FA-NUR310 EAQ3

Which drug can cause chemical burns? A. Anthralin B. Prednisone C. Tazarotene D. Calcipotriene

A. Anthralin Anthralin is a strong irritant that has an action similar to tar. So this drug can cause chemical burns with topical use. Prednisone is a corticosteroid applied topically to treat psoriasis. Tazarotene and calcipotriene are teratogenic (cause birth defects).

Which dermatologic problem is treated by using intralesional corticosteroids? A. Psoriasis B. Cellulitis C. Erysipelas D. Carbuncles

A. Psoriasis Psoriasis is a dermatologic problem treated by using intralesional corticosteroids. Cellulitis, erysipelas, and carbuncles are treated by using systemic antibiotics such as synthetic sulfur.

After reviewing the client's laboratory reports, the physician concludes that the client has primary hypofunction of the adrenal gland. Which clinical manifestation is likely to be observed in that client? A. Edema at extremities B. Uneven patches of pigment loss C. Reddish-purple stretch marks on the abdomen D. "Buffalo hump" between shoulders on the back

B. Uneven patches of pigment loss Vitiligo[1][2] is manifested by the presence of large patchy areas of pigment loss. This is mainly caused by primary hypofunction of the adrenal gland. Presence of edema at extremities indicates fluid and electrolyte imbalances mainly observed in a client with thyroid problems. Presence of reddish-purple stretch marks on the abdomen and "buffalo hump" between shoulders on the back of the neck often indicates excessive adrenocortical secretions.

A client is admitted with a suspected malignant melanoma on the arm. When performing the physical assessment, what would the nurse expect to find? A. Large area of petechiae B. Red birthmark that has recently become lighter in color C. Brown or black mole with red, white, or blue areas D. Patchy loss of skin pigmentation

C. Brown or black mole with red, white, or blue areas Melanomas have an irregular shape and lack uniformity in color. They may appear brown or black with red, white, or blue areas. Petechiae are pinpoint red dots that indicate areas of bleeding under the skin. A red birthmark is a vascular birthmark and often fades over time. A patchy loss of skin pigmentation indicates vitiligo.

Which clinical manifestation is characterized by eczematous eruption with well-defined geometric margins? A. Drug eruption B. Atopic dermatitis C. Contact dermatitis D. Nonspecific eczematous dermatitis

C. Contact dermatitis In contact dermatitis, localized eczematous eruptions are seen with well-defined geometric margins. In drug eruption, bright-red erythematosus macules and papules are seen. In atopic dermatitis, lichenification with scaling and excoriation is observed. Lichenification with weeping papules and macules is seen in nonspecific eczematous dermatitis.

Which test would the client undergo to receive a diagnosis of systemic lupus erythematosus? A. Patch test B. Photo patch test C. Direct immunofluorescence test D. Indirect immunofluorescence test

C. Direct immunofluorescence test A direct immunofluorescence test is used in the diagnosis of systemic lupus erythematosus. The patch test and photo patch test are used to evaluate allergic dermatitis and photo allergic reactions. An indirect immunofluorescence test is performed on a blood sample.

A client with the diagnosis of breast cancer is scheduled to receive radiation therapy to the affected area. The nurse teaches the client about how to care for the area that will be irradiated. Which client statement indicates the nurse needs to follow up? A. "I will leave the skin markings intact." B. "I will protect the skin from sources of heat." C. "I will wear soft clothing over the upper body." D. "I will use an oatmeal-based lotion after each treatment."

D. "I will use an oatmeal-based lotion after each treatment." While undergoing radiation therapy, lotions, powders, and ointments should not be applied to the area. The skin markings should not be removed, because they form the parameters for the delivery of radiation. To protect the irradiated skin, sunlight and heat should be avoided. Nonirritating clothing should be worn over the area to prevent trauma to the delicate irradiated skin.

Which term should the nurse use to describe bone loss greater than normal but less than that caused by osteoporosis? A. Osteopenia B. Osteomyelitis C. Osteomalacia D. Osteoarthritis

A. Osteopenia Osteopenia is defined as bone loss that is more than normal but not yet at the level for a diagnosis of osteoporosis. Osteomyelitis is infection of bone or bone marrow. Osteomalacia is softening of bones due to calcium or vitamin D deficiency. Osteoarthritis is cartilage deterioration in the joints.

After a client has a total gastrectomy, the nurse plans to include in the discharge teaching the need for what treatment? A. Monthly injections of cyanocobalamin B. Regular daily use of a stool softener C. Weekly injections of iron dextran D. Daily replacement therapy of pancreatic enzymes

A. Monthly injections of cyanocobalamin Intrinsic factor is lost with removal of the stomach, and cyanocobalamin is needed to maintain the hemoglobin level once the client is stabilized; injections are given monthly for life. Adequate diet, fluid intake, and exercise should prevent constipation. Weekly injections of iron dextran are not considered routine. Daily replacement therapy of pancreatic enzymes does not affect pancreatic enzymes.

Which surgical procedure is appropriate for the removal of a vocal cord due to laryngeal cancer? A. Cordectomy B. Tracheotomy C. Total laryngectomy D. Oropharyngeal resections

A. Cordectomy A cordectomy is a surgical procedure performed in clients with laryngeal cancer; this surgery involves the removal of a vocal cord. A tracheotomy is a surgical incision in the trachea for the purpose of establishing an airway. A total laryngectomy is a surgical procedure in which the entire larynx, hyoid bone, strap muscles, and one or two tracheal rings are removed. A nodal neck dissection is also done in a total laryngectomy if the nodes are involved. An oropharyngeal resection is a surgical procedure performed to treat cancer of the oropharynx.

Which component of skin maintains optimal barrier function? A. Keratin B. Melanin C. Collagen D. Adipose tissue

A. Keratin Keratin is a protein produced by keratinocytes that helps to maintain optimal barrier function. Melanin pigment is produced by melanocytes and gives color to the skin. Collagen is a protein produced by fibroblasts. Its production is increased during tissue injury and helps form scar tissue. Adipose tissue is the subcutaneous fat that insulates the body and absorbs shock.

Which key feature does the nurse associate with a stage 2 pressure ulcer? A. Presence of non-intact skin B. Development of sinus tracts C. Damage to the subcutaneous tissues D. Appearance of a reddened area over a bony prominence

A. Presence of non-intact skin The skin is nonintact in stage 2 of pressure ulcers. Sinus tracts may develop during stage 4 of pressure ulcers. The subcutaneous tissue becomes damaged or necrotic during stage 3 of pressure ulcers. A reddened area over a bony surface occurs in stage 1 of pressure ulcers.

The nurse is teaching the client about wound healing. Which feature is associated with the "maturation phase" of normal wound healing? A. The scar is firm and inelastic on palpation. B. Fibrin strands form a scaffold or framework. C. White blood cells migrate into the wound. D. Epithelial cells are grown over the granulation tissue bed.

A. The scar is firm and inelastic on palpation. The maturation phase of normal wound healing involves a mature scar that is firm and inelastic when palpated. In the proliferative phase, the fibrin strands form a scaffold or framework. White blood cells migrate into the wound during the inflammatory phase. In the proliferative phase, the epithelial cells are grown over the granulation tissue bed.

A nurse is caring for a client who had major abdominal surgery one day ago. What factor increases the risk of this client developing a wound dehiscence? A. Placement of a T-tube B. Client being overweight C. Presence of excessive flatus D. Client receiving prophylactic antibiotics

B. Client being overweight Being grossly overweight is a predisposing factor to wound dehiscence because of decreased vascularity and fragility of adipose tissue and the added tension on the suture line. Placement of a T-tube does not contribute to dehiscence; a T-tube helps remove bile from the common bile duct. The presence of excessive flatus causes discomfort, not dehiscence. If the client is receiving the antibiotics because of the presence of a wound infection, then the infection is the risk factor for wound dehiscence. Receiving steroids, not prophylactic antibiotics, increases the risk of dehiscence because steroids slow collagen synthesis necessary for wound healing.

What could be the possible cause of a scald injury? A. Contact with grease B. Contact with hot liquids or steam C. Contact with alkali in oven cleaners D. Contact with open flame in house fires

B. Contact with hot liquids or steam Scalding injuries usually result from contact with hot liquids or steam. Contact with grease and the alkali in oven cleaners may cause chemical injuries. An open flame in house fires may cause thermal injuries.

Which skin infection would cause facial paralysis? A. Candidiasis B. Herpes zoster C. Herpes simplex D. Dermatophytosis

B. Herpes zoster Facial paralysis is the clinical sign of Bell's palsy, a complication of the herpes zoster infection. This is seen when the trigeminal nerve is infected by the varicella-zoster virus. Candidiasis is a fungal infection not associated with Bell's palsy. Herpes simplex is a viral infection and may not cause Bell's palsy. Dermatophytosis is also a fungal infection not associated with Bell's palsy.

Which drug is a newer treatment option for treating metastatic melanoma? A. Lomustin B. Ipilimumab C. Carmustine D. Temozolomide

B. Ipilimumab Ipilimumab is a type of immunotherapy and is monoclonal antibody. It is a newer option of drug therapy used in the treatment of metastatic melanoma. Lomustin, carmustine, and temozolomide are established chemotherapy drugs in use for many years for the treatment of metastatic melanoma.

A client who had a choledochostomy to explore the common bile duct is returned to the surgical unit with a T-tube in place. What is the priority intervention when caring for this client? A. Irrigate the T-tube as necessary B. Protect the abdominal skin from bile drainage C. Have the client wear a binder when out of bed D. Empty the T-tube drainage bag every two hours

B. Protect the abdominal skin from bile drainage The enzymatic activity of bile can cause excoriation and skin breakdown; the skin should be protected. A T-tube is not irrigated. A binder will not protect the skin, although it may support abdominal musculature. Drainage is emptied when the bag is full or at routine intervals (usually every 8 to 12 hours).

Which surgery is used to treat excessive wrinkling or sagging of facial skin? A. Rhinoplasty B. Rhytidectomy C. Dermabrasion D. Blepharoplasty

B. Rhytidectomy Rhytidectomy is the removal of excess skin and tissue from the face; this is the surgery used to treat wrinkling or sagging of facial skin. Rhinoplasty is the removal of excessive tissue or cartilage from the nose. Dermabrasion is the process of removing the facial epidermis or a portion of the dermis to treat acne scars. Blepharoplasty is the removal of bulging fat in the periorbital area; this is used to treat bags under the eyes.

A nurse is caring for an older adult who was admitted to the hospital to be treated for dehydration. While the nurse is providing discharge teaching, the client asks what to do about itchy dry skin? What is the best response by the nurse? A. Wear plenty of warm clothes to keep moisture in the skin. B. Use a moisturizer on the skin daily to help reduce itching. C. Take hot tub baths only twice a week to reduce drying of the skin. D. Expose the skin to the air to help reduce the sensation of itching.

B. Use a moisturizer on the skin daily to help reduce itching. Lubricating the skin with a moisturizer effectively relieves dryness and thus the pruritus (itching). Wearing warm clothing will not lubricate the skin or relieve pruritus. Warm or cool, not hot, tub baths will reduce itching. Exposing the skin to the air causes further drying and will not relieve pruritus.

A client who is receiving combination chemotherapy for stage II Hodgkin disease is at risk for stomatitis. Which information should the nurse include in the teaching plan? A. "Rinse the mouth three times a day with lemon juice and water." B. "Brush the teeth once daily and use dental floss after each meal." C. "Clean the mouth with a soft toothbrush or a gentle spray." D. "Gently clean the mouth with commercial mouthwash."

C. "Clean the mouth with a soft toothbrush or a gentle spray." Chemotherapy destroys the rapidly dividing cells of the oral mucosa; frequent gentle oral hygiene limits additional trauma. Although it is recommended to rinse the mouth every 2 hours, the client does not need to brush teeth and clean the mouth as often. Lemon juice is too caustic to the compromised mucosa. Flossing can disrupt and traumatize the gum surfaces; oral hygiene is needed more than once a day. Commercial mouthwashes contain alcohol, which is irritating to the mucosa.

What is the source of an Integra graft? A. Porcine skin B. Cadaveric skin C. Glycosaminoglycan bonded to silicone membrane D. Porcine collagen bonded to silicone membrane

C. Glycosaminoglycan bonded to silicone membrane Glycosaminoglycan bonded to silicone membrane is the source of an Integra artificial skin graft. Porcine skin is the source of a xenograft. Cadaveric skin is the source of an allograft. Porcine collagen bonded to silicone membrane is the source of a biobrane graft.

Which clinical finding occurs due to thinning of the subcutaneous layer? A. Decreased tone and elasticity B. Decreased sensory perception C. Increased risk for hypothermia D. Increased susceptibility to dry skin

C. Increased risk for hypothermia Thinning of the subcutaneous layer results in increased risk for hypothermia. Degeneration of elastic fibers in the dermis results in decreased tone and elasticity. In the dermis, reduced number and function of nerve endings leads to decreased sensory perception. A decrease in dermal blood flow results in increased susceptibility to dry skin.

Which characteristic does the nurse associate with a punch biopsy? A. It is usually indicated for superficial or raised lesions. B. It is more uncomfortable than other biopsies while healing. C. It is performed using a circular cutting instrument 2 to 6 mm in diameter. D. It removes only the portion of the skin that rises above the surrounding tissue.

C. It is performed using a circular cutting instrument 2 to 6 mm in diameter. Punch biopsy is a common technique that involves the use of a small circular cutting instrument with a diameter of 2 to 6 mm. Shave biopsies are usually recommended for superficial or raised lesions. Excisional biopsies are comparatively more uncomfortable than punch or shave biopsies. Shave biopsies remove the skin portion that rises above surrounding tissues.

What would the nurse state is a cause of systemic altered inflammatory response in impaired wound healing? A. Uremia B. Cirrhosis C. Leukemia D. Hypovolemia

C. Leukemia Leukemia is a cause of systemic altered inflammatory response in impaired wound healing. Uremia, cirrhosis, and hypovolemia are systemic impaired cellular proliferation responses in impaired wound healing.

A preschool-aged child with leukemia who is undergoing chemotherapy is susceptible to rectal ulcerations. What should the nurse recommend to the parents that will lessen the severity of this problem? A. Encourage lying on the abdomen when in bed. B. Have the child wear cotton underpants at night. C. Apply rectal ointment liberally four times a day. D. Clean the child's perianal area after each bowel movement.

D. Clean the child's perianal area after each bowel movement. Meticulous toilet hygiene is essential to prevent infection and promote comfort. Changing positions in bed is preferable. Underpants keep the area moist and promote bacterial growth; it is preferable to leave the area exposed to air, even if it remains under bed linens. Ointments tend to occlude and trap organisms, thus promoting infection.

Which urodynamic study provides information on bladder capacity, bladder pressure, and voiding reflexes? A. Radiography B. Renal arteriography C. Electromyography (EMG) D. Cystometrography (CMG)

D. Cystometrography (CMG) Cystometrography (CMG) is an urodynamic study that provides information on bladder capacity, bladder pressure, and voiding reflexes. Radiography is a diagnostic test for clients with disorders of kidney and urinary system to screen for the presence of two kidneys, to measure kidney size, and to detect gross obstruction in kidneys or urinary tract. Renal arteriography is a diagnostic study used to determine renal blood vessel size and abnormalities. Electromyography (EMG) is an urodynamic study used to test the strength of perineal muscles in voiding.

Which infection is caused due to fungus? A. Furuncle B. Folliculitis C. Herpes zoster D. Dermatophytosis

D. Dermatophytosis Dermatophytosis is a fungal infection in which single or multiple patches appear on the skin. Furuncle is a bacterial infection in which small, tender, erythematous nodules filled with pus appear on the skin. Folliculitis is a bacterial infection in which erythematous pustules appear singly or in groups on the skin. Herpes zoster is a viral infection in which lesions are present on an erythematous base.

Which type of biopsy would the nurse identify as required for removal of entire lesions on the skin? A. Punch biopsy B. Shave biopsy C. Incisional biopsy D. Excisional biopsy

D. Excisional biopsy An excisional biopsy is required to remove entire lesions on the skin. A punch biopsy provides full thickness skin for diagnostic purposes. A shave biopsy provides a thin specimen for diagnostic purposes. An incisional biopsy is used along with shave and punch biopsies.

Which secondary skin lesion may include athlete's foot as an example? A. Scar B. Scale C. Ulcer D. Fissure

D. Fissure An example of a fissure-type secondary lesion is athlete's foot. Surgical incisions and healed wounds are examples of scar-type secondary lesions. A scale-type secondary lesion would include flaking of the skin following a drug reaction or sunburn. Ulcer-type lesions may include pressure ulcers or chancres.