ms prepu 56: Management of Patients with Dermatologic Disorders
The nurse is providing instruction to a client with acne. The nurse promotes avoidance of which food(s)? Select all that apply. Chocolate Onions Bananas Ice cream Correct response: Incorrect response: Your selection: Explanation: The nurse should promote avoidance of foods associated with flare-up of acne, particularly those high in refined sugars, including chocolate, cola, and ice cream.
Chocolate Ice cream Correct response: Incorrect response: Your selection: Explanation: The nurse should promote avoidance of foods associated with flare-up of acne, particularly those high in refined sugars, including chocolate, cola, and ice cream.
The nurse is assessing a client's skin when the client points out a mole. The nurse brings the mole to the physician's attention when which characteristic is noted? You Selected: Diameter exceeding 6 mm Correct response: Diameter exceeding 6 mm Explanation: The nurse brings the mole to the physician's attention when characteristics of melanoma are detected, such as a diameter exceeding 6 mm. Other characteristics of melanoma include asymmetric appearance; irregular, indistinct borders; and red, white, or blue coloration.
Diameter exceeding 6 mm Explanation: The nurse brings the mole to the physician's attention when characteristics of melanoma are detected, such as a diameter exceeding 6 mm. Other characteristics of melanoma include asymmetric appearance; irregular, indistinct borders; and red, white, or blue coloration.
Which of the following information regarding the transmission of lice would the nurse identify as a myth? You Selected: Lice can jump from one individual to another. Correct response: Lice can jump from one individual to another. Explanation: The nurse is correct to identify that lice cannot jump from one individual to another. Direct contact is needed for transmission. The other options are correct.
Lice can jump from one individual to another. Explanation: The nurse is correct to identify that lice cannot jump from one individual to another. Direct contact is needed for transmission. The other options are correct.
Which of the following nonsedating antihistamines is appropriate for daytime pruritus? You Selected: Fexofenadine (Allegra) Correct response: Fexofenadine (Allegra) Explanation: Nonsedating antihistamine medications such as Allegra are more appropriate to relieve daytime pruritus. Benadryl or Atarax, when prescribed in a sedative dose at bedtime, may be beneficial in producing a restful and comfortable sleep. Ativan has sedating properties and is used as an antianxiety medication.
Fexofenadine (Allegra) Explanation: Nonsedating antihistamine medications such as Allegra are more appropriate to relieve daytime pruritus. Benadryl or Atarax, when prescribed in a sedative dose at bedtime, may be beneficial in producing a restful and comfortable sleep. Ativan has sedating properties and is used as an antianxiety medication.
While examining a client's leg, a nurse notes an open ulceration with visible granulation tissue in the wound. Until a wound specialist can be contacted, which type of dressing should the nurse apply? You Selected: Moist sterile saline gauze Correct response: Moist sterile saline gauze Explanation: Moist sterile saline dressings support wound healing and are cost-effective. Dry sterile dressings adhere to the wound and debride the tissue when removed. Petroleum supports healing but is expensive. Povidone-iodine is used as an antiseptic cleaning agent but because it can irritate epithelial cells, it shouldn't be left on an open wound.
Moist sterile saline gauze Explanation: Moist sterile saline dressings support wound healing and are cost-effective. Dry sterile dressings adhere to the wound and debride the tissue when removed. Petroleum supports healing but is expensive. Povidone-iodine is used as an antiseptic cleaning agent but because it can irritate epithelial cells, it shouldn't be left on an open wound.
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? You Selected: Never pick or squeeze a furuncle. Correct response: Never pick or squeeze a furuncle. Explanation: The client with a furuncle should never pick or squeeze it as the drainage is infectious and this practice favors the spread of the infection. Infections by organisms that usually exist harmlessly on the skin surface cause furuncles. Keeping the hair short, clean, and away from the face and forehead, avoiding cosmetics, and using tepid bath water do not help in preventing the spread of a furuncle.
Never pick or squeeze a furuncle. Explanation: The client with a furuncle should never pick or squeeze it as the drainage is infectious and this practice favors the spread of the infection. Infections by organisms that usually exist harmlessly on the skin surface cause furuncles. Keeping the hair short, clean, and away from the face and forehead, avoiding cosmetics, and using tepid bath water do not help in preventing the spread of a furuncle.
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? You Selected: Psoriasis is an inflammatory dermatosis that results from an overproduction of keratin. Correct response: Psoriasis is an inflammatory dermatosis that results from an overproduction of keratin. Explanation: Current evidence supports an autoimmune basis for psoriasis (Porth & Matfin, 2009). Periods of emotional stress and anxiety aggravate the condition, and trauma, infections, and seasonal and hormonal changes may also serve as triggers. In this disease, the epidermis becomes infiltrated by activated T cells and cytokines, resulting in both vascular engorgement and proliferation of keratinocytes. Epidermal hyperplasia results.
Psoriasis is an inflammatory dermatosis that results from an overproduction of keratin. Explanation: Current evidence supports an autoimmune basis for psoriasis (Porth & Matfin, 2009). Periods of emotional stress and anxiety aggravate the condition, and trauma, infections, and seasonal and hormonal changes may also serve as triggers. In this disease, the epidermis becomes infiltrated by activated T cells and cytokines, resulting in both vascular engorgement and proliferation of keratinocytes. Epidermal hyperplasia results.
The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stand for? You Selected: Asymmetry Correct response: Asymmetry Explanation: When following the ABCD method for assessing skin lesions, the A stands for "asymmetry," the B for "border irregularity," the C for "color variation," and the D for "diameter."
The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stand for? You Selected: Asymmetry Correct response: Asymmetry Explanation: When following the ABCD method for assessing skin lesions, the A stands for "asymmetry," the B for "border irregularity," the C for "color variation," and the D for "diameter."
A 1-year-old client has a localized rash and is miserably itchy. The client's mother indicates having just started to use a new skin cream and that the rash developed within 12 hours of the first dose. What treatments would pediatrician prescribe? Select all that apply. remove allergen cool baths without soap twice daily apply hydrogen peroxide to dry rash All options are correct. Correct response: Incorrect response: Your selection: Explanation: Treatment for both types of dermatitis is to remove the substances causing the reaction. This is done by flushing the skin with cool water.
remove allergen cool baths without soap twice daily Explanation: Treatment for both types of dermatitis is to remove the substances causing the reaction. This is done by flushing the skin with cool water.
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? You Selected: "To prevent evaporation of water from the hydrated epidermis." Correct response: "To prevent evaporation of water from the hydrated epidermis." Explanation: The nurse should tell the client that applying an emollient immediately after taking a bath or shower prevents evaporation of water from the hydrated epidermis, the skin's upper layer. Although emollients make the skin feel soft, this effect occurs whether or not the client has just bathed or showered. An emollient minimizes cracking of the epidermis, not the dermis (the layer beneath the epidermis). An emollient doesn't prevent skin inflammation.
"To prevent evaporation of water from the hydrated epidermis." Explanation: The nurse should tell the client that applying an emollient immediately after taking a bath or shower prevents evaporation of water from the hydrated epidermis, the skin's upper layer. Although emollients make the skin feel soft, this effect occurs whether or not the client has just bathed or showered. An emollient minimizes cracking of the epidermis, not the dermis (the layer beneath the epidermis). An emollient doesn't prevent skin inflammation.
A client has a rash on the arm that has been treated with an antibiotic without eradicating the rash. What type of examination can be used to determine if the rash is a fungal rash using ultraviolet light? You Selected: A Wood's light examination Correct response: A Wood's light examination Explanation: A Wood's light is also known as a black light and is a handheld device that can identify certain fungal infections that fluoresce under long-wave ultraviolet light. In a darkened room, when a physician or nurse aims the light at a lesion caused by a fungus that fluoresces, the lesion emits a blue-green color. It is the only test that uses a light, the others use skin scrapings.
A Wood's light examination Explanation: A Wood's light is also known as a black light and is a handheld device that can identify certain fungal infections that fluoresce under long-wave ultraviolet light. In a darkened room, when a physician or nurse aims the light at a lesion caused by a fungus that fluoresces, the lesion emits a blue-green color. It is the only test that uses a light, the others use skin scrapings.
A client comes to the physician's office for treatment of severe sunburn. The nurse takes this opportunity to discuss the importance of protecting the skin from the sun's damaging rays. What is the appropriate teaching by the nurse to prevent skin damage? You Selected: "Apply sunscreen even on overcast days." Correct response: "Apply sunscreen even on overcast days." Explanation: Sunscreen should be applied even on overcast days, because the sun's rays are as damaging then as on sunny days. The sun is strongest from 10 a.m. to 4 p.m. — not from 1 to 4 p.m. Sun exposure should be minimized during these hours. The nurse should recommend sunscreen with a sun protection factor of at least 15. Sitting in the shade when at the beach doesn't guarantee protection against sunburn alone because sand, concrete, and water can reflect more than half the sun's rays onto the skin.
A client comes to the physician's office for treatment of severe sunburn. The nurse takes this opportunity to discuss the importance of protecting the skin from the sun's damaging rays. What is the appropriate teaching by the nurse to prevent skin damage? You Selected: "Apply sunscreen even on overcast days." Correct response: "Apply sunscreen even on overcast days." Explanation: Sunscreen should be applied even on overcast days, because the sun's rays are as damaging then as on sunny days. The sun is strongest from 10 a.m. to 4 p.m. — not from 1 to 4 p.m. Sun exposure should be minimized during these hours. The nurse should recommend sunscreen with a sun protection factor of at least 15. Sitting in the shade when at the beach doesn't guarantee protection against sunburn alone because sand, concrete, and water can reflect more than half the sun's rays onto the skin.
A client is being treated for acne vulgaris. What warning must be given to this client regarding the application of benzoyl peroxide? You Selected: Use gloves with application. Correct response: Use gloves with application. Explanation: Warn clients using acne preparations containing benzoyl peroxide that this ingredient is an oxidizing agent and may remove the color from clothing, rugs, and furniture. Thorough handwashing after drug use may not remove all the drug and permanent fabric discoloration may still occur. Users of products containing benzoyl peroxide should wear disposable plastic gloves when applying the drug.
A client is being treated for acne vulgaris. What warning must be given to this client regarding the application of benzoyl peroxide? You Selected: Use gloves with application. Correct response: Use gloves with application. Explanation: Warn clients using acne preparations containing benzoyl peroxide that this ingredient is an oxidizing agent and may remove the color from clothing, rugs, and furniture. Thorough handwashing after drug use may not remove all the drug and permanent fabric discoloration may still occur. Users of products containing benzoyl peroxide should wear disposable plastic gloves when applying the drug.
A 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? You Selected: Through the application of extreme cold, the tissue is destroyed. Correct response: Through the application of extreme cold, the tissue is destroyed. Explanation: Cryosurgery is the application of extreme cold to destroy tissue. The other statements are false.
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? You Selected: Through the application of extreme cold, the tissue is destroyed. Correct response: Through the application of extreme cold, the tissue is destroyed. Explanation: Cryosurgery is the application of extreme cold to destroy tissue. The other statements are false.
A client is undergoing photochemotherapy involving a combination of a photosensitizing chemical and ultraviolet light. What health problem does this client most likely have? You Selected: psoriasis Correct response: psoriasis Explanation: Photochemotherapy is used to treat psoriasis.
A client is undergoing photochemotherapy involving a combination of a photosensitizing chemical and ultraviolet light. What health problem does this client most likely have? You Selected: psoriasis Correct response: psoriasis Explanation: Photochemotherapy is used to treat psoriasis.
A client with a history of diabetes mellitus has recently developed furunculosis. What is causing the client's condition? You Selected: infection Correct response: infection Explanation: Furuncles and carbuncles are caused by skin infections with organisms that usually exist harmlessly on the skin surface.
A client with a history of diabetes mellitus has recently developed furunculosis. What is causing the client's condition? You Selected: infection Correct response: infection Explanation: Furuncles and carbuncles are caused by skin infections with organisms that usually exist harmlessly on the skin surface.
A client with atopic dermatitis is ordered a potent topical corticosteroid to be covered with an occlusive dressing. To address a potential client problem associated with this treatment, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement, the nurse should add which "related-to" phrase? You Selected: Related to percutaneous absorption of the topical corticosteroid Correct response: Related to percutaneous absorption of the topical corticosteroid Explanation: A potent topical corticosteroid may increase the client's risk for injury because it may be absorbed percutaneously, causing the same adverse effects as systemic corticosteroids. Topical corticosteroids aren't involved in significant drug interactions. These preparations cause vasoconstriction, not vasodilation. A potent topical corticosteroid is rarely ordered for use on the face, neck, or intertriginous sites because application on these areas may lead to increased adverse effects.
A client with atopic dermatitis is ordered a potent topical corticosteroid to be covered with an occlusive dressing. To address a potential client problem associated with this treatment, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement, the nurse should add which "related-to" phrase? You Selected: Related to percutaneous absorption of the topical corticosteroid Correct response: Related to percutaneous absorption of the topical corticosteroid Explanation: A potent topical corticosteroid may increase the client's risk for injury because it may be absorbed percutaneously, causing the same adverse effects as systemic corticosteroids. Topical corticosteroids aren't involved in significant drug interactions. These preparations cause vasoconstriction, not vasodilation. A potent topical corticosteroid is rarely ordered for use on the face, neck, or intertriginous sites because application on these areas may lead to increased adverse effects.
A dermatologist recommends an over-the-counter suspension to relieve pruritus. The nurse advises the patient that the lotion should be applied: You Selected: Overnight to enhance absorption. Correct response: Every 3 to 4 hours for sustained effectiveness. Explanation: Lotions are frequently used to replenish lost skin oils or to relieve pruritus. They are usually applied directly to the skin, but a dressing soaked in the lotion can be placed on the affected area. Lotions must be applied every 3 or 4 hours for sustained therapeutic effect because if left in place for a long period, they may crust and cake on the skin.
A dermatologist recommends an over-the-counter suspension to relieve pruritus. The nurse advises the patient that the lotion should be applied: You Selected: Overnight to enhance absorption. Correct response: Every 3 to 4 hours for sustained effectiveness. Explanation: Lotions are frequently used to replenish lost skin oils or to relieve pruritus. They are usually applied directly to the skin, but a dressing soaked in the lotion can be placed on the affected area. Lotions must be applied every 3 or 4 hours for sustained therapeutic effect because if left in place for a long period, they may crust and cake on the skin.
A nurse is assessing a client with a new skin disorder. Which questions would the nurse include when asking the client about the change in skin condition? Select all that apply. When did the disorder first begin, and where did it first appear? Where are the lesions located? Has the problem spread? Have you tried to treat the lesions? Do you exercise daily? Correct response: Incorrect response: Your selection: Explanation: The nurse would ask the client when and where the disorder started, where the lesions are located and if they have spread, and if the client has attempted to treat them. The client's exercise habits would not affect the skin disorder.
A nurse is assessing a client with a new skin disorder. Which questions would the nurse include when asking the client about the change in skin condition? Select all that apply. When did the disorder first begin, and where did it first appear? Where are the lesions located? Has the problem spread? Have you tried to treat the lesions? Do you exercise daily? Correct response: Incorrect response: Your selection: Explanation: The nurse would ask the client when and where the disorder started, where the lesions are located and if they have spread, and if the client has attempted to treat them. The client's exercise habits would not affect the skin disorder.
A patient is being evaluated for nodular cystic acne. What systemic pharmacologic agent may be prescribed for the treatment of this disorder? You Selected: Isotretinoin (Accutane) Correct response: Isotretinoin (Accutane) Explanation: Isotretinoin vitamin A compounds (i.e., retinoids) are used with dramatic results in patients with nodular cystic acne unresponsive to conventional therapy. One compound is isotretinoin, which is used for active inflammatory popular pustular acne that has a tendency to scar. Isotretinoin reduces sebaceous gland size and inhibits sebum production. It also causes the epidermis to shed (epidermal desquamation), thereby unseating and expelling existing comedones.
A patient is being evaluated for nodular cystic acne. What systemic pharmacologic agent may be prescribed for the treatment of this disorder? You Selected: Isotretinoin (Accutane) Correct response: Isotretinoin (Accutane) Explanation: Isotretinoin vitamin A compounds (i.e., retinoids) are used with dramatic results in patients with nodular cystic acne unresponsive to conventional therapy. One compound is isotretinoin, which is used for active inflammatory popular pustular acne that has a tendency to scar. Isotretinoin reduces sebaceous gland size and inhibits sebum production. It also causes the epidermis to shed (epidermal desquamation), thereby unseating and expelling existing comedones.
The nurse is working with community groups. At which of the following locations would the nurse anticipate a possible scabies outbreak? You Selected: Swimming pool Correct response: College dormitory Explanation: The nurse is correct to anticipate a potential scabies outbreak in a college dormitory. Outbreaks are common where large groups of people are confined or housed. Spread of scabies is from skin-to-skin contact. Although there are groups of people at the shopping mall, swimming pool, and gymnasium, typically, there is no personal contact.
College dormitory Explanation: The nurse is correct to anticipate a potential scabies outbreak in a college dormitory. Outbreaks are common where large groups of people are confined or housed. Spread of scabies is from skin-to-skin contact. Although there are groups of people at the shopping mall, swimming pool, and gymnasium, typically, there is no personal contact.
Which medication classification may be used for contact dermatitis? You Selected: Corticosteroids Correct response: Corticosteroids Explanation: Corticosteroids are used for contact dermatitis. Antifungals, antivirals, and saline irrigations are not used in the treatment of contact dermatitis.
Corticosteroids Explanation: Corticosteroids are used for contact dermatitis. Antifungals, antivirals, and saline irrigations are not used in the treatment of contact dermatitis.
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? You Selected: Impaired Skin Integrity Related to Scaly Lesions Correct response: Impaired Skin Integrity Related to Scaly Lesions Explanation: An appropriate diagnosis for a client with psoriasis would include Impaired Skin Integrity as it relates to scaly lesions. Psoriasis causes pain but does not normally affect the oral cavity. Similarly, tissue integrity is impaired, but not through the process of epidermal shedding. Psoriasis is not related to an increased risk for melanoma.
Impaired Skin Integrity Related to Scaly Lesions Explanation: An appropriate diagnosis for a client with psoriasis would include Impaired Skin Integrity as it relates to scaly lesions. Psoriasis causes pain but does not normally affect the oral cavity. Similarly, tissue integrity is impaired, but not through the process of epidermal shedding. Psoriasis is not related to an increased risk for melanoma.
In assessing a scar, you notice an overgrowth of tissue. It is best described as a You Selected: Keloid Correct response: Keloid Explanation: Keloids are benign overgrowths of fibrous tissue at the site of a scar or trauma. They appear to be more common among dark-skinned people. Keloids are asymptomatic but may cause disfigurement and cosmetic concern. The treatment, which is not always satisfactory, consists of surgical excision, intralesional corticosteroid therapy, and radiation.
In assessing a scar, you notice an overgrowth of tissue. It is best described as a You Selected: Keloid Correct response: Keloid Explanation: Keloids are benign overgrowths of fibrous tissue at the site of a scar or trauma. They appear to be more common among dark-skinned people. Keloids are asymptomatic but may cause disfigurement and cosmetic concern. The treatment, which is not always satisfactory, consists of surgical excision, intralesional corticosteroid therapy, and radiation.
Which infecting agent causes scabies? You Selected: Itch mite Correct response: Itch mite Explanation: Several skin disorders involve an infecting agent. Scabies is caused by Sarcoptes scabiei, an itch mite. Parasitic fungi cause dermatophytosis in skin, scalp, and nails. Shingles is caused by a reactivated virus.
Itch mite Explanation: Several skin disorders involve an infecting agent. Scabies is caused by Sarcoptes scabiei, an itch mite. Parasitic fungi cause dermatophytosis in skin, scalp, and nails. Shingles is caused by a reactivated virus.
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? You Selected: Kaposi sarcoma Correct response: Kaposi sarcoma Explanation: Kaposi sarcoma is a frequent comorbidity in clients with AIDS. With platelet disorders, the nurse observes ecchymoses (bruising) and purpura (bleeding into the skin). Urticaria (wheals or hives) is the manifestation of allergic reactions. A painless chancre or ulcerated lesion is a typical finding in the client with syphilis.
Kaposi sarcoma Explanation: Kaposi sarcoma is a frequent comorbidity in clients with AIDS. With platelet disorders, the nurse observes ecchymoses (bruising) and purpura (bleeding into the skin). Urticaria (wheals or hives) is the manifestation of allergic reactions. A painless chancre or ulcerated lesion is a typical finding in the client with syphilis.
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? You Selected: Kaposi sarcoma Correct response: Kaposi sarcoma Explanation: Kaposi sarcoma is a frequent comorbidity of clients with AIDS. With platelet disorders, the nurse observes ecchymosis (bruising) and purpura (bleeding into the skin). Urticaria (wheals or hives) is the manifestation of allergic reactions. A painless chancre or ulcerated lesion is a typical finding in clients with syphilis.
Kaposi sarcoma Explanation: Kaposi sarcoma is a frequent comorbidity of clients with AIDS. With platelet disorders, the nurse observes ecchymosis (bruising) and purpura (bleeding into the skin). Urticaria (wheals or hives) is the manifestation of allergic reactions. A painless chancre or ulcerated lesion is a typical finding in clients with syphilis.
The nurse notes that a client who uses a wheelchair for long periods after recovering from an amputation has a reddened area over the coccyx. Which teaching will the nurse provide to the client to relieve the pressure? Select all that apply. Perform push-ups. Move from side to side. Shift weight in the chair. Complete half push-ups. Tense the quadriceps muscles. Correct response: Incorrect response: Your selection: Explanation: For the client who spends long periods of time in a wheelchair, pressure can be relieved by performing push-ups or pushing down on armrests and raising the buttocks off the seat of the chair. Another action is moving from side to side while sitting in the chair. Shifting weight in the chair is done by bending forward with the head down between the knees if able and constantly moving in the chair. One additional action is to complete one half of a push-up by completing a push-up on the right side and then the left side by pushing down on the armrest. Tensing the quadriceps muscle is used to strengthen the muscle for walking.
Perform push-ups. Move from side to side. Shift weight in the chair. Complete half push-ups. Explanation: For the client who spends long periods of time in a wheelchair, pressure can be relieved by performing push-ups or pushing down on armrests and raising the buttocks off the seat of the chair. Another action is moving from side to side while sitting in the chair. Shifting weight in the chair is done by bending forward with the head down between the knees if able and constantly moving in the chair. One additional action is to complete one half of a push-up by completing a push-up on the right side and then the left side by pushing down on the armrest. Tensing the quadriceps muscle is used to strengthen the muscle for walking.
Pressure ulcers are caused by: You Selected: Low capillary pressure Correct response: Extrinsic factors Explanation: Pressure ulcers involve breakdown of the skin due to prolonged pressure, friction, and shear forces, and insufficient blood supply, usually at bony prominences.
Pressure ulcers are caused by: You Selected: Low capillary pressure Correct response: Extrinsic factors Explanation: Pressure ulcers involve breakdown of the skin due to prolonged pressure, friction, and shear forces, and insufficient blood supply, usually at bony prominences.
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? You Selected: Scabies Correct response: Scabies Explanation: Signs and symptoms of scabies include gray-brown burrows, epidermal curved or linear ridges, and follicular papules. Clients complain of severe itching that usually occurs at night. Scabies commonly occurs in school-age children. The most common areas of infestation are the finger webs, flexor surface of the wrists, and antecubital fossae. Impetigo is a contagious, superficial skin infection characterized by a small, red macule that turns into a vesicle, becoming pustular with a honey-colored crust. Contact dermatitis is an inflammation of the skin caused by contact with an irritating chemical or allergen. Dermatophytosis, or ringworm, is a disease that affects the scalp, body, feet, nails, and groin. It's characterized by erythematous patches and scaling.
Question 9 See full question27sReport this Question 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? You Selected: Scabies Correct response: Scabies Explanation: Signs and symptoms of scabies include gray-brown burrows, epidermal curved or linear ridges, and follicular papules. Clients complain of severe itching that usually occurs at night. Scabies commonly occurs in school-age children. The most common areas of infestation are the finger webs, flexor surface of the wrists, and antecubital fossae. Impetigo is a contagious, superficial skin infection characterized by a small, red macule that turns into a vesicle, becoming pustular with a honey-colored crust. Contact dermatitis is an inflammation of the skin caused by contact with an irritating chemical or allergen. Dermatophytosis, or ringworm, is a disease that affects the scalp, body, feet, nails, and groin. It's characterized by erythematous patches and scaling.
A 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: You Selected: Removal of the tumor, layer by layer. Correct response: Removal of the tumor, layer by layer. Explanation: Mohs micrographic surgery removes the tumor layer by layer. The first layer excised includes all evident tumor and a small margin of normal-appearing tissue. The specimen is frozen and analyzed by section to determine if all the tumor has been removed. If not, additional layers of tissue are shaved and examined until all tissue margins are tumor-free.
Removal of the tumor, layer by layer. Explanation: Mohs micrographic surgery removes the tumor layer by layer. The first layer excised includes all evident tumor and a small margin of normal-appearing tissue. The specimen is frozen and analyzed by section to determine if all the tumor has been removed. If not, additional layers of tissue are shaved and examined until all tissue margins are tumor-free.
With repeated reactions of contact dermatitis, which of the following can occur? You Selected: Secondary bacterial infection Correct response: Secondary bacterial infection Explanation: If repeated reactions occur, or if the patient continually scratches the skin, lichenification (thickening of the horny layer of the skin) and pigmentation occur. Secondary bacterial invasion may follow. During shingles, there will be pain along the sensory nerve. Sepsis and hemorrhage would not occur from repeated bouts of contact dermatitis.
Secondary bacterial infection Explanation: If repeated reactions occur, or if the patient continually scratches the skin, lichenification (thickening of the horny layer of the skin) and pigmentation occur. Secondary bacterial invasion may follow. During shingles, there will be pain along the sensory nerve. Sepsis and hemorrhage would not occur from repeated bouts of contact dermatitis.
The nurse is caring for a client who may have a lice infestation. The nurse is using a bright light focused on an area of the head to confirm the presence of lice. In which manner is it easiest to differentiate nits from dandruff? You Selected: Nits are located near the scalp. Correct response: Nits are difficult to move from hair shafts. Explanation: Lice eggs, or nits, can be confused with dandruff. However, dandruff consists of fine, white particles of dead, dry scalp cells that can be easily picked from the hair. Nits, on the other hand, look like small, yellowish-white ovals and are quite firmly fixed to the hair shaft. The nurse is correct to use the difference of the nits being securely attached to the hair shaft as a guide to confirmation of lice infestation.
The nurse is caring for a client who may have a lice infestation. The nurse is using a bright light focused on an area of the head to confirm the presence of lice. In which manner is it easiest to differentiate nits from dandruff? You Selected: Nits are located near the scalp. Correct response: Nits are difficult to move from hair shafts. Explanation: Lice eggs, or nits, can be confused with dandruff. However, dandruff consists of fine, white particles of dead, dry scalp cells that can be easily picked from the hair. Nits, on the other hand, look like small, yellowish-white ovals and are quite firmly fixed to the hair shaft. The nurse is correct to use the difference of the nits being securely attached to the hair shaft as a guide to confirmation of lice infestation.
The nurse is instructing the parents of a child with head lice. Which statement should the nurse include? You Selected: Disinfect brushes and combs with bleach. Correct response: Use shampoo with piperonyl butoxide. Explanation: The nurse's instructions should include shampooing with piperonyl butoxide, washing clothes in hot water, and disinfecting brushes and combs with piperonyl butoxide shampoo.
The nurse is instructing the parents of a child with head lice. Which statement should the nurse include? You Selected: Disinfect brushes and combs with bleach. Correct response: Use shampoo with piperonyl butoxide. Explanation: The nurse's instructions should include shampooing with piperonyl butoxide, washing clothes in hot water, and disinfecting brushes and combs with piperonyl butoxide shampoo.
The nurse is instructing the parents of a child with head lice. Which statement should the nurse include? You Selected: Use shampoo with piperonyl butoxide. Correct response: Use shampoo with piperonyl butoxide. Explanation: The nurse's instructions should include shampooing with piperonyl butoxide, washing clothes in hot water, and disinfecting brushes and combs with piperonyl butoxide shampoo.
The nurse is instructing the parents of a child with head lice. Which statement should the nurse include? You Selected: Use shampoo with piperonyl butoxide. Correct response: Use shampoo with piperonyl butoxide. Explanation: The nurse's instructions should include shampooing with piperonyl butoxide, washing clothes in hot water, and disinfecting brushes and combs with piperonyl butoxide shampoo.
The nurse is instructing the patient in how to apply a corticosteroid cream to lesions on the arm. What intervention can the nurse instruct the patient to do to increase the absorption of the medication? You Selected: Apply an occlusive dressing over the site after application. Correct response: Apply an occlusive dressing over the site after application. Explanation: Corticosteroids are widely used in treating dermatologic conditions to provide anti-inflammatory, antipruritic, and vasoconstrictive effects. The patient is educated to apply this medication according to strict guidelines, using it sparingly but rubbing it into the prescribed area thoroughly. Absorption of topical corticosteroids is enhanced when the skin is hydrated or the affected area is covered by an occlusive or moisture-retentive dressing (Karch, 2013).
The nurse is instructing the patient in how to apply a corticosteroid cream to lesions on the arm. What intervention can the nurse instruct the patient to do to increase the absorption of the medication? You Selected: Apply an occlusive dressing over the site after application. Correct response: Apply an occlusive dressing over the site after application. Explanation: Corticosteroids are widely used in treating dermatologic conditions to provide anti-inflammatory, antipruritic, and vasoconstrictive effects. The patient is educated to apply this medication according to strict guidelines, using it sparingly but rubbing it into the prescribed area thoroughly. Absorption of topical corticosteroids is enhanced when the skin is hydrated or the affected area is covered by an occlusive or moisture-retentive dressing (Karch, 2013).
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? You Selected: Hyperthyroidism Correct response: End-stage kidney disease Explanation: Systemic disorders associated with generalized pruritus include chronic kidney disease.
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? You Selected: Hyperthyroidism Correct response: End-stage kidney disease Explanation: Systemic disorders associated with generalized pruritus include chronic kidney disease.
Which term describes a fungal infection of the scalp? You Selected: Tinea capitis Correct response: Tinea capitis Explanation: Tinea capitis is a fungal infection of the scalp. Tinea corporis involves fungal infections of the body. Tinea cruris describes fungal infections of the inner thigh and inguinal creases. Tinea pedis is the term for fungal infections of the foot.
Tinea capitis Explanation: Tinea capitis is a fungal infection of the scalp. Tinea corporis involves fungal infections of the body. Tinea cruris describes fungal infections of the inner thigh and inguinal creases. Tinea pedis is the term for fungal infections of the foot.
To treat a client with acne vulgaris, the physician is most likely to order which topical agent for nightly application? You Selected: Tretinoin (retinoic acid [Retin-A]) Correct response: Tretinoin (retinoic acid [Retin-A]) Explanation: Tretinoin is a topical agent applied nightly to treat acne vulgaris. Minoxidil promotes hair growth. Zinc oxide gelatin treats stasis dermatitis on the lower legs. Fluorouracil is an antineoplastic topical agent that treats superficial basal cell carcinoma.
To treat a client with acne vulgaris, the physician is most likely to order which topical agent for nightly application? You Selected: Tretinoin (retinoic acid [Retin-A]) Correct response: Tretinoin (retinoic acid [Retin-A]) Explanation: Tretinoin is a topical agent applied nightly to treat acne vulgaris. Minoxidil promotes hair growth. Zinc oxide gelatin treats stasis dermatitis on the lower legs. Fluorouracil is an antineoplastic topical agent that treats superficial basal cell carcinoma.
What advice should the nurse give a client with dermatitis until the etiology of the dermatitis is identified? You Selected: Wear rubber gloves when in contact with soaps. Correct response: Wear rubber gloves when in contact with soaps. Explanation: The nurse should advise the client to wear rubber gloves when coming in contact with any substance such as soap or solvents. The client should avoid wool, synthetics, and other dense fibers. The client should use tepid bath water and should pat rather than rub the skin dry.
Wear rubber gloves when in contact with soaps. Explanation: The nurse should advise the client to wear rubber gloves when coming in contact with any substance such as soap or solvents. The client should avoid wool, synthetics, and other dense fibers. The client should use tepid bath water and should pat rather than rub the skin dry.
A client recently received lip and tongue piercings and subsequently developed a superinfection of candidiasis from the antibacterial mouthwash. What would the nurse recommend for this client? You Selected: Use an antifungal mouthwash or salt water. Correct response: Use an antifungal mouthwash or salt water. Explanation: The client can substitute an antifungal mouthwash or salt water if a superinfection of candidiasis develops from the al mouthwash. A soft-bristled toothbrush should be used to avoid additional oral injury, but it is not the recommended solution for this problem. After eating, the client should rinse the mouth for 30 to 60 seconds with an antifungal mouthwash or salt water. Moving the jewelry at the piercing area back and forth during washing helps clean the pierced tract but does not solve the problem.
Use an antifungal mouthwash or salt water. Explanation: The client can substitute an antifungal mouthwash or salt water if a superinfection of candidiasis develops from the al mouthwash. A soft-bristled toothbrush should be used to avoid additional oral injury, but it is not the recommended solution for this problem. After eating, the client should rinse the mouth for 30 to 60 seconds with an antifungal mouthwash or salt water. Moving the jewelry at the piercing area back and forth during washing helps clean the pierced tract but does not solve the problem.
The nurse is instructing the parents of a child with head lice. Which statement should the nurse include? You Selected: Use shampoo with piperonyl butoxide. Correct response: Use shampoo with piperonyl butoxide. Explanation: The nurse's instructions should include shampooing with piperonyl butoxide, washing clothes in hot water, and disinfecting brushes and combs with piperonyl butoxide shampoo.
Use shampoo with piperonyl butoxide. Explanation: The nurse's instructions should include shampooing with piperonyl butoxide, washing clothes in hot water, and disinfecting brushes and combs with piperonyl butoxide shampoo.
A nurse is assessing a client with a new skin disorder. Which questions would the nurse include when asking the client about the change in skin condition? Select all that apply. When did the disorder first begin, and where did it first appear? Where are the lesions located? Has the problem spread? Have you tried to treat the lesions? Do you exercise daily? Correct response: Incorrect response: Your selection: Explanation: The nurse would ask the client when and where the disorder started, where the lesions are located and if they have spread, and if the client has attempted to treat them. The client's exercise habits would not affect the skin disorder.
When did the disorder first begin, and where did it first appear? Where are the lesions located? Has the problem spread? Have you tried to treat the lesions? Explanation: The nurse would ask the client when and where the disorder started, where the lesions are located and if they have spread, and if the client has attempted to treat them. The client's exercise habits would not affect the skin disorder.
When performing a skin assessment, the nurse notes a localized skin infection of a single hair follicle. The nurse documents the presence of You Selected: a furuncle. Correct response: a furuncle. Explanation: Furuncles are localized skin infections of a single hair follicle. They can occur anywhere on the body but are most prevalent in areas subjected to irritation, pressure, friction, and excessive perspiration, such as the back of the neck, the axillae, or the buttocks. A carbuncle is a localized skin infection involving several hair follicles. Cheilitis refers to dry cracking at the corners of the mouth. Comedones are the primary lesions of acne, caused by sebum blockage in the hair follicle.
When performing a skin assessment, the nurse notes a localized skin infection of a single hair follicle. The nurse documents the presence of You Selected: a furuncle. Correct response: a furuncle. Explanation: Furuncles are localized skin infections of a single hair follicle. They can occur anywhere on the body but are most prevalent in areas subjected to irritation, pressure, friction, and excessive perspiration, such as the back of the neck, the axillae, or the buttocks. A carbuncle is a localized skin infection involving several hair follicles. Cheilitis refers to dry cracking at the corners of the mouth. Comedones are the primary lesions of acne, caused by sebum blockage in the hair follicle.
Which drug is an oral retinoid used to treat acne? You Selected: Isotretinoin Correct response: Isotretinoin Explanation: Isotretinoin, an oral retinoid, is used in clients diagnosed with nodular cystic acne that does not respond to conventional therapy. Estrogen, tetracycline, and benzoyl peroxide are not oral retinoids.
Which drug is an oral retinoid used to treat acne? You Selected: Isotretinoin Correct response: Isotretinoin Explanation: Isotretinoin, an oral retinoid, is used in clients diagnosed with nodular cystic acne that does not respond to conventional therapy. Estrogen, tetracycline, and benzoyl peroxide are not oral retinoids.
Which of the following nonsedating antihistamines is appropriate for daytime pruritus? You Selected: Fexofenadine (Allegra) Correct response: Fexofenadine (Allegra) Explanation: Nonsedating antihistamine medications such as Allegra are more appropriate to relieve daytime pruritus. Benadryl or Atarax, when prescribed in a sedative dose at bedtime, may be beneficial in producing a restful and comfortable sleep. Ativan has sedating properties and is used as an antianxiety medication.
Which of the following nonsedating antihistamines is appropriate for daytime pruritus? You Selected: Fexofenadine (Allegra) Correct response: Fexofenadine (Allegra) Explanation: Nonsedating antihistamine medications such as Allegra are more appropriate to relieve daytime pruritus. Benadryl or Atarax, when prescribed in a sedative dose at bedtime, may be beneficial in producing a restful and comfortable sleep. Ativan has sedating properties and is used as an antianxiety medication.
Which procedure done for skin cancer conserves the most amount of normal tissue? You Selected: Mohs micrographic surgery Correct response: Mohs micrographic surgery Explanation: 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.
Which procedure done for skin cancer conserves the most amount of normal tissue? You Selected: Mohs micrographic surgery Correct response: Mohs micrographic surgery Explanation: 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.
Which skin condition is caused by staphylococci, streptococci, or multiple bacteria? You Selected: Impetigo Correct response: Impetigo Explanation: Impetigo is seen at all ages but is particularly common among children living under poor hygienic conditions. Scabies is caused by the itch mite. Pediculosis capitis is caused by head lice. Poison ivy is a contact dermatitis caused by the oleoresin given off by a particular form of ivy.
Which skin condition is caused by staphylococci, streptococci, or multiple bacteria? You Selected: Impetigo Correct response: Impetigo Explanation: Impetigo is seen at all ages but is particularly common among children living under poor hygienic conditions. Scabies is caused by the itch mite. Pediculosis capitis is caused by head lice. Poison ivy is a contact dermatitis caused by the oleoresin given off by a particular form of ivy.
Which term refers most precisely to a localized skin infection of a single hair follicle? You Selected: Furuncle Correct response: Furuncle Explanation: Furuncles occur anywhere on the body but are most prevalent in areas subjected to irritation, pressure, friction, and excessive perspiration, such as the back of the neck, the axillae, or the buttocks. A carbuncle is a localized skin infection involving several hair follicles. Cheilitis refers to dry cracking at the corners of the mouth. Comedones are the primary lesions of acne, caused by sebum blockage in the hair follicle.
Which term refers most precisely to a localized skin infection of a single hair follicle? You Selected: Furuncle Correct response: Furuncle Explanation: Furuncles occur anywhere on the body but are most prevalent in areas subjected to irritation, pressure, friction, and excessive perspiration, such as the back of the neck, the axillae, or the buttocks. A carbuncle is a localized skin infection involving several hair follicles. Cheilitis refers to dry cracking at the corners of the mouth. Comedones are the primary lesions of acne, caused by sebum blockage in the hair follicle.
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: You Selected: "All family members need to be treated." Correct response: "All family members need to be treated." Explanation: When someone sharing a home with others contracts scabies, all individuals in the home need prompt treatment whether or not they're symptomatic. Towels and linens should be washed in hot water. Scabies can be transmitted from one person to another before symptoms develop.
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: You Selected: "All family members need to be treated." Correct response: "All family members need to be treated." Explanation: When someone sharing a home with others contracts scabies, all individuals in the home need prompt treatment whether or not they're symptomatic. Towels and linens should be washed in hot water. Scabies can be transmitted from one person to another before symptoms develop.
A client visits the physician's office for treatment of a skin disorder. As a primary treatment, the nurse expects the physician to order: You Selected: a topical agent. Correct response: a topical agent. Explanation: Although many drugs are used to treat skin disorders, topical agents — not IV or oral agents — are the mainstay of treatment.
a topical agent. Explanation: Although many drugs are used to treat skin disorders, topical agents — not IV or oral agents — are the mainstay of treatment.
Which is not a category of medications used for treatment of the skin? You Selected: inhaled steroids Correct response: inhaled steroids Explanation: Inhaled steroids are not used for skin disorders. Topical corticosteroids, antihistamines, and antibiotics are all used in the treatment of skin disorders.
inhaled steroids Explanation: Inhaled steroids are not used for skin disorders. Topical corticosteroids, antihistamines, and antibiotics are all used in the treatment of skin disorders.
The classic lesions of impetigo manifest as You Selected: honey-yellow crusted lesions on an erythematous base. Correct response: honey-yellow crusted lesions on an erythematous base. Explanation: The classic lesions of impetigo are honey-yellow crusted lesions on an erythematous base. Comedones in the facial area are representative of acne. A carbuncle is an abscess of skin and subcutaneous tissue. Herpes zoster is exhibited by patches of grouped vesicles on red and swollen skin.
honey-yellow crusted lesions on an erythematous base. Explanation: The classic lesions of impetigo are honey-yellow crusted lesions on an erythematous base. Comedones in the facial area are representative of acne. A carbuncle is an abscess of skin and subcutaneous tissue. Herpes zoster is exhibited by patches of grouped vesicles on red and swollen skin.
A client is being treated for acne vulgaris. What contributes to follicular irritation? You Selected: overproduction of sebum Correct response: overproduction of sebum Explanation: The overproduction of sebum provides an ideal environment for bacterial growth within the irritated follicle. The follicle becomes further distended and irritated, causing a raised papule in the skin.
overproduction of sebum Explanation: The overproduction of sebum provides an ideal environment for bacterial growth within the irritated follicle. The follicle becomes further distended and irritated, causing a raised papule in the skin.
The nurse teaches the client who demonstrates herpes zoster (shingles) that You Selected: the infection results from reactivation of the chickenpox virus. Correct response: the infection results from reactivation of the chickenpox virus. Explanation: It is assumed that herpes zoster represents a reactivation of latent varicella (chickenpox) virus and reflects lowered immunity. It is believed that the varicella zoster virus lies dormant inside nerve cells near the brain and spinal cord and is reactivated with weakened immune systems and cancers. A person who has had chickenpox is immune and therefore not at risk of infection after exposure to a client with herpes zoster. Some evidence indicates that infection is arrested if oral antiviral agents are administered within 24 hours of the initial eruption.
the infection results from reactivation of the chickenpox virus. Explanation: It is assumed that herpes zoster represents a reactivation of latent varicella (chickenpox) virus and reflects lowered immunity. It is believed that the varicella zoster virus lies dormant inside nerve cells near the brain and spinal cord and is reactivated with weakened immune systems and cancers. A person who has had chickenpox is immune and therefore not at risk of infection after exposure to a client with herpes zoster. Some evidence indicates that infection is arrested if oral antiviral agents are administered within 24 hours of the initial eruption.