Dermatology for my beezies

The nurse would expect the occurrence of scabies to occur more commonly among children who: a. attend day care. b. live in unsanitary conditions. c. reside in rural areas. d. play outside.

B. Live in unsanitary conditions Rationale: Scabies does occur in daycare centers, but it occurs more commonly in unsanitary conditions. Scabies is not associated directly with rural areas or outdoor play areas.

A nurse is teaching a group of clients about skin cancer. The nurse should explain that melanoma arises from which of the following tissues? A. Subcutaneous B. Epidermis C. Dermis D. Stratum Corneum

C. Dermis

The nurse is caring for a client with an open pressure injury with minimal necrotic tissue. Which dressing should the nurse identify as most appropriate for the​ client? A. Hydrocolloid dressing B. Transparent dressing C. Skin prep Granulex D.​ Wet-to-dry gauze dressing with sterile normal saline

​D. Wet-to-dry gauze dressing with sterile normal saline

A nurse in the emergency department is assessing a client who has extensive burns, including on her face. Which of the following assessments should the nurse perform first? A. Estimation of burn injury B. Characteristics of cough/sputum C. Extent of peripheral edema D. Amount of urine output

B. Characteristics of cough/sputum Rationale: ABC framework A patient who has burns to the face is at risk for pulmonary injury, development of a BRASSY cough can indicate impending loss of airway.

During a regular follow-up visit, Jane points out a sore that has developed on her mouth. She is diagnosed with herpes simplex. Which medication does the nurse anticipate Jane will receive? A. miconazole (Monistat) B. acyclovir (Zovirax) C. clotrimazole (Lotrimin) D. anthralin (Anthra-Derm)

B. acyclovir (Zovirax)

The nurse will anticipate application of which medication to treat a client diagnosed with impetigo? A. Retinoic acid (Renova) B. Mupirocin (Bactroban) C. Isotretinoin (Amnesteem) D. Benzoyl peroxide (Benoxyl)

B. Mupirocin (Bactroban) Rationale: Impetigo is a skin disorder caused by bacteria and is treated with a topical antibacterial agent, mupirocin.

A 10-year-old presents with vesicles consistent with vesicular impetigo. What is the most likely cause of the condition? a. Herpes virus b. Candida albicans c. Streptococcus pyogenes d .Human papillomavirus (HPV)

C. Streptococcus pyogenes Rationale: Vesicular impetigo is caused by Streptococcus pyogenes. Vesicular impetigo is not caused by herpes, Candida albicans, or HPV.

A nurse on the surgical unit is caring for 4 clients who have healing wounds. Which of the following wounds should the nurse expect to heal by primary intention? A. Partial-thickness burn B. Stage III pressure ulcer C. Surgical Incision D. Dehisced sternal wound

C. Surgical incision Rationale: With primary intention, a clean wound is closed mechanically, leaving well approximated edges and minimal scarring. A surgical incision is an example of a wound that heals by primary intention. Partial thickness burns heal by spontaneous re-epithelialization. Since if involves the uppermost layers of the dermis, scarring can be minimal and extensive depending on the depth of the burn. Stage III pressure ulcer heals by secondary intention. A dehisced sternal wound can either be closed by secondary or tertiary intention.

A nurse is caring for an adolescent client who has burn wounds on her face and hands. Which of the following statements by the client indicates that she has adapted to her changed body image? A. "May I go with my family to the visitor's lounge?" B. "I'll see my friends when I get home". C. "My dad is coming to visit. Can you fix my hair?" D. "I told my cousins I'm in protective isolation".

A. "May I go with my family to the visitors lounge?" Rationale: This statement demonstrates a positive self-image since the client is asking to visit with her family in a public setting.

You have a patient who has multiple burns on their body. Using the rule of nines, what is the estimate extent of burn injury to the following patient. The following areas are burned: Anterior trunk, anterior left arm, and posterior left leg. A. 31.5 % B. 36% C. 28.5 % D. 30%

A. 31.5% Rationale: Using the rule of nines you would get 31.5%. The anterior trunk is: 18%, anterior left arm 4.5%, posterior left leg 9%....total equals 31.5.

Which patient is at risk for compartment syndrome due to a burn? A. A 25 year old with circumferential burn of the anterior and posterior left arm. B. A 7 year old with a burn of the left and right ear. C. A 55 year old with an electrical burn on the neck. D. A 15 year old with a chemical burn to the right foot.

A. A 25 year old with circumferential burn of the anterior and posterior left arm. Rationale: Circumferential burns of the extremities produce a tourniquet like effect and leads to vascular problems.

A 20-year-old Caucasian woman presents to the hospital with a 2-month history of itchiness of her scalp. On examination you note greasy yellowish scales on her scalp and eyebrows. What is the most likely diagnosis? A. Seborrheic dermatitis B. Atopic dermatitis C. Nummular dermatitis D. Pompholyx

A. Seborrheic dermatitis Rationale: This patient most probably has seborrheic dermatitis. It is characterized by greasy scales over the scalp. It may also be visible along the hairline, on the eyebrows, in the external auditory canals, in the nasolabial folds, and over the sternum. There may be some pruritus. Not correct for this question, but should know: Atopic dermatitis: is characterized by chronic pruritic lesions marked by exacerbations and remissions. There is a personal or family history of asthma, allergic rhinitis, food allergies, or eczema. In the acute phase, they may present with erythematous patches, weeping, and crusted plaques. In the chronic phase, they present with hyperpigmented lichenified lesions. It commonly affects the face, neck, wrists, antecubital, and popliteal fossae. Nummular dermatitis: is characterized by chronic coin-shaped, crusted lesions, which are usually pruritic. They commonly appear on the trunk and extensor surfaces of the extremities, especially the pretibial areas. Pompholyx: is characterized by scaling and deep-seated vesicles on the palms, fingers, and soles, which are pruritic. There may also be erythema and scaling.

ubella, rubeola, and roseola are common communicable diseases caused by _____ infection. a. viral b. bacterial c. yeast d. fungal

A. Viral Rationale: Rubella, rubeola, and roseola are all caused by a virus, not bacteria, yeast, or a fungus.

The nurse is discussing with a client OTC and Rx topical medications available for treatment of acne. Which drugs are used in the treatment of acne? (Select all that apply.) A. Isotretinoin (Claravis) B. Clindamycin (Cleocin) C. Benzoyl peroxide (Benoxyl) D. Vitamin A acid (Ascor L 500) E. Norethindrone and ethinyl estradiol

B, C, D

The nurse would be correct in identifying the duration of rubella as: a. 12 hours b .1-3 days. c. 7days. d. 12-15 days.

B. 1-3 days. Rationale: Rubella has a duration of 1-3 days.

A nurse is teaching a group of clients about skin cancer. The nurse should explain that basal cell carcinoma originates from which of the following tissues? A. Subcutaneous B. Epidermis C. Dermis D. Stratum corneum

B. Epidermis Rationale: Basal cell carcinoma originates from the epidermal layer of skin. It is the most common form of skin cancer.

A client with deep tissue damage develops eschar. Which procedure should the nurse anticipate being​ prescribed? A. Application of a barrier cream B. Surgical debridement C. Application of a​ moisture-retaining protective dressing D. Application of a petroleum ointment

B. Surgical debridement

A 35-year-old obese man presents with a 6-month history of itchy rash. He was referred to you by his primary care physician, who treated him for tinea cruris over a period of 4 months with limited success. A brief history reveals the patient is bipolar on lithium, does not smoke, and takes no other medications aside from the terbinafine (Lamisil) tablets prescribed by the primary physician. On physical examination, the rash is located primarily in the intertriginous areas of the groin, but it can also be seen in the axillary and sacral regions. The morphology is variable, but it is largely consistent with that of erythematous plaques. Scaling is widely observed, except for in the groin, where the plaques are moist and more confluent. The dermatologist does a KOH preparation of the scrapings and finds no hyphae. What is the likely diagnosis? A. Atopic dermatitis B. Psoriasis C. Intertrigo D. Candidiasis

B. Psoriasis Rationale: Psoriasis is a very common chronic inflammatory condition of the skin. The lesions are variably pruritic and are characterized by sharply demarcated papules and rounded plaques. A silvery scale is frequently observed covering the erythematous plaques. Depending on the distribution and character of the lesions, psoriasis can be further categorized into several sub-groupings. The most common subtype (plaque type) of psoriasis is usually distributed on the elbows, knees, sacral area/gluteal cleft, and scalp. However, there is also a less common variety known as inverse psoriasis. This is where the plaque lesions form in intertriginous regions in addition to scalp, palms, and soles. Because of the moisture in the intertriginous areas, scales may not be evident. Other forms of psoriasis include eruptive or guttate psoriasis as well as some variants where the lesions are more pustular in character. The etiology of psoriasis is not well defined, but there may be some association with certain medications, such as lithium and beta-blockers.

A patient is being discharge after having autografting. What would you include in your discharge education? A. Avoid using splints or any type of support garment. B. Encourage for the site to be exposed to sunlight to promoted melanin production. C. Keep the site free from pressure and keep the site lubricated. D. Encourage weight-bearing exercise every 4 to 6 hours.

C. Keep the site free from pressure and keep the site lubricated. Rationale: The patient should avoid the sunlight due to increase risk of sunburn to delicate skin. In addition, the patient should avoid weight-bearing activites to prevent damage to the newly grafted skin. It is best to encourage splints and support garments to protect the skin during acitiviy.

As a home care nurse, you are providing care to a 63 year old male who suffered a massive stroke. He has paralysis on upper and lower extremities. He has a PEG tube with tubing feedings. The patient's daughter provides care to the patient. You notice the patient has a stage I pressure ulcer on the sacral area. What would you NOT include when educating the daughter on preventing further breakdown of the current pressure ulcer and how to prevent other ones from forming? A. Exercise the extremities actively and passively. B. Turn and re-position the patient every 2 hours. C. Keep the skin moist and layer the sacral area with extra sheet layers. D. Use pillows to elevated bony prominences.

C. Keep the skin moist and layer the sacral area with extra sheet layers. Rationale: You will keep the pressure ulcer dry and clean and avoid extra sheets (this could increase the risk for moisture and form wrinkles and friction onto the skin. All the other options are correct education material.

A nurse is caring for a client who has regular occupational exposure to sunlight and presents for evaluation of several skin lesions. Which of the following findings should alert the nurse to the possibility of malignant melanoma? A. A pearly papule that is 0.5 cm (0.20 in.) wide with raised, indistinct borders on the upper right shoulder B. Several flat, pigmented, circumscribed areas of various sizes of the bridge of the nose C. A raised, circumscribed lesion on the face that contains yellow-white purulent material. D. An irregularly shaped brown lesion with light blue areas on the neck

D. An irregularly shaped brown lesion with light blue areas on the neck This is a neoplasm of dermal or epidermal cells, usually starts on back, scalp, face, neck, metastasizes readily to other areas. May have hints of blue, white or red tones, irregular borders, changes in color or size.

A preceptor is observing a nursing student provide care to a patient with major burns to the face and head. What nursing intervention does the student perform correctly?* A. Assist the patient with eating food tray. B. Uses gloves and face mask when providing care. C. Places the patient in trendelenburg position. D. Elevates the head of the bead at 30'.

D. Elevates the head of the bead at 30'. Rationale: Due to edema and respiratory issues patient with facial burns should have the HOB at 30'. In addition, strict isolation protocol is implemented because they patient is at high risk for infection ( gloves and facial mask are not sufficient enough). In addition, the patient will not be eating but will be on tube feedings.

LR, at 6 years of age, presents at clinic with a solitary nonpruritic lesion around his upper lip. Closer inspection reveals some vesicles and honey-colored crusts. The most likely diagnosis is: a. Herpes simplex b. Varicella c. Nummular eczema d. Impetigo

D. Impetigo Rationale: The classic presentation of impetigo is that of vesicles that rupture leaving honey-colored crusts

As a nurse working on a burn unit, which of your patients are at high risk for internal tissue damage? A. Patient in room 2101 with a chemical burn to face. B. Patient in room 2106 with a radiation burn on the abdomen. C. Patient in room 2103 with a thermal burn to peritoneal area. D. Patient in room 2101 with an electrical burn on torso.

D. Patient in room 2101 with an electrical burn on torso. Rationale: Electrical burns are caused by heat generated by electrical current which is transferred through the body. This current burns the skin but also affects internal tissue as well.

A nurse is providing teaching to a client who is wheelchair bound and his caregiver about ways to reduce the risk of pressure ulcer formation. Which of the following instructions should the nurse include? A. Move between the bed and wheelchair once every 2 hours. B. Make sure your caregiver massages your skin daily. C. Use a rubber ring when sitting on the bedside. D. Shift your weight in the wheelchair every 15 minutes.

D. Shift your weight in the wheelchair every 15 minutes.

A client has a pressure injury on the right elbow that is covered with eschar and extensive tissue damage. Which stage should the nurse document this ulcer to​ be? A. Stage 3 B. Stage 2 C. Stage 1 D. Stage 4

D. Stage 4

A client who has been sedated and on mechanical ventilation for several days is on a​ low-air-loss bed;​ however, the client has a localized purple area of discoloration over the coccyx that does not blanch. Which pressure injury should the nurse suspect for this​ client? A. Stage 1 pressure injury B. Stage 3 pressure injury C. Bruising D. Suspected deep tissue injury

D. suspected deep tissue injury

Individuals of which descent are more prone to developing keloids? a. Black b .Northern European c. Asian d. Native American

a. Black Rationale: Blacks are at greater risk for the development of keloids. Neither Northern Europeans, Asians, nor Native Americans are at great risk for the development of keloids.

HB is 2 days old. Her mother calls and reports a rash consisting of redness and yellow-white "bumps" all over her body except for the palms and soles. The infant most likely has: a. Erythema toxicum b. Transient neonatal pustular melanosis c. Molluscum contagiosum d. Milia

a. Erythema toxicum Rationale: The location (all over the body) and type of lesion (papule as opposed to vesicle) are consistent with the rash seen in erythema toxicum

If a patient has carbuncles, the infection will be located in the: a. hair follicles. b. papillary layer of the dermis c. reticular layer of the dermis d. subcutaneous tissue.

a. Hair follicles Rationale: Carbuncles are a collection of infected hair follicles and usually occur on the back of the neck, the upper back, and the lateral thighs. Carbuncles are not associated with the papillary or reticular layers of the dermis or the subcutaneous tissue.

In infants, the lesions associated with atopic dermatitis are most likely to be distributed on the: a. cheeks and forehead b. Wrists and ankles c. Antecubital and popliteal fossae d. Flexural surfaces

a. cheeks and forehead Rationale: The infantile phase of atopic dermatitis follows a different distribution pattern than that associated with the childhood phase, which may include the face, trunk, and extensor surfaces

DM, 7-years-old, presents with a beefy red macular-papular rash in the diaper area with satellite lesions on the abdomen. The appropriate treatment would be: a. clotrimazole b. A&D ointment c. Gentian violet 1 to 2% d. cornstarch

a. clotrimazole Rationale: The rash described is Candida albicans and should be treated with an antifungal

To promote efficient wound healing, which dressing should be applied to a superficial ulcer? a. Thick and dry b. Flat and moist c. Bulky and dry d. None

b. Flat and moist Rationale: Superficial ulcers should be covered with flat, moisture-retaining dressings. Superficial ulcers should not be covered with dressings that are dry and thick (bulky). Dressings should not be avoided.

Mrs. Franklin is concerned about a light pink lesion on the back of 2-month-old Aaron's neck that darkens with crying. This description is consistent with: a. Sturge-Weber disease b. Salmon patch c. Port-wine stain d. Hemangioma

b. salmon patch Rationale: A salmon patch is a flat, light pink to light red mark seen on the eyelid, glabella, or nape of neck that intensifies with crying

The mother of a 4-month-old TW states that the infant has been irritable and has not been sleeping well. During the physical exam, you note papular lesions on his feet and erythematous papules over his back. To confirm your suspicion of scabies you would order a: a. Wood's lamp examination b. Microscopic skin scraping c. KOH preparation of skin scraping d. Skin culture

b. Microscopic skin scraping Rationale: microscopic skin scaping of burrows will reveal the mite, eggs, or feces if scabies are present. Although skin scapings are not routinely done, they are definitive if there is any doubt of the diagnosis

Which of the following statements regarding treatment of pediculosis capitis is true? a. Carpeting and furniture must be shampooed and sprayed with a pediculicide b. Nonwashable items that have come into contact with an infected person should be sealed in a plastic bag for 2 to 4 weeks c. Hair must be trimmed close to the scalp to insure elimination of nits d. Frequent shampooing with Permethrin 1% will prevent reinfestation

b. Nonwashable items that have come into contact with an infected person should be sealed in a plastic back for 2 to 4 weeks Rationale: Objects that cannot be washed should be sealed in plastic bags. Since eggs mature in 7 to 10 days, 2 to 4 weeks should be sufficient to prevent reinfestation. Frequent shampooing and close haircuts are unnecessary and may contribute to feeling shame and embarrassment. Environmental cleaning includes vacuuming, although sprays are not recommended.

A 7-year-old African American female presents with several hyperkeratotic raised, periungual lesions on the two middle fingers of her left hand. She has a history of nail biting. The most likely diagnosis is: a. Impetigo b. Molluscum contagiousum c. Verruca vulgaris d. Herpetic whitlow

c. Verruca vulgaris Rationale:*Common warts are found most usually on fingers, hands, and feet in children and are often preceded by trauma such as nail biting or picking at cuticles

Mrs. J brings her 6-year-old son in because of "hives" that she describes as a red raised rash. Which of the following below would support a diagnosis of erythema multiforme rather than urticaria? a. Lesions that blanch with pressure b. Eyelid edema c. Lesions that are present for more than 24 hours d. Intense pruritis

c. Lesions that are present for more than 24 hours Rationale: Urticarial lesions tend to be pruritic and blanch with pressure but generally fade within a few hours. Due to the large number of mast cells present in the eyelids, edema is common with urticaria. The lesions of erythema multiforme are fixed and present for up to 2-3 weeks.

A 10-year-old male is playing with matches and gets burned. His burn is waxy white in appearance. This burn is classified as: a. first degree. b. superficial partial-thickness. c. deep partial-thickness. d. third degree.

c. deep partial-thickness. Rationale: Deep partial-thickness burns involve the entire dermis, sparing skin appendages such as hair follicles and sweat glands. These wounds look waxy white. First-degree burns are red and have no blisters. Superficial burns involve fluid-filled blisters. Third-degree burns are dry and have a leathery appearance.

LR, at 6 years of age, presents at clinic with a solitary nonpruritic lesion around his upper lip. Closer inspection reveals some vesicles and honey-colored crusts. The treatment of choice for LR would be: a. Acyclovir b. Topical steroids c. Topical antibiotics d. Petrolatum/lanolin ointment

c. topical antibiotics Rationale: Impetigo is a bacterial infection, most likely caused by staph or strep. Mild cases may be treated with topical antibiotics; if no resolution, systemic antibiotics may be necessary

An increase in _____ is associated with pruritus .a. substance P b. norepinephrine c. dopamine d. acetylcholine

d. Acetylcholine Rationale: Acetylcholine, not substance P, is one of the itch mediators. Neither norepinephrine nor dopamine is considered an itch mediator.

During your newborn examination, you note a generalized lacy reticulated blue discoloration. This clinical presentation describes :a. Harlequin color change b. Mongolian spots c. Blue nevus d. Cutis marmorata

d. Cutis marmorata Rationale: Mongolian spots and blue nevus have a bluish discoloration. Cutis marmorata is the only condition that is generalized. Harlequin color change is more red than pale

When examining a 7-month-old RV, you note red scaly plaques in his diaper area, particularly in the inguinal folds, with satellite lesions on his abdomen. The appropriate treatment would be: a. Petrolatum/lanolin ointment b. Petroleum jelly c. Zinc oxide d. Nystatin

d. Nystatin Rationale: The presence of satellite lesions indicates a candida rash requiring an antifungal agent such as nystatin

You examine CC, a newborn, and observe numerous white papular lesions on the cheeks, forehead, and nose. You suspect either milia or neonatal acne. Which physical finding helps confirm a diagnosis of milia? a. Papular lesions are intermixed with pale yellow macules b. Papular lesions have an erythematous circular ring at the base c. Papular lesions are surrounding a lacy-blue area with erythematous mottling d. Papular lesions, yellow in color, are observed on the hard palate

d. Papular lesions, yellow in color, are observed on the hard palate Rationale: In milia there is an oral counterpart of yellow, papular lesions on the hard palate known as Epstein's pearls, which does not occur in neonatal acne

During 3-year-old JT's physical examination, you observe eight, light brown macules, ranging in size from 0.5 to 0.75cm on his trunk, arms, and legs. Your management plan would be to: a. Educate the family to apply sunscreen frequently b. Explain that the lesions will fade with time. c. Refer to a dermatologist d. Document the findings and reevaluate in six months

d. Refer to a dermatologist Rationale: The lesions described are café au lait spots. Six or more of these lesions may indicate neurofibromatosis and should be referred for further evaluation

The nurse is assessing a patient who has been diagnosed with MRSA on the right arm. The nurse anticipates use of which medication to treat the MRSA? A. bacitracin B. neomycin C. polymyxin B D. mupirocin (Bactroban)

A. Bacitracin

A nurse is teaching a client who has extensive deep partial and full thickness burns and requires a topical antimicrobial medication. The goal of this medication therapy is to reduce which of the following outcomes? A. Bacterial growth B. Scarring C. Skin graft size D. Pain

A. Bacterial growth Rationale: Topical antimicrobial medications, especially broad spectrum antimicrobials, prevent bacteria from entering the skin. This and a dressing provide a protective covering of the skin with burns and exposed body tissues.

A nurse is assessing a patient with a pearly papule that is 0.5 cm (0.20 in.) wide with raised, indistinct borders on the upper right shoulder. What type of skin cancer does this describe? A. Basal cell carcinoma B. Squamous cell C. Melanoma D. Acne

A. Basal cell carcinoma Rationale: Usually pale in color, pearly or flaky in appearance. Slow-growing skin tumor that results from sun exposure in clients who have fair skin.

A patient with 55% burns is groaing out in pain and rates pain 10 on 1-10 scale. You have PRN orders for the following medications. What is the best option for this patient? A. IV Morphine B. Oral Lortab liquid suspension C. IM Demerol D. Subcutaneous Demerol

A. IV Morphine Rationale: IV route is the best option when a patient has burns. If a medication is given IM or subq, hypovolemia may disrupt absorption. In addition, oral route should be avoid due to potential GI dysfunction.

A nurse is providing discharge instructions to a client who is postoperative following surgical excision of a basal cell carcinoma. Which of the following findings should the nurse include as an indication of a moles potential malignancy? A. Ulceration B. Blanching of surrounding skin C. Dimpling D. Fading of color

A. Ulceration Rationale: Ulceration, bleeding, and exudation are indications of a moles potential malignancy. Increasing size is also a warning sign.

During a full body admission assessment, you note the patient has a stage III pressure ulcer. How would you document the appearance of the wound? A. Area is red and does not blanch. B. Full-thickness skin loss to dermis and subcutaneous tissues. C. Partial thickness of dermis with shallow open ulcer. D. Full thickness with bone and tendon visible.

B. Full-thickness skin loss to dermis and subcutaneous tissues. Rationale: This question asks for the characteristics of a stage 3 pressure ulcer. Stage 3 pressures are full-thickness skin loss to dermis and subcutaneous tissues.

A client asks what effect nutrition has on skin integrity. Which response should the nurse make that explains the relationship of nutrition to pressure injury​ development? A.​"Increased dietary intake of carbohydrates and minerals can cause pressure​ injuries." B.​"Increased dietary intake of protein can cause pressure​ injuries." C.​"Poor dietary intake of​ kilocalories, protein, and iron can increase the risk of pressure​ injuries." D.​"Poor dietary intake of carbohydrates and minerals can increase the risk of pressure​ injuries."

C. "Poor dietary intake of kilocalories, protein, and iron can increase the risk of pressure injuries."

A 28-year-old woman has a history of obesity and diabetes. Upon physical exam, she has velvety hyperpigmented plaques over the back of her neck, groin, axilla, and breast area. The area has a dirty appearance with a rough texture. What treatment can help with this condition? A. Vancomycin B. Topical steroids C. Metformin D. Antifungal

C. Metformin Rationale: Metformin is the correct answer because, while there is no specific treatment for acanthosis nigricans, this skin condition is usually a sign of hyperinsulinemia and insulin resistance, which can be treated by weight loss and the use of metformin.

A nurse is assessing a client who is bedridden and was admitted from home. The nurse notes a shallow crater in the epidermis of the client's sacral area. The nurse should document that the client has a pressure ulcer at which of the following stages? A. IV B. I C. III D. II

D. II (stage 2) Rationale: Stage II pressure ulcers involve partial-thickness skin loss of the epidermis and dermis. Ulcer is visible and superficial and can look like an abrasion, blister, or shallow crater.

When assessing a patient diagnosed with localized scleroderma, which changes in the skin will be observed? a .Cyanosis b. Hyperpigmented c. Necrosis d. Thickening

D. Thickening Rationale: Localized scleroderma is manifested by thickening, not cyanosis, of the skin. Localized scleroderma is not manifested by necrosis or hyperpigmentation.

Acne vulgaris involves inflammation of the: a. hair follicles. b. sebaceous follicles c. eccrine glands. d. apocrine glands.

b. sebaceous follicles Rationale: Acne is a disorder of the pilosebaceous units, known as sebaceous follicles. Acne is not associated with inflammation of hair follicles, eccrine glands, or apocrine glands.

Pityriasis rosea is caused by a: A. Parasite. B. Virus. C. Bacteria D. Fungus.

B. Virus Rationale: Pityriasis rosea is caused by a virus. Pityriasis rosea is not caused by a parasite, a bacterium, or a fungus.

A nurse is caring for a client who has a large wound healing by secondary intention. The nurse should inform the client that which of the following nutrients (in addition to protein) promotes wound healing? A. Vitamin B1 B. Calcium C. Vitamin C D. Potassium

C. Vitamin C Rationale: Protein and vitamin C promote wound healing.

The mother of a 4-month-old TW states that the infant has been irritable and has not been sleeping well. During the physical exam, you note papular lesions on his feet and erythematous papules over his back. Having confirmed the diagnosis of scabies in TW, the treatment of choice would be :a. Permethrin 5% b. Lindane 1% c. Sulfur ointment 6% d. Crotamiton 10%

a. Permethrin 5% Rationale: Permethrin is the only safe choice in this case. Lindane is contraindicated in infants under 6 months of age. Sulfur ointment and crotamiton are not as effective and are difficult to use

A nurse is caring for a client who has burn injuries on his trunk. The nurse is explaining what to expect from the prescribed hydrotherapy. Which of the following statements by the client indicates an understanding of the teaching? A. I will be on a special shower table. B. The water temperature will be very cool to ease my pain. C. The nurse will use a firm-bristled brush to remove loose skin. D. The nurse will use scissors to open small blisters.

A. I will be on a special shower table. A special shower table facilitates examination and debridement of the wound during hydrotherapy. Advantages of using shower technique: -Constant temperature of water maintained. -Lower risk of wound infection compared to bath water. Water should be warm, not cold. The nurse uses soft washcloths or gauze to scrub/debride wounds gently. SMALL BLISTERS LEFT INTACT, LARGE BLISTERS ARE OPENED.

A nurse is planning care for a client who has a deep partial thickness and full thickness thermal burns over 40% of his total body surface and is in the acute phase of burn injury. Which of the following interventions should the nurse include in the plan? A. Initiate range of motion exercises B. Use clean technique to provide wound care. C. Place the client on a low-protein diet. D. Maintain the client on bed rest

A. Initiate range of motion exercises Rationale: This assists with maintaining mobility and preventing contractures. Wound care should be done using sterile technique to reduce risk of infection.

Which cells are involved in initiating immune responses in the skin? A. Langerhans cells B. Merkel cells C. Keratinocytes D. Melanocyte

A. Langerhans cells Rationale: The Langerhans cells process the antigen and carry it to T cells. T cells then become sensitized to the antigen, inducing the release of inflammatory cytokines and the symptoms of dermatitis. Merkel cells are associated with nerve cells. Keratinocytes are part of the epidermal layer of the skin and are not involved in immune responses. Melanocytes synthesize the skin's pigment.

A nurse in the providers office is assessing a client's skin lesions. the nurse notes that the lesions are 0.5 cm (0.20 in) in size, elevated, and solid with distinct borders. The nurse should document these findings as which of the following skin lesions? A. Papules B. Macules C. Wheals D. Vesicles

A. Papules Rationale: A papule is a small, solid, elevated lesion with distinct borders. It is usually smaller than 10 mm in diameter. Common lesions of warts and elevated moles. Macules are changes of skin color that are flat, variably shaped, discolored, and small (typically less than 10 mm in diameter). Freckles, rash associated with rubella are examples. Wheals (hives) are transient, elevated, irregularly shaped lesions caused by localized edema/allergic reaction. Vesicle is circumscribed elevated lesion or blister containing serous fluid. Ex. Herpes simplex, poison ivy, chicken pox

A 6-month-old infant presents to the pediatrician's office with a two-day history of increased fussiness, poor feeding, low-grade fever and rash. The family returned from a trip to India last week. The rash appears on the trunk in several stages of erythematous macules, vesicular papules and pustules. Which of the following is the most likely diagnosis? A. Herpes simplex B. Measles C. Pityriasis rosea D. Varicella

D. Varicella Rationale: Varicella (chicken pox) is a highly contagious viral infection that is transmitted either through air-borne route or direct contact with the infected individual. The incubation period is 10-21 days. The infected individual is contagious for 2 days before the rash appears and until all the lesions have crusted over. There is a prodromal phase of malaise, headache, conjunctivitis, poor appetite and low-grade fever. The rash typically starts at the hairline, with formation of macules which progress to fluid-filled vesicles (dew drops on a rose pedal). Crops of lesions typically appear at the same time with vesicles in various stages of healing on the body. Infants have some immunity from maternal antibodies until 6 months of age. First dose of the varicella vaccine is given at 12 months of age. In healthy children < 12 years of age, chickenpox is usually a self-limited illness requiring only supportive care. Patients > 12 years of age are at higher risk for severe disease and should receive oral acyclovir. Immunocompromised patients should receive intravenous acyclovir.

A patient is undergoing a escharotomy. Which of the following is correct about the procedure? A. It is performed on circumferential burns and is usually performed at bedside without anesthesia. B. It is performed on radiation burns and requires general anesthesia. C. It is performed if tissue perfusion does NOT return after a fasciotomy. D. None of the options are correct.

A. It is performed on circumferential burns and is usually performed at bedside without anesthesia Rationale: Escharotomy are performed at the beside without anesthia because the nerves are already damaged. It is first performed when a patient has a circumferential burn and if tissue perfusion fails to return a fasciotomy is performed in the operating room.

A 32-year-old migrant worker presents because some of his toenails have changed color and have become brittle. You ask him to remove his shoes and socks; you note a yellow-brown discoloration of the first and fifth toenails. On closer exam, the toenails have become thickened and friable; there is debris under the nail distally. What is the most likely diagnosis? A. Tinea unguium B. Acute paronychia C. Tinea pedis D. Onychomycosis

A. Tinea unguium Rationale: The clinical picture is suggestive of Tinea unguium. Typical findings include subungual hyperkeratosis and yellow-brown discoloration with debris under the nail distally and laterally. Explanations for others: Acute paronychia is an acute infection of the lateral or proximal nail fold. Findings include throbbing pain, erythema, swelling, and pain. There may or may not be an abscess. These findings are not present in this patient. Tinea pedis is incorrect. Tinea pedis is tinea infection of the foot, also known as athlete's foot, and is characterized by itchy lesions and scaling in the interdigital spaces and on the soles of the feet. Onychomycosis caused by Candida, the entire nail bed is thickened and dystrophic, and it most commonly occurs on the fingernails and is associated with immunocompromise.

A nurse is assessing a client who has peripheral vascular disease and a venous ulcer on the right ankle. Which of the following findings should the nurse expect in the clients affected extremity? A. Absent pedal pulses B. Ankle Swelling C. Hair Loss D. Skin Atrophy

B. Ankle Swelling Rationale: Swelling is a manifestation of venous insufficiency due to poor venous return. Other manifestations can include brown pigmentations and cellulitis.

A 6-year-old presents with slightly umbilicated, dome-shaped lesions on the skin of the trunk, face, and extremities. The child is diagnosed with molluscum contagiosum caused by a highly contagious :a. bacterium. b. virus. c. fungus d. parasite.

B. Virus Rationale: Molluscum contagiosum is caused by a virus. Molluscum contagiosum is not caused by a bacterium, a fungus, or a parasite.

A nurse is assessing the abdominal incision of a client who is 3 days postoperative. The incision is slightly edematous and pink with crusting on the edges and is draining serosanguineous fluid. Which of the following assessments describes the incision? A. This incision is showing early signs of infection B. The incision is showing early signs of dehiscence C. The incision is showing signs of healing without complications. D. The incision is showing signs of developing a fistula

C. The incision is showing sings of healing without complications Rationale: These assessment findings are consistent with appropriate healing without complications. Signs of wound infection include warmth, erythema, purulent drainage. Dehiscence is the separation of the layers of skin and tissue in a wound. A fistula is a complication of wound healing that involves the formation of an abnormal passageway within or from a wound. SIGN: development of chronic drainage of fluids from a wound.

A nurse is assessing a client who sustained a superficial partial-thickness and deep partial-thickness burns 72 hours ago. Which of the following findings should the nurse report to the provider? A. Edema in the burned extremities B. Severe pain at the burn sites C. Urine output 30 mL/hr. D. Temperature of 39.1 C or 102.4 F

D. Temperature of 39.1 C or 102.4 F Rationale: Elevated temperature is an indication of infection. The nurse should report this to the provider. Sepsis is a critical finding following major burn injury. Initially burn injury are relatively pathogen-free, but the 3rd day following injury, early colonization of the wound surface by gram negative organisms changes to predominantly gram positive opportunistic organism.

A nurse is conducting discharge teaching about foot care for a client who has diabetes mellitus. Which of the following instructions should the nurse include? A. Wear nylon socks with shoes every day. B. Trim toenails by rounding the edges of the nail. C. Apply lotion between the toes after bathing D. Test water temperature with the wrist.

D. Test water temperature with the wrist. Thermometer may also be used. Patients with diabetes have peripheral nerve damage, making temperature determinations difficult and increases risk of burns. Clean cotton socks should be worn with shoes. Lotion is applied to feet, but not between toes. This can cause skin break down, ulcer. Toe nails should be cut straight across to prevent ingrown toenails, prevent pain/infection.

A 28-year-old male is admitted to the burn unit 2 hours after receiving second- and third-degree burns over 50% of his body surface in an industrial explosion. Abnormal vital signs include low blood pressure and tachycardia. Lab results show a high hematocrit due to a. sickle cell syndrome. b. fluid movement out of the vascular space. c. renal failure. d. increased vascular protein secondary to increased metabolism.

b. Fluid movement out of the vascular space Rationale: Fluid and protein movement out of the vascular compartment results in an elevated hematocrit. Sickle cell syndrome does not result in increased hematocrit. Renal failure can occur, but this does not result in an increase in the hematocrit. Protein loss leads to decreased protein, not increased.

You are assigned five patients on your nursing unit. Which patient is at most risk for pressure ulcers? A. A 72 year old female weighing 82 lbs. with stress incontinence and dementia B. a 90 year old male with congestive heart failure who has 3+ pitting edema in the lower extremities. C. A 6 month old with the flu D. An ambulatory 88 year old with dementia who is admitted with shingles.

A. A 72 year old female weighing 82 lbs. with stress incontinence and dementia

A nurse is planning care for a client who has acute systemic lupus erythematosus (SLE) and is scheduled to begin treatment for systemic manifestations. Which of the following types of medications should the nurse plan to administer? A. Corticosteroids B. Antimalarials C. Antidepressants D. Opioids

A. Corticosteroids Rationale: Corticosteroids such as prednisone are the treatment of choice for systemic manifestations of SLE because of their rapid anti-inflammatory action.

The nurse would correctly identify the etiologic agent of smallpox as: a. a bacterium. b. a virus. c. insects. d. mites.

B. Virus Rationale: The etiologic agent of smallpox is a virus, not bacteria, insects, or mites.

A nurse in the emergency department is caring for a client who has a snakebite on her arm. Which of the following interventions should the nurse implement? A. Immobilize the limb at the level of the heart. B. Apply a tourniquet to the affected limb. C. Use a sterile scapula to incise the wound. D. Apply ice to the skin over the snakebite wound.

A. Immobilize the limb at the level of the heart. Management focuses on limiting the spread of venom. Any constrictive clothing/jewelry removed before swelling worsens.

The nurse is assessing a patient who has an area of persistent, non-blanchable redness over a bony prominence. The tissue is swollen and congested, and the client reports pain at the site. What stage does this nurse suspect? A. I B. IV C. II D. III

A. I (Stage 1) with darker skin tones, the ulcer can appear blue or purple and different from other skin areas.

A 42-year-old female presents with raised red lesions with a brownish scale. She was diagnosed with discoid lupus erythematosus. This disorder is related to: A. Infection. B. trauma. C. autoimmunity D. cancer.

C. Autoimmunity Rationale: Discoid lupus is related to autoimmunity, not infection, trauma, or cancer.

A nurse in the providers office is caring for a client who has a new diagnosis of herpes zoster. The nurse should anticipate a prescription for which of the following medications? A. Zoster vaccine B. Acyclovir C. Amoxicillin D. Infliximab

B. Acyclovir Rationale: Acyclovir is an antiviral medication that inhibits the replication of the virus that causes herpes zoster.

A patient is prescribed bacitracin topical ointment. What does the nurse suspect as the possible diagnosis based on the medication prescribed? A. Fungal infection B. Bacterial infection C. Parasitic infection D. Viral infection

B. Bacterial infection Rationale: Bacitracin is a polypeptide antibiotic that is applied topically for the treatment or prevention of local skin infections caused by susceptible aerobic and anaerobic gram-positive organisms such as staphylococci, streptococci, anaerobic cocci, corynebacteria, and clostridia.

A wound scar that is sharply elevated, irregularly shaped, and progressively enlarging is a result of excessive amounts of _____ accumulated during connective tissue repair. A. elastin B. collagen C. keratin D. calcification

B. Collagen Irregular scar formation is due to excessive fibroblast activity and collagen formation. Irregular scar formation is not due to excessive elastin, keratin, or calcification.

A nurse is caring for a client who has a prescription for silver sulfadiazine cream to be applied to her burn wounds. The nurse should evaluate the client for which of the following laboratory findings? A. Hyponatremia B. Leukopenia C. Hyperchloremia D. Elevated BUN

B. Leukopenia Rationale: Transient leukopenia is an adverse effect of silver sulfadiazine Silver sulfadiazine does not cause electrolyte imbalance

A community health nurse is teaching a group of clients about malignant melanoma. Which of the following traits places a client at risk for developing malignant melanoma? A. Brown eyes B. Light skin C. Black hair D. Dark skin

B. Light skin Rationale: Light skin and less pigmentation place a client at risk for developing malignant melanoma. Clients with light hair (blond/red) have an increased risk of developing malignant melanoma

A nurse is evaluating the laboratory values of a client who is in the resuscitation phase following a major burn. Which of the following laboratory findings should the nurse expect? A. Hemoglobin 10 g/dL. B. Sodium 132 mEq./L C. Albumin 3.6 g/dL. D. Potassium 4.0 mEq/dL.

B. Sodium 132 mEq/L. Rationale: The nurse should anticipate this finding because sodium is trapped in the interstitial space. Hemoglobin will be elevated, not decreased due to loss of fluid volume. This level of albumin is in the expected range, albumin with a major burn will be low during the resuscitation phase. This is an expected potassium range. Potassium will be elevated during the resuscitation phase.

A client has been prescribed clotrimazole (Lotrimin, Mycelex-G) for the treatment of jock itch. To document this diagnosis in the client's medical record, the nurse should use which fungal infection name? A. Tinea pedis B. Tinea cruris C. Tinea capitis D. Tinea corporis

B. Tinea cruris Rationale: Infections caused by dermatophytes are called tinea, or ringworm, infections. Where they occur: Tinea pedis (foot) - "athlete's foot" Tinea cruris (groin) - "jock itch" Tinea corporis (body) Tinea capitis (scalp)

The charge nurse receives report for all clients on the unit. Which client should the nurse consider as being at risk for the development of pressure​ injuries? (Select all that​ apply.) A. Client admitted to an acute care unit B Client with a history of anorexia nervosa C. Client on bedrest D. Client with type 1 diabetes mellitus E. Client who is​ 92-years-old

B. client with a history of anorexia nervosa C. client on bedrest D. client with type I diabetes E. client who is 92. years old

A 45-year-old male presents with a chronic blister-forming disease of the skin and oral mucous membranes. The nurse would recognize this condition as: A. lupus erythematosus B. pemphigus. C. psoriasis. D. eczema.

B. pemphigus Rationale: Pemphigus is manifested by chronic blister formation. Lupus erythematosus is manifested by rash and arthritis, not blisters. Psoriasis is manifested by gray-white skin plaques. Eczema is not manifested by blisters.

A nurse is teaching a group of young adult clients about health promotion techniques to reduce the risk of skin cancer. Which of the following instructions should the nurse include? A. Apply a broad spectrum sunscreen 5 minutes before sun exposure. B. Wear a sun visor instead of a hate when outside in the sun. C. Avoid exposure to the midday sun. D. Use a tanning booth instead of sunbathing outdoors.

C. Avoid exposure to midday sun. Rationale: Midday sun is strongest between 10-4. Broad spectrum sunscreen should be applied 15 minutes prior to sun exposure. A wide brimmed offers more protection than a sun visor. Sun beds, sun bathing, tanning pills should all be avoided.

You see BD for the first time at age 6 weeks. BD has a bright red, raised, rubbery lesion of irregular shape and 2cm in diameter on the occiput. What condition do you suspect BD has? a. Malignant melanoma b. Port-wine stain c. Capillary hemangioma d. Burn

C. Capillary hemangioma Rationale: Capillary hemangiomas are bright red or blue-red nodular tumors of varying sizes and shapes with a rubbery and rough surface that occur predominately on the head and face

A nurse in the dermatology clinic is using the ABCDE method while screening several lesions for skin cancer on a client. Which of the following findings should the nurse report to the provider? A. Symmetric shape B. Border regularity C. Color variation within a lesion D. Diameter greater than 4 mm

C. Color variation within a lesion A: Asymmetric shape B. Border irregularity C: Color variation within lesion D. Diameter greater than 6 mm E: Evolution (changes size, shape, color)

A client is burned through all the dermis with only a few epidermal appendages intact. This burn is classified as: a. first degree. b. superficial partial-thickness c. deep partial-thickness. d. third degree.

C. Deep-partial thickness Rationale: Deep partial-thickness burns involve the entire dermis, sparing skin appendages such as hair follicles and sweat glands. First-degree burns involve only the epidermis. Superficial partial-thickness burns involve deeper thickness. Third-degree burns involve destruction of the entire epidermis, dermis, and often underlying subcutaneous tissue.

A 4-month-old is diagnosed with atopic dermatitis (AD). Which assessment finding will most likely support this diagnosis? a. Blistering b. Moist reddened skin c. Dry, itchy skin d. White patches

C. Dry, itchy skin Rationale: AD has a constellation of clinical features that include dry, sensitive, itchy, and easily irritated skin because the barrier function of the skin is impaired. Blistering, moist skin is not associated with AD. White patches are characteristic of other disorders, such as measles.

A nurse is screening a client for skin cancer. When teaching the client about skin cancer risk, which of the following risk factors should the nurse include? A. Cigarette smoking B. Low-fiber diet C. Excessive exposure to UV light D. Human papillomavirus

C. Excessive exposure to UV light Rationale: Ultraviolet light from tanning beds, sunlight, occupational exposure to chemical carcinogens, and chronic skin irritation are risk factors for skin cancer.

A client is in the​ high- Fowler position to facilitate breathing. Which body pressure area should the nurse be most concerned​ about? A. Knee B. Ilium C. Heels D. Zygomatic bone

C. Heels

A patient who has a deep partial thickness and full thickness thermal burns over 40% of his total body surface and is in the acute phase of burn injury should be placed on what type of diet? A. High carbohydrate diet B. High fat, high sodium diet C. High calorie, high protein diet D. No oral intake, TPN administration only

C. High calorie/ high protein diet Rationale: This diet promotes wound healing

The nurse identifies that a client is at risk for impaired skin integrity. Which intervention should the nurse add to this​ client's plan of​ care? (Select all that​ apply.) A. Keep the head of the bed elevated more than 30 degrees. B. Place the client in the​ side-lying position only. C. Inspect the skin every day. D. Avoid massaging bony prominences. E. Use positioning devices.

C. Inspect the skin every day D. Avoid massaging bony prominences. E. Use positioning devices.

A nurse is caring for a client who has full thickness burns covering 63% of her body and smoke inhalation. Which of the following nursing actions is the top priority? A. Monitor intake and output B. Administer antibiotics C. Monitor respiratory status D. Encourage fluid and food intake

C. Monitor respiratory status Rationale: ABC approach, smoke inhalation most likely includes a thermal injury to the tracheobronchial tree. Edema from the inflammatory response to heat can obstruct the airway. Endotracheal intubation may become necessary to maintain a patent airway.

A nurse is planning care for a client who has been admitted for a treatment of malignant melanoma of the upper leg without metastasis. The nurse should plan to prepare the client for which of the following procedures? A. Curettage B. External radiation therapy C. Regional chemotherapy D. Surgical excision.

D. Surgical excision Rationale: surgical excision is used for small, superficial lesions. Deeper lesions require wide local excision followed by skin grafting. Curettage is used for small lesions that are not melanomas. Melanoma is resistant to radiation therapy. However, combining radiation with corticosteroids may be helpful for patients with metastatic disease. Regional or topical chemotherapy is treatment for localized tumors and superficial basal cell carcinomas, not malignant melanoma.

A 23-year-old man presents with unbearable itching in his genital area. The itching increases in intensity at night. He admits to several recent sexual encounters with different people in the past month. Skin exam reveals multiple excoriated papules and burrows with surrounding inflammation. What is the most likely diagnosis? A. Tinea cruris B. Pediculosis pubis C. Molluscum contagiosum and HPV D. Scabies

D. Scabies. Rationale: The correct answer is scabies because intense pruritis, especially at night, with excoriated papules and characteristic burrows or raised tunnels under the skin are a typical presentation. Explanation for others: Tinea cruris is a fungal infection and can also be intensely pruritic but does not cause the dermatologic manifestations noted above. Pediculosis pubis, an arthropod, is another cause of pruritis but does not cause the dermatologic manifestations noted above, and typically the lice and their nits are seen on examination. Molluscum contagiosum and HPV are caused by viruses, are not pruritic lesions, and do not present as excoriated papules with burrows.

The nurse is examining a patient who tells the nurse, I sure sweat a lot, especially on my face and feet but it doesn't have an odor. The nurse knows that this condition could be related to: a. Eccrine glands. b. Apocrine glands. c. Disorder of the stratum corneum. d. Disorder of the stratum germinativum.

a. Eccrine glands. The eccrine glands are coiled tubules that directly open onto the skin surface and produce a dilute saline solution called sweat. Apocrine glands are primarily located in the axillae, anogenital area, nipples, and naval area and mix with bacterial flora to produce the characteristic musky body odor. The patients statement is not related to disorders of the stratum corneum or the stratum germinativum.

During an examination, the nurse finds that a patient has excessive dryness of the skin. The best term to describe this condition is: a. Xerosis. b. Pruritus. c. Alopecia. d. Seborrhea.

a. Xerosis. Xerosis is the term used to describe skin that is excessively dry. Pruritus refers to itching, alopecia refers to hair loss, and seborrhea refers to oily skin.

A 52-year-old female diagnosed with systemic scleroderma is at risk for which complication? a. Cutaneous vasculitis b. Raynaud phenomenon c. Cellulitis d .Infection

b. Raynaud phenomenon Rationale: Scleroderma can trigger Raynaud phenomenon. Scleroderma is not associated with vasculitis, cellulitis, or infection.

A 22-year-old woman comes to the clinic because of severe sunburn and states, I was out in the sun for just a couple of minutes. The nurse begins a medication review with her, paying special attention to which medication class? a. Nonsteroidal anti-inflammatory drugs for pain b. Tetracyclines for acne c. Proton pump inhibitors for heartburn d. Thyroid replacement hormone for hypothyroidism

b. Tetracyclines for acne Drugs that may increase sunlight sensitivity and give a burn response include sulfonamides, thiazide diuretics, oral hypoglycemic agents, and tetracycline.

A 35-year-old pregnant woman comes to the clinic for a monthly appointment. During the assessment, the nurse notices that she has a brown patch of hyperpigmentation on her face. The nurse continues the skin assessment aware that another finding may be :a. Keratoses. b. Xerosis. c. Chloasma. d. Acrochordons.

c. Chloasma. In pregnancy, skin changes can include striae, linea nigra (a brownish-black line down the midline), chloasma (brown patches of hyperpigmentation), and vascular spiders. Keratoses are raised, thickened areas of pigmentation that look crusted, scaly, and warty. Xerosis is dry skin. Acrochordons, or skin tags, occur more often in the aging adult.

A 42-year-old woman complains that she has noticed several small, slightly raised, bright red dots on her chest. On examination, the nurse expects that the spots are probably: a. Anasarca. b. Scleroderma. c. Senile angiomas. d. Latent myeloma.

c. Senile angiomas. Cherry (senile) angiomas are small, smooth, slightly raised bright red dots that commonly appear on the trunk of adults over 30 years old.

A newborn infant has Down syndrome. During the skin assessment, the nurse notices a transient mottling in the trunk and extremities in response to the cool temperature in the examination room. The infants mother also notices the mottling and asks what it is. The nurse knows that this mottling is called: a. Caf au lait. b. Carotenemia. c. Acrocyanosis. d. Cutis marmorata.

d. Cutis marmorata Persistent or pronounced cutis marmorata occurs with infants born with Down syndrome or those born prematurely and is a transient mottling in the trunk and extremities in response to cool room temperatures. A caf au lait spot is a large round or oval patch of light-brown pigmentation. Carotenemia produces a yellow-orange color in light-skinned persons. Acrocyanosis is a bluish color around the lips, hands and fingernails, and feet and toenails.

A patient comes to the clinic and states that he has noticed that his skin is redder than normal. The nurse understands that this condition is due to hyperemia and knows that it can be caused by: a. Decreased amounts of bilirubin in the blood b. Excess blood in the underlying blood vessels c. Decreased perfusion to the surrounding tissues d. Excess blood in the dilated superficial capillaries

d. Excess blood in the dilated superficial capillaries Erythema is an intense redness of the skin caused by excess blood (hyperemia) in the dilated superficial capillaries.

A woman is leaving on a trip to Hawaii and has come in for a checkup. During the examination the nurse learns that she has diabetes and takes oral hypoglycemic agents. The patient needs to be concerned about which possible effect of her medications? a. Increased possibility of bruising b. Skin sensitivity as a result of exposure to salt water c. Lack of availability of glucose-monitoring supplies d. Importance of sunscreen and avoiding direct sunlight

d. Importance of sunscreen and avoiding direct sunlight Drugs that may increase sunlight sensitivity and give a burn response include sulfonamides, thiazide diuretics, oral hypoglycemic agents, and tetracycline.

A man has come in to the clinic for a skin assessment because he is worried he might have skin cancer. During the skin assessment the nurse notices several areas of pigmentation that look greasy, dark, and stuck on his skin. Which is the best prediction? a. Senile lentigines b. Actinic keratoses c. Acrochordons d. Seborrheic keratoses

d. Seborrheic keratoses Seborrheic keratoses appear like dark, greasy, stuck-on lesions that primarily develop on the trunk. These lesions do not become cancerous. Senile lentigines are commonly called liver spots and are not precancerous. Actinic (senile or solar) keratoses are lesions that are red-tan scaly plaques that increase over the years to become raised and roughened. They may have a silvery-white scale adherent to the plaque. They occur on sun-exposed surfaces and are directly related to sun exposure. They are premalignant and may develop into squamous cell carcinoma. Acrochordons are skin tags and are not precancerous.