea pedis

Which is a synonym of "athlete's foot"?

Tinea pedis

Which medication is most effective for the treatment of multiple actinic keratosis?

Topical therapy of 5-fluorouracil

A patient who is on chemotherapy reports diffuse redness and large blisters on the inner side of the lower lip. What could be the possible diagnosis?

Toxic epidermal necrolysis

Which condition is characterized by the presence of a rash of white or red edematous papules?

Urticaria

When educating a patient about pressure injury prevention, what does the nurse suggest?

Use barrier ointments to protect intact skin if incontinence is present.

Which is a common area for candidial infections to occur?

Vagina

A patient with skin inflammation reports redness and itching in the skinfold area. Which therapy is most suitable in this patient?

Water-soluble creams