Med-Surg Chapter 61: Managements of Patients With Dermatologic Problems

Which of the following advice should the nurse give a client with dermatitis until the etiology of the dermatitis is identified?

Wear rubber gloves when in contact with soaps.

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

Every 3 to 4 hours for sustained effectiveness.

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. Which instruction best prevents skin damage?

"Apply sunscreen even on overcast days."

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

"To prevent evaporation of water from the hydrated epidermis."

A client has been diagnosed with shingles. Which of the following medication classifications will reduce the severity and prevent development of new lesions?

Antiviral

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?

Apply an occlusive dressing over the site after application.

Which of the following terms refers to a graft derived from one part of a patient's body and used on another part of that same patient's body?

Autograft

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

Autolytic debridement

The nurse caring for a patient with repeated episodes of contact dermatitis is providing instruction to prevent future episodes. Which of the following should the nurse include?

Avoid cosmetics with fragrance.

A patient has developed a boil on the face and the nurse observes the patient squeezing the boil. What does the nurse understand is a potential severe complication of this manipulation?

Brain abscess

The nurse is working with community groups. At which of the following locations would the nurse anticipate a possible scabies outbreak?

College dormitory

The nurse is conducting an admission history and physical examination of a patient with a history of contact dermatitis. The nurse assesses if the patient utilizes which of the following medication classifications?

Corticosteroids

Which of the following medication classifications may be used for contact dermatitis?

Corticosteroids

The nurse should assess all possible causes of pruritus for a patient complaining of generalized pruritus. What does the nurse understand can be other causes for this condition?

End-stage kidney disease

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

Frequent inspection of oral cavity

When performing a skin assessment, the nurse notes a localized skin infection of a single hair follicle. The nurse documents the presence of which of the following?

Furuncle

The classic lesions of impetigo are manifested as which of the following?

Honey-crusted lesions on an erythematous base

Which of the following reflect the pathophysiology of cutaneous signs of HIV disease?

Immune function deterioration

Development of malignant melanoma is associated with which of the following risk factors?

Individuals with a history of severe sunburn

What is the major cause of death in toxic epidermal necrolysis (TEN)?

Infection

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

Isotretinoin (Accutane)

Which of the following is an oral retinoid used in the treatment of acne?

Isotretinoin (Accutane)

Which of the following is accurate regarding isotretinoin (Accutane)?

It is teratogenic in humans.

The nurse assesses the patient and observes reddish-purple to dark blue macules, plaques, and nodules. The nurse recognizes that these manifestations are associated with which of the following conditions?

Kaposi's sarcoma

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

Keloid

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

Lice can jump from one individual to another.

The nurse caring for a patient notes that the patient's lower extremities are covered with very dry skin and that the horny layer of the skin has become thickened. The nurse notes the finding as being which of the following?

Lichenification

The nurse is caring for a client with questionable 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?

Nits are difficult to move from hair shafts.

A night-shift nurse receives a call from the emergency department about a client with herpes zoster who is going to be admitted to the floor. Based on this diagnosis, where should the nurse assign the client?

Private room

A patient is diagnosed with psoriasis after developing scales on the scalp, elbows, and behind the knees. The patient asks the nurse where this was "caught." What is the best response by the nurse?

Psoriasis is an inflammatory dermatosis that results from an overproduction of keratin.

The nurse is instructing the parents of a child with head lice. Which of the following statements should the nurse include?

Shampoo with piperonyl butoxide (RID).

The nurse is assessing a patient for psoriatic lesions after treatment with a nonsteroidal cream. What type of lesion does the nurse know is characteristic of psoriasis?

Red, raised patch covered with silver scales

A patient is scheduled for Mohs' microscopic surgery for removal of a skin cancer lesion on his forehead. The nurse knows to prepare the patient by explaining that this type of surgery requires:

Removal of the tumor, layer by layer.

A patient complains of severe itching that intensifies at night. The nurse decides to assess the skin using a magnifying glass and penlight to look for the "itch mite." The nurse suspects the skin condition known as:

Scabies

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

Secondary bacterial infection

A patient visits a health clinic with a skin lesion on her right forearm. The lesion is inflamed, swollen, and draining. The nurse practitioner knows the best choice of a treatment would be the application of which of the following?

Soothing lotion

To treat a client with acne vulgaris, the physician is most likely to order which topical agent for nightly application?

Tretinoin (retinoic acid [Retin-A])

A young college student recently had her tongue and lip pierced. She has developed a superinfection of candidiasis from the antibacterial mouthwash. Which of the following would be the correct recommendation for her?

Use an antifungal mouthwash or salt water.

A client is being treated for acne vulgaris. What warning must be given to this client regarding the application of benzoyl peroxide?

Use gloves with application.

The home health nurse is caring for a client with scabies. When instructing on the proper procedure to wash preworn contaminated clothing, which nursing instruction is essential?

Use hot water throughout wash cycle.

The nurse is providing instruction to a patient with acne. The nurse promotes avoidance for which of the following foods? Select all that apply. Chocolate ice cream bananas

chocolate ice cream

A client with a history of diabetes mellitus has recently developed furunculosis. What is causing the client's condition?

infection

While assessing the skin of a 45-year-old, fair-skinned female client, the nurse notes a lesion on the medial aspect of her lower leg. It has irregular borders, with various shades of black and brown. The client states that the lesion itches occasionally and bled slightly a few weeks ago. She also reveals a history of sunburns. Based on these signs and symptoms, the nurse suspects:

melanoma

The nurse is teaching a patient about the correct use of topical concentrated corticosteroids. The nurse includes which of the following? Select all that apply. Hypertrichosis is normal. Apply to intertriginous areas. Avoid prolonged use. Avoid applying to the face.

Avoid applying to the face. Avoid prolonged use.

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?

Moist sterile saline gauze