Chapter 23, Nursing Managment: Integ. Problems: Dermatologic Care and Procedures

A nurse is assessing a patient with a bee sting. To relieve pain, what will most likely be included in the patient's treatment plan? Select all that apply. Antihistamines Antipruritic lotion Cold compresses Chlorocyclohexane Gamma-Benzene hexachloride

Antihistamines Antipruritic lotion Cold compresses

Which practice would the nurse teach a patient when applying topical medication in the form of a paste? Avoid applying medications directly on to dressings. Use a tongue blade whenever the patient's skin integrity allows. Avoid covering skin regions that have topical medication in place. Apply a layer of medication that is just thick enough to ensure coverage.

Apply a layer of medication that is just thick enough to ensure coverage.

A patient presents with intense pain and pruritus from a recent bee sting. What is the most appropriate nursing action? Apply moisturizers. Apply warm compresses. Apply a local antipruritic lotion. Administer antibiotics as prescribed.

Apply a local antipruritic lotion.

The nurse is caring for a patient with a skin suture. How should the nurse care for this wound? Clean daily with saline solution. Cover with a wet sterile dressing. Apply an antibiotic and leave open to air. Administer diphenhydramine to treat inflammation.

Apply an antibiotic and leave open to air.

A patient has an itchy and painful rash on the anterior surface of both arms three days after coming into contact with poison ivy. To promote comfort, the nurse should suggest which nonpharmacologic intervention? Bathe in a tub of lukewarm water Soak the affected areas in kitchen vinegar Cover the affected areas with dry dressings Apply cool tap water compresses to the affected areas

Apply cool tap water compresses to the affected areas

Which intervention would be most helpful in managing cellulitis in an 83-year-old patient with heart failure? Maintain strict bed rest Apply moist heat and elevation Soak the extremity in cool, sterile saline Perform passive range of motion exercises

Apply moist heat and elevation

A patient with a skin infection is prescribed a topical ointment. What action should the nurse take when applying this treatment? Applying a thin layer of the ointment on the affected area Spreading the ointment on the affected area in a circular motion Applying a thick layer of ointment with a gloved hand for better results Applying the ointment on the affected area and then applying a dressing

Applying a thin layer of the ointment on the affected area

Which nursing intervention would be most helpful in managing a patient newly admitted with cellulitis of the right foot? Applying warm, moist heat Encouraging frequent ambulation Not elevating the affected extremity Wrapping the foot snugly in blankets

Applying warm, moist heat

A patient has been prescribed isotretinoin for severe acne. What assessment should the nurse perform before administering the drug? Select all that apply. Assess liver function test. Assess the patient's fluid intake. Perform pulmonary function tests. Ask the patient whether she is pregnant. Ask the patient whether she is planning to conceive.

Assess liver function test. Ask the patient whether she is pregnant. Ask the patient whether she is planning to conceive.

The nurse is providing preoperative teaching for the patient having a face-lift (rhytidectomy) surgery. Which patient response indicates the patient understands the teaching? "I am afraid of the pain afterwards, while it is healing." "I can't wait to have my forehead and lip wrinkles eliminated." "I have some time off work so I will not look so bad when I go back." "Now I can be excited to go to my 50th high school reunion this week."

"I have some time off work so I will not look so bad when I go back."

The nurse is teaching safety to a patient who has been prescribed phototherapy. Which statements by the patient indicate that teaching has been effective? "I can be exposed to the sun any time except during sunrise." "I can be exposed to ultraviolet bulbs at home but cannot go outside." "I can remove my protective eyewear if the glass windows are closed." "I must wear protective eyewear that blocks 100 percent of the ultraviolet light when going out."

"I must wear protective eyewear that blocks 100 percent of the ultraviolet light when going out."

A nurse advises a patient with skin that is extremely sensitive to the sun to select a sunscreen which blocks both UVA and UVB rays. Which statements by the patient indicate that the teaching is effective? Select all that apply. "The sunscreen should be water resistant." "The sunscreen should have an SPF of at least 15." "The sunscreen should be labeled as broad spectrum." "The sunscreen should have benzophenone as the major constituent." "The sunscreen should have para-aminobenzoic acid (PABA) as the major constituent."

"The sunscreen should be water resistant." "The sunscreen should be labeled as broad spectrum." "The sunscreen should have benzophenone as the major constituent."

The nurse should teach a patient who is taking which drug to avoid prolonged sun exposure? Tetracycline Ipratropium Morphine sulfate Oral contraceptives

Tetracycline

The nurse is caring for patients who have undergone various cosmetic topical procedures and are experiencing side effects. Which patient had the epidermis and top dermal layer removed by application of aluminum oxide? A patient with a light pink tone skin for about 24 hours A patient with moderate swelling and crusting for a week A patient with photosensitivity with slight irritation of the skin A patient with erythema, swelling, flaking, and changes in pigmentation

A patient with a light pink tone skin for about 24 hours

The nurse is caring for patients who are experiencing side effects of different cosmetic topical procedures. Which patient may have been treated for fine wrinkling? A patient with severe redness, flaking, and oozing at the treated area A patient who has photosensitivity and a pink tone that lasts for 24 hours A patient with redness and inflammation and increase in the pigmentation A patient who is experiencing photosensitivity and has redness lasting for seven weeks

A patient with redness and inflammation and increase in the pigmentation

A patient with severe dermatitis is prescribed a therapeutic bath. What actions should the nurse take when providing the bath to this patient? Select all that apply. Have the patient soak in a bath for 20 minutes once a day. Add sodium bicarbonate, but not oils, directly to the bath water. Fill the bathtub until the affected area is covered with cool water. Apply cream to the affected area after getting out of the bathtub. Dry the affected area by rubbing with a towel after getting out of the bathtub.

Add sodium bicarbonate, but not oils, directly to the bath water. Apply cream to the affected area after getting out of the bathtub.

A nurse is teaching a patient about self-examination of skin lesions. The skin should be examined for which characteristics? Select all that apply. Depth of the lesion Asymmetry of the lesion Temperature of the lesion Irregularity of the borders of the lesion A change or evolution in appearance of the lesion

Asymmetry of the lesion Irregularity of the borders of the lesion A change or evolution in appearance of the lesion

A nurse is assessing a woman who has nodulocystic acne. While administering isotretinoin, which interventions are necessary to ensure patient safety? Select all that apply. Conduct a pregnancy test. Conduct a liver function test. Conduct a cholesterol level test. Perform a hemoglobin level test. Determine if the patient has a history of depression.

Conduct a pregnancy test. Conduct a liver function test. Conduct a cholesterol level test. Determine if the patient has a history of depression.

Which nursing intervention would be most effective in improving the comfort of a patient with herpes zoster? Direct sunlight Dry heating pad Cool, wet dressing Warm, moist compress

Cool, wet dressing

A patient is experiencing atrophy of the skin of the forearm that started after three weeks of treatment. Which therapy should the nurse suspect the patient is undergoing? Mupirocin therapy Hydroxyzine therapy Corticosteroid therapy Topical fluorouracil therapy

Corticosteroid therapy

Which surgical therapy can only be used to remove small, soft skin tumors and superficial lesions? Excision Curettage Skin scraping Punch biopsy

Curettage

Which surgical approach is used for coagulation of bleeding deep vessels to obtain hemostasis? Curettage Cryosurgery Electrodesiccation Electrocoagulation

Electrocoagulation

A patient diagnosed with malignant melanoma has been prescribed vemurafenib. The nurse recalls that the medication was prescribed on the basis of what test? Genetic testing Clark level testing Microdermabrasion Breslow's measurement

Genetic testing

A patient has itchy red papules that are circumscribed with vesicles. Which drug treatments should the nurse expect to be prescribed for this patient? Select all that apply. Cetirizine Mupirocin Fluorouracil Hydroxyzine Corticosteroids

Hydroxyzine Corticosteroids

The nurse receives a patient from the postanesthesia care unit (PACU) who has just undergone a rhytidectomy to remove the redundant soft tissue of the neck as a result of sun damage. Which postoperative nursing interventions are appropriate? Select all that apply. Ice packs Mild analgesics Circulation assessments Loose, noncompressing dressings Supporting the patient's decision for elective surgery

Ice packs Mild analgesics Circulation assessments Supporting the patient's decision for elective surgery

The nurse is teaching the residents of an independent living facility about preventing skin infections and infestations. What should be included in the teaching? Use cool compresses if an infection occurs. Oral antibiotics will be needed for any skin changes. Antiviral agents will be needed to prevent outbreaks. Inspect skin for changes when bathing with mild soap.

Inspect skin for changes when bathing with mild soap.

A patient diagnosed with actinic keratosis is prescribed fluorouracil. To prevent side effects of the medication, what action should the nurse take? Administer an antihistamine. Instruct the patient to avoid sunlight. Advise the patient to use antipruritic lotion. Administer gamma-benzene hexachloride.

Instruct the patient to avoid sunlight.

A patient is diagnosed with vaginal candidiasis. What nursing interventions are appropriate for this patient? Select all that apply. Administer antibiotics as advised. Instruct the patient to keep the area clean and dry. Instruct the patient to avoid any vaginal suppositories. Inform the patient to abstain from sex or use condoms. Instruct the patient to use antifungal powder on the affected skin.

Instruct the patient to keep the area clean and dry. Inform the patient to abstain from sex or use condoms. Instruct the patient to use antifungal powder on the affected skin.

A patient is recovering from incision and drainage for a furuncle. What action should the nurse take when caring for this patient? Clean the oozing wound with soap and plain water. Leave the crust that forms over the damaged area undisturbed. Keep the wound dry and covered with a dressing for rapid healing. Use antibiotic ointment with a dressing that is both absorbent and adherent.

Leave the crust that forms over the damaged area undisturbed.

The patient is in the hospital for a surgical procedure and has dry skin and pruritus on the legs that cause the patient to scratch at the skin uncontrollably. What measures can the nurse use to help stop the itch/scratch cycle? Select all that apply. Moisturize the skin on the legs. Provide a warm blanket and room. Administer antihistamines at bedtime. Use careful hand washing after rubbing her legs. Cleanse the legs with a saline solution twice daily.

Moisturize the skin on the legs. Administer antihistamines at bedtime.

The patient has been diagnosed with tinea unguium (onychomycosis) under the nails and does not like the oral antifungal medication. What is the best alternate treatment the nurse should describe for the patient? Nail avulsion Antifungal cream Thinning of fingernails Soaking nails in salt water

Nail avulsion

The patient with a stage IV pressure ulcer on the coccyx will need a skin graft to close the wound. What postoperative care should the nurse expect to use to facilitate healing? No straining of the grafted site The wound will be exposed to air Soft tissue expansion will be done daily The pressure dressing will not be removed

No straining of the grafted site

The nurse is preparing to administer a topical corticosteroid preparation to a patient who has a severe skin inflammation. Which of these forms of topical corticosteroids is the most potent delivery system for this agent? Gel Spray Cream Ointment

Ointment

Which base used for topical agents produces a drying effect of the skin? Gel Paste Cream Ointment

Paste

A patient complains of excessive itching along the abdomen near the umbilicus. What instructions should the nurse give to the patient to relieve pruritus? Select all that apply. Rub the affected area gently. Place moist cotton sheets on the affected area. Warm the affected area with warm compresses. Apply menthol or camphor locally to the affected area. Use good-quality moisturizers on the affected area after drying it.

Place moist cotton sheets on the affected area. Apply menthol or camphor locally to the affected area. Use good-quality moisturizers on the affected area after drying it.

A nurse is caring for a patient with liver disease that is scheduled for psoralen plus UVA therapy (PUVA). The nurse understands that the reason that extreme caution should be exercised while administering the therapy to the patient is what? Psoralen will excrete slowly in the patient. Psoralen will cause erythema in the patient. Psoralen will prolong photosensitivity in the patient. Psoralen will cause nausea and vomiting in the patient.

Psoralen will prolong photosensitivity in the patient.

A patient presents with tiny skin lesions on the chest and back that have a diameter less than 0.5 cm. Which procedure should be used to obtain a sample of these lesions? Curettage Skin scraping Punch biopsy Electrodessication

Punch biopsy

A 56-year-old white patient presents with a flat, dry, scaly area on the eyebrows that is treated with a chemical peel. What should the nurse include in the discharge teaching? Metastasis of this type of cancer is rare. The patient has an increased risk for melanoma. Recurrence of the premalignant lesion is possible. Untreated lesions may metastasize to regional lymph nodes.

Recurrence of the premalignant lesion is possible.

The nurse is caring for a patient with purulent drainage from an inflamed site. Which are the most appropriate actions for the nurse to take? Select all that apply. Soak the affected area in salt water. Use cool, sterile water for wet dressing. Use tap water at room temperature for wet dressing. Leave the wet dressing in place for 10 to 30 minutes. Replace the wet dressing if the patient's skin appears macerated.

Soak the affected area in salt water. Leave the wet dressing in place for 10 to 30 minutes.

When teaching sun safety guidelines, what instructions should the nurse include when teaching about sunscreen lotion and creams? Select all that apply. Sunscreens are not required in cloudy weather. Sunscreens should be reapplied after six hours. Sunscreens should be reapplied immediately after swimming. Sunscreens should have a minimum sun protection factor (SPF) of 15. Sunscreens should be applied 20 to 30 minutes before going outdoors.

Sunscreens should be reapplied immediately after swimming. Sunscreens should have a minimum sun protection factor (SPF) of 15. Sunscreens should be applied 20 to 30 minutes before going outdoors.

In teaching a patient who is using topical fluorouracil (5-FU) to treat actinic keratosis, the nurse should tell the patient which of these? Select all that apply. Systemic side effects are very rare. The patient will look worse before looking better. The patient needs to avoid sunlight during treatment. Treatment with this medication is limited to one week. Abruptly discontinuing the use of the medication may cause a reappearance of the actinic keratosis.

Systemic side effects are very rare. The patient will look worse before looking better. The patient needs to avoid sunlight during treatment.

A nurse is assessing a patient diagnosed with malignant melanoma. The nurse understands that the prognosis of the cancer can be assessed by using the Breslow's measurement. How is the prognosis related to Breslow's measurement? The larger the tumor, the worse the prognosis The deeper the tumor, the worse the prognosis The darker the tumor, the worse the prognosis The greater number of tumors, the worse the prognosis

The deeper the tumor, the worse the prognosis

A patient is being treated for scaly skin lesions. The results of a potassium hydroxide (KOH) test that was performed using the scrapings of the lesions are positive. How should the nurse interpret the result? The patient has scabies. The patient has a fungal infection. The patient has contact dermatitis. The patient has basal cell carcinoma.

The patient has a fungal infection.

Which assessment finding of a 70-year-old male patient's skin should the nurse prioritize? The patient's complaint of dry skin that is frequently itchy. The presence of an irregularly shaped mole that the patient states is new. The presence of veins on the back of the patient's leg that are blue and tortuous. The presence of a rash on the patient's hand and forearm to which the patient applies a corticosteroid ointment.

The presence of an irregularly shaped mole that the patient states is new.

A patient with skin lesions is advised to have a patch test. The nurse applies the patch on the patient's skin and instructs the patient to come back after two days for further treatment. What is the likely reason the patch test was performed? To determine the presence of melanoma in the patient. To determine the prognosis of skin cancer in the patient. To determine the presence of skin infections in the patient. To determine the causative agents of allergies in the patient.

To determine the causative agents of allergies in the patient.

A nurse is caring for a patient diagnosed with shingles. The primary health care provider prescribes acyclovir to be administered as soon as possible. The most likely reason for the medication is to prevent what? To prevent pain To prevent postherpetic neuralgia To prevent worsening of symptoms To prevent the patient from getting restless

To prevent postherpetic neuralgia

Which cosmetic procedure improves the appearance of both acne scarring and actinic and seborrheic keratoses? Use of chemical peels Application of tretinoin Use of α-hydroxy acids Use of microdermabrasion

Use of chemical peels

Which cosmetic procedure is teratogenic? Use of tretinoin Use of chemical peels Use of α-hydroxy acids Use of microdermabrasion

Use of tretinoin

The patient has had rashes and alopecia. What vitamin in which foods should be encouraged as a nutritional aid to these problems? Vitamin B 6 in liver, cauliflower, salmon, and carrots Vitamin C in peppers, dark leafy greens, broccoli, and kiwi Vitamin A in sweet potatoes, carrots, and dark leafy greens Vitamin D in canned salmon, sardines, fortified dairy, and eggs

Vitamin B 6 in liver, cauliflower, salmon, and carrots

What action should the nurse take to help a patient with pruritus? Keep the area as dry as possible. Administer fexofenadine to control itching. Allow the patient to gently rub the itching area for quick relief. Wet cotton sheets with warm water and place them over the itching area.

Wet cotton sheets with warm water and place them over the itching area.