Chapter 61

Which skin condition is caused by staphylococci, streptococci, or multiple bacteria? Scabies Pediculosis capitis Poison ivy Impetigo

Impetigo Explanation: Impetigo is seen at all ages but is particularly common among children living under poor hygienic conditions. Scabies is caused by the itch mite. Pediculosis capitis is caused by head lice. Poison ivy is a contact dermatitis caused by the oleoresin given off by a particular form of ivy

Which of the following uses the body's own digestive enzymes to break down necrotic tissues? Autolytic debridement Enzymatic debridement Wet to dry dressings Wet dressings

Autolytic debridement Explanation: Autolytic debridement is a process that uses the body's own digestive enzymes to break down necrotic tissue. Application of enzymatic debriding agents speeds the rate at which necrotic tissues is removed. A form of mechanical debridement is a wet to dry dressing, which removes necrotic tissue and absorbs small to large amounts of exudates.

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. Wash skin in very hot water. Use a fabric softener. Wear gloves during the day.

Avoid cosmetics with fragrance. Explanation: The nurse should teach the client to avoid cosmetics, soaps, and laundry detergents that contain fragrance. Other prevention methods include avoidance of heat and fabric softeners. Gloves used for cleaning and washing dishes should be worn to no longer than 15 to 20 minutes/day, and cotton-lined gloves should be used.

The nurse is conducting an admission history and physical examination of a client with a history of contact dermatitis. The nurse assesses whether the client uses which medication classification? Corticosteroids Saline irrigations Antifungals Antivirals

Corticosteroids Explanation: Corticosteroids are used for contact dermatitis. Antifungals, antivirals, and saline irrigations are not used in the treatment of contact dermatitis.

Which medication classification may be used for contact dermatitis? Corticosteroids Saline irrigations Antifungals Antivirals

Corticosteroids Explanation: Corticosteroids are used for contact dermatitis. Antifungals, antivirals, and saline irrigations are not used in the treatment of contact dermatitis.

Which of the following superficial fungal infections begins in the skin between the toes and spreads to the soles of the feet? Tinea corporis Tinea capitis Tinea pedis Tinea cruris

Explanation: Tinea pedis is an infection that begins in the skin between the toes and spreads to the soles of the feet. Tinea corporis is a skin infection of the body. Tinea capitis invades the hair shaft below the scalp. Tinea cruris is a skin infection of the groin.

Which is the primary preventable cause of skin cancer? Fair skin Exposure to UV radiation Skin disease Excess melanin

Exposure to UV radiation Explanation: Skin cancer is caused by exposure to UV radiation, both artificial and in sunlight. Fair-skinned individuals are more susceptible because they do not have as many melanin-producing cells within their skin. Skin diseases do not cause cancer.

The nurse is conducting a community education program on malignant melanoma. The nurse knows that the participants understand the teaching when they identify which characteristic as a risk factor? History of suntans Dark skin Mediterranean descent Family history of pancreatic cancer

Family history of pancreatic cancer Explanation: A family history of pancreatic cancer is a risk factor for malignant melanoma. Additional risk factors include fair skin, freckles, blue eyes, blond hair, Celtic or Scandinavian descent, history of sunburns, previous melanoma, family history of melanoma, and a family or personal history of multiple atypical nevi.

Which of the following nonsedating antihistamines is appropriate for daytime pruritus? Diphenhydramine (Benadryl) Fexofenadine (Allegra) Lorazepam (Ativan) Hydroxyzine (Atarax)

Fexofenadine (Allegra) Explanation: Nonsedating antihistamine medications such as Allegra are more appropriate to relieve daytime pruritus. Benadryl or Atarax, when prescribed in a sedative dose at bedtime, may be beneficial in producing a restful and comfortable sleep. Ativan has sedating properties and is used as an antianxiety medication.

Which term refers most precisely to a localized skin infection of a single hair follicle? Furuncle Carbuncle Cheilitis Comedone

Furuncle Explanation: Furuncles occur anywhere on the body but are most prevalent in areas subjected to irritation, pressure, friction, and excessive perspiration, such as the back of the neck, the axillae, or the buttocks. A carbuncle is a localized skin infection involving several hair follicles. Cheilitis refers to dry cracking at the corners of the mouth. Comedones are the primary lesions of acne, caused by sebum blockage in the hair follicle.

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? Platelet disorders Allergic reactions Kaposi sarcoma Syphilis

Kaposi sarcoma Explanation: Kaposi sarcoma is a frequent comorbidity of clients with AIDS. With platelet disorders, the nurse observes ecchymosis (bruising) and purpura (bleeding into the skin). Urticaria (wheals or hives) is the manifestation of allergic reactions. A painless chancre or ulcerated lesion is a typical finding in clients with syphilis.

Which procedure done for skin cancer conserves the most amount of normal tissue? Moh's micrographic surgery Electrosurgery Cryosurgery Surgical excision

Moh's micrographic surgery Explanation: Moh's micrographic surgery is the technique that is most accurate and that best conserves normal tissue. The procedure removes the tumor layer by layer. Electrosurgery, cryosurgery, and surgical excision do not conserve the amount of normal tissu

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? A. Dry sterile dressing B. Sterile petroleum gauze C. Moist, sterile saline gauze D. Povidone-iodine-soaked gauze

Moist sterile saline gauze Explanation: Moist sterile saline dressings support wound healing and are cost-effective. Dry sterile dressings adhere to the wound and debride the tissue when removed. Petroleum supports healing but is expensive. Povidone-iodine is used as an antiseptic cleaning agent but because it can irritate epithelial cells, it shouldn't be left on an open wound.

What advice should the nurse give a client with a furuncle to prevent the spread of the infection? Keep hair short, clean, and away from the face and forehead. Never pick or squeeze a furuncle. Avoid the use of cosmetics. Use tepid bath water.

Never pick or squeeze a furuncle. Explanation: The client with a furuncle should never pick or squeeze it as the drainage is infectious and this practice favors the spread of the infection. Infections by organisms that usually exist harmlessly on the skin surface cause furuncles. Keeping the hair short, clean, and away from the face and forehead, avoiding cosmetics, and using tepid bath water do not help in preventing the spread of a furuncle.

Which condition is an autoimmune disease involving immunoglobulin G? Stevens-Johnson syndrome (SJS) Toxic epidural necrolysis (TEN) Pemphigus Bullous pemphigoid

Pemphigus Explanation: Pemphigus is an autoimmune disease involving immunoglobulin G. TEN, SJS, and bullous pemphigoid do not involve immunoglobulin G.

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. Psoriasis is an inflammatory dermatosis that results from a superficial infection with Staphylococcus aureus. Psoriasis results from excess deposition of subcutaneous fat. Psoriasis comes from dermal abrasion.

Psoriasis is an inflammatory dermatosis that results from an overproduction of keratin. Explanation: Current evidence supports an autoimmune basis for psoriasis (Porth & Matfin, 2009). Periods of emotional stress and anxiety aggravate the condition, and trauma, infections, and seasonal and hormonal changes may also serve as triggers. In this disease, the epidermis becomes infiltrated by activated T cells and cytokines, resulting in both vascular engorgement and proliferation of keratinocytes. Epidermal hyperplasia results.

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: Destruction of the tissue by electrical energy. Removal of the tumor, layer by layer. A process of deep-freezing the tumor, thawing and refreezing. The use of radiation therapy.

Removal of the tumor, layer by layer. Explanation: Mohs micrographic surgery removes the tumor layer by layer. The first layer excised includes all evident tumor and a small margin of normal-appearing tissue. The specimen is frozen and analyzed by section to determine if all the tumor has been removed. If not, additional layers of tissue are shaved and examined until all tissue margins are tumor-free.

The classic lesions of impetigo manifest as comedones in the facial area. honey-yellow crusted lesions on an erythematous base. abscess of skin and subcutaneous tissue. patches of grouped vesicles on red and swollen skin.

honey-yellow crusted lesions on an erythematous base. Explanation: The classic lesions of impetigo are honey-crusted lesions on an erythematous base. Comedones in the facial area are representative of acne. A carbuncle is an abscess of skin and subcutaneous tissue. Herpes zoster is exhibited by patches of grouped vesicles on red and swollen skin.

There is an increase in the incidence of skin cancer being reported. Which have been identified as factors that predispose to malignant changes in the skin? Select all that apply. thinning ozone layer residence in high-altitude areas where the atmosphere is thinner than at sea level prolonged, repeated exposure to UV rays in those who do farming, fishing, road construction, etc. use of sun block

orrect response: thinning ozone layer residence in high-altitude areas where the atmosphere is thinner than at sea level prolonged, repeated exposure to UV rays in those who do farming, fishing, road construction, etc. Explanation: Contributing factors include the thinning ozone layer; residence in high-altitude areas where the atmosphere is thinner than at sea level; and prolonged, repeated exposure to UV rays in those who do farming, fishing, road construction, etc. Use of sunblock is a protector from UV rays

A client is being treated for acne vulgaris. What contributes to follicular irritation? overproduction of sebum chocolate stress potato chips

overproduction of sebum Explanation: The overproduction of sebum provides an ideal environment for bacterial growth within the irritated follicle. The follicle becomes further distended and irritated, causing a raised papule in the skin.

A patient is being evaluated for nodular cystic acne. What systemic pharmacologic agent may be prescribed for the treatment of this disorder? Isotretinoin (Accutane) Benzoyl peroxide Retin-A Salicylic acid

sotretinoin (Accutane) Explanation: Synthetic vitamin A compounds (i.e., retinoids) are used with dramatic results in patients with nodular cystic acne unresponsive to conventional therapy. One compound is isotretinoin, which is used for active inflammatory popular pustular acne that has a tendency to scar. Isotretinoin reduces sebaceous gland size and inhibits sebum production. It also causes the epidermis to shed (epidermal desquamation), thereby unseating and expelling existing comedones.

Which statement is accurate regarding isotretinoin? It is teratogenic in humans. Contraceptives are not needed during treatment. To achieve the full effect of the medication, the client should take vitamin A supplements. The side effects are irreversible.

t is teratogenic in humans. Explanation: Isotretinoin is teratogenic in humans, meaning that it can have an adverse effect on a fetus, causing central nervous system and cardiovascular defects, and structural abnormalities of the face. Contraceptives are needed during treatment. The client should not take vitamin A supplements while taking this drug. Side effects are reversible with the withdrawal of the medication.

A client with scabies has been prescribed a scabicide. Which of the following advice should the nurse give the client before beginning the treatment? Wear clean clothing. Avoid contact with others who have scabies. Expect itching to continue for 2 to 3 weeks after the treatment. Have a thorough bath.

Have a thorough bath. Explanation: Before any treatment begins, the nurse advises the client to bathe thoroughly. Wearing clean clothing and avoiding contact with others who have scabies are essential in preventing a recurrence. As a part of client teaching, the nurse explains that itching may continue for 2 to 3 weeks after the treatment.

What is the major cause of death in toxic epidermal necrolysis (TEN)? Infection Hemorrhage Renal failure Liver failure

Infection Explanation: The major cause of death from TEN is infection, and the most common sites of infection are the skin and mucosal surfaces, lungs, and blood. Hemorrhage, renal failure, and liver failure are not the major causes of TEN.

The nurse is working with community groups. At which of the following locations would the nurse anticipate a possible scabies outbreak? College dormitory Shopping mall Gymnasium Swimming pool

The nurse is working with community groups. At which of the following locations would the nurse anticipate a possible scabies outbreak? You Selected: Gymnasium Correct response: College dormitory Explanation: The nurse is correct to anticipate a potential scabies outbreak in a college dormitory. Outbreaks are common where large groups of people are confined or housed. Spread of scabies is from skin-to-skin contact. Although there are groups of people at the shopping mall, swimming pool, and gymnasium, typically, there is no personal contact.

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

infection Explanation: Furuncles and carbuncles are caused by skin infections with organisms that usually exist harmlessly on the skin surface.

The nurse notes that the client's lower extremities are covered with very dry skin and that the horny layer of the skin has become thickened. The nurse notes the finding as dermatitis. acantholysis. lichenification. pyodermas.

lichenification. Explanation: The nurse should note this as being lichenification, also called scaling. Dermatitis is an inflammation of the skin. Acantholysis is a separation of the epidermal cells from each other, and pyodermas is a bacterial skin infection.

Which of the following information regarding the transmission of lice would the nurse identify as a myth? Lice can be spread by sharing of hats, caps, and combs. Lice can jump from one individual to another. Lice need to be removed from the hair with a fine comb. Lice can be seen without magnification.

Lice can jump from one individual to another. Explanation: The nurse is correct to identify that lice cannot jump from one individual to another. Direct contact is needed for transmission. The other options are correct.

With repeated reactions of contact dermatitis, which of the following can occur? Pain along the sensory nerve Sepsis Secondary bacterial infection Hemorrhage

Secondary bacterial infection Explanation: If repeated reactions occur, or if the patient continually scratches the skin, lichenification (thickening of the horny layer of the skin) and pigmentation occur. Secondary bacterial invasion may follow. During shingles, there will be pain along the sensory nerve. Sepsis and hemorrhage would not occur from repeated bouts of contact dermatitis.

The nurse is caring for a client diagnosed with herpes zoster. Which statement by the client needs further clarification by the nurse? "Herpes zoster is a reactivation of the varicella virus." "Even though this is from a childhood disease, I am still contagious." "Once I get the infection, I cannot get it again." "Herpes zoster is caused by a viral infection."

"Once I get the infection, I cannot get it again." Explanation: The nurse is correct to clarify that even though the client has herpes zoster, the client can get herpes zoster again. The virus is contagious and can reoccur. All of the other options are correct.

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 2 weeks 3 weeks 6 weeks

1 month Explanation: If the infection has spread, other members of the family and close friends also complain of pruritus about 1 month later.

A patient has developed a boil on the face and the nurse observes the patient squeezing the boil. What does the nurse understand is a potential severe complication of this manipulation? Scarring Brain abscess Erythema Cellulitis

Brain abscess Explanation: Nurses must take special precautions in caring for boils on the face because the skin area drains directly into the cranial venous sinuses. Sinus thrombosis with fatal pyemia can develop after manipulating a boil in this location. The infection can travel through the sinus tract and penetrate the brain cavity, causing a brain abscess.

The nurse is providing instruction to a client with acne. The nurse promotes avoidance of which food(s)? Select all that apply. Chocolate Onions Bananas Ice cream

Chocolate Ice cream Explanation: The nurse should promote avoidance of foods associated with flare-up of acne, particularly those high in refined sugars, including chocolate, cola, and ice cream.

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: "Just be careful not to share linens and towels with family members." "All family members need to be treated." "If someone develops symptoms, tell him to see a physician right away." "After you're treated, family members won't be at risk for contracting scabies."

"All family members need to be treated." Explanation: When someone sharing a home with others contracts scabies, all individuals in the home need prompt treatment whether or not they're symptomatic. Towels and linens should be washed in hot water. Scabies can be transmitted from one person to another before symptoms develop.

Dry, rough, scaly skin with the presence of itching is best described as: Candidiasis Shingles Pruritus Seborrhea

Pruritus Explanation: Pruritus (itching) is one of the most common symptoms of patients with dermatologic disorders. Itch receptors are unmyelinated, penicillate (brush-like) nerve endings that are found exclusively in the skin, mucous membranes, and cornea.

To treat a client with acne vulgaris, the physician is most likely to order which topical agent for nightly application? Zinc oxide gelatin Tretinoin (retinoic acid [Retin-A]) Fluorouracil (5-fluorouracil, 5-FU [Efudex]) Minoxidil (Rogaine)

Tretinoin (retinoic acid [Retin-A]) Explanation: Tretinoin is a topical agent applied nightly to treat acne vulgaris. Minoxidil promotes hair growth. Zinc oxide gelatin treats stasis dermatitis on the lower legs. Fluorouracil is an antineoplastic topical agent that treats superficial basal cell carcinoma.

Which drug is a topical corticosteroid used to treat psoriasis? Triamcinolone Coal tar Neutrogena Methotrexate

Triamcinolone Explanation: Triamcinolone is a topical corticosteroid used to treat psoriasis. Coal tar is used for mild to moderate lesions of psoriasis. Neutrogena is a medicated shampoo. Methotrexate is a systemic therapy for psoriasis.

Which of the following reflect the pathophysiology of cutaneous signs of HIV disease? Genetic predisposition High CD4 count Decrease in normal skin flora Immune function deterioration

Immune function deterioration Explanation: Cutaneous signs may be the first manifestations of HIV, appearing in more than 90% of HIV-infected patients as immune function deteriorates. Common complaints include pruritus, folliculitis, and chronic actinic dermatitis. Cutaneous signs of HIV disease correlate to low CD4 counts. Cutaneous signs of HIV disease appear as immune function deteriorates.

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? Potassium hydroxide test Skin biopsy A Wood's light examination Fungal culture

A Wood's light examination Explanation: A Wood's light is also known as a black light and is a handheld device that can identify certain fungal infections that fluoresce under long-wave ultraviolet light. In a darkened room, when a physician or nurse aims the light at a lesion caused by a fungus that fluoresces, the lesion emits a blue-green color. It is the only test that uses a light, the others use skin scrapings.

Which assessment finding indicates an increased risk of skin cancer? A dark mole on the client's back An irregular scar on the client's abdomen A deep sunburn White irregular patches on the client's arm

A deep sunburn Explanation: A deep sunburn is a risk factor for skin cancer. A dark mole or an irregular scar is a benign finding. White irregular patches are abnormal but aren't a risk for skin cancer.

The nurse is caring for a patient with extensive bullous lesions on the trunk and back. Prior to initiating skin care, what is a priority for the nurse to do? Wash the lesions vigorously. Rupture the bullous lesions. Administer analgesic pain medication. Apply cold compresses.

Administer analgesic pain medication. Explanation: The patient with painful and extensive lesions should be premedicated with analgesic agents before skin care is initiated.

Which skin condition is caused by staphylococci, streptococci, or multiple bacteria? Scabies Pediculosis capitis Impetigo Poison ivy

Impetigo Explanation: Impetigo is seen at all ages but is particularly common among children living under poor hygienic conditions. Scabies is caused by the itch mite. Pediculosis capitis is caused by head lice. Poison ivy is a contact dermatitis caused by the oleoresin given off by a particular form of ivy.

Which drug is an oral retinoid used to treat acne? Isotretinoin Estrogen Tetracycline Benzoyl peroxide

Isotretinoin Explanation: Isotretinoin, an oral retinoid, is used in clients diagnosed with nodular cystic acne that does not respond to conventional therapy. Estrogen, tetracycline, and benzoyl peroxide are not oral retinoids.

A client has been diagnosed with shingles. Which of the following medication classifications will reduce the severity and prevent development of new lesions? Antiviral Antipyretics Analgesics Corticosteroids

Antiviral Explanation: Oral acyclovir (Zovirax), when taken within 48 hours of the appearance of symptoms, reduces their severity, and prevents the development of additional lesions. Corticosteroids, analgesics,, and antipyretics are not used for this purpose.

The nurse is caring for a geriatric client with thin, chapped, itchy skin. Which nursing intervention should the nurse alter in the plan of care? Daily bathing with warm-hot water Maintenance of foam pad on wheelchair Use of a gait belt for ambulation Applying lanolin ointment

Applying lanolin ointment Explanation: Lanolin ointment is good to apply to dry skin because it helps moisturize. Bathing a geriatric client is unnecessary, and hot water will dry the skin further. Due to a decrease in epidermal replacement rates, excessive drying of an older person's skin can lead to pruritus, dryness, and infection. The nurse would not alter the plan of using a gait belt for ambulation or using a foam pad on the wheelchair.

Development of malignant melanoma is associated with which risk factor? History of severe sunburn African American heritage Skin that tans easily Residence in the Northeast

History of severe sunburn Explanation: Ultraviolet rays are strongly suspected as the etiology of malignant melanoma. Fair-skinned, blue-eyed, light-haired people of Celtic or Scandinavian origin are at higher risk for developing malignant melanoma. People who burn and do not tan are at risk for developing malignant melanoma. Elderly individuals who retire to the southwestern United States seem to have a higher incidence of developing malignant melanoma.

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 Allograft Homograft Heterograft

Autograft Explanation: Full-thickness autografts and pedicle flaps are commonly used for reconstructive surgery, months or years after the initial injury. An allograft is a graft transferred from one human (living or cadaveric) to another human. A homograft is a graft transferred from one human (living or cadaveric) to another human. A heterograft is a graft obtained from an animal of a species other than that of the recipient.

A dermatologist recommends an over-the-counter suspension to relieve pruritus. The nurse advises the patient that the lotion should be applied: Hourly to prevent evaporation. Twice a day to prevent crusting on the skin. Overnight to enhance absorption. Every 3 to 4 hours for sustained effectiveness.

Every 3 to 4 hours for sustained effectiveness. Explanation: Lotions are frequently used to replenish lost skin oils or to relieve pruritus. They are usually applied directly to the skin, but a dressing soaked in the lotion can be placed on the affected area. Lotions must be applied every 3 or 4 hours for sustained therapeutic effect because if left in place for a long period, they may crust and cake on the skin.

The nurse is conducting a community education program on basal cell carcinoma (BCC). Which statement should the nurse make? It is more invasive than squamous cell carcinoma (SCC). It metastasizes through blood or the lymphatic system. It begins as a small, waxy nodule with rolled translucent, pearly borders. It is a malignant proliferation arising from the epidermis.

It begins as a small, waxy nodule with rolled translucent, pearly borders. Explanation: BCC usually begins as a small, waxy nodule with rolled, translucent, pearly borders. It is less invasive than SCC. It does not metastasize through the blood or lymphatic system. SCC is a malignant proliferation arising from the epidermis.

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. Freezes the growth, so the physician can remove it at the next appointment Removes the entire growth Lasers the growth off

Through the application of extreme cold, the tissue is destroyed. Explanation: Cryosurgery is the application of extreme cold to destroy tissue. The other statements are false.

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 commercial grade laundry detergent. Pretreat clothing where scabies contact existed. Wash clothes through two laundry cycles. Use hot water throughout wash cycle.

Use hot water throughout wash cycle. Explanation: The nurse is correct to use hot water throughout the wash cycle. Using hot water kills scabies and infectious agents on the laundry. If using the correct wash settings, the client does not need to use commercial-grade laundry detergent, the clothing does not need pretreated nor washed through two cycles.

The nurse is instructing the parents of a child with head lice. Which statement should the nurse include? Use shampoo with piperonyl butoxide. Use shampoo with Kwell. Wash clothes in cold water. Disinfect brushes and combs with bleach.

Use shampoo with piperonyl butoxide. Explanation: The nurse's instructions should include shampooing with piperonyl butoxide, washing clothes in hot water, and disinfecting brushes and combs with piperonyl butoxide shampoo.

What advice should the nurse give a client with dermatitis until the etiology of the dermatitis is identified? Rub the skin vigorously to dry. Wear rubber gloves when in contact with soaps. Use hot water for bathing. Use wool, synthetics, and other dense fibers.

Wear rubber gloves when in contact with soaps. Explanation: The nurse should advise the client to wear rubber gloves when coming in contact with any substance such as soap or solvents. The client should avoid wool, synthetics, and other dense fibers. The client should use tepid bath water and should pat rather than rub the skin dry.

A patient is being evaluated for nodular cystic acne. What systemic pharmacologic agent may be prescribed for the treatment of this disorder? Isotretinoin (Accutane) Benzoyl peroxide Retin-A Salicylic acid

a furuncle. Explanation: Furuncles are localized skin infections of a single hair follicle. They can occur anywhere on the body but are most prevalent in areas subjected to irritation, pressure, friction, and excessive perspiration, such as the back of the neck, the axillae, or the buttocks. A carbuncle is a localized skin infection involving several hair follicles. Cheilitis refers to dry cracking at the corners of the mouth. Comedones are the primary lesions of acne, caused by sebum blockage in the hair follicle.

Which is not a category of medications used for treatment of the skin? inhaled steroids topical corticosteroids antihistamines antibiotics

inhaled steroids Explanation: Inhaled steroids are not used for skin disorders. Topical corticosteroids, antihistamines, and antibiotics are all used in the treatment of skin disorders.

Which of the following aggravates the condition caused by acne vulgaris? Sunlight Chocolates High-fat diet Cosmetics

Cosmetics Explanation: Acne vulgaris is aggravated by cosmetics. Any correlation with specific food items such as chocolate is more myth than fact. Sunlight does not aggravate the condition caused by acne vulgaris.

A nurse is examining a client's scalp for evidence of lice. The nurse should pay particular attention to which part of the scalp? Temporal area Top of the head Behind the ears Middle area

Behind the ears Explanation: Adult lice usually bite the scalp behind the ears and along the back of the neck. Because such lice are tiny (1 to 2 mm) with grayish white bodies, they are hard to see. However, their bites result in visible pustular lesions. Although lice may bite any part of the scalp, bites are less common on the temporal area, top of the head, and middle area.

he 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? Dandruff is throughout the hair. Nits are difficult to move from hair shafts. Nits are located near the scalp. Dandruff looks white and flakey.

Nits are difficult to move from hair shafts. Explanation: The nurse is correct to use the difference of the nits being securely attached to the hair shaft as a guide to confirmation of lice infestation. Dandruff is fine, white particles of dead, dry scalp cells that can be easily picked from the hair.

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. Which instruction best prevents skin damage? "Apply sunscreen even on overcast days." "Minimize sun exposure from 1 to 4 p.m., when the sun is strongest." "Use a sunscreen with a sun protection factor of 6 or higher." "When at the beach, sit in the shade to prevent sunburn."

"Apply sunscreen even on overcast days." Explanation: Sunscreen should be applied even on overcast days, because the sun's rays are as damaging then as on sunny days. The sun is strongest from 10 a.m. to 3 p.m. (11 a.m. to 4 p.m. daylight saving time) — not from 1 to 4 p.m. Sun exposure should be minimized during these hours. The nurse should recommend sunscreen with a sun protection factor of at least 15. Sitting in the shade when at the beach doesn't guarantee protection against sunburn because sand, concrete, and water can reflect more than half the sun's rays onto the skin.

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? Use very warm water to clean the face prior to applying the medication. Wash the face several times a day and reapply the medication. Scrape the scaly patches off prior to applying the medication. Avoid using the medication around the eyelids because it may cause cataracts and glaucoma.

Avoid using the medication around the eyelids because it may cause cataracts and glaucoma. Explanation: Seborrheic dermatitis of the body and face may respond to a topically applied corticosteroid cream, which allays the secondary inflammatory response. However, this medication should be used with caution near the eyelids because it can lead to glaucoma and cataracts.

The nurse recommends which type of therapeutic bath for its antipruritic action? Sodium bicarbonate (baking soda) Colloidal (oatmeal) Water Saline

Colloidal (oatmeal) Explanation: Colloidal oatmeal baths are recommended to decrease itching associated with a dermatologic disorder such as psoriasis. Baking soda baths are cooling but dangerous because the tub gets very slippery and a bath mat must be used in the tub. Water and saline baths have the same effect as wet dressings and are not known to counteract itching.

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? Semi-private room with a client diagnosed with pneumonia Isolation room with negative airflow Semi-private room with a client who had chickenpox and was admitted with a GI bleed Private room

Private room Explanation: Herpes zoster, a highly contagious infection, is transmitted by direct contact with vesicular fluid or airborne droplets from the infected host's respiratory tract. Placing the client with a client diagnosed with pneumonia places that client at risk for contracting herpes zoster. An isolation room with negative airflow isn't necessary for the client with herpes zoster. The nurse should assign the client to a private room. The client could safely room with the client who already had chickenpox; however, visitors might be unnecessarily exposed.

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? Impetigo Scabies Contact dermatitis Dermatophytosis

Scabies Explanation: Signs and symptoms of scabies include gray-brown burrows, epidermal curved or linear ridges, and follicular papules. Clients complain of severe itching that usually occurs at night. Scabies commonly occurs in school-age children. The most common areas of infestation are the finger webs, flexor surface of the wrists, and antecubital fossae. Impetigo is a contagious, superficial skin infection characterized by a small, red macule that turns into a vesicle, becoming pustular with a honey-colored crust. Contact dermatitis is an inflammation of the skin caused by contact with an irritating chemical or allergen. Dermatophytosis, or ringworm, is a disease that affects the scalp, body, feet, nails, and groin. It's characterized by erythematous patches and scaling.

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. Use a soft-bristled toothbrush. Rinse the mouth after eating food. Move the piercing back and forth during washing.

Use an antifungal mouthwash or salt water. Explanation: The client can substitute an antifungal mouthwash or salt water if a superinfection of candidiasis develops from the antibacterial mouthwash. A soft-bristled toothbrush should be used to avoid additional oral injury, but it is not the recommended solution for this problem. After eating, the client should rinse her mouth for 30 to 60 seconds with an antifungal mouthwash or salt water. Moving the jewelry at the piercing area back and forth during washing helps clean the pierced tract but does not solve the problem.

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. Only use with contact dermatitis. Apply a thick layer to assure coverage. Use with over-the-counter drying agents.

Use gloves with application. Explanation: Warn clients using acne preparations containing benzoyl peroxide that this ingredient is an oxidizing agent and may remove the color from clothing, rugs, and furniture. Thorough handwashing after drug use may not remove all the drug and permanent fabric discoloration may still occur. Users of products containing benzoyl peroxide should wear disposable plastic gloves when applying the drug.

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: wash her hands, apply a pediculicide to the client's scalp, and remove any observable mites. isolate the client's bed linens until the client is no longer infectious. notify the nurse in the day surgery unit of a potential scabies outbreak. place the client on enteric precautions.

isolate the client's bed linens until the client is no longer infectious. Explanation: To prevent the spread of scabies to other hospitalized clients, the nurse should isolate the client's bed linens until the client is no longer infectious — usually 24 hours after treatment begins. Other required precautions include using good hand-washing technique and wearing gloves when applying the pediculicide and during all contact with the client. Although the nurse should notify the nurse in the day surgery unit of the client's condition, a scabies epidemic is unlikely because scabies is spread through skin or sexual contact. This client doesn't require enteric precautions because the mites aren't found in feces.

A physician has ordered a wet-to-damp dressing for an infected pressure ulcer. The nurse knows that the primary reason for this treatment is to: prevent the spread of the infection. debride the wound. keep the wound moist. reduce pain.

keep the wound moist. Explanation: Wet-to-damp dressings keep the wound bed moist, which helps promote the growth of granulation tissue. Because dead tissue adheres to a dry dressing, wet-to-dry dressings are used for debriding wounds. Wet-to-damp dressings don't prevent the spread of infection. Although these dressings provide a soothing, cool feeling, they don't relieve pain.

The nurse teaches the client who demonstrates herpes zoster (shingles) that once the client has had shingles, they will not have it a second time. a person who has had chickenpox can contract it again upon exposure to a person with shingles. the infection results from reactivation of the chickenpox virus. no known medications affect the course of shingles.

the infection results from reactivation of the chickenpox virus. Explanation: It is assumed that herpes zoster represents a reactivation of latent varicella (chickenpox) virus and reflects lowered immunity. It is believed that the varicella zoster virus lies dormant inside nerve cells near the brain and spinal cord and is reactivated with weakened immune systems and cancers. A person who has had chickenpox is immune and therefore not at risk of infection after exposure to a client with herpes zoster. Some evidence indicates that infection is arrested if oral antiviral agents are administered within 24 hours of the initial eruption.