integumentary

A nurse reinforces instructions to a client who has complained of chronic dry skin and episodes of pruritus. Which of the following client statements indicates an understanding of the teaching? Select all that apply: 1. "I should drink eight to ten glasses of water a day." 2. "I need to avoid using astringents on my skin." 3. "I should use a dehumidifier, especially during the winter months." 4. "I should limit myself to one shower per day and apply an emollient to my skin after the shower."

1, 2, 3, 4

A client is being admitted to the hospital for the treatment of acute cellulitis of the lower left leg. The client asks the nurse to explain what cellulitis means. The nurse bases the response on the understanding that the characteristics of cellulitis include: Select all that apply: 1. An acute superficial infection 2. An inflammation of the lymphatics 3. A superficial infection caused by Staphylococcus 4. A skin infection into the deep dermis and subcutaneous fat

1, 3, 4 An acute superficial infection. A superficial infection caused by staphylococcus. A skin infection into the deep dermis and subcutaneous fat

A nurse reinforces instructions to a group of clients regarding measures that will assist with the prevention of skin cancer. Which statement by a client indicates the need for further instruction? 1. "I need to wear sunscreen when participating in outdoor activities." 2. "I need to avoid sun exposure before 10:00 ᴀᴍ and after 4:00 ᴘᴍ." 3. "I need to wear a hat, opaque clothing, and sunglasses when in the sun." 4. "I need to examine my body monthly for any lesions that may be suspicious."

2. "I need to avoid sun exposure before 10:00 ᴀᴍ and after 4:00 ᴘᴍ."

A nurse is caring for a client with a skin infection who is receiving amoxicillin (Amoxil) 500 mg every 8 hours. Which of the following indicates to the nurse that the client is experiencing a frequent side effect related to the medication? 1. Severe abdominal cramps 2. Vaginal drainage 3. Fever 4. Severe watery diarrhea

2. Vaginal drainage

A client is receiving topical corticosteroid therapy for the treatment of psoriasis. The nurse anticipates noting which health care provider's prescription in the client's medical record that will maximize the effectiveness of this therapy? 1. Rub the application into the skin. 2. Place the area under a heat lamp for 20 minutes. 3. Apply a dry sterile dressing over the affected area. 4. Cover the application with a warm, moist dressing and an occlusive outer wrap.

4. Cover the application with a warm, moist dressing and an occlusive outer wrap.

Which of the following individuals is least likely at risk for the development of psoriasis? 1. A 32-year-old African American 2. A client with a systemic illness 3. An individual who has experienced a significant amount of emotional distress 4. A woman experiencing menopause

1. A 32-year-old African American

A nurse is reviewing the health care record of a client with a lesion that has been diagnosed as malignant melanoma. The nurse would expect which characteristic of this type of lesion to be documented in the client's record? 1. An irregularly shaped lesion 2. A small papule with a dry, rough scale 3. A firm nodular lesion topped with a crust 4. A pearly papule with a central crater and a waxy border

1. An irregularly shaped lesion

A nurse is assigned to care for a client with herpes zoster. Which of the following characteristics would the nurse expect to note when assessing the lesions of this infection? 1. Clustered skin vesicles 2. A generalized body rash 3. Small blue-white spots with red bases 4. A fiery red edematous rash on the cheeks

1. Clustered skin vesicles

A nurse in a health care provider's office has scheduled a client with dermatitis to be seen in 1 week for a patch test. The nurse would tell the client to do which of the following before the procedure? 1. Discontinue the prescribed antihistamine 2 days before the test. 2. Refrain from eating solid food on the day of the test. 3. Do not eat or drink anything on the morning of the test. 4. Shower using povidone-iodine on the morning of the test.

1. Discontinue the prescribed antihistamine 2 days before the test.

A client exhibits erythema of the skin. The nurse plans care, knowing that which factors are responsible for this finding? Select all that apply. 1. Fever 2. Vasodilation 3. Inflammation 4. Deoxygenated hemoglobin 5. Excessively high environmental temperature

1. Fever 2. Vasodilation 3. Inflammation 5. Excessively high environmental temperature

The nurse provides home care instructions to a client with systemic lupus erythematous and tells the client about methods to manage fatigue. Which statement by the client indicates a need for further instructions? 1. I should take hot baths because they are relaxing. 2. I should sit whenever possible to conserve energy. 3. I should avoid long periods of rest because it causes joint stiffness. 4. I should do some exercises, such as walking when I am not fatigued.

1. I should take hot baths because they are relaxing.

A client with severe psoriasis has a problem of chronic low self-esteem. The nurse should plan to incorporate which nursing action when working with this client? 1. Listening attentively 2. Keeping communications brief 3. Approaching the client in a formal manner 4. Avoiding looking at the affected skin areas

1. Listening attentively

The nurse is preparing to perform an assessment on a client being seen in the clinic. On review of the client's record, the nurse notes that the client has psoriasis. The nurse would expect to observe which characteristics on assessment of the client's psoriatic lesions? Select all that apply. 1. Red, raised papules 2. Large plaques covered by silvery scales 3. Tiny red vesicles that weep serous material 4. Erythema noted mostly under the breast area 5. Pink to dark red, patchy eruptions on the skin

1. Red, raised papules 2. Large plaques covered by silvery scales

The health education nurse provides instructions to a group of clients regarding measures that will assist in preventing skin cancer. Which instructions should the nurse provide? Select all that apply. 1. Sunscreen should be applied every 8 hours. 2. Use sunscreen when participating in outdoor activities. 3. Wear a hat, opaque clothing, and sunglasses when in the sun. 4. Avoid sun exposure in the late afternoon and early evening hours. 5. Examine your body monthly for any lesions that may be suspicious.

2, 3, 5 Use sunscreen when participating in outdoor activities. Wear a hat, opaque clothing, and sunglasses when in the sun. Examine your body monthly for any lesions that may be suspicious.

The nurse reviews home care instructions with a client diagnosed with impetigo. Which statement indicates that the client does not understand the measures that will prevent the spread of infection? 1. "I need to take the full course of the antibiotics." 2. "My clothes can be laundered with other household members' clothes." 3. "I must wash my hands thoroughly and frequently throughout the day." 4. "I need to wash my dishes and eating utensils separate from other household members."

2. "My clothes can be laundered with other household members' clothes."

A client is undergoing radiation therapy to treat lung cancer. Following the treatment, the nurse notes that the chest and neck are red, and the client is complaining of pain at the radiation site. The nurse interprets this data as: 1. An allergic reaction to the radiation 2. A superficial injury to tissue from the radiation 3. An ischemic injury, much like decubitus formation 4. A cutaneous reaction to products formed by lysis of the neoplastic cells

2. A superficial injury to tissue from the radiation

A nurse is preparing a poster for a health fair about prevention and early detection of skin cancer. The nurse would include on the poster instructions to avoid which of the following activities? 1. Wearing a hat, opaque clothing, and sunglasses when in the sun 2. Being in the sun for prolonged periods between 10:00 ᴀᴍ and 3:00 ᴘᴍ 3. Using sunscreen when spending time outdoors 4. Examining the skin monthly for any lesions that might be cancerous

2. Being in the sun for prolonged periods between 10:00 ᴀᴍ and 3:00 ᴘᴍ Rationale: The client should be instructed to avoid sun exposure between the hours of 10:00 ᴀᴍ and 3:00 ᴘᴍ. Sunscreen, a hat, opaque clothing, and sunglasses should be worn when spending time outdoors. The client should examine the body monthly for the appearance of any possible cancerous or precancerous lesions.

The home care nurse visits an older client who was discharged from the hospital after diagnostic testing. The client complains of chronic dry skin and episodes of pruritus. Which measure should the nurse recommend for the client to alleviate this discomfort? 1. Run a dehumidifier in the home. 2. Apply astringents to the skin twice daily. 3. Apply emollients to the skin after bathing. 4. Take baths twice daily using a dilute solution of alcohol and water.

3. Apply emollients to the skin after bathing.

The nurse has provided discharge instructions to a client who has had cryosurgery to remove a malignant skin lesion. The nurse determines that the client understands the instructions if the client makes which statement? Select all that apply. 1. "I need to avoid baths or showers for 7 to 10 days." 2. "I need to clean the site as prescribed to prevent infection." 3. "I need to apply ice to the site continuously to prevent swelling." 4. "I need to expect some swelling and tenderness in the affected area." 5. "I need to apply alcohol-soaked dressings twice a day for 30 minutes each time."

2. "I need to clean the site as prescribed to prevent infection." 4. "I need to expect some swelling and tenderness in the affected area."

A client calls the emergency department and tells the nurse that he has been cleaning a wooded area and that he came into direct contact with poison ivy shrubs. The client tells the nurse that he cannot see anything on the skin and asks the nurse what to do. The nurse makes which statement to the client? 1. "Come to the emergency department." 2. "Apply calamine lotion immediately to the exposed skin areas." 3. "Take a shower immediately, and lather and rinse several times." 4. "It is not necessary to do anything if you cannot see anything on your skin."

3. "Take a shower immediately, and lather and rinse several times."

A nurse is reviewing the health care provider's prescriptions written for a client admitted with a diagnosis of acute cellulitis of the lower leg. The nurse should question which prescription? 1. Obtain blood cultures. 2. Administer antibiotics. 3. Apply cold compresses to the affected area. 4. Administer acetaminophen (Tylenol) for fever.

3. Apply cold compresses to the affected area.

A nurse inspects the oral cavity of a client with cancer and notes white patches on the mucous membranes. The nurse determines that this occurrence: 1. Is common 2. Suggests that the client is anemic 3. Is characteristic of a thrush infection 4. Is indicative that oral hygiene needs to be improved

3. Is characteristic of a thrush infection

A client returns to the clinic for follow-up treatment after a skin biopsy of a suspicious lesion that was performed 1 week ago. The biopsy report indicates that the lesion is a melanoma. The nurse understands that which of the following describes a characteristic of this type of a lesion? Submit 1. Metastasis is rare. 2. It is encapsulated. 3. It is highly metastatic. 4. It is characterized by local invasion.

3. It is highly metastatic.

A client with acquired immunodeficiency syndrome (AIDS) is diagnosed with cutaneous Kaposi's sarcoma. Based on this diagnosis, the nurse understands that this has been determined by which of the following? 1. Swelling in the genital area 2. Swelling in the lower extremities 3. Punch biopsy of the cutaneous lesions 4. Appearance of reddish-blue lesions on the skin

3. Punch biopsy of the cutaneous lesions

The clinic nurse notes that the health care provider has documented a diagnosis of herpes zoster (shingles) in the client's chart. Based on an understanding of the cause of this disorder, the nurse determines that this definitive diagnosis was made by which diagnostic test? 1. Patch test 2. Skin biopsy 3. Culture of the lesion 4. Wood's light examination

3. Culture of the lesion

A client with cellulitis of the lower leg has had cultures collected from the affected area. The nurse reading the culture report understands that which organism is not part of the normal flora of the skin and is a common source of wound infections? 1. Candida albicans 2. Staphylococcus aureus 3. Escherichia coli (E. coli) 4. Staphylococcus epidermidis

3. Escherichia coli (E. coli)

The nurse prepares a plan of care for a client with a diagnosis of acute cellulitis of the lower leg. On reviewing the plan of care, the nurse understands the treatment if the care plan includes which measure? 1. Cold compresses to the affected area 2. Heat lamp treatments four times daily 3. Warm compresses to the affected area 4. Alternating hot to cold compresses every 2 hours

3. Warm compresses to the affected area

Which of the following individuals is least likely at risk for the development of Kaposi's sarcoma? 1. A renal transplant client 2. A male with a history of same-sex partners 3. A client receiving antineoplastic medications 4. An individual working in an environment in which exposure to asbestos is possible

4. An individual working in an environment in which exposure to asbestos is possible

Which of the following individuals would be at the greatest risk for development of an integumentary disorder? 1. An adolescent 2. An older female 3. A physical education teacher 4. An outdoor construction worker

4. An outdoor construction worker

The nurse has provided instructions to a client with pruritus regarding measures to relieve the discomfort. Which statement, if made by the client, indicates a need for further instruction? 1. "I should use tepid water for bathing." 2. "I need to keep my skin lubricated and cool." 3. "After bathing, I should pat my skin dry rather than rubbing it." 4. "I should apply a lubricant to my skin after bathing when my skin is thoroughly dry."

4. "I should apply a lubricant to my skin after bathing when my skin is thoroughly dry."

The nurse prepares to care for a client with acute cellulitis of the lower leg. The nurse anticipates that which interventions will be prescribed for the client? Select all that apply. 1. Antibiotic therapy 2. Cold compresses to the affected area 3. Warm compresses to the affected area 4. Intermittent heat lamp treatments four times daily 5. Alternating hot and cold compresses continuously

1. Antibiotic therapy 3. Warm compresses to the affected area

A nurse reviews a client's chart and notes that the health care provider has documented a diagnosis of paronychia. Based on this diagnosis, which of the following would the nurse expect to note during data collection? 1. Red, shiny skin around the nail bed 2. White, taut skin in the popliteal area 3. White, silvery patches on the elbows 4. Swelling of the skin near the parotid gland

1. Red, shiny skin around the nail bed

A nurse is discussing skin biopsy with a client scheduled for the procedure. The nurse tells the client to expect how much discomfort during the procedure? 1. Slight because the local anesthetic may burn or sting 2. None because it is done under general anesthesia 3. None because it is painless 4. Somewhat painful but easily managed with opioids afterward

1. Slight because the local anesthetic may burn or sting

The health education nurse provides instructions to a group of clients regarding measures that will assist in preventing skin cancer. Which instruction(s) should the nurse reinforce to the client? Select all that apply. 1. Use sunscreen when participating in outdoor activities. 2. Wear a hat, opaque clothing, and sunglasses when in the sun. 3. Avoid sun exposure in the late afternoon and early evening hours. 4. Examine your body monthly for any lesions that may be suspicious. 5. Sunscreen should be applied every 8 hours.

1. Use sunscreen when participating in outdoor activities. 2. Wear a hat, opaque clothing, and sunglasses when in the sun. 4. Examine your body monthly for any lesions that may be suspicious.

A client is newly admitted to the hospital with cellulitis of the lower leg. The nurse checks the health care provider's prescription sheet to see if which of the following therapies has been prescribed for site care? 1. Intermittent heat lamp treatments 2. Alternating hot and cold compresses 3. Warm compresses 4. Cold compresses

3. Warm compresses Rationale: Warm compresses may be used to decrease the discomfort, erythema, and edema that accompany cellulitis. Definitive treatment includes antibiotic therapy after appropriate cultures have been done. Other supportive measures also are used to manage symptoms such as fatigue, fever, chills, headache, or myalgia. Heat lamps are not used because of the risk of burns and because moist heat is most useful in treating this disorder.

A client has undergone laser surgery to remove two nevi. The nurse determines that the client has understood discharge instructions if he or she makes which statement? 1. "I can expect significant discomfort after the procedure." 2. "I need to cleanse the operated areas daily using scrubbing motions." 3. "I need to protect the operated areas from direct sunlight for at least 3 months." 4. "I need to report any signs of swelling or redness immediately to the health care provider."

3. "I need to protect the operated areas from direct sunlight for at least 3 months."

The nurse is reviewing discharge instructions for a client who had a skin biopsy. Which statement by the client indicate a need for further instruction? 1. "I will use the antibiotic ointment as prescribed." 2. "I will return in 7 days to have the sutures removed." 3. "I will remove the dressing as soon as I get home and wash it with tap water." 4. "I will call the health care provider (HCP) if I see any drainage from the wound."

3. "I will remove the dressing as soon as I get home and wash it with tap water."

The nurse in the ambulatory care unit is providing home care instructions to a client after cryotherapy for the treatment of malignant skin lesions. Which statement would be most appropriate for the nurse to include in the home care instructions for this client? 1. "Apply ice to the site to prevent swelling." 2. "Clean the site with alcohol three times daily." 3. "Apply a warm, damp washcloth if discomfort occurs." 4. "Avoid showering or taking baths until seen by the health care provider in 1 week."

3. Apply a warm, damp washcloth if discomfort occurs.

An older client is complaining of chronic dry skin and occasional pruritus. The nurse tells the client to avoid which of the following that will aggravate the condition? 1. Applying emollient to the skin after a shower 2. Using a humidifier, especially during the winter months 3. Drinking 8 to 10 glasses of water a day 4. Using astringents to clean the skin

4. Using astringents to clean the skin Rationale: The client should avoid the use of rubbing alcohol, astringents, or other drying agents on the skin. The client should take one 15- to 20-minute warm bath or one shower per day. The client should then apply an emollient to prevent water evaporation from the hydrated epidermis. A room humidifier is useful during the winter months or whenever a furnace is in use. The client should maintain a daily fluid intake of 3000 mL, unless contraindicated, and should avoid ingestion of alcohol and caffeine.

The nurse is reviewing the discharge instructions for the client who had a skin biopsy. Which statement, if made by the client, would indicate a need for further instruction? 1. "I will keep the dressing dry." 2. "I will watch for any drainage from the wound." 3. "I will use the antibiotic ointment as prescribed." 4. "I will return tomorrow to have the sutures removed."

4. "I will return tomorrow to have the sutures removed."

The nurse is providing information to a client scheduled for a skin biopsy. The client asks the nurse how painful the procedure is. The nurse should make which response to the client? 1. "The procedure is painless." 2. "A preoperative medication will put you to sleep." 3. "An analgesic will be prescribed after the procedure." 4. "The local anesthetic may cause a stinging sensation, but the surgeon will numb the area so that pain will not be felt."

4. "The local anesthetic may cause a stinging sensation, but the surgeon will numb the area so that pain will not be felt."

The nurse is conducting a screening program to identify clients at risk for an integumentary disorder. Which client seen at the screening would be most likely to be at risk for development of an integumentary disorder? 1. An athlete 2. An adolescent 3. An older client 4. A client who tans in an indoor tanning bed

4. A client who tans in an indoor tanning bed.

In planning care for the client with psoriasis, the nurse understands that which represents a priorityclient problem? 1. Fatigue 2. Constipation 3. Impaired safety 4. Altered body image

4. Altered body image

A client is experiencing chronic pruritus. To promote hydration of the skin, the nurse should tell the client to take which measure? 1. Maintain room humidity at less than 40%. 2. Use very hot or very cold water for bathing. 3. Apply emollients once the skin is thoroughly dry. 4. Avoid bathing in the shower or tub more than once daily.

4. Avoid bathing in the shower or tub more than once daily.

A client complains of chronic pruritus. The nurse investigating this complaint would review the medical record for documentation of which disorder as a cause of this problem? 1. Anemia 2. Hypothyroidism 3. Addison's disease 4. Chronic kidney disease

4. Chronic kidney disease

The clinic nurse assesses the skin of a client with a diagnosis of psoriasis. The nurse understands that which characteristic is associated with this skin disorder? 1. Oily skin 2. Clear, thin nail beds 3. Red-purplish scaly lesions 4. Silvery-white scaly patches

4. Psoriasis is silvery-white scaly patches

A client being seen in an ambulatory clinic for an unrelated complaint has a butterfly rash noted across the nose. The nurse interprets that this finding is consistent with early manifestations of which disorder? 1. Hyperthyroidism 2. Pernicious anemia 3. Cardiopulmonary disorders 4. Systemic lupus erythematosus (SLE)

4. Systemic lupus erythematosus (SLE)