Med-Surge: Dermatology (20 Questions)

What is a wheal?

Also known as hives, wheals are transient, elevated, irregularly shaped lesions caused by localized edema. Wheals are a common manifestation of an allergic reaction.

secondary intention wound healing

when a wound is allowed to remain open and heal by granulation, epithelialization, and contraction - used for dirty wounds.

Hemoglobin (Hgb), range is?

• Females 12-16 g/dL • Males 14-18 g/dL

A nurse in a provider's office is caring for a client who has a new diagnosis of herpes zoster. The nurse should anticipate a prescription for which of the following medications?

Acyclovir

A nurse is assisting with the development of a program to educate clients about measures to reduce the risk of skin cancer. Which of the following instructions should the nurse include?

Avoid exposure to the midday sun ( avoid skin exposure to the sun between 1100 and 1500)

How often should you reapply sunscreen?

re-apply a broad-spectrum sunscreen every 2 hr during sun exposure.

Squamous cell carcinoma (SCC)

skin cancer that begins in the epidermis but may grow into deeper tissue; does not generally metastasize to other areas of the body

A nurse is assisting with the admission of a client who is bedridden and was admitted from home. The nurse notes a shallow crater in the epidermis of the client's sacral area. The nurse should document that the client has a pressure ulcer at which of the following stages?

A stage II pressure ulcer.

A nurse is reinforcing discharge teaching with a client who is postoperative following a surgical excision of a basal cell carcinoma. Which of the following ndings should the nurse include as an indication of malignancy of a mole?

Ulceration, bleeding, or exudation are indications of a mole's potential malignancy. Increasing size is also a warning sign.

What is a papule? is a small, solid, elevated lesion with distinct borders. It is usually smaller than 10 mm in diameter. Warts and elevated moles are examples of papules.

A small, solid, elevated lesion with distinct borders. It is usually smaller than 10 mm in diameter. Warts and elevated moles are examples of papules.

What are melanomas?

Malignant neoplasms with atypical melanocytes in both the epidermis, the dermis, and sometimes the subcutaneous cells. It is the most lethal type of skin cancer.

A nurse is reinforcing teaching with a client who has burn injuries to his trunk about what to expect from the prescribed hydrotherapy. Which of the following statements by the client indicates an understanding of the teaching?

"I will be on a special shower table."•

A nurse is caring for an adolescent client who has burn wounds on her face and hands. Which of the following statements by the client indicates that she has adapted to her changed body image?

"May I go with my family to the visitor's lounge?"• (The client is asking to visit with her family in a public setting)

A nurse is reinforcing teaching with a client who is wheelchair-bound and his caregiver about ways to reduce the risk of pressure ulcer formation. Which of the following instructions should the nurse include?

"Shift your weight in the wheelchair every 15 minutes."•

Tertiary intention healing

- aka delayed primary intention - type of wound healing where wounds are left open 3-5 days to allow edema or infection to resolve or exudates to drain. Then they closed with sutures, staples or adhesive skin

What is a vesicle?

A circumscribed, elevated lesion or blister containing serous fluid. Vesicles typically arise with herpes simplex, poison ivy, and chickenpox.

A nurse is assisting with the development of an education session about malignant melanoma for a group of clients. The nurse should include that which of the following clients has an increased risk for developing malignant melanoma?

A client who has a light complexion.

A nurse in an urgent care clinic is caring for a client who has a snakebite on her arm. Which of the following actions should the nurse take?

Immobilize the limb at the level of the heart.

A nurse is collecting data from a client who has an arm lesion. Which of the following characteristics is a clinical manifestation of a malignant melanoma?

Irregularly shaped with blue, red or white tones

Fourth-degree frostbite

Is when the skin of the affected area is frozen. Blisters do not appear. The client's muscles and bones are affected.

A nurse is caring for a client who has a lesion on the back of his right hand. The client asks the nurse which type of skin cancer is the most serious. Which of the following responses should the nurse make?

Melanomas

A nurse in a provider's office is collecting data from a client who has skin lesions. The nurse notes that the lesions are 0.5 cm (0.20 in) in size, elevated, and solid, with very distinct borders. The nurse should document the findings as which of the following skin lesions?

Papules

Basal cell carcinoma (BCC)

Skin cancer in the basal cell layer of the epidermis; very common cancer caused by sun exposure but rarely metastasizes or spreads.

A nurse is assisting with the care of a client who is in the resuscitation phase following a major burn. Which of the following laboratory findings should the nurse expect?

Sodium 132 mEq/L•

A nurse is contributing to the plan of care for a client who has been admitted for treatment of a malignant melanoma of the upper leg without metastasis. The nurse should expect the provider to perform which of the following procedures?

Surgical excision

A nurse on a surgical unit is caring for four clients who have healing wounds. Which of the following wounds should the nurse expect to heal by primary intention?

Surgical incision

What is a stage IV pressure ulcer?

The client has full-thickness tissue loss, with destruction, tissue necrosis, and visible damage to muscle, bone, or supporting structures.

Actinic Keratosis (AK)

The most common skin precancer, these scaly or crusty growths (lesions) are caused by damage from the sun's ultraviolet rays (UVR). Untreated AKs can advance to squamous cell carcinoma (SCC).

What is a stage 1 pressure ulcer?

The skin is intact with an area of persistent, non-blanchable redness, usually over a bony prominence.

A nurse is reinforcing teaching with a client who has a large wound healing by secondary intention. The nurse should instruct the client that which of the following nutrients promotes wound healing?

Vitamin C (A diet high in protein and vitamin C is recommended)

Second-degree frostbite.

When the skin of the affected area has large, fluid-filled blisters.

A nurse is caring for a client who has been applying silver sulfadiazine cream to a deep partial-thickness arm burn for the past 2 weeks. The nurse should monitor the client for which of the following adverse effects?

Leukopenia is an adverse effect of silver sulfadiazine; therefore, the nurse should monitor the client for an allergic reaction causing a decrease in the client's WBC count.

A nurse is caring for a client whose wounds are covered with a heterograft dressing. In response to the client's questions about the dressing, the nurse explains that it is obtained from which of the following sources?

Pig skin, Heterografts are obtained from an animal, usually a pig.

Potassium (Ka), range is?

Range: 3.5-5.0 mEq/L

A nurse is observing the skin of a client who has frostbite. The client has small blisters that contain blood and the skin of the affected area does not blanch. The nurse should classify this injury as which of the following?

Third degree frostbite. (When a client has third-degree frostbite, the skin of the affected area has small blisters that are blood-filled and the skin does not blanch.)

Third-degree frostbite.

When the skin of the affected area has small blisters that are blood-filled and the skin does not blanch.

First-degree frostbite.

When the skin of the affected area is reddened and looks waxy.

What is primary intention healing?

With primary intention, a clean wound is closed mechanically, leaving well-approximated edges and minimal scarring. (Surgical

Partial thickness burn

a burn in which the epidermis (first layer of skin) is burned through and the dermis (second layer) is damaged. Burns of this type cause reddening, blistering, and a mottled appearance. Also called a second-degree burn.

What is a macule?

A variably shaped, discolored, and small, (typically smaller than 10 mm in diameter), change in the color of the skin. Freckles and the rash associated with rubella are types of macules.

What is a stage II pressure ulcer?

There is partial-thickness skin loss involving the epidermis and the dermis. The ulcer is visible and superficial. It can appear as an abrasion, blister, or shallow crater.

What is a stage III pressure ulcer?

There is full-thickness tissue loss with damage to or necrosis of subcutaneous tissue. The ulcer might extend down to, but not through, the underlying fascia. The ulcer appears as a deep crater with or without undermining of adjacent tissue and without exposed muscle or bone. Drainage and infection are common.