dermatologic disorders and wounds PREPU

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.

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

A patient has a moisture-retentive dressing for the treatment of a sacral decubitus ulcer. How long should the nurse leave the dressing in place before replacing it?

12 to 24 hours

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

Which of the following uses the body's own digestive enzymes to break down necrotic tissues?

Autolytic debridement

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

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 dermatologist recommends an over-the-counter suspension to relieve pruritus. The nurse advises the patient that the lotion should be applied:

Every 3 to 4 hours for sustained effectiveness.

Which of the following nonsedating antihistamines is appropriate for daytime pruritus?

Fexofenadine (Allegra)

The nurse is developing a plan of care for a client with toxic epidermal necrolysis (TEN) or Stevens-Johnson syndrome. Which action should the nurse include?

Frequently inspect the oral cavity

A client with diabetes mellitus has impaired skin integrity due to an injury. Which skin disorder is the client likely to develop?

Furuncle

A client with diabetes mellitus has impaired skin integrity due to an injury. Which skin disorder is the client likely to develop

Furuncle Furunculosis is associated with diabetes mellitus because an elevated blood glucose level promotes microbial growth. Infections by organisms that usually exist harmlessly on the skin surface cause furuncles. When an injury such as that caused by squeezing a lesion impairs the integrity of the skin, microorganisms can enter and colonize in the skin. Psoriasis is a genetic predisposition. Dermatitis is caused by allergens. Dermatophytosis is caused by fungal parasites. The client is unlikely to develop psoriasis, dermatitis, and dermatophytosis.

Which sedative medication is effective for treating pruritus?

Hydroxyzine

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 Lesion

Which skin condition is caused by staphylococci, streptococci, or multiple bacteria?

Impetigo

Which drug is an oral retinoid used to treat acne?

Isotretinoin

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

Isotretinoin (Accutane)

The nurse is conducting a community education program on basal cell carcinoma (BCC). Which statement should the nurse make?

It begins as a small, waxy nodule with rolled translucent, pearly borders.

The nurse is providing teaching to a client with acne who is using isotretinoin therapy. Which statement should the nurse make

It is teratogenic in humans.

Which infecting agent causes scabies?

Itch mite

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

Which of the following information regarding the transmission of lice would the nurse identify as a myth

Lice can jump from one individual to another.

The nurse and nursing assistant are moving a client who slid down in the chair. What does the nurse encourage the assistant to avoid shearing when moving the client to a higher position in the chair?

Lift the client, do not slide them.

A nurse in a healthcare provider's office teaches a client how to apply plastic film as an occlusive dressing to cover a medicated ointment applied to the arm. What important teaching point would be included by the nurse?

Limit use of the dressing to 12 hours.

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

Methotrexate

Which procedure done for skin cancer conserves the most amount of normal tissue?

Mohs micrographic surgery Mohs 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 tissue.

The nurse is caring for a client with a furuncle. What advice should the nurse give a client with a furuncle to prevent the spread of the infection?

Never pick or squeeze a furuncle

A patient is diagnosed with malignant melanoma that directly invades the adjacent dermis (vertical growth). The nurse knows that this type of melanoma has a poor prognosis. Which of the following is most likely the type of melanoma described in this scenario?

Nodular melanoma A nodular melanoma is a spherical, blueberry-like nodule with a relatively smooth surface and a relatively uniform, blue-black color. A nodular melanoma invades directly into adjacent dermis (i.e., vertical growth) and therefore has a poorer prognosis.

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:

Removal of the tumor, layer by layer.

A dermatologist has asked the nurse to assist with examination of a client's skin using a Wood light. This test will allow the health care provider to assess for which of the following?

Unusual patterns of pigmentation on the client's skin

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

chocolate ice cream

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.

The classic lesions of impetigo manifest as

honey-yellow crusted lesions on an erythematous base.

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?

hrough the application of extreme cold, the tissue is destroyed.

Which skin condition is caused by staphylococci, streptococci, or multiple bacteria?

impetigo

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

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

overproduction of sebum

A nurse is admitting a client with toxic epidermal necrolysis. What is the nursing priority in preventing sepsis?

preventing infection

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

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

Scabies are spread by which type of transmission?

skin to skin contact

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

Photochemotherapy has been used as a treatment for which of the following skin disorders

Psoriasis

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

With repeated reactions of contact dermatitis, which of the following can occur?

Secondary bacterial infection

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 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.

A physician orders an emollient for a client with pruritus of recent onset. The client asks why the emollient should be applied immediately after a bath or shower. How should the nurse respond?

To prevent evaporation of water from the hydrated epidermis."

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])

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 hot water throughout wash cycle

A patient who was recently diagnosed with pruritus on the chest and back is given information about skin care and bathing. The most important advice on cleansing is to avoid:

Washing with soap and hot water.

What advice should the nurse give a client with dermatitis until the etiology of the dermatitis is identified

Wear rubber gloves when in contact with soaps.

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 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 drug is an oral retinoid used to treat acne?

isotretinoin

In assessing a scar, you notice an overgrowth of tissue. It is best described as a

keloid

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

lichenification. 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 is also known as "jock itch"?

tina cruris

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's instructions should include shampooing with piperonyl butoxide, washing clothes in hot water, and disinfecting brushes and combs with piperonyl butoxide shampoo