Chapter 65: Caring for Clients with Skin, Hair, and Nail Disorders (NCLEX Review Questions/ PrepU)

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

What percent of those undergoing piercings suffer complications?

31%

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 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 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

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 working with a family whose 5-year-old daughter has been diagnosed with impetigo. What educational intervention should the nurse include in this family's care?

Teaching about the importance of maintaining high standards of hygiene

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

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

Use gloves with application.

What is the best nursing advice for people who have frequent outbreaks of tinea pedis (athlete's foot)?

Wear different shoes each day.

When a client with shingles (herpes zoster) asks the nurse about what causes the disease, what is the most correct reply?

It is caused by the reactivation of a dormant virus.

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

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."

What health teaching is essential when a female client is prescribed isotretinoin (Accutane) for treating acne vulgaris?

Techniques for avoiding pregnancy

The physician prescribes cephalexin (Keflex) 4 g daily in four equally divided doses for 10 days for a client with a carbuncle. If the supplied dose of the drug is 250 mg/capsule, how many capsules should the nurse instruct the client to take each time the drug is self-administered?

4 capsules

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

Which drug is an oral retinoid used to treat acne?

Isotretinoin

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

A biopsy of a scalp lesion of an Anglo-American client reveals the presence of a basal cell carcinoma. What characteristic most likely is a co-contributor to the development of this type of skin cancer?

Male pattern baldness

A client has just undergone surgery for malignant melanoma. Which of the following nursing actions should be prioritized?

Anticipate the need for, and administer, appropriate analgesic medications.

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 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

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

Ice Cream Chocolate

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

Isotretinoin (Accutane)

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 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.

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

Overproduction of sebum

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'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 30-year-old male client has just returned from the operating room after having a "flap" done following a motorcycle accident. The client's wife 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 nurse is planning the care of a client with herpes zoster. What medication, if given within the first 24 hours of the initial eruption, can arrest herpes zoster?

Acyclovir

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?

Administer analgesic pain medication.

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

A nurse on a pediatric unit spends significant time teaching parents the correct techniques for medicating their children and family members. What is an important piece of education when applying topical medications?

Apply exactly as directed.

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 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

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 client presents at the free clinic with a black, wartlike lesion on his face, stating, "I've done some research, and I'm pretty sure I have malignant melanoma." Subsequent diagnostic testing results in a diagnosis of seborrheic keratosis. The nurse should recognize what significance of this diagnosis?

The client requires no treatment unless he finds the lesion to be cosmetically unacceptable.

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 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.

The nurse teaches the client who demonstrates herpes zoster (shingles) that

the infection results from reactivation of the chickenpox virus.