SDL: Integumentary NCLEX

A topical corticosteroid is prescribed for an infant with dermatitis in the gluteal area. The nurse provides instructions to the mother regarding the use of the medication. Which statement by the mother indicates an understanding of the use of the medication? A. "I should not rub the medication into the skin" B. "The medication will help relieve the inflammation" C. "I need to apply the medication in a thick layer to protect the skin" D. "I should protect the area by covering it with a diaper and plastic pants

B. "The medication will help relieve the inflammation"

A nurse gives a 13 year old client an ice bag to place over her sprained ankle. How long should the nurse have the client apply the bag before removing it? A. 25 minutes B. 20 minutes C. 15 minutes D. 10 minutes

B. 20 minutes

While caring for a client recovering from a major burn injury, the nurse notes a significant increase in urine output. The nurse will plan care for which stage of burn treatment? A. Emergent B. Acute C. Rehabilitative D. Resuscitative

B. Acute The acute stage begins with the start of diuresis and ends with the closure of the burn wound. Choices A and D are incorrect because this phase begins from the onset of injury and ends through successful fluid resuscitation as evidenced by diuresis. Choice C is incorrect because the rehabilitative phase begins after the burn wound has been closed and continues until the client is able to return to the highest level of independence and functioning.

Tetracycline is prescribed for a client with sever acne. The nurse instructs the client regarding the importance of reporting which finding if it occurs? A. Sunburn B. Persistent diarrhea C. Epigastric Burning D. Abdominal cramping

B. Persistent diarrhea Adverse effects include GI irritation manifested as epigastric burning, cramps, nausea, vomiting, and diarrhea. These effects do not need to be reported unless they become persistent

A home health nurse is visiting a client who has been started on therapy with clotrimazole. The nurse determines the effectiveness of the medication by noting a decrease in which problem? A. Pain B. Rash C. Fever D. Sneezing

B. Rash Clotrimazole is an antifungal agent used in the treatment of cutaneous fungal infections

Which of the following burns is most painful A. First degree B. Second Degree C. Third Degree D. Fourth degree

B. Second Degree

When evaluating the initial laboratory values of a client with an extensive burn injury, the emergency department nurse notes an elevated hematocrit level. What does this finding indicate? A. The client did not suffer internal hemorrhage B. The client requires aggressive fluid replacement therapy C. The client inhales carbon manoxide D. The client requires anticoagulation therapy

B. The client requires aggressive fluid replacement therapy Elevated hematocrit is caused by massive loss of intravascular fluid into the interstitium (third spacing)

Silver sulfadiazine is prescribed for a client with a partial-thickness burn and the nurse provides teaching about the medication. Which statement made by the client indicated the need for further teaching? A. "The medication is an antibacterial" B. "The medication will help heal the burn" C. "The medication is likely to cause stinging every time it is applied" D. "The medication should be applied directly to the wound"

C. "The medication is likely to cause stinging every time it is applied" Silver sulfadiazine is an antibacterial that has a broad spectrum of activity against gram-positive bacteria, gram-negative bacteria, and yeast

A 10 year old male is playing with matches and gets burned. His burn is waxy white in appearance. This burn is classified as: A. First degree B. Superficial partial-thickness C. Deep partial-thickness D. Third degree

C. Deep partial-thickness

The fluid most often used in fluid resuscitation following major burn injury is: A. 0.9% normal saline B. Human Albumin C. Lactated Ringer D. 5% Dextrose in water

C. Lactated Ringer

Tinea capatis is an infection involving the: A. Trunk B. Feet C. Scalp D. Nails

C. Scalp Tinea capitis is ringworm of the scalp which is a fungal infection

A client is seen in the clinic for a complaint of scalp itching that has been persistent over the past several weeks. After an assessment, it is determined that the client has head lice. Permethrin shampoo is prescribed, and the nurse provides instructions to the client regarding the use of the medication. The nurse should tell the client to take which measure? A. Put the medication in 1 time only B. Leave the medication in for at least 4 hours C. Wash, rinse, and towel-dry the hair before applying D. Leave the shampoo on for 8-12 hours and then remove by washing

C. Wash, rinse, and towel-dry the hair before applying

The school nurse has provided instructions regarding the use of permethrin rinse to the parents of the children diagnosed with pediculosis capitis (head lice). Which statement by one of the parents indicates the need for further instruction? A. "It is applied to the hair and then shampooed out" B. "The hair should not be shampooed for 24 hours after treatment" C. "The permethrin rinse can be obtained over the counter in a local pharmacy" D. "It is applied to the hair after shampooing, left on for 10 minutes, and then rinsed out"

A. "It is applied to the hair and then shampooed out" Permethrin is an OTC scabicide that kills lice and eggs, applied after shampooing, left on for 10 minutes, and should not be shampooed for 24 hours after treatment

A patient comes to the clinic for a follow-up appointment after using a glucocorticoid ointment for eczema for 3 weeks. Because the patient is pleased with the results, she states that she would like to continue treatment with an oral glucocorticoid. What response from the nurse is most appropriate? A. "Oral glucocorticoids have more systemic side effects and are only indicated if topical glucocorticoids have been ineffective" B. Oral glucocorticoids will have fewer side effect, so your suggestion is good" C. "You make an excellent point! Topical glucocorticoids can cause skin atrophy, whereas oral agents don't have the same effect" D. "Oral glucocorticoids are more convenient to use, so I agree with your suggestion"

A. "Oral glucocorticoids have more systemic side effects and are only indicated if topical glucocorticoids have been ineffective"

A 40 year old is diagnosed with skin cancer. It is explained that the most important risk factor for skin cancer is: A. Amount of direct sun exposure at a young age B. Amount of sun exposure over age 50 C. Lifetime amount of sun exposure D. Living in equatorial regions where the sun is most intense

A. Amount of direct sum exposure at a young age

The nurse is applying a topical corticosteroid to the client with eczema. The nurse should apply the medication to which body area? Select all that apply A. Back B. Axilla C. Eyelids D. Soles of feet E. Palms of the hand

A. Back D. Soles of feet E. Palms of the hand Nurse should avoid areas of high absorption such as scalp, axilla, face, eyelids, neck, perineum, and genitalia

Which type of microbe cause Tinea infections? A. Fungus B. Virus C. Gram-negative bacterium D. Mite

A. Fungus

A burn client has been having 1% silver sulfadiazine applied to burn twice a day for the past 3 days. Which lab abnormality indicates that the client is experiencing a side or adverse effect of this medication? A. Serum sodium of 120 mEq/L B. Serum potassium of 3.0 mEq/L C. White blood cell count of 3000 mm3 D. pH 7.30, PaCO2 of 32 mmHg, HCO3 of 19 mEq/L

C. White blood cell count of 3000 mm3 Transient leukopenia typically occurs after 2-3 days of treatment

A topical corticosteroid is prescribed for a client with dermatitis. The nurse provides instructions to the client regarding the use of the medication. Which statement by the client would indicate the need for further instruction? A. "I need to apply the medication in a thin film" B. "I should gently rub the medication into the skin" C. "The medication will help relieve the inflammation and itching" D. "I should place a bandage over the site after applying the medication"

D. "I should place a bandage over the site after applying the medication"

The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse remind the children that chemical sunscreens are most effective when applied which times? A. Immediately before swimming B. 5 minutes before exposure to sun C. Immediately before exposure to sun D. At least 30 minutes before exposure to sun

D. At least 30 minutes before exposure to sun

A client with a total body surface are burn of 45% is experiencing hypovolemic shock. How can the nurse explain this type of shock to the client's family? A. Inflammation causes hyperemia B. Decreased peristalsis increases the risk of aspiration C. Antidiuretic hormone is released from the posterior pituitary gland D. Fluid shifts from capillaries into interstitial compartment reducing circulating fluid volumes

D. Fluid shifts from capillaries into the interstitial compartment reducing circulating fluid volumes

A 50 year old male recently underwent a liver transplant and is taking immunosuppresive drugs. He now has painful vesicular eruptions on the face and trunk. He reports that he had chickenpox as a child. Which is the most likely diagnosis based on his chickenpox history? A. Erysipelas B. Poliomyelitis C. Warts D. Herpes Zoster

D. Herpes Zoster

A patient wants to know which malignant skin lesion is the most serious. The correct response is: A. Basal cell carcinoma B. Squamous cell carcinoma C. Kaposi Sarcoma D. Malignant Melanoma

D. Malignant melanoma

Which of the following best describes the typical lesion of psoriasis? A. Purplish papules B. Firm raised pruritic nodules C. Moist red vesicles D. Silvery plaques on an erythematous base

D. Silvery plaques on an erythematous base Psoriasis is a common skin condition that speeds up the life cycle of skin cells and causes cells to build up rapidly on the surface of the skin

The most reliable criteria of adequate fluid resuscitation following a major burn injury is : A. Blood pressure B. Pulse rate C. Respiratory rate D. Urine output

D. Urine output

Silver sulfadiazine is prescribed for a client with a burn injury. Which laboratory finding requires the need for follow-up by the nurse? A. Glucose level of 99mg/dL B. Magnesium level of 1.4 mEq/L C. Platelet level of 300,000 mm3 D. White blood cell count of 3000mm3

D. White blood cell count of 3000 mm3 Adverse effect of silver sulfadiazine is leukopenia

A client is burned through all the dermis with only a few epidermal appendages intact. This burn is classified as: A. First degree B. Superficial partial-thickness C. Deep partial-thickness D. Third Degree

c. Deep partial-thickness